Hit Me Baby...One More Time

Today I made the long trek down to our new RE's office. I am totally out of my element with this protocol so the whole time I kept thinking that I needed to be 'quiet' and follicle free. So when the ultrasound showed several follicles on the first ovary I had an internal freak-out moment. But when he said things were looking good on that side I was confused and it must have showed. He reminded me that there is no suppression and they want to work with the body's natural process of starting follicular formation and that things were timing very well. So normal breathing patterns resumed and I was given the all clear to start my meds tonight.

My meds are different than what I originally thought. When I asked about the changes, he said that he thought more about our needs and decided that Follistim and Menopur might work better. So that's what I'm using. I have to say that the Gonal was easier since I didn't have to load anything, just put on a needle, turned the dial and pushed. The whole spinning plunger on the Follistim is a bit disconcerting but I'll get used to it.

I feel totally normal this cycle, no extreme fatigue, hotflashes, and drugged brain. It's wonderful. I can only hope that my body is preferring it as well and it leads to better quality embryos. I am continuing to do acupuncture this cycle as well and really enjoy my quiet times. To add to those quiet moments, I also downloaded the Circle and Bloom IVF relaxation and imagery mp3's. They are quiet nice and lead you through visualization of your body doing what it needs to do at peak performance. From what I read if you really let yourself get involved with the process the results are much better so I'm embracing my body mind connection imagery as much as possible. I've been trying to put them at the end of my fertility yoga sessions with lots of good hip openers. School is continuing to go very well and it might actually be proving to be a blessed distraction. I hope it makes the 2ww go by fast as well since I will be immersed in studying rather than guessing and second guessing myself.

I go in for a blood draw on Friday and will get the next set of instructions for my cycle. Here's to visualizing those follicles growing healthy eggs!

Cycle Day 1

Well after much confusion, Aunt Flow has officially arrived and I am scheduled for my cycle day 3 ultrasound. I think that 'irritation' confused her a bit but nonetheless she is here and we are ready to get started. I will also be incorporating the Circle and Bloom relaxation tracks as part of our cycle treatment in addition to our regular acupuncture. So for the next three days I will be thinking quiet thoughts for my ovaries. *Shhh* Be very, very quiet so that we can get this thing going.

P.S. I had a question about the IM shots; there will be no PIO this cycle as we will be using the suppositories and Ovidrel is subq so my tushy is completely spared :0)

OK, now for some quiet thoughts....

Officially 'Irritated'

Yesterday we drove down to the satellite clinic for our education and pre-treatment treatment. It was a really nice, newly remodeled clinic. The staff was very nice and we went in right away to have the endometrial irritation portion of our appointment. To call it an ‘irritation’ is a vast understatement. It’s more like an endometrial torture session. I practically ripped Hammer’s arm off I was gripping it so hard. I happened to look up once at him and he was stark white and had a look of fear and concern. I’m assuming it was for me but it might have also been from the very real possibility of losing his arm. I took 800 mg of pain killers but it was nowhere near enough. I guess the positive side was that my cervix behaved and did not require it to be clamped to keep it stabilized which I hear is also incredibly painful. I still hurt from where they took the biopsy and I have to continue low doses of painkiller to be comfortable at work.

We did have good news though that both of our kayrotyping came back as normal. This was such a relief because I have been nervous waiting for the results and think that maybe there is something wrong. But all that worry was for nothing!

Afterwards we had our educational appointment where they went over my protocol, showed me how to use the follistim pen, how I could mix it with the Menopur to reduce the number of shots etc. It was here that we realized I will have NO IM shots!!! My little tushy is completely spared the pain of those gigantic needles. Instead of generic HCG which has to be mixed and administered in the muscle, they ordered Ovidrel which can be given subQ. And no PIO either because they ordered the suppositories. Seriously I’m going to think I’m missing something this cycle because it’s going to be sooo easy in comparison to what we’ve done in the past. That and I am going to be knocked out during the retrieval instead of wide away with only some dilautid and xanax.

So our cycle will start once AF shows up. On day 2 or 3 of my cycle I’ll drive down for an ultrasound to see if everything is quiet and if so we’ll start the stims. I’m getting very excited and am really praying that my body will be super nice and quiet because I really, really don’t want to go through an other ‘irritation’ or should I say ‘torture.’

Things I Forgot to Mention

1.  We are having karyotyping done to see if there is anything genetic that might be hindering our getting pregnant.  If it's me we could do PGD but if it's Hammer then it's much more difficult. We're praying that our results come back normal for both.

2. I started school!  Well prereqs anyway.  This all was getting started back when we thought our last cycle had ended.  I had just began the process of what it would take to get into the Pediatric Nurse Practitioner program back in November when our world turned upside down.  And after we had our appointment with the andrologist Hammer was still leaning toward adoption.  We discussed and thought that it would be worth while to start the school  process.  Honestly, I really didn't think we'd be doing another cycle as Hammer seemed like he really had his mind made up.  But here we are, me working FT, going to school on weekends and planning an IVF cycle.  Good times.  Now if I could just ensure that I don't have a retrieval/transfer on Sat during class :)  But honestly I'm just not going to worry about this.  I've done this enough times to know the ropes and that everything works out just fine.

3.  I've also made a commitment to not doubt this cycle and to just believe that it will work.  Because it has before, twice.  So I need to have faith that we are in the right place, with the right team.

Decision Made

We had our second opinion appointment on Monday June 13th.  It was about 2 1/2 hours to get down to the clinic so we gave ourselves plenty of time.  The clinic was in a very nice office high rise and appeared new and modern compared to our old clinic which was a throw back to the early 90's.  But looks aren't always everything and they needed to do more than win us over with their wood floors, comfy waiting room chairs, and track lighting.

We first met with a financial coordinator who explained that since we have to pay out of pocket they reduce the costs.  But we noted that it will be about 2,000 - 3,000 more than what we had been paying at the other clinic.  From what we can tell it's mostly due to the cost of the egg retrieval because they have an anesthesiologist on staff and they actually knock you out  Unlike our last few cycles where I just got a shot of dilauded and got to watch (and feel) the whole thing.  Although I'm fascinated by watching that sort of stuff so it didn't bother me too much.  (I was the crazy girl who requested a hand mirror so that I could watch the dermatologist remove a mole from my neck; it was so cool.)

After this we were taken back to the RE's office.  He was finishing up with a patient so we had time to read all his accolades and there were many.  So he certainly won us over with all the awards and credentials: three time winner of the city's best fertility doctor, three degrees, two specialities etc.  Finally we were able to meet him and he spent a long time going over the massive medical record we had sent ahead of time.  He made several suggestions for a possible future cycle, confirmed things that we had been thinking, and overall made us feel very comfortable.  He did do a physical exam and confirmed that everything looked good, normal and that I had ovulated a few days prior.

We left with a lot to think about, which is why I haven't posted.  We decided to take some time to discuss what we had learned and where we felt we were being led.  And while I love you all, Hammer is dead on right that I'm totally influenced by what I  read about all of your successes rather than focus on what is best for our family.  I just want to believe this will work and so I want to be told this by anyone who is willing.  So, while it was difficult, we took our time to talk things through and pray about what would come next for us.  And we have come to a decision......


We are going to do one more cycle!

So here is the plan:

• Begin taking 75mg of DHEA a day.  I take 25 mg three times a day which has been difficult because it makes me very nauseated.  It doesn't matter if I take it with a meal or not.  I hope it's worth it but the funny part is, if it works I'll probably still be nauseous; but it would be the best kind.
• Increase folic acid to 1,600 mcg.  He is of the school of thought that any MTHFR should increase folic acid and it won't hurt.  He said I didn't need to the Folgard brand because he trusted that I would know what to do here.
• Take baby aspirin 3 days a week and increase to every day after transfer.  Same school of MTHFR thought here and I'm ok with that too.
• Endometrial biopsy/irritation scheduled for July 13th.  This was suggested by our previous RE and we brought it up to the new RE to get his thoughts.  He said that it could only help and was happy to add it to the protocol.  It is supposed to be similar in discomfort to an HSG although slightly less painful but since my HSG was a horrific experience I'm not looking forward to it.  Thankfully Hammer will be there and can stay in the room.  The theory about this is that if they irritate the lining it will cause it to react by 'repairing' and hopefully in this active state make it more likely for it to grab onto an embryo. 
• Antagonist protocol.  Yes people, there will be NO lupron!  Or birth control pills!  After reviewing my starting estrogen levels he feels I was WAY over suppressed on the long lupron protocol.  With start of new cycle at end of July I will begin Gonal on day 2-3.  Compared to my last cycles, this should be like putting the pedal to the metal.  Whether my body responds better will remain to be seen but he hopes that my overall estrogen levels will improve for better egg quality.  I also won't be taking an LH drug like I did last time (Luveris) either.
• Hammer does his 10 day 'prep' for day of retrieval.  This is the game plan that Dr. Russell told us to do.  We did mention that he had a fever but the RE said that by the time of retrieval he would be into another sperm cycle so it shouldn't be an issue.
• Do assisted hatching.  This is what we did with the last cycle so he wanted to continue that since it got us our best results.

I'll keep you all posted when I get my official schedule but that won't be until my July 13th appointment.

While I'd like to end on a positive note I do want to mention that another reason prevented me from posting.  One of my IRL friends who struggled with many miscarriages finally welcomed a beautiful little baby girl at the end of April.  At just 9 weeks old she developed severe jaundice this past weekend and was rushed to our children's hospital.  Yesterday her parents received devastating news that she was born without a bile duct, a condition known as Biliary Atresia.  While there is a procedure that they will be doing this Friday to create one for her out of her own intestine it's only about 30% successful.  And regardless of this procedure she will have to have a liver transplant before she reaches 20 years old.  This hit us very hard because they have become such close friends as they fully understand what we've been through.  It made me question if we should move forward with this cycle.  It just seems so unfair that they would have to go through this after such a long and difficult road just to have her.  I would just ask for your prayers for this precious little girl, so loved, so wanted and so in need of a miracle.

Scheduled

After getting some positive feed back from the andrologist we decided to make an appointment for a second opinion.  So I finally made the call and it's set for June 13th, the day after our 7th anniversary.  Nothing more romantic than having a complete stranger check out your who-ha right after celebrating the day of your wedding.  Seriously though, this was the only date that worked out with Hammer's travel.  Plus it's a good excuse at work to take a day off without raising too much suspicion.  We're keeping this one very quiet since nothing may come of it depending on what we hear. 

When I called I had to give our history to the nurse and I totally started crying when I had to discuss our last miscarriage.  She was very sweet on the phone and ended up changing the RE she was going to schedule us with saying that the new RE would be better with 'unique' stimulation cycles and has a background in early miscarriage.  I also mentioned that we were working with an andrologist and when I mentioned his name she had nothing but the nicest things to say.  She also said that she would give me a form to send to them so that they would request our records from the RE so that we would not have to interact with them.  So far things have been positive, let's cross our fingers that this continues.

One set back though is that Hammer had a very high fever on Mother's Day, like 102+ temperature.  That means if we do anything it cannot be until the end of July or early August as we are out a whole sperm cycle.  It's a bummer but I'm not going to worry about it because I can't.  We might not even end up doing anything regardless so worrying is just not worth it. 

Moving Forward

We finally heard back on the results of our repeat DNA test. It has been great working with this doctor as he took so much time with us even on the phone. In his opinion he feels that we have moved into the normal range. Normal for people who do not need IUI’s or take up to a year to get pregnant are <20%. Since we now sit at below 30% we’re in the +1 year TTC, IUI and possibly IVF range so this is an improvement. He gave us some tips for TTC naturally but did recommend that we should still look for assistance only because it’s been such a long time. After some discussion between Hammer and I, we decided that we would at least get the second opinion. Dr. R gave us some suggestions for the RE’s in his area which he works with often and they were the same names that were recommended to us by others. So today I put in a call for an appointment with one of them. We’ll have to see when we can coordinate a trip to the clinic (~2 hours away) with our crazy schedules so I’ll post more when I know. Thank goodness I have family down there which would make any treatment we might do so much easier and a bit more affordable.


As far as naturally trying, Hammer and I have been doing the ‘Hopeful Protocol,’ as I like to call it, along with our TTC modifications for Hammer. I got this from the Happy Hopeful’s who are to welcome their first baby after TTC for several years and ended up getting prego this way. It involves taking the supplements evening primrose and flax seed oil during a cycle. It also has you take high amounts of soy isoflavones on the same days when you would have taken clomid which supposedly help make a healthier egg so it’s almost like poor man’s clomid. I can tell you that I definitely ovulate very ‘strong’ when I take this. This past month my temps started to go triphasic and I was late which I never have been before on the last three months taking these supplements (or ever for that matter). I even went out and bought some HPTs because I was two days late. I got a box of FRER and an EPT. The EPT was the only one where both Hammer and I swore there was a very, very faint start of a ‘+’ but that was all we got. So we think we might have had a ‘blip’ but there is no real way to confirm it. I am concerned that maybe the soy is messing up my lining similar to clomid so I’m taking a month or two off to see if it helps at all and made an appointment with my regular Gyn to see if she has any thoughts as well. We’ll still be doing the ‘prepping’ before TTC with some modifications as suggested by Dr. R on our phone conference. I now feel that I have the hang of the Ovacue and I love that it confirms ovulation (I got the extra attachment) which makes me feel more confident in our TTC efforts BUT we still have to use OPK’s to help us with timing things. So it’s not the money saver I was hoping for but when your DH has to do his thing for practically 2 weeks straight it is nice to tell him with confidence that he can take some time off. I’m actually feeling bad for him. I know it’s not like taking shots but seriously, if you were told you had to have a “big O” every day for two weeks imagine the pressure that would put on you. It’s not like with woman where getting prego doesn't depends on us having an “O” or not but it does require our DH’s to do so. And while it’s fun, I would l think 2 weeks straight of fun would really start to get old. He’s been a real trooper and I have to give him some credit. Thanks honey :)