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!!

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.