Saturday, May 30, 2009

New Blog

For privacy issues, I created a new blog address and linked it with a new email address. I'm going to wait a couple of weeks and then delete my other blog. I want to give all of my wonderful supporters a chance to catch my new blog address before I get rid of my old blog.

Monday, May 25, 2009

Confirmation

This morning my temps dropped drastically. And my spotting got heavier. I think it's a possibility that my period will come before 15DPO. Which is fine with me. I'm ready to just move past this cycle and get on to a new one.

I just don't understand why it's not working. I know it can take awhile, but logically I still don't get it. We were twice as fertile as any normal couple! I had 2 eggs, and we put as many sperm in my uterus as I would have gotten through normal intercourse if he had a sperm count of like 400 million motile sperm! Why didn't it work?

Sunday, May 24, 2009

Shit.

Well, I started spotting today at 12DPO. Right on schedule. Which means my period will be along any day now... probably right on the 27th, as planned.

I hate my life.

Saturday, May 23, 2009

OPKs Getting Darker

Okay, I know I said I was going to stop peeing on OPKs. But I am physically unable to. Or maybe it's that I'm mentally unable to. Yesterday and today I took them. That makes a total of 4 days in a row, and all the tests were taken at the same time of the day.

Interestingly, every day the test line gets a little bit darker. It started out almost non-existent, and each day it's become more visible.

I also started paying attention to my boobs today, and they are sore. Which doesn't have to mean anything. They were sore last month too.

Today I'm 11DPO, and last month I started lightly spotting at 12DPO. I guess if I start spotting tomorrow I'll know it's probably over.

Frig. I need time to speed up. I have to know!

Friday, May 22, 2009

Is There Still Hope?

I haven't been posting about my 2 week wait, because I've really been trying to not obsess during it. I'm 10 DPO right now and I've been having cramps every day since 5DPO. Last month I didn't have any cramps until slight ones started in the evening of 11DPO. Those were just period cramps, obviously. Also, last night for several hours (2am-5am) I was lying awake feeling nauseous.

I was pretty sure I wasn't pregnant. I took an OPK at 8DPO and 9DPO, and both of them were the most negative OPKs I've ever had. There was barely a second line on either of them (although the one at 9DPO was slightly darker than the day before). I usually have very visible lines all the time. Since OPKs detect HCG, I was very disappointed that they were so negative. I've been cramping since 5DPO, so if that was implantation you'd THINK something would show up by now.

I had pretty much lost hope. But today, my hope is renewed. Ashley got pregnant from her IVF cycle!! She took an OPK on Tuesday, and there was no second line at all. Then on Thursday she had a beta done and it was 104!! So obviously a negative OPK means nothing if you can have a beta of 104 48 hours later.

I should really stop taking OPKs.

And I really should go back to ignoring my 2 week wait.

I guess I'll probably know in a couple of days. I usually spot for several days before my period comes.

Wednesday, May 13, 2009

Review Appointment

I had a review appointment with my RE this morning. There were several points we raised with him, and we got good solutions for pretty much everything. The most important point (to me) is my rising FSH levels, but I'll address that last.

1) I have not been responding that well to my medications. Dr. Martin agrees. He didn't think it would be so hard to get me to ovulate. Next cycle I'm doing 7.5 mg of Femara on CD 3, 100g of Clomid on CD 3-7, and 75IU of Bravelle from CD 6 on. We're adding the Femara instead of increasing my dose of Clomid, because the Femara helps sensitize you to the Clomid. I didn't ovulate on just 50 mg of Clomid, but when I added the 7.5 mg of Femara on CD 3, I did produce an egg. Hopefully this new combination will help me make it to ovulation with at least 3 eggs.

2) Justin's sperm counts appeared to have been decreasing steadily. Dr. Martin explained that men are unreliable (which I already knew), and that there's no reason at this point to think that Justin's sperm has permanently decreased. For the IUI's this month his recoveries were pretty good, so maybe that SA of 2 million on May 10 was a fluke. He suggests we continue IUI's with his sperm.

3) I'm concerned with my FSH levels. My FSH is 8, which should be "fine," except for the fact that I'm 24 years old. Dr. Martin agreed with me; he said I should have an FSH of 4 or 5 at 24 years old, so my FSH is high. He said that the entire fertility world always uses the cutoff of 10 - anything below 10 means your ovarian reserve is fine. But we should also be relating that number to the age of the female. If someone is 42 and has an FSH of 8, they're doing pretty good for their age. But for a 24 year old, that's pretty brutal.

The problem with high FSH is that it's always been believed that there's nothing that can be done about it. You can't reverse decreased ovarian reserve. Perhaps that's not true.

In December 2008 there was a compilation of studies released that show that DHEA can improve fertility in women with high FSH. DHEA is a mildly androgenic precursor hormone for both testosterone and estrogen. The fertility world is starting to think that maybe part of the nonresponsiveness of the ovaries to medications isn't because the ovaries are running out of eggs, but rather because the ovaries' inability to make its steroid hormones in order to promote egg maturity within it's follicles.

Several studies have been done with women who have decreased ovarian reserve. The studies followed their IVF attempts both before and after treatment with DHEA and compared their results to those of a control group that did not take DHEA. The studies showed that treatment with DHEA (in women with dimished ovarian reserve) significantly:
-improves the woman's response to medication (more eggs are developed)
-increases the number of eggs that successfully fertilize
-increases the number of normal Day 3 embryos
-increases the number of embryo transfers
-increases the overall cumulative pregnancy rate

Just one example: in 2005 there was a 42 year old woman with decreased ovarian reserve undergoing IVF. She was on the maximum dosage of fertility drugs, but she only produced one egg. She went on DHEA for 9 months, then repeated the exact same drug protocol that she used for her first IVF. This time she developed 17 eggs.

There is also evidence of a decreased miscarriage rate, which may be due to a decreased abnormal chromosome number. DHEA improves the maturation process of the egg, resulting in a better quality egg.

I'm pretty excited about the drug. I'm hoping it will make my ovaries more responsive to medications and that my eggs will mature more normally. I'm not sure how quickly it starts working, so I don't know if I will see improvements next cycle or not. But I'm feeling better about my high FSH.

I love my RE.

IUI #2 (Part 2)

Part 2 of our second IUI was this morning. I was still getting positive OPKs yesterday evening (I don't know about today because I haven't tested), so I'm really glad we opted to go with the double IUI (for timing reasons, not because we needed more sperm). We weren't expecting a great recovery, but it ended up being 6.7 million! That's half of what we got yesterday, but it's higher than both of our recoveries for our last IUI. We were pretty happy with that.

All in all I have 20.2 million sperm swimming through my uterus and fallopian tubes.

*Please catch an egg; please catch an egg!*

Tuesday, May 12, 2009

IUI #2 (Part 1)

Both Justin and I were so nervous before the IUI. He's usually really positive, but not today. We were both convinced that they were going to tell us that they could only recover 307 sperm, or something ridiculous like that.

The nurses walked in to do the IUI and informed us that for our insemination we have 13.5 million motile sperm. 13.5 MILLION!!! I was like "You've GOT to be kidding me!!! WAY TO GO, BABE!!!" We cheered, and gave each other high fives (I'm sure the nurses found us very amusing).

13.5 million motile sperm right into the uterus. If you compare that to regular intercourse (where only 3-5% of the motile sperm make it into the uterus), it'd be like having sex with a man who has 270 million motile sperm in his sample! Considering most men have around 50% motility, and considering Justin always has a sample of 5mL, that's a sperm count of 108 million/mL!!

We always figure this out so that Justin knows what kind of "man" he is with that sample.

Don't ask me where all that sperm came from, considering the fact that 46 hours beforehand he only had 2 million sperm. But I don't care!! It was there!!

We're still doing another IUI tomorrow. We don't need to, numbers wise, but we have to be there for our review appointment for the RE anyway. And I feel better "timing wise" if we do the IUI's two days in a row. Since my surge is still pretty intense at this point I'd like to cover all our bases. I know that you ovulate 36 hours after the peak of your surge, but unless you're taking blood every hour there's no way to know when exactly the peak of your surge was.

So, great day. I think the only thing that could have made me happier than the 13.5 million motile sperm would be finding out that I'm pregnant. Hopefully that'll be happening two weeks from now.

Monday, May 11, 2009

The Case of the Disappearing Follicle

I went for bloodwork and ultrasound again today. I am EXHAUSTED.

My last ultrasound on Saturday showed 3 follies at 13, 14, and 17. Today showed 2 follies at 16 and 23.

I have given up trying to figure out my body. I have no idea what happened. The follicle on my left grew from 13 to 23 in 48 hours. One follicle on my right shrunk 1 mm. And another follicle disappeared.

I'm hoping it's just hiding somewhere, but the ultrasound tech didn't seem to think so. I think she just didn't want to go back in there. Can a follicle really shrink or disappear? That seems ridiculous to me.

Anyway, our IUIs are Tuesday and Wednesday. I'm taking both days off of work. I deserve it. I am so friggin tired. I barely even want to do the IUI's. We have such a small chance; it's like banging my head against a wall. It's probably a waste of $250. But I spent all this time monitoring my cycle, and I injected myself 11 times (it was only supposed to be 5 times)... I guess we'll do it.

We're starting to explore our other options for next cycle. We have a review appointment with the RE on Wednesday to talk about what we should do now that we know that those extremely low counts weren't just a fluke. I'm feeling pretty crushed.

May 10th SA

Justin did an SA yesterday. We wanted to know if his count had gone up from last month, when it had plunged as low as 4 million.

Well, it hadn't. His count was 2 million/mL. With 33% motility.

We were pretty devastated. It's barely even worth doing an IUI with a count like that. Our chances of success would be about 3%.

Saturday, May 9, 2009

Today's Ultrasound

Well, today's ultrasound didn't go that great. On CD 11 (Thursday) I had a 12mm and a 16 mm on my right, and a 13mm on my left. I did extra injections on CD 11 and 12 to help the follicles grow, but apparently my ovaries didn't get the memo.

Today (CD13) I had a 14mm and a 17mm on my right, and still a 13mm on my left! That sucker didn't grow!!

So with two extra injections over 2 extra days I only got 3mm of growth. Total. Over 3 follicles. How lame is that?

I have to keep doing injections - which I am so happy about, seeing as I should have been done them on DAY 10 and I'm going to have to keep going until at least Day 15. Tomorrow I have to do just bloodwork, but since it's a Sunday I have to drive an hour away to do it. Then Monday I have to do bloodwork and ultrasound, so I have to drive an hour away again. Before I start work at 8:45. We all know how much I love doing that.

I have no idea when the IUI's will be now. I'm tentatively guessing Tuesday and Wednesday. That's the soonest they could be. I know I'm not going to surge at this point; my estradiol was only at around 580 yesterday (last month on CD 13 I had a 22mm follicle and my estradiol was 1300 and I didn't surge on my own). So Monday, IF my follicles are big enough, I can trigger and do the IUI's on Tuesday and Wednesday. But what do I know? I thought the IUI's would be on Sunday and Monday. As I previously mentioned, my ovaries are retarded.

Case in point: a 5mm follicle appeared next to my 13mm follicle. It was not there on Thursday. I figure that another one wanted in on the deal, and that's where all the FSH went. That's why the original follicles aren't growing. I'm okay with that, as long as the tiny bugger speeds up and grows. Otherwise, SHARE THE WEALTH! (Literally. Those injections are expensive.)

I want all of the original 3 follicles to be over 16 mm before I trigger (how else will I get triplets?) Otherwise I will just keep waiting. Unless, of course, they truly are not growing. Then I will just have to deal with the one that's already mature.


Dear Body:
I would appreciate it if you would hold off on an LH surge until I say the word. If you don't... well, I already hate you anyway. That's not gonna change.
Lauren

Day 3 Bloodwork (from April 28)

I have to get Day 3 bloodwork done every cycle because we suspect I might be heading into premature ovarian failure (POF). My FSH levels have been in the "normal" range, but high for my age. However, the way FSH can work with POF is that it can look normal for months, then suddenly go super high, and then go back down to normal. However, if you even have that one high reading it means you are screwed. Even if it doesn't show up all the time. That doesn't matter. Your highest FSH level isn't your "worst case scenario," it is your scenario.

I did the bloodwork on Day 2 this month, and I got the results today. I'm not happy.

FSH - 8
LH - 6.5
Estradiol - 104
Prolactin - 11.2
TSH - 2.02

Here are the results from my March Day 3 bloodwork.

Here are the results from my April Day 3 bloodwork.

I have a problem with the fact that in March my FSH was 7. In April it was 7.6 And now for my May cycle it is 8. It seems to be steadily rising. I'm only 24; my FSH should be at, like, 5. (Reference: FSH is used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate.)

I also have a problem with my rising estradiol levels. In March it was below 73. In April it was 101. In May it's 104. (Reference: E2 should be between 25-75. Lower levels are better for stimulating, and higher levels could indicate either a functional cyst or diminished ovarian reserve.)

This is crap.

Friday, May 8, 2009

Funny

My grade 2/3 class (ages 7 and 8) and I were just outside playing soccer baseball for Phys. Ed. One of my students, Daniel, who is notoriously wimpy, fell down and scraped his elbow. He started yelling, "I'm bleeding! I'm bleeding!"

Steven, who was on his team, turned to him, exasperated, and yelled back, "It doesn't matter! You're a man!"

Exhausted

I'm exhausted in so many ways.

Yesterday morning I woke up at 4:30am. Today I woke up at 5:15am. Tomorrow I'm going to have to get up early again to drive an hour to the RE's.

I'm tired of being poked and prodded with needles and ultrasound wands. My veins have developed some serious scar tissue, so the simplest blood draw is extremely painful for me. I'm sick of reconstituting my stupid Bravelle and injecting myself every morning. That stuff serious hurts!

I'm sick of driving all over tarnation.

I'm tired of trying to figure out what to tell my principal about my appointments and IUIs. I'm pretty confident that my IUIs will be Sunday and Monday again. So what do I tell him for Monday? And when do I tell him? I won't know for sure until Saturday. Am I supposed to call him at home on the weekend? If I call in sick on Monday I'll be calling from my cell phone because I'll already be at the clinic. If that doesn't look suspicious, I don't know what does.

I'm sick of worrying about how many meds to stock up on because I'm losing my benefits at the end of July. I don't know if I'll stay on the Bravelle for forever. I don't know how long it'll take me to get pregnant. If I do get pregnant I don't know when I'll start trying again, and this stuff has an expiry date!

I'm just tired on the havoc infertility is reeking on my life. I want to get pregnant. I want to be tired because a baby is reeking havoc on my life.

Thursday, May 7, 2009

For Once

For once I have left an ultrasound without disappointment.

I got to the RE's at 6:45 am. I got my blood drawn, and then went back to wait for my ultrasound. The ultrasound technician was late - WTF! Doesn't she know we're all on schedules?!? And somehow some woman who was there after me got in first. A woman who lives 5 minutes from the clinic. That's pretty retarded.

Anyway, my uterine lining was at an 8, which is normal for me for Day 11. Then, the follicles. Yes, that's right, I said follicleS. On my right side I had a 12mm and a 16mm. On my left side I had a 13mm.

I had 3 follicles.

I am thrilled. I do, however, have to keep doing injections today and tomorrow to make these guys grow. I was supposed to be done yesterday. No such luck.

I got out of there at around 7:40. I called Justin to have him drive to the highway to meet me on my way to work so he could bring me my injections. I should have brought them with me, because I anticipated this, but I didn't. I'm retarded. I got to our meeting place 10 minutes early, and he ended up being 5 minutes late. I sat there for 15 minutes, working myself up into a rage. Each minute that went by was another minute I was going to be late for work. If he had been there when I got there I would have been early for work.

Instead I ended up being 10 minutes late. And I had to reconstitute the Bravelle and inject myself in my classroom in a giant hurry, with shaky hands because I was so upset and rattled.

All in all I'd say it was a neutral morning. If I hadn't been late for work and mad at my husband it would have been a great morning. I am really happy to have 3 follicles.

Tomorrow I'm just doing bloodwork. The clinic made a new arrangement with a lab here in town so that I can get my blood drawn here instead of driving an hour away just for that. I'm really glad, because I was going to be so pissed if I had to get up at 4:30am to drive an hour away just to get a blood test.

I noticed something today. Something I noticed and wondered about last cycle, but I didn't know if it meant anything.

I do an odd number of injections before the CD 11 ultrasound. One side gets 3, and the other gets 2. The past two cycles the side that has gotten the greater number of injections is the side that has developed more follicles (or the only follicle, as in the case of last month). It doesn't make any sense, because I thought the injections just got absorbed into the blood stream. Each ovary should benefit equally. But for me, so far, that doesn't seem to be the case. I guess we'll see what happens next month.

If there IS a next month. Mua ha ha.

In all seriousness, I really hope the sperm are up to the task. I hate that I can have all the follicles in the world but still not get pregnant. Male factor infertility sucks. There's just nothing you can DO about it!

Wednesday, May 6, 2009

Tomorrow's Ultrasound

Tomorrow I have my Day 11 blood work and ultrasound. Yes, this means I have the joy of waking up at 4:30am to drive an hour away and try and get back to start teaching at 8:45. It's a really excellent start to my day.

I'm nervous. I'm always nervous before my ultrasounds because I always have such bad experiences. This cycle is no different. I'm afraid of having only one follicle. Or worse - no follicles. I was having twinges on both sides for awhile, which made me think that I was growing at least one follicle on each side. But I don't feel anything anymore. It doesn't make any sense to me. I've been doing injections every day. I even did one this morning. You'd think my follicle(s) would still be growing.

I have been awfully busy today, so maybe I just haven't been paying attention. But my awareness of my lack of twinging is freaking me out. I hate wasting all that time and gas to drive to the RE and find out there's nothing going on.

I don't understand how that could be possible, since I'm on Clomid and injectables. But it wouldn't be unheard of for my stupid ovaries to not do what they're supposed to.

Wish me luck!

Friday, May 1, 2009

Addicted

I'm addicted to fertility drugs.

I'm on CD 5 right now. It's my third day of meds, so I've already taken 300 mg of Clomid altogether. At this point I usually would have only taken 150 mg, and overall I'd only take 250 mg. So I've already taken more Clomid just in three days than I normally would have taken in the whole five days. And tomorrow I start the daily injections, instead of the lame alternate day ones I did last cycle.

The only reason I mention this is because I like the whole idea of it. I'm the opposite of a lot of other people, who want to be on the smallest dose of meds possible. I just know that I need the big guns, so I want to be taking as much of each drug as possible (which is why I was disappointed that they took away the Femara). If it was up to me I'd be on 200 mg of Clomid from 3-7 and 150IU of Bravelle from 3-12. I bet my ovaries would respond to that protocol!

It's less than a week until my first ultrasound. I'm very nervous for it. This is my third cycle of monitoring. In my past two cycles I had 6 ultrasounds altogether and only one of them wasn't an enormous disappointment (that would be the one where my follicle grew from 13mm to 22mm in 48 hours; but there was still only one follicle).

I wish my body would just cooperate and grow the 3-5 follicles that it's supposed to. But I know it won't. So I'm just hoping for 2. I know there's a good chance that I'll still only have 1, so in a way I'm trying to prepare myself for that. But I know I will still be massively disappointed if that's the case. Although hopefully I won't drive 45 minutes in the wrong direction afterwards, and end up having to call in sick to work.

It's just that when you're sitting on that table next to the ultrasound machine and that wonderful dildo cam, with that enormous but flimy paper towel draped over your naked lower body, you feel so full of hope. You imagine those pictures of ultrasounds that you've seen where there are multiple large follicles, and you know that that should be you. You're on the right medication protocol. You should be the one to have multiple follicles.

And then you get told you only have one. A small one. Or none, as in the case of my first cycle.

There's just no way to avoid the crash.