Waiting....again

I feel like I've written a post about waiting a hundred times already. But, here I go again! 

 I woke up early this morning and don't have any therapy sessions scheduled until 9:20. I only have to drive ten minutes down the road to get there. It's rainy and gloomy outside this morning and it looks chilly. The leaves are just a little past peak, but still amazingly beautiful. Even though I have tons of time this morning, I will still find a way to be late. 

Here are some photos I look the other day (when it was sunny) of the leaves in the finger lakes. 

It's hard to believe I'm actually "cycling" right now because I'm just taking birth control pills... Again. This protocol for the FET cycle is long and complicated. I don't go back into the clinic until halloween at which time I likely add in Lupron the following day. From the 1st-5th I overlap with birth control pills and Lupron. On the 5th I stop bcp's and on the 6th I'll drop my dosage of Lupron in half. Then I go back for more blood work and a sono on November 8th. If all goes well I start estrogen, Lovenox, baby aspirin, and Neupogen the 9th. I return for blood work and sono on November 14th and 19th. We have a tentative transfer date for November 26th, which feels like a lifetime away right about now.

This is Dr. Br.averman's preferred protocol. He said that the Lupron aids in implantation. I was happy at first to see we would be using Lupron. The main reason? That would be because we bought an entire kit ($199) for a 30 unit trigger. I was glad to see we would be using more of it. That was until I looked at the complete calendar and became completely overwhelmed. I know I will be okay as long as I take it one day at a time.

At my clinic the plan was to bring me back one more time (Oct 29th) for a lining check. As long as everything looked good I would start progesterone that day and transfer 5 days later (Nov 2nd). I'm bummed we are adding in essentially a whole extra month, but I'm trying to convince myself it is a good thing. I emailed Dr. B this morning about trying to fit in an endometrial biopsy since I'm guessing I will get another period before we transfer.

The days are once again dragging as I wait on birth control pills. I'm thinking I need something fun to look forward to, I'm jut trying to figure out what that is. Any suggestions? We had talked about visiting W's cousin and gf in NYC.

I'm not really too great at waiting. I can't find productive enough ways to fill my time. I started quilting a few months ago and have pieced together two of the fronts of two different quilts.

Quilt #2- I started it because I LOVED the fabric and had to have it. 

 That is the part I really enjoyed. Now I have to finish the backing and edges and its just not as rewarding or fun. I recently finished an amazing book and now don't know what to read. The pick for book club this month looks pretty awful. Any tips or tricks for combating boredom?

Freeze Report

I was so nervous to call. I dreaded it. When my friend texted me to get the report and I told her I was too scared, she encouraged me strongly to call. 

I feel more invested in this cycle than previous ones. That's part of why I was so nervous. 

I finally called around 12:30 and spoke with a nurse. She was able to tell me that we have a lucky 7 embryos frozen. I asked for their report cards and she said she would have to get an embryologist to call me back. 

A little while later my phone rang. This is what I found out.

On day five they froze three embryos. Of those we had a 5AC, 4BC, and a 3BC. 

On day six they froze four embryos. They were a 4AC, 4BC, 4BC, and 4CC.

She also said they were watching four more to see if they would be able to freeze them on day seven. I didn't realize that was a possibility. 

When AF showed up on Tuesday I emailed Dr. Br.averman. He suggested I schedule a baseline appointment and we didn't talk a whole lot about instructions beyond that. He wanted to know how many embryos we had before we talked next steps. That's one thing I've figured out about him. He likes to take things one step at a time. I'm always trying to look to the next step, so find this somewhat frustrating. It's forcing me to live more in the moment than plan ahead. We had exchanged a few emails about different protocols but he didn't specifically say what to do for me. 

My baseline appointment was this morning. My ovaries were still pretty big and "angry" as the NP put it, but my lining was thin. Both ovaries had some left over cysts but she didn't seem too concerned about it. She asked what the plan was, and not knowing, I just went with the flow. She came back with instructions and my next appointment scheduled. 

When I asked her to fax the results from today's appointment she stopped and stared at me for a second or two before saying, "If that's what you want." Seriously?

I emailed the nurse at Dr. B's office and asked if Dr. B was going to give me a calendar. Well, come to find out he wants me to do something entirely different. The theme of this IVF cycle all along? Different is better!! I guess I'll have to contact the NP and tell her of the change of plans. 

To those of you who have done FET's, what was your protocol? 

All I know right now is this one involves 2 weeks of birth control pills before anything else. I'm pretty sure it also adds Lupron, Progesterone, and Estrace at some point. It's amazing how many months I have spent on the pill while we have been trying to get pregnant. My clinic was happy to have me take Estrace 3x's/day until I started progesterone. Pretty simple. Things are going to get complicated again. 

I forgot to tell this story sooner. The day before my retrieval I had to go for blood work to be sure the lupron trigger worked. I made the appointment for a bit later in the day and ended up having some cancellations for the time after. I called a friend and my MIL to see if either of them wanted to have lunch with me, but was unsuccessful. So then I called my FIL and he gladly agreed. He was so patient and a fantastic listener as I jabbered on about the newest news with us TTC wise. When I told him I had a procedure the next day he asked me, "Are things coming out or going in?" That's one way to put it!

Consult

Tuesday, July 31st was our long awaited appointment with Dr. Br.averman. We live in Upstate NY and planned to make the drive down for the appointment. I scheduled it a few months ago and then the weekend prior I got an email confirmation about it. I thought I had scheduled the appointment for the NYC office, but the email said it would be on Long Island. No biggie, it was actually good for us because it meant we wouldn't have to navigate around the city and leave our car at some bus or train station as was our plan.

The appointment was at 5:45 so we left really early in order to have some time on the beach. We spent about 3 hours on Jo.nes Beach and had a great time. It was totally surreal to be sitting on the beach on a Tuesday of a work week. It's a really beautiful beach and it wasn't busy at all. 

We left the beach with lots of time to get to our appointment in case there was traffic. We arrived at the office at about 5:30 and walked in.

All of the lights were shut off. I called the number and it rang and rang. Finally we saw a receptionist in the office despite it definitely being closed. W and I knocked on the door repeatedly and she came over.

I showed her the email and she told me that Dr. Br.averman was in the NYC office on that day. She suggested she call over and see if we could still make it on time to see him since he was running a bit behind.

It took her a while but she finally came back and said she didn't think he would be there by the time we got there. She gave me his cell phone number and we said we were going to try to make it since we had come so far to see him.

So, at 6:00 we were heading from Long Island into NYC with crazy traffic. We never intended to drive into Manhattan so we were both a little overwhelmed. On the way, Dr. B called me himself and told me he would wait for me so not to kill ourselves trying to get there.

We got into midtown Manhattan with the use the map on my phone and W dropped me on some random corner in order to go find parking. I power walked a few blocks and made it to the second floor. I poked my head in a random office and they said his office was down the hall. I went down the hall and wandered around some random office that has no signs of being open.

At that point I pulled out his cell phone number and called him. Somewhat annoyed he asked me how I got that address since it was an old one. I told him it was on my iphone and I just followed what it said. At that point it was about 7:10 and he said he would wait for me but probably not be able to stay for long. He said, "It's not your day, is it?"

I called W frantically and he was just about to pay $25 for parking. Luckily it was just in time and he was able to pull out of the garage and head towards where I was. He picked me up and we headed to the correct address.

He once again dropped me at the corner and I hustled a few blocks to the office. Finally, around 7:30 I arrived in the right place.

Nada

That's how many of the frozen embryos we transferred implanted. I had the formality of my beta today to tell me what I already knew. The nurse said, "Hey, you never know" when I told her I knew it was negative. When she left the room W also said that is also the slogan for the lottery.

 I started testing the day before we left for vacation and nothing ever appeared. I used Wondfo and bought 3 FRER tests. I only used one of those at 7dp5dt and that's when I knew it was over. The consolation prize? An amazing vacation in Mexico. We ate, drank, swam, relaxed, read, ziplined, snokeled, rappelled, sunned ourselves, and enjoyed each other and the surroundings. I think every 2ww should end either with a positive pregnancy test or a relaxing vacation. Add that to my bill!

Our resort was amazing and adults only so I didn't have any great (or not so great) families to watch and feel jealous about. No cute babies or screaming children, so it was pretty great. I read 2 1/2 of the 3 Hunger Games books and can't wait to see the movie. 

At my appointment this morning I asked about another IVF cycle. We can start as soon as AF shows by taking BCP's. Oh joy! They gave me a free pack of pills and told me to call on CD 1. We discussed the Lupron and Antagonist protocols and the NP gave me a few good reasons why the Antagonist wouldn't be a good idea. 

First, my estradiol levels peaked at 7672 last cycle. Since I wasn't on any antagonist we were able to pull that out of the "back pocket" to make my levels drops way down. Also, they retrieved 28 eggs. With no suppression the NP said my response could be scary, especially with polycystic ovaries. We will switch from Menopur to Luveris this cycle and use a much lower dose. She said I may stim for more days but hopefully we will keep my estradiol levels a bit lower and more under control. 

How do I feel about doing it again? Eh, whatever it takes, right? I'm not excited to go through the egg retrieval process again, but it will be ok. I don't think waiting or taking any time off helps me. In fact, it just reminds me of the negative experience with all the waiting with RE #1. 

BTW, we transferred all 4 of our frozen embryos. I'm not sure what their grades were, how many cells survived, etc. We decided to thaw all 4 thinking they wouldn't all make it. I wanted to transfer 3 this time but when we were told all 4 survived, my RE and I agreed to put them all back. Part of the decision making process is that with the package deal we bought in order to move on to another fresh cycle you have to use up all of the frozen ones first. I wanted to transfer 3, so it didn't make sense to keep just one frozen. I'm pretty bummed that none of my 4 blastocysts implanted. I guess it wasn't the right time or the right embryos. That's all I can really say about it. No use feeling badly. 

Onward and upward. 

Today's Appointment

I really need a cure for fertility clinic anxiety. The mix of Metformin, Estradiol and stress/anxiety is not working out so well for me. The estrogen leads to nausea which leads to Liz not eating a whole lot these days. The plus is that this also leads to my pants being a little looser, leaving a little extra room for our Thanksgiving feast. 

Any tips or hints to combat fertility clinic anxiety?

The clinic was empty today and I was the only person there. They had me undress from the waist down, gave me a real sheet to cover myself with, and I waited for Dr. S. He didn't take too long and immediately asked about the bleeding when he entered the room. I told him it's still going on and is heavy like a period. 

He then did the scan. My lining measured 6.5 and had a trilaminar stripe. He said this didn't correspond with me having a period. We talked about the dates I had spotting, how I had a positive OPK in October, and the plan for the future. He was confused that I was bleeding despite what my endometrium looked like. I never cease to have unexpected problems. 

We came up with a plan. The plan is for me to continue on the estradiol (vaginally rather than orally to help reduce nausea) and rescan on Monday. He sent me for blood work to measure progesterone, estrogen, and Vitamin D (per my request). If I am still bleeding or my lining has decreased on Monday we will cancel the cycle and look to do the FET with the Lupron protocol probably some time in January. If the bleeding has stopped and my lining is thicker, we will continue as planned and consider this bleeding "breakthrough bleeding" which apparently sometimes occurs on estrogen. I really don't know what the plan is if my lining stays the same, I guess that isn't very likely. 

So, my Monday will be spend at two different fertility clinics, getting two different ultrasounds. Doesn't that sound like a ton of fun? At least they aren't back-to-back. One appointment is at 8:30 and the other is at 2:00. Hopefully I can get some work done in between those times.

Until then I will be cooking, entertaining, black friday shopping (eek), spending time with family, relaxing, and trying to step away from thinking about this whole thing. I will instead focus on all the positive and great things I have going on in my life. I fully appreciate these things and am incredibly thankful. I got the sweetest card from a family of a little boy I work with today. It literally brought tears to my eyes (maybe hormones played a part) and made my day. A card like that beats any present any day. I hope everyone has a GREAT Thanksgiving!!

Answers and a plan

Dr. S called on monday evening. He started to talk about protcols for the FET and I immediately interrupted him and said, "I think we might have a different problem." When I told him the spotting never turned into bleeding he wasn't really concerned. Here I was, stressing the f*&% out and he is all casual and says it's no biggie. He said with the D&C only being about 5 weeks prior he wouldn't have expected my lining to build up that much. He wanted to call my spotting on Friday as CD1 and start the frozen cycle.

He presented two option for the protcol. The first being estrogen only like I did previously. The other option involved suppressing me first with Lupron and then using the estrogen. He spent more time talking about the Lupron one. He told me when they discussed my case in conference that the Lupron seemed like the best idea. He then started to look at the calendar and count out the days only to find with the Lupron the transfer would fall the week after Christmas when there is a "skeleton crew" working.

I then asked if we could do the protocol without Lupron. He wasn't completely pleased at first but finally talked himself into it. By the end of the conversation he was in agreement that if we do the FET right now the estrogen protocol is the best one. He warned me that the fluid could return and that we could be in the same situation again, but I realize this can happen with or without Lupron.

So Monday night he called in oral estrogen to my pharmacy and I started. We chatted briefly yesterday and I received a call later in the day that I have an ultrasound scheduled for next Wednesday at 9:00. Transfer is tentatively scheduled for Dec 5th!!!!!

IVF here we come...again (sort of)

So we got the green light for an IVF cycle next month. AF arrived promptly on Friday (exactly 2 weeks after day 2 of IUI's) and I called the nurse at my clinic. At first the nurse starting listing everything we would have to do, and then I reminded her that we completed all of those steps in January. In case you don't know, we had started an IVF cycle in Jan after I learned my tubes were blocked in late October. Come to find out, the Lupron helped me to ovulate and when I went for my suppression check (ultrasound) there was a gestational sac. I did Lupron for a little over 2 weeks and that was the end of that IVF. Apparently at least one tube wasn't blocked. 

During our initial conversation the nurse said she would talk to my RE and give me a call back. She called a few hours later and gave me some tentative dates and my protocol. I will be doing the long Lupron protocol and was instructed to use some form of birth control this cycle. Here are the dates: Lupron start date June 16th, ultrasound/start stims July 1, retrieval July 12th. The only date I am going to count on in the Lupron start date. From there, I am going to roll with it. I am excited and nervous to have a plan in place and am now feeling much tighter with money. I want to do some research on ways to improve egg quality since this is a concern of mine. I am hoping there are some supplements are items I can add to my diet that will help. Anyone know of anything?

Around the homestead our garden is doing well. Below is the "map" I worked on this evening which shows everything we planted in our vegetable garden. A lot has come up from seeds, and some we planted as larger, already established plants. I will have to take a "real life" pic since it doesn't look as great as the map. 

I am so happy to have a 3 day weekend to relax. We always say weekends are too short and this one feels like a great amount of time. Only 2 weeks until our party so we are planning and working a lot on stuff around the house. I hope everyone is having a great weekend and getting as much beautiful weather as we are.