Something New Every Time

I went to my clinic for my appointment yesterday. Apparently the person I talked to on the phone the previous day put it into the computer as 'check problem' and the receptionist was very concerned when I checked in. She asked me if I was feeling alright and I had to explain to her that my period was late. There wasn't any real problem so to speak. 

When I first walked in I saw a massage chair in the waiting room. I asked the receptionist about it and she said Dr. K has something new every week. I guess a massage in the waiting room is the new thing this week. As I sat there watching someone get a message I couldn't help but think it was a bit strange. I can only imagine if there was a moaner in the chair. How much more uncomfortable and awkward would the waiting room be then?

She asked me if I wanted a complementary massage on my way out but I had to decline. 

So they drew my blood and did an ultrasound. The nurse said she thought she saw post-ovulatory cysts on each of my ovaries, but needed to look at my blood results to be sure. She wrote me a prescription for provera and told me to take it unless they called. 

They called later to tell me that my hormones were elevated and that I was going to get a period on my own. I didn't need to take the provera. My progesterone was at 9, my LH was at 10.25, and my estradiol was 238. Unfortunately my HCG was <0.5. 

The thing I don't understand is that I had a positive ovulation test on the night of the 11th and the morning of the 12th. That was 17/16 days ago. I'm not sure what is going on but I wish I had used the tests beyond the positive. Maybe there was another surge? Who the heck knows. 

Thank God For Dogs

When I got home this afternoon I heated up my lunch. It was gumbo and I left it in the glass pyrex dish and popped it in the microwave. As I was carrying it from the kitchen to the living room it slipped out of my hands. I guess I wasn't holding it well because it was so hot. It. splattered. everywhere! It really was unbelievable the mess it made. It even splattered on to the 10 foot ceiling. 

So I did what any pet owner would do. I called the two dogs in and encouraged them to clean up the mess. They did a great job and left little for me to clean up. I wiped down the couch and W had to later get a ladder to clean off the ceiling. The dogs and I were both grateful for each other. 

I scheduled an appointment with Dr. Braver.man for July 31st. W and I will both take the day off from work and make the drive into NYC. I also have an appointment tomorrow with my clinic to see what's keeping AF away. I'm not rushing things and I'm trying to go with the flow and worry less. I'm not going to lie, I'm a little worried I have a cyst or something, but there's nothing I can do about it. 

Lesson of the day? Dogs clean up better than humans!

What's Going On

There's not much to report on, but I figured I should give some kind update or another.

Last week was the last week of the school year. Although I work through the summer I have a vastly reduced caseload and rather enjoy it. It's so nice to work shorter days. Today I worked from 9-1:30 and it was pretty amazing. I also realized I only have 1 girl on my caseload for the summer thus far. Help me with the patience to deal with all little boys! I'm going to be supervising a graduate student for a few weeks so that should keep me on the ball and better prepared in general. 

Two weeks ago tonight I got a positive OPK. I have taken a few pregnancy tests and I don't think this cycle was a winner. That's OK. Now I'm just waiting on AF to start my next FET. 

Tonight as we were eating dinner we heard a huge crash and looked outside to see that someone had crashed their truck into the telephone pole right outside our house. Luckily the guy was fine and W was able to call 911. The reason he veered off the road and hit the pole? He was taking a puff on his inhaler on the way to the store to buy cigarettes. 

I've done the initial forms to see about Dr. Braver.man. He is a reproductive immunologist in NYC. Although I have another cycle covered with C.NY I would like his input on what we could do differently. I spent the time filing out his comprehensive history form on Sunday. This morning I saw a number on my phone that I figured was his office. I didn't pick it up because I was running late and it isn't something I'm jumping up and down to do right away. Well, when I listened to my voicemail the message was from Dr. Braver.man himself. He said he read my information and had some ideas. It seemed like the biggest thing he had ideas about was the coasting. I emailed him tonight to see how consulting with my doctor would work. I also found out that a phone consultation is not covered by my insurance but an in office one is. I'm still digesting and trying to figure out if it is worth it. When I looked at his blog they listed a 75% success rate for fresh IVF cycles for women my age. My clinic is 33%. That is such a huge difference I think it is worth investigating. Also, he specializes in recurrent pregnancy loss, which unfortunately, I appear to fall in that category now. 

We attended a wedding this weekend of a friend from graduate school. The wedding was on Cor.nell's campus and was amazing! The bride and groom seemed so happy and in love and everything was beautiful. The food was amazing and everything was really fun. I can't believe how much I ate....

We had our BBQ on Friday and it went really well. It was nice to have all young people there and everyone had a great time. I had way too much wine this weekend between the BBQ and wedding and the cold I had last week has progressed and I'm still feeling crappy. I'm definitely ready to start feeling better. 

So that's the update on what's going on. 

June ICLW

Hello and welcome to my blog. I decided to do ICLW again this month. It has been a while, but I am looking forward to it. 

My name is Liz and I am 28. My husband is W and he is 30. We have been TTC baby #1 for about 2 years and seeing a RE almost the entire time. I got a referral quickly by going to my GYN for a pre-conception check up. At that time I requested blood work since some of my cycles had been a bit longer. My testosterone was high and I quickly received the diagnosis of PCOS and the suggestion to see an endocrinologist. In addition, I lost my left tube to a paratubal cyst last March. 

 I have done 2 IUI cycles (both BFN), 3 IVF cycles (1 BFN, 2 chemical pregnancies) and 1 FET (BFN). Once I get AF again we will do our second FET with frozen embryos from IVF #3. If you want to find out more you can check out the other pages on the top of my blog. 

I am a speech pathologist and work with children from birth to age 5. I love my job, challenging as it is. The children say some of the funniest things, and it always keeps me on my toes. Today I arrived at a house and their two boys were in the pool swimming. I see the younger brother for therapy and the other brother loves to join in most days. Today he decided he was going to stay in the pool instead. After our session was over we headed back outside. I guess at that point the older brother decided he wanted to come inside. He took one look at us and said, "I missed all the fun?" As if swimming in the pool isn't more fun. 

I like to ask other people questions for ICLW so here goes:

What is your favorite color?

Mine is green

What would I find in your refrigerator right now?

We have a ton of prepped food for our BBQ we are having tomorrow. Coleslaw, potato salad, chicken, beer, wine, and some hot dogs. 

What is the last book you read/the last movie you saw in the theatre?

I read the Hunger Games and am currently embarrassed to admit I am reading Fifty Shades. The last movie we saw was the 5 Year Engagement

If you were on death row, what would your last meal be?

Lobster, corn on the cob, and salt potatoes 

Balance

There are so many things we struggle with when faced with infertility. The thing I have struggled most with is finding balance. Typically this is not something I have trouble with. I have always considered myself a pretty balanced person. That is, until I had trouble making a baby. 

This past month I have found myself in a very different place then I've been for the past year. At first I was disappointed and angry I couldn't do another cycle right away. Then I found peace. Well, I haven't mastered this yet but I'm really working on it. 

Switching clinics was a great thing. I am glad I did it. But it added an extra thing to obsess over... an online database where I could find all of my information from each appointment. At my first clinic I had to specifically ask and felt like I was bothering them to get this information. Now, I easily log on to find updated E2 levels, numbers of follicles, etc.

I've made some realizations. I've realized I obsess far too much over each cycle. The numbers in particular. Throughout this journey I have been bombarded with numbers. Numbers that I read far too much into. Numbers that determined my happiness. Estradiol levels, progesterone levels, LH levels, dosage amounts, follicle numbers and sizes, HCG levels, TSH levels, numbers of eggs, number of fertilized eggs, number of embryos of day 3/5, grades of embryos, and the list continues. What I've come to realize is that these numbers don't matter. What matters is whether I get pregnant or not, and nothing else. None of these numbers lead to success or failure, they are just added things to stress over.  

I've blogged about this SO many times. Talked about how I gave up control. But honestly, I never did. I'm accepting my obsessive nature and trying to change that. 

It's easy for me to say these things now since I'm not doing a cycle. I'm not getting any numbers to plug into google. But I am really trying to stay more grounded, obsess less, and leave things up to chance/luck/my RE/anything else you want to add.

The balance part comes in knowledge. Knowledge is power and we are always our best advocates. I enjoy learning and have become empowered with my knowledge. When and how do you draw the line between being a knowledgeable advocate for yourself and obsessing too much?

Follow-Up Chat/WTF Appointment

My appointment didn't go exactly as I had hoped, but it was pretty good overall. My plan was to let my RE (Dr. Greene) tell me what he thought before asking any questions. Well, he came into the room, introduced himself (even though I've met him 3 times already), and immediately asked me what questions I had. 

So first I asked why he thought I was having chemical pregnancies. He said that he thought it was likely genetic. He explained that at the point that we transfer the embryos they have only made simple determinations as to what type of cells they are going to be (placenta, fetus, etc.) but it's not very complicated. The cells are multiplying and dividing, but not getting too detailed. He made an analogy to a book. It is as if the embryo copied all of the chapter titles of the book, but didn't yet get any words. He said that as things progress the embryo needs to make more complicated divisions and the cells determine exactly what everything will be (liver, brain, blood vessels, etc.) This is where there appears to be a problem. 

He didn't recommend donor eggs, donor sperm, or PGD at this time. He recommended we just keep trying. This I found somewhat frustrating. It's not that I want to do any of these things, but I wish we had more concrete answers. 

His recommendation was to do the FET before moving on to another fresh cycle. He said the quality isn't great for the ones we have, but it is best to focus on this as our next step. When the embryos were frozen both were graded 4CC. 

He then said grading is just a beauty contest. It's not that he doesn't give the embryologists credit for the amazing job they do, but he and the other doctors at the practice don't care as much about the grade. He said it probably means more to me than it does to him. Dr. G told me a story about a woman who had only 1 embryo to transfer that the embryologists graded as so poor they didn't even recommend transferring. This woman got pregnant and her son now speaks 3 languages and plays 2 instruments. He said even though our embryos didn't get a great grade on their report card there's no reason to believe they can't turn out to be perfect babies. The grading plays no part on what the child ends up as, it's just a simple way of judging them when they are at such an early stage. Once they implant there is no reason to believe they will be inferior or imperfect. 

He also said he did a study which compared embryos with PGD. He said often the best looking ones were the ones that were the most abnormal. His theory was that the ones that don't look as great could have had a simple problem during division and they already corrected themselves, giving them a less than perfect appearance. 

Dr .G didn't seem to think the coasting had much of an effect on my eggs. He said the HCG trigger is what is responsible for the final maturation and not the other meds. He did say that one option is to do a staggered cycle. This is when you don't coast at all but you freeze all embryos and transfer them in a subsequent cycle. 

He didn't see any problems with egg quality, sperm quality, or embryo quality. This is pretty good because I was worried about my eggs and embryos. My last clinic told me that all of our embryos were slow to develop. He said this wasn't the case with my past 2 cycles. He compared it to puberty. Just because people go through it at slightly different times doesn't mean either are better or worse off. 

I asked about my thyroid since my levels vary a bit. Since they are always (more or less) within the normal range he didn't think any further testing was necessary. He said TSH levels can affect a person's ability to get pregnant, but don't typically unless they are grossly abnormal. 

I asked about doing a panel for RPL but he said it wasn't going to change anything we are doing. It is just more testing and more money, but it won't change our current protocol. He was skeptical about Lovenox, but said the other doctor in the clinic highly believed in it. He said there weren't any specific studies to prove it is effective. He seemed to be on board with intralipids and Metformin to help reduce miscarriage rates. 

I really wanted a plan for our next IVF, but he was more focused on the upcoming FET. He said he could sit down and look specifically at my past cycles and make a new plan, but he didn't feel like we should focus on that yet. He said I could email him any time and I plan to (if necessary) about this rather than booking another appointment if our FET doesn't work.

The dialogue part of the appointment was pretty short and a nurse popped her head into a room at one point and I heard something about someone being ready for an HSG. He pretty much wrapped things up and said to stay positive and focus on our next FET rather than trying to plan for our next IVF. 

I then asked if I was going to get an ultrasound. He said I could if I wanted one. I explained that I was wondering if this cycle was ovulatory or not and wanted to get a prescription for progesterone if it wasn't. 

They brought me into another room and I waited a bit. I'm guessing he did the HSG in that time. Then he came in and did the ultrasound. First was my lining. It was a bit thin for me at 7.5. He then went to my right ovary (the one with a tube) and there was a great looking follicle which measured about 17 mm. On my left ovary (the one without a tube) there was another one which was larger and a little bigger than 20. I asked about a natural FET and he asked when my HCG came back negative. I think how recent that was paired with my thin lining made him say it wouldn't be a good cycle to do it. He said I should pick up ovulation tests and start using them. He then said we should definitely try on our own this month.

To find out I was actually ovulating was pretty great. There are some perks to going to a fertility clinic, such as getting a peak inside even when you are not actively cycling. In total, W and I only tried on our own 3 months. One was the first month before we saw a RE, and 2 cycles were post D&C so I don't even know if they were ovulatory. Sometimes I wonder if we could do this on our own, but it's hard to have faith in my body at this point. Dr. Greene did say that often women get pregnant in the cycles immediately following an IVF cycle. This is because the eggs are exposed to a more favorable environment preceding final maturation and ovulation. I would certainly take a natural pregnancy at this point!

I know this post is thorough and I may have bored the crap out of you, but I wanted to document and remember as much from the appointment as possible. I'm a seeker of information and always try to understand as much of this process as I can. 

I've been peeing on OPK's for a few days now. Since I have so many and they are cheap, there is no concern with using more than 1 per day. This afternoon the line was darker than it has been and there has been an abundance of EWCM. I'm hoping I get a positive soon and I will keep you posted. 

Tick Tock

The clock is not moving fast enough. This whole "month off" thing feels like it is taking forever! I guess I didn't realize how bad I still was feeling about things until this morning. I haven't wanted to work any day this week. Time seems to be dragging, especially without anything too great to look forward to.

BigBadWolf etsy shop

 I have my list of questions ready for my appointment tomorrow, so we shall see what transpires from it all. I also will have an ultrasound so can get an idea as to whether this cycle will be ovulatory or not. If not, I think I will ask for a prescription for progesterone so I can start that within a reasonable time frame and not have to wait forever for AF to show up again.

I bought a bunch of OPK's but I'm not holding my breath. I started using them this morning and the second line was pretty darn faint. I have a whole bunch and can pee on things with reckless abandon so that should help pass the time.

I've been looking at the profiles of women who donate their eggs for my clinic and have been feeling more comfortable about going that route if need be. It's not ideal, but heck, I can pick someone smarter than me! There is so much information in the profile including what they got on the SAT's, educational background, family history, previous cycle history, pictures, etc. I have to laugh that there is more information available about their families than we know about my own. Both of my parents were adopted and neither of them know their birth parents. My dad is in contact with two sisters, but thats all. It seemed like all of the good looking ones were already matched and it felt a little like online dating, but it's interesting to look at the profiles if nothing else. My clinic just introduced a new egg donor program and the prices are pretty good, much better than what I thought they would be. I'm more comfortable with donated eggs than adoption at this point, especially because as far as anyone else would be concerned it would be our child. I'd like to experience pregnancy so this is the next best option.

I guess I'm expecting my RE to tell me my eggs are crap tomorrow. I'm prepared at least. We have our frozen embryos and another fresh IVF already paid for, so I guess the most productive thing at this point is to look towards those with a positive mind frame.

I do know my face is breaking out, I feel super fat and crappy about my body (big surprise after another failed cycle), and I've been extra moody. I feel like I'm going through rehab and am detoxing. The headaches have been pretty darn consistent as well.

Oh yeah, my HCG level was negative at under 5 this week. Yay, right?!?

Things Are Looking Up

I'm feeling so much better and so glad for it. The headaches continue to linger here and there, but nothing like earlier this week. AF decided to halt her game and peace out, but I'm OK with that. I still feel like my sense of smell is really heightened and I've been feeling nauseous here and there. 

We had a super productive weekend. My dad came out and helped W build a raised annual bed for my dahlias. It is 8x4 so should be pretty amazing once I get things planted in there. We also pretty much completed planting the veggie garden. This year we put in green beans, lettuce, spinach, sugar snap peas, zucchini, yellow squash, a ton of tomatoes, corn, a bunch of peppers, cucumbers, herbs (cilantro, parsley, lavender, oregano, basil, rosemary, thyme, sage), and okra. There is half a bed left that we are planning to put broccoli in. We tried to buy it today but they were sold out. 

The bathroom is also making great progress. The vanity finally came in and we got the top tiled and tomorrow W will grout it. Most of the trim is back up but some of it still needs to be stained. The storage cabinet that my step-dad built got painted, and the lighting fixtures are in. We are so close!! This week we will get the sink and fixtures for the vanity in, the storage cabinet up in the bathroom, and the shelf in the back of the tub tiled. It really looks like a completely different room and I am so happy for that. 

I have to go back tomorrow to see what my HCG levels are. I think it will be negative, but only time will tell. I have my consult Friday with my RE and I'm really looking forward to what he has to say. I hope he has a good plan for the future because I know we need some changes. We can't continue to do the same thing and expect different results. Isn't that the definition of stupidity? 

I've been talking with the mom of one of the kids I work with who went through numerous rounds of IVF. She is so good about talking me down from any ledge I find myself on. I'm so glad to have someone who understands it all. I'll be sad when I no longer see her son for therapy even though he's a little nut. 

I am feeling so much better. Having my physical health back really helps. Things are really looking up!