Trigger

New Years Eve... and I'm over here looking at the clock waiting to trigger. Crazy!!

:)

Consult #1

Today was a busy day on the Vagina Tour (lol). I went in for a follie scan with my current RE for our IUI (scheduled for Thursday), then back home to pick up DH and get on our way to Consult #1.

In a nutshell: Consult #1 was awesome!!!

Right off the bat, I was super impressed by how personable Dr. P is. It didn't take long for me to mention that I'm a marathoner (I love throwing that out there! Even if I can't run a marathon right now, it still feels so good to call myself a marathoner!), and he told us that he's a triathlete! Instant points to his street cred!! Obviously, there's more to all of this than that, but I feel understood by this doctor. When it comes to being an endurance junkie, it really takes one to know one.

After spending some time discussing our history, it was clear that he really did read our sizable file before the meeting. Even better yet, he actually had a few ideas on how he would approach our next IVF cycle differently if we were to cycle with him. I really, really liked how genuine and sincere he was while explaining everything to us. As a teacher, I appreciate his presentation style very much and thought he was highly effective (ugh, fellow teachers may eye roll with me on that one!). The best thing, in my opinion, was how adamant he was about "leaving no stone unturned" for our next IVF cycle. I couldn't agree more! TURN ALL THE STONES!!!

Here are the big points that he brought up:

1. Morphology/ICSI - This doctor seemed to be far more concerned about our borderline morphology than our current doctor. He explained that the previous standards indicated anything lower than 14% was abnormal. Recently, this has been changed to anything lower than 5% is abnormal. Our first SA was 4% and the second was 6%. For this reason, he would do ICSI for all mature eggs retrieved. 
2. Immunology Testing - A few of my fellow Dreamers and Bumpies have done this, so it was familiar to me. Basically, it's a blood test to see if I have NK cells that could possibly be attacking embryos in my uterus. If the test comes out positive, then I could take intralipids, an infusion, prior to ET to make NK cells a nonissue. Dr. P said that he was borderline about prescribing this, but the fact that I have endometriosis is what pushed him to recommend this option.
3. Lupron Protocol - Dr. P explained his reasoning for why this might be a beneficial protocol for us over the Antagonist Protocol (which is what we've tried the past two times). It all made sense. But simply put: it's a different approach, and perhaps we would do better with it.
4. Lining - Another topic that was far more concerning to Dr. P than our current doctor. I told him how my lining was always a source of stress for me throughout my cycles, and he asked how thick I usually measured. My current doctor considers 6 to be borderline, whereas Dr. P considers 8 to be borderline. When I told him that I had fluid in my lining at the beginning of IVF#1, he said that was extremely concerning to him. The good news is that there are ways to help the situation (like taking Viagra! And doing a FET rather than a fresh ET).
5. CGH (Embryo Testing) - this is similar to PGD, but instead of just testing a few of the chromosomes, this screens all of the chromosomes. In order to do this, we would need more than two embryos to make it to Day 3 to justify the large expense (that is likely not covered by insurance).

How do I feel about all the above? I feel hopeful. I can't describe how valuable that is to me! I am very much looking forward to Consult #2 which is just a few days away!

IUI 4.1 Follie Scan #3

CD12, 9 nights of Follistim behind me (50iu each night except for last night... 16.667iu... for the full story, click here). Here's what this morning's follie scan showed:

Lining: 7.8
Right: 17, 16, 14, 11 (smaller follies were present, but not recorded)
Left: (small follies were present, but not recorded)
E2: 281 (it actually went down from Sunday's 340)
Instructions: 75iu Follistim tonight (I have to open the cartridge after all!), TI tonight or tomorrow, Ovidrel (trigger) tomorrow night between 9-10:00pm

IUI 4.1 is on like Donkey Kong! We are scheduled for 9:30am on Thursday, January 2, 2014 (whoa! New Year!). It's actually kinda funny the way that we are straddling the new year with this IUI. I will be triggering in literally the last few hours of 2013, and then go in for the IUI on the second day of 2014.

It does stink that the IUI is scheduled for the first day back to work after our long winter break. It's a good thing that I have an excellent relationship with my principal. I already told her and the vice principal that we are doing fertility treatments, so this appointment will come as no surprise. I count myself very, very lucky that I have their understanding and full support (my principal literally said to me, "Family comes first. Right now, your career has to come second to that. If there is anything I can do to make this less stressful for you, please just let me know.").

Even with everything above looking so perfect and wonderful... I know it's not. At a glance, it looks like we have a great shot this cycle. But if you've been around this blog for more than a few posts, then you know that this IUI is a long shot. We are 100% expecting for this to result in a BFN, just like every other cycle that has come before it. But even knowing the odds... we have to do something. As much as I hope and pray that this will result in our miracle... and as much as it's going to crush me when I get my period... I am trying to keep a realistic expectation of all this. But it doesn't hurt to hope. And pray. And cross fingers. Even a 1% chance is better than no chance.

Open a new vial for 8.33iu??

I always feel spaztastic whenever I have to call the RE hotline (which now has occurred twice). I knew I would have to open up a new cartridge of Follistim soon (it's a 300iu vial, but the pharmacist routinely overfills the vials). I did my injection for tonight, 25iu, and fell short by literally one click on the Follistim pen. The last thing I want to do is open a new vial and then go in for monitoring tomorrow just for them to tell me that I'm all done stimming. What a waste for literally a few drops!! So I called the hotline. The RE on call told me that she thought it would be ok to skip the remaining dose (8.333333iu). Whew! I may need to open it tomorrow if I need more, but at least this way it gives the doctor a chance to see if it is really necessary.

Honestly, with 8 follicles... I'm worried that I'm going to get canceled. And either way, ovulation is going to hurt like crazy. I'm so frustrated with my ovaries.

IUI 4.1 Follie Scan #2

CD10, 7 nights of Follistim (50iu each), and this is what happens:

Lining: 6.0
Right: 13, 12, 12, 10, 10
Left: 10, 10, 11
E2: 340 (I like this slow rise in spite of the amount of follies)
Instructions: 50iu tonight, 25iu tomorrow, monitoring Monday

I am not looking forward to the ovulation pains. I also feel that we are quickly approaching my breaking point. I feel defeated and broken. 

IUI 4.1 Follie Scan #1

CD8, today was a double header on the Vagina Tour. I had monitoring this morning then my annual with my OBGyn. After five nights of Follistim (50iu each), here are my stats:

Lining: 5.9
Right: 11, 11, 9, 7
Left: 10, 10
E2: 206 (rising nicely from two days ago, 96)
Instructions: 50iu Follistim for the next two nights, return for monitoring on Saturday

Today's appointment was especially awkward. The waiting room was packed because all of the satellite offices are closed this week (due to the holidays). There were three couples there with their child... ::side eye:: and literally all seats in the waiting room were taken. Dr. R did my ultrasound. Usually they give you enough time to empty your bladder & disrobe from the waist down before they come in. The doctor usually knocks and asks if you're ready. Well, I guess Dr. R was in a rush today, because after I had used the bathroom, I was kicking off my shoes and she burst into the room. I stared at her like a deer in headlights. She left the room and waited for me to get set. 

Then I went to my OBGyn appointment. Ugh, jump on the scale... Fine, but I'm taking my boots off first. I liked their scale a lot more than my RE's. And the nurse even took two pounds off for clothing. Blood pressure was normal. Time to get prepped in the exam room. I was prepared for "waist down" but nope, everything off but socks. I forgot about that part. Dr. K came in the room (after I had plenty of time to study the pregnancy poster). She asked me to fill her in on our TTC efforts. Depressing. Pity eyes galore. She wished me luck and said she hoped that I'd be coming in before my next annual appointment with good news.

How do I feel about all of this? My emotions are so mixed and intense... I can't even handle it right now. Christmas was hard. I am excited to get to the New Year... I am so sad about 2013. I had high hopes... 13 is one of my favorite numbers... I was sure it would be our lucky year. But no. 2013 goes down in the personal history books as the worst year to date. I hope, wish, and pray every day that 2014 will bring our miracle.

The Power of Empathy

One of my fellow Dreamers and Bumpies shared this video... LOVE IT!