Monday, September 28, 2009

8dp3dt BFN

Yes it is relatively early, but FRER is snow white both this morning and this evening, and the chances for a healthy beta with a healthy pregnancy are just too slim for me to hold any hope at all. And I haven't been wrong in over a dozen IVF cycles. Yes, I'll keep up my progesterone til beta, mainly because I'm in no mood to deal with AF in the next few days and don't even want to think about CD2 testing. But mentally moving on already... or at least trying to. This time I'm struggling more than usual.

Really hard getting through the day, seems like there were pregnant bellies everywhere I looked. Hard to hold back the tears when out in public.

This is the downside to testing early, but by beta day I'll be well past the worst of it, so the official call becomes almost a non-event.

Sunday, September 27, 2009

7dp3dt

And this morning's stick was a negative. Nothing really after 5 minutes or so.

But it did actually get an extremely faint 2nd line after leaving it out for half the day, but the line is still lighter than yesterday morning's one (which has also darkened quite a bit since yesterday).

That is the annoying thing about FRERs, since they get darker the longer they are left out, it is a bit tricky when trying to compare with the previous day's line. So I find myself imagining what the line looked like at 5-10 minutes yesterday rather than what it looks like now!

My two BFPs were both on 7dp3dt, so I usually pay extra attention when testing on this day. Of course, neither of those stuck so perhaps it isn't the best yardstick to measure against.

Saturday, September 26, 2009

6dp3dt

Did the baseline POAS this morning! As expected, there is the lightest of lines from what is left of the trigger shot, so light I am not even going to attempt to take a picture of it. I was expecting something extremely light because my hcg the morning after my trigger was only 270 this time, whereas last cycle it was over 450. In any case, this is a good baseline to compare subsequent sticks to, it won't be hard to tell if the line is getting darker.

As for symptoms, it is all the usual progesterone induced stuff for me... heaviness/achiness around the uterus, overwhelming fatigue, but only slightly sore boobs this time.

Wednesday, September 23, 2009

3dp3dt

I have been just soooo sleepy and in a total brain fog the last few days, and today I found out why: Progesterone came back at 144!

I'm on the same amount of supplements as every other time, but this is by far the highest it has been. I'm not sure this is a good thing, it seems so unnatural to jack it up that high! I am on 400mg suppositories twice a day, and one 200mg oral prometrium at night.

I'm struggling to get any work done, and even typing up this short blog entry is an effort. And I didn't have the energy to argue with the nurse about getting an ultrasound done (I usually skip the luteal phase scan) so I'm off to get that done early tomorrow. I am still on east coast time so getting up early won't be a problem... but by noon I am ready to be done for the day!

Sunday, September 20, 2009

Transfer

Just a quick update today, believe it or not I am still sleepy from the valium and it is now evening!

Well, here they are:



It was a 3 day transfer and both are 4 cells: the one on the left is a grade 2B, the one on the right is a 1A.

Saturday, September 19, 2009

Day 2 after ER

Both embies have divided normally! After last month's disaster at retrieval, each step that we clear now feels like a bonus.

They are both at 2 cells. Looking back through my notes, I have always had 4 cells by day 2. The embryologist did say that she checked the embies first thing in the morning, and they may well have divided again by the time she called me. She wasn't concerned, so I am trying not to be either!

Transfer tomorrow morning!

Friday, September 18, 2009

Fertilization call

Both eggs fertilized! I guess DP's sperm didn't mind being frozen and thawed, then forced into an egg through ICSI. Another hurdle down.

I never buy my return ticket home until after the fertilization call, because you just never know. Today I bought my ticket home for after transfer, and with Continental Airlines they give you 24 hours in which to change your mind or cancel with no penalty. So if tomorrow's call brings devastating news, I still have time to change my flight. But as long as there is some cell division by Sunday, the embies are going in!

Starting the progesterone suppositories today. Sore boobies, here we come.

Thursday, September 17, 2009

Retrieval day

It was so strange to do this day alone, I am so used to DP taking care of me! I just hoped that things would go smoothly as I wouldn't have a shoulder to cry on if things went badly, like last month.

I took a taxi from the hotel to the clinic. I got there on time, and started filling out the consent forms that they have us sign every time before a retrieval.

Then I got called back for an ultrasound to make sure I haven't ovulated yet. I appreciate this step because I am a self-pay patient, and I would much rather find out at this step if I have already ovulated so I can avoid the costs of retrieval and anesthesia. The ultrasound tech was really making me nervous, as she took quite a while longer than was typical, looking around as if trying to find the follicle. Then she asked me what my E2 was yesterday... yikes! Is there something wrong? Apparently not. Not sure what that was about, but I suspect it was something to do with the cyst/hydro/weird thing that has been showing up on the ultrasounds the entire cycle, perhaps she was still trying to figure out what it was. When she was done I took the result sheet back to the front desk, and saw I had a 19 and a 20, and my lining was 11mm.

Next up I handed in my consent forms and the notarized letter from DP, and went over the post retrieval meds with the IVF nurse. I got changed into the paper gown, booties and cap. Since we were using frozen sperm this time, I then had to go to andrology and identify my partners sperm. They showed me the tiniest frosty vial ever, I almost blurted out "is that it?" There was barely anything in there! I verified his name on the vial, and filled out more forms for the sperm.

I got taken into another room while waiting for the patient ahead of me to finish retrieval. While waiting, I could hear the embryologists confirming the eggs... 1, 2, 3,...4, 5, 6, 7... I am thinking wow, what a great haul! ...oh wait, they are still on the one ovary? ... 8, 9, ... and on it went up to 23. Twenty three eggs! She must have been a donor, and today there is one very happy recipient.

While the procedure room was being turned over, the doctor came in to see me for a quick chat. I explained I was very nervous because last time we did not get any eggs at all. She smiled and said she thought I would be ok this time. I instantly calmed down with her reassurance, even though she couldn't possibly know for sure, her soothing bedside manner was just what I needed at that point.

Once in the procedure room, things moved very quickly. They started the meds in my IV while I was getting into position on the table and I was out in probably under 20 seconds.

Waking up from retrieval, they told me they got 2 eggs! I think that is what they said, I hope I didn't dream it. I probably should have confirmed once I was more awake! I haven't had more than 1 egg at retrieval in over a year so I was thrilled!

The nurses were kind enough to call a taxi while I was in the recovery room, and amazingly the taxi arrived very quickly, before I was even dressed. Usually it takes 30 minutes for the cab to come! Since I was alone, the nurse made sure I was able to get dressed on my own ok, and walked me out to the taxi as I was still lightheaded and a bit shaky. The taxi driver was used to picking up patients from the clinic after procedures, and he helped me out of the cab and held onto my arm all the way into the lobby of the hotel up to the elevator. I wasn't expecting that, and to be honest I did worry beforehand about how I would get around while still unsteady from the anesthesia. Glad it all went smoothly!

While resting in the hotel, I checked in with DP every hour or so between naps to let him know I was ok. So far all is well, nothing but sleepiness really. No pain, no nausea, just a bit of the usual discomfort and tiny amount of spotting.

Wednesday, September 16, 2009

Nervous!

I think this is the most nervous I have been before a retrieval! Well, maybe not as nervous as the first time, but that was back in 2006 and it was a different kind of nervousness then. I was more scared of the procedure itself back then.

I'm pretty sure I have been somewhat traumatized by the last retrieval, where for the first time we came up empty handed, despite promising hormone levels. I am also stressed about the odd E2 pattern over the course of stims, and now the possible hydro.

Today I found out that E2 has risen nicely to 496, but the progesterone is 3.2! I thought they usually say that levels above 3 or 5 (depending on where you read) generally indicates ovulation has occurred. Good grief, had I already ovulated?! Talk about stressful! But my LH was 1 so no natural surge had started. This had me freaked out for a while this morning, so I turned to Dr Google to find out more. After all, things are a bit different to a typical natural cycle with all the IVF meds manipulating the hormone levels. Thankfully I found some studies that mentioned porgesterone levels on the day of oocyte retrieval, and they were in a large range. One study talked about levels between 10-30, indicating that these were fairly typical levels. Well if that is the case, then 3.2 on the day before retrieval shouldn't be too high. I am in a transition period between trigger and ovulation where the levels are changing quickly, so hopefully all is ok.

Add to that, this will be the first time I will be alone for retrieval, and the first time we will be using frozen sperm. I hope I don't get too sick from the anesthesia this time, as I will be recovering alone in the hotel room. Most of the time I am ok after retrieval, just drowsy, but every now and then I get an anesthesiologist who uses a slightly different cocktail that doesn't wear off as cleanly.

One interesting thing about using frozen sperm is that the clinic requires a notarized letter stating that DP gives his consent to use his sperm for my IVF cycle. The letter has the date of the IVF cycle, so we would have to produce a new notarized letter each cycle we want to use his frozens.

The plan is to take a cab to and from the clinic. Then keep in constant touch with DP by phone or internet once they release me. He has all the contact details for the hotel and clinic, just in case. Although complications are rare, I feel better being prepared as much as I can.

Tuesday, September 15, 2009

CD 15 - Triggering tonight

I have 2 follies around 18. This is the best showing for over a year, it is usually just the one!

I have been going in for daily monitoring, and the last few days have been so stressful. Now they are thinking the cyst thing is a possible hydro, which just makes my heart sink.

Usually when someone has a hydrosalpinx it needs to be treated, either by removing or ligating the tube, before proceeding with IVF because it lowers the odds of implantation by around 50%. It is a relatively straightforward procedure done by laparoscopy.

But in my case, with a history of extensive pelvic surgery and a massive amount of scarring, 2 doctors have said that they do not recommend more surgery for treating a hydro because the risks outweigh the benefits. Even diagnosing a hydro through a HSG is difficult in my case, because the scar tissue has distorted my right tube so much, that it no longer resembles a normal tube on a HSG film anyway.

The other thing that has been weird this cycle is my E2. After a dip, a rise, another dip, another rise it has now plateaued. Here is how the numbers look up to trigger:


FSHE2LH Prog Follies Meds
CD2 1.4231.32.8 -
CD8812911.9cyst?, 10, 10150 Bravelle
CD91014411.7cyst?, 10, 9150 Bravelle
CD101012411.2cyst?, 10, 9150 Bravelle
CD111024811.3cyst?, 13, 1075 Bravelle AM, 150 Bravelle PM, Cetrotide
CD12?168??14, 1375 Bravelle AM, 150 Bravelle PM, Cetrotide
CD13---- 75 Bravelle AM, 150 Bravelle PM, Cetrotide
CD141735511.216, 1675 Bravelle AM, 150 Bravelle PM, Cetrotide
CD151535911.4hydro?, 17.6, 1875 Bravelle AM, 225 Bravelle PM, Cetrotide

Sunday, September 13, 2009

CD13

This is another month where the cycle days match the day of the month, making it very easy to remember what day I am on!

So I have been going in for bloods and ultrasound every day since Tuesday, except today as the clinic dies not do monitoring on Sundays. It isn't typical that they would have me in each day, but my results have been strange so I think they are puzzled.

The cyst or whatever it is has been hanging around and changing shape. They aren't totally sure it is inside the ovary. This makes me very nervous in case it is another hydro. I'm hoping it is just a weird cyst and nothing more, but it seems that even the ultrasound techs aren't 100% sure. The right ovary was looking pretty clear just last cycle, so whatever it is, it has come up quickly.

My E2 has also been strange. It has dropped, jumped up, and then dropped again. Not sure if the cyst has something to do with the E2 jumping around like that, or if it is just a bad month. They have increased the stims a bit to twice a day, hope that gives the follies and the E2 a kick.

I have been laying low, trying not to think too much about this cycle. I do have 2 follies though, and it has been more than a year since I have produced 2 follies in one cycle so that is one small positive. They were 14 and 13 yesterday.

Will be going back in again tomorrow, but with all the weirdness of this cycle I am not too hopeful.

Tuesday, September 8, 2009

CD8 - Irregular follie

I flew into Philly last night so I am back in a hotel in lovely Mt Laurel, NJ again! Different one this time though, I like to mix it up a bit.

Today when I went in to Cooper I had the pleasure of meeting one of my internet friends and her DH. There aren't many positive things to come out of going through infertility, but meeting my online buddies in real life has been a truly wonderful experience. I have met a few people now whose successes have been against the odds in what can only be described as far from typical cycles, it is very inspiring.

Well, this morning's scan showed something unexpected... a follicle at 22 already! It was irregularly shaped though, so maybe it was a cyst and not a follicle. There were 3 others around the 9-10mm mark, which is much more typical for this time in the cycle.

But is the 22 really a follicle? I'd have to trigger tonight if it were. Good thing we decided to freeze some sperm a few weeks ago, I don't think DP could make it over here with such short notice.

I spent much of the day wondering if I should get some hCG asap.

When the bloods came in it looked a little clearer:

FSH - 8 (Yay! It didn't skyrocket!)
E2 - 129 (not high enough for a typical mature follie, so the 22 could be a cyst)
LH - 1.0 (no sign of surging, as might be expected if it were a large follie)
Prog. - 1.9 (still a follicular phase level)

Tonight, at cycle day 8, I get to start stims: 150 Bravelle.

Still not totally convinced that the 22 is an innocent bystander, but that's what we'll go with for now. Back in for another look tomorrow.

Saturday, September 5, 2009

Odd baseline

I wasn't really sure whether I wanted to cycle this month or just take the month off. I had reached a good place after my vacation and so I thought I'd just go in for my baseline bloodwork and take it from there. If the FSH is over 20, then I'm not really up to going through another cycle like last month.

So I went in for bloods the other day expecting the usual high FSH and E2<10. But instead I got something different. Very different:

FSH - 1.4!
E2 - 23
LH - 1.3
Prog. - 2.8

I have not been on any meds since the no-egg retrieval a few weeks back.

I was astounded by the low FSH, especially after last month. At first I was so happy, thinking wow! My ovaries are acting young again! Also my AF came with unusually strong cramps, just like when I was young.

But then I started thinking that this is just the wild hormonal fluctuations of perimenopause. But still, a low FSH even in this case is still better than a high one, isn't it? Does it mean I have a slightly better chance this month?

Then I started thinking that maybe this level is too low. I went back and looked at the labcorp FSH reference range, and I notice that it says for menstruating females over 15 years old, the follicular phase FSH should be 2.5 - 10.2.

Shoot, I'm well below that. Wonder what that means. Now I'm thinking bad things like my hypothalamus (is that the part of the brain that produces FSH?) is shutting down. Maybe the hypothalamus is tired of having the ovaries ignore it and has gone on strike.

Well, I am going ahead and starting another IVF cycle because I am curious to see what happens next with the numbers. I figure with a month like this, it can either go really well, or really badly. I kind of get the feeling that my FSH will skyrocket as usual and I'll be somewhat in the same situation as many of the previous months this year. But we'll never know unless we try, right?

Tuesday, September 1, 2009

Feeling good!

The mini vacation in Washington DC has done wonders. That awful, failed IVF retrieval is now a distant memory, yet it only happened about a week and a half ago! DP's work paid for the hotel room and his travel, and I am so glad I decided to tag along for the ride. We even got upgraded to the club floor, so free breakfast and light dinner was literally right outside my door. Perfect for when DP was working late and I had to fend for myself for dinner, which turned out to be every night.

I walked around in the DC heat and humidity like a mad woman, determined to see as much as possible in my short stay. Physically I was drained, but it felt oh so good to be distracted and at the same time get some exercise in!

I've been back home for a few days now, and have been keeping up the physical exercise I started with all that walking last week. Well, we'll see how long that lasts.

And I finally got around to updating the look of my blog today, it needed a fresher, softer look. I particularly like the paper crane, they are auspicious in Japanese culture for wishes of good health. Here's to healthier fertility for us all!