62 Days

After my last post complaining about how long it had been since I'd had a period, my period finally arrived. It was a 62 day cycle and I wasn't thrilled to see Aunt Flo the morning of my scheduled massage. Poor timing! 

Yesterday I met with my gynecologist. Despite an insanely long wait my actual appointment was brief. I described my symptoms and he did an exam. He ordered blood work and told me he wanted me to have a sono done. Then he said I should schedule an appointment and we'll "figure things out." When I described what had happened with the ovulation tests he said I was likely having overlapping cycles. A LH surge doesn't necessarily mean ovulation. I interpret this as I'm likely making cysts. 

We talked about the different hormone tests he planned to run. When I mentioned I had high testosterone in the past he said that the testosterone is what fuels the LH surge. I'm guessing that means mine is high since I'm having multiple LH surges per cycle. 

I didn't get much of a chance to ask many questions, but I'm hoping next time I talk to him it will be more thorough. I understand he needs the blood work results to make decisions about how to treat me, but I guess I would have liked to have gotten some idea as to what he'll do. I think I was hoping for more resolution because it's not fun feeling like your hormones are crazy and all over the place. 

I left the appointment and immediately went and got my blood work done. I go back on January 7th for the sono and follow-up appointment. Dr. R did say that if I didn't hear from him next week regarding the blood work results to call for them. I also started taking Myo-inositol. I really should add in Vitamin D too. We'll see if it makes a difference.

Birthday Festivities

My birthday was Wednesday, but the celebrations lasted almost all week. On Wednesday (my birthday) my hubby and I went out for a great Italian dinner. We had delicious food and he got me a great present. A huge bouquet of beautiful flowers and a blue-ray player that can stream off of the internet with surround sound. We have really been enjoying that! 

On Thursday we had dinner with my parents and brother. The family tradition is a lobster dinner for my birthday and it is always delicious. We had ice cream cake and it was nice to see them and spend some time at their house. We talked about an upcoming wedding (Sep 3rd) where we are going to Cape Cod. I am super excited to see all of my step-father's family and have a great time. Hopefully I won't be drinking at that wedding : )

Friday afternoon I went for a walk with co-worker C. She is the one who had baby Max a few months ago and is one of the few people completely in the loop about my fertility treatments. We were able to talk for a while and hang out with Max. He is really growing into his cheeks and was fun to hold. He is smiling and cooing and is super cute. Friday night we had my B friend over and we rented a movie through our new blue-ray player and drank some wine. We stayed up late talking and laughing. 

Last night my in-laws took us out for an AMAZING dinner. It was the best meal I've had in over a year and was so indulgent (as if every other dinner this week wasn't). After that we met up with B and her new guy interest at a bar and had some drinks. Her birthday is today so we were able to celebrate some after it hit midnight. I don't think W and I have been to a bar even a handful of times since we have been married. Definitely different for us, but still very fun. 

Today we went over to my in-laws house and went swimming. My in-laws have been great about asking what is new in the treatment area and my FIL was super excited that I had extra syringes he could use for house projects. 

Tomorrow is my appointment. I'm not nervous about it. It will be quick and I expect to hear from the nurse or my RE later in the day. I will know what my lining measures tomorrow and that is all that is important right now. I did find out from the nurse at my clinic that my estradiol levels were 23 on day 5 of my cycle. This means although there were cysts, that they weren't producing estrogen. I don't expect them to be gone since I have felt them from time-to-time, but I also don't think they are much of an issue. The estradiol patches have been going fine. When I changed from one patch every two days to two, I got pretty bad headaches. Tomorrow afternoon I change from 2 patches to 4 and am expecting some more headaches. I joke that the brand is Vivelle and that it sounds sexy. Not sure, don't ask. I have definitely been feeling more feisty and irritable this week, but W is great about it all. I am really hoping my transfer will be moved up to this week, but I should have a better idea tomorrow. Right now it is scheduled for a week from tomorrow. 

In terms of eating healthy and exercising, that part hasn't been going well. It doesn't even feel like I am doing a cycle since I haven't had many appointments. Yoga was cancelled last week and I didn't go the week before that. I haven't been to acupuncture at all. I said to W it felt very similar to the cycle we did Clomid and an IUI for. It was basically one ultrasound and an appointment. This cycle is a little more than that (likely 3 ultrasounds) and will hopefully be much more successful. I am mixed in my feelings about the FET. I know our embryos aren't the best quality, but I really want it to work.  I'm so sick of fighting for this, that I have days where I wonder if it's all worth it. I know it will be, but I just want to not have to fight any longer. I think there are times where I lose track of what exactly I am fighting for, I just know I haven't won yet and need to continue. 

If it's not one thing....

I had my appointment on Friday afternoon. W wasn't able to make it since he was working, so I was nervous and anxious the hours leading up to my appointment. I was still bleeding and didn't have high hopes for a green light to start the FET.

 When I got there the ultrasound tech took me down to the room and told me Dr. S wanted to watch. I was shaking at that point. I told her I need Valium for all of my future appointments. Dr. S stood in the room with his arms crossed, looking at the screen. I think he was making us both nervous.

Well, my uterus looked great. It was clear of any fluid. This was such a huge relief.

Then the tech went on to scan my ovaries, and boom, huge cysts on each. I think the right ovary had 2 or 3 cysts and the left had 1. They weren't exactly small either (about 2-3 cm). Since I have had so many ultrasounds I knew the cysts as soon as I saw them. The tech told me to get dressed and meet my RE in his office.

At that point I was grateful the fluid was gone, but nervous as to what the cysts would mean. My RE then wanted to do a literature search about cysts and starting a FET cycle. Since he works in an academic setting and does research himself, he is always consulting the literature prior to making decisions. He even had 3 articles printed relating to PCOS and FET protocols that he had found prior to my appointment. Good thing I took classes about research and statistics so I can better understand when he pulls them and the technical terms out.

When he came back he told me that the cysts weren't going to pose a problem to the FET cycle. In fact, they may help if they are estrogen producing. That seemed odd to me, but I guess I don't need my ovaries to produce eggs this month, so the fact that they have cysts is fine. They typically prescribe estrogen during a FET cycle in hopes that it will build up your lining, so the cysts may help to do the same thing. My lining was at 4.7 on day 5 and he thought it was a little thicker due to the cysts. He prescribed me Vivelle patches and sent me to get my estradiol levels checked.

I have a protocol I will follow where every other day I change the patch. As time goes on, I increase the number of patches I put on until I am up to 4 every other day. I was able to get 8 patches covered by my insurance, but the rest will be OOP since that is a typical month supply. Without insurance the pharmacy quoted me $72 for 8 patches. This is going to get expensive quickly....

 I'm not sure I will get to the 4 patches every other day since we started on day 5 instead of day 1, and I likely have extra estrogen due to the cysts. He wants to wait until my lining is at least 8 before we do the transfer. The tentative date now is August 15 for transfer, but we will see. I have a feeling it will be sooner.

I kept my appointment for the 8th and they will check my lining then. It feels weird to be doing a cycle but not popping any pills or shooting up with any needles (is it possible to me a drug addict to fertility meds?) Estrogen patches are seriously anticlimactic. It doesn't even feel like I am doing anything. At some point I will start progesterone IM shots and will likely also do Medrol. This is a steroid that is given when assisted hatching is done.

My hubby and I have been talking about how amazing it would be if this cycle worked. The financial burden of fertility treatments is huge, and a big weight would be lifted if we didn't have to pay for another round of IVF. We can do it if needed, but I'd love to be able to spend money on things outside of making babies. The chances are better than it won't work, but I am holding some hope out for my little totsicles.