Friday's update

What a boring blog title eh?

This morning--the follicles had grown a little bit, but they're still all under 10 mm. I'm not concerned about that per se...as long as they keep growing. Granted, I don't really want to have to have a marathon stim session, but we'll just see what each day brings.

I also went and had my regroup with my Dr. I must say that--even given what happened last cycle when she never called (although we talked through that)--I really like her. She gave me a huge hug when she saw me. I was all sheepish and said "It's me, the pain in the side patient!" and she kept saying how I was not bothering her by arguing about doses and meds, that she likes patients who are informed, and that she knows this is our last go and how important it all is. We had a really great regroup--she is quite happy with the progress as so far, my E2 isn't too high, my LH is lowish, my P4 is very low, and I have a decent number of follicles. I'm kind of right in the middle, which is unusual for me.

We discussed freezing and she is fine with vitrifying day 3 embryos; that way, we know whether or not we have anything worth coming back to transfer. We talked a lot about my lining, about doing the D&C, about my hyperplasia. She said the head embryologist wanted to do our MICSI, so that's good I suppose.

She wants me to come back to her office on Monday for another regroup just to talk. She didn't charge for today's and won't for Monday's either. Fine by me.

Mr. LastChance gets here tonight. We plan on going to Boulder and to Rocky Mountain National Park over the weekend, but Dr. M does want me monitored every single day. She expects my E2 to start climbing fast, so she lowered my GonalF and Menopur doses.

I'm happy. I'm not too stressed. It's a vacation with a remote chance for an embryo or two. Nothing more, nothing less.

Thanks for reading this boring old update!

Oh yeah: here's the numbers:
E2: 566
LH: 1.2
P4: 0.2

First report...sigh of relief!

Ok.

I'm breathing out.

My LH today came in at 1.3, P4 <0.2 and E2 up to 329.

I told them the first E2 didn't really count--funny thing, my regular nurse today said the same thing. I'm just glad the E2 went up a decent amount but isn't, um, say, 2500 like last time.

They counted fourteen follicles and said a few more could pop up soon too. I really don't need super high numbers, just a good fertilization rate and some quality eggs. Duh.

I'm enjoying myself. I'm not as lonely. With all the 'stuff' that's been going on with my family and my life of late this is the first time in a long time that I'm just relaxing (minus the inherent stress of IVF out of state). Like, today after monitoring the shuttle driver took me to my Mecca, aka SuperTarget, and I wandered around for an hour, picked up some groceries for my uber healthy high protein stimulation diet, and then when I got back to the hotel I put my PJs back on and have basically lazed around all day.

Aaaaaahhhh, the good life.

Mr. LastChance and I have been calling this a "small vacation with a remote possibility of getting an embryo or two." It's a way to keep ourselves sane.

I'm about to go to the gym and get a little exercise and then I'll be stuck in the room again tonight, but it's not so bad. I could write. I can read blogs. I can watch bad TV while snacking on bell peppers and hummus and drinking whey protein drinks.

At least for now, things are ok.

I've arrived.

I made it to the cooler weather. That's something at least.

I had three different phone conversations via my nurses with my doctor. She really kept insisting on doing the Menopur today. She said that my LH level was fine, no need to worry. She said she was quite worried about my low E2, despite my repeated remindings that it was only after two days of stims and that I always do this on long lupron and then--WHOOSH--it starts to shoot right up. That didn't seem to help.

And I relented.

I shot up in the airport and once I felt the sting of the Menopur I thought "Well there goes nothing."

So tomorrow morning bright and early I'll have the LH checked again. Obviously my fear is that it's much higher and then it's too late, what have I done, why did I give in, etc.

I wanted to trust them so much and so I did. I argued every which way I knew how and at that point if I hadn't done it, I feared they would fire me. Or label me difficult. Which shouldn't matter....yikes yikes yikes.

But it's done now. I have to just trust. And let go.

More freaking out tomorrow, I'm sure.

Thanks for the advice and the listening ears (errr, reading eyes??). It's lonely out here.

Hoping to see some follicles tomorrow....

See? This is what I am afraid of

My LH yesterday was 1.6.



To me, that is high.



All the articles I've read talk about supplementing with LH if LH is under 1. If it is over 1.5 then maybe supplemental LH is detrimental.

I will admit: I did not take my menopur this morning like they wanted. I wanted to see my LH level and I figured a few hours wasn't going to really matter.

But now the problem is getting to talk to the doctor, through the nurses, who seem to not really understand my concerns. I sent an email directly to the doctor but I doubt she'll see it/get it any time soon.

This is my last shot and I am so scared to mess it up. I'm trying to trust both my instincts, the research, and the doctors recommendations, which seems nearly impossible to do all at the same time right now.

SIGH.

Already with the drama!

What's an IVF cycle without drama?

So my E2 was only 72. After two days of stims. Personally, I wasn't too surprised or worried. My first two local cycles I had slow to rise E2 that then rocketed up. And 72 after two days of stims is higher than those cycles after 3-4 days of stims.

But CCR.M. did not agree.

When they called, they said "Your doctor really wants you to add Menopur tonight....(awkward pause)...but it's up to you."

Oh dear.

You see, I had raised some issues with Menopur. Mostly because on cycles 3 and 4 my fert rates went to hell and those were my two Menopur cycles. So I was kind of scared of Menopur. I had read research that said to measure endogenous LH and only add it if someone is really suppressed, otherwise, it can funk up the eggs.

So on today's lab, guess what test couldn't be done in one day? Of course. LH.

So they had my E2 and my P4 but no LH.

I squeaked out: "Can't we just wait and see what the LH is tomorrow and then decide? After all, you normally wouldn't have even had any results after only two days of stims..."

They reaffirmed that she wants to add it.

I hung up.

And then panicked. And then paged them back. They were clearly annoyed.

Then they said: "The E2 is really low. And that's not good. So she wants you to add it."

So I did. Gulp.

It's done now.

I know my body. My E2 will take off. The follicles will grow. I just don't want to wind up in a situation like last time where I coasted repeatedly. If I get the LH number tomorrow and it's not suppressed I'm going to be a little upset.

Any thoughts?

First monitoring appointment...sort of

So I went in this morning for my first monitoring.

After only two days of stims.

Oh well...didn't show much.

I'm trying not to be disappointed, to remember that it is only two days of stims.

It's an ob/gyn, not an RE, so he looked around and said that he saw some clusters of very small follicles and a few measurable ones.

Reassure me?

Last IVF I went in after three days of stims on microdose lupron flare and there were 21 follicles already! And my E2 was 2600.

Well we all know how that cycle tanked.

I definitely know I stimmed too hard last time and I don't want that this time, but I don't want to stim too slowly either....

This is always so hard because with me, it's always something.

Sigh.

EDIT TO ADD: My E2 was 2600 after FOUR days of stims, not three on the last one. Still way too high. But at least I'm not so behind.

My E2 today was only 79...at least higher than at suppression, right??

Hooray!

Well, I'm one day off but I am cleared to start stims tonight. Holy cow, how did I get here??

There was so much drama with AF. I swear. But by Friday late afternoon she arrived. But then my nurse said that they only would count that as day 1 if it had started before 4 pm. Grrrrr. But then she said that if I could get my bloodwork done on Sunday morning and it was fine for suppression, then I could start up stims Sunday night. I asked if that was written in my chart so the weekend nurses would understand and she said yes. Foreshadowing....

Some time early afternoon on Saturday I spoke with on of the other nurses and she said "well why don't you just get your bloodwork done now and start stims tomorrow?" So I got all excited and started on a quest to find a lab. Hello. There are no labs that would do my bloodwork on a Saturday afternoon.

I had the brilliant idea to call Houston IVF, which is the sister clinic to CC.R.M. The very nice on call nurse said for me just to show up super early on Sunday and they'd draw the labs, handle the exchange of info, etc. I was actually glad to have a real IVF clinic handling it all rather than a lab, so I was happy.

Mr. LastChance and I got up at the crack of dawn to drive to said sister-clinic, which was way across town from where we were staying, and naturally in the opposite direction of the hospital where I would be spending the rest of Sunday, but what are you gonna do, right? We arrived at 7:30 on the dot. In the end, here's a quick rundown:

--it took 1.5 hours for me to get my blood drawn because--for the love of Gawd--they had to enter me as a new patient and they needed some stupid code that no one knew because it was the weekend.

--it cost $255 for the bloodwork. Why am I surprised?

--there was a woman in the waiting room who came in with her three little boys under the age of 4. Why the F was she at an infertility clinic? For the record, they all called her "Mom" and they were horribly behaved.

--because I was panicking over how long things were taking and how I was supposed to be at the hospital taking care of someone very important to me, I started crying. You know--the whole stress of it all just came tumbling down around me. The lab tech started hugging me and praying over me and that just made me cry harder. Then the nurse who'd helped me get everything set up started hugging me and saying she was praying for me, etc. I started blubbering about how it was my fifth and last chance at IVF and generally made an ass of myself.

Geez, if this is how I am now--pre-stims--imagine me in a few days!

--CC.R.M. weekend nurse called and left a message on my cell saying: "We got your labs and they're perfect. So start stims Monday night!" Click.

Luckily I just had to call her back and told her about my Sunday night plans and she said, "Well, if that's what your nurse said then go ahead." Yeah, no problemo there.


So ladies in the know: what are the odds CC.R.M. will let me just keep my original flight (Wednesday) and get my first stim check there, which will be after four days of stims instead of the usual three? You know, because of my stinkin' clinic schedule at my work, that would make life one million times easier...

But halleluiah--I'm starting those stims tonight. Give me that massive dose of Gonal plus some growth hormone--I'm ready.

GULP.

Florence Jean Castelberry

Make that, aunt Florence Jean Castleberry.

Warning: TMI ahead.

I went and had my ultrasound. Yay no cysts!

But even better, before he did the ultrasound he used the speculum (that is NOT the better part, believe you me), but he spotted some fluid. I always spot before full flow. I'll leave it at that....but surely AF is on her way. He said my lining was supremely thick so it needed to come out.

I am not using my old RE for my local monitoring this go-around. I guess I felt like a double-failure going back. It was awkward enough the first go-around, like I was saying "You guys couldn't fix me so I'm going somewhere who can, and by the way I need you guys to help me out too." They were nice enough, but it was all perfunctory.

So I didn't really want to admit failure with fancy clinic to my old RE either. I know--pathetic eh? It just reinforces the fact that in my brain, I still feel like my reproductive failure is somehow my own personal fault or something. I need to work on that.

So instead my ob/gyn is doing the monitoring. He is so unbelievably nice. He was so sympathetic and just talked to me for fifteen minutes before the exam this morning. He and his wife had to do IVF so he at least gets it. I really feel like he's part of the team. All he wants is to be able to deliver my baby one day.

And then, he only charged me $40 for the exam and visit. Compare that to the $180-190 for my old RE's office for a vaginal ultrasound.

I love this man.

So... I talked to my nurse. She said that the "days of the week" rule is, in fact, a rule, but it's flexible. Her words were "You have enough to worry about, let us worry about everything else." It sounds good in theory, and her words were appreciated, but she should tell that to back-up nurse who freaked me the hell out yesterday with the possibility of a one-week delay. Don't they know us IFers (especially those on their fifth cycle) are basically teetering on the brink at all times and it doesn't take much to push us right on over?

So I'm heading out of town this afternoon/evening. It's a trip I need to take, to visit someone who I need to see. If AF shows up in full red force today, I'll find a lab in Houston to do my bloodwork tomorrow morning and they might let me start stims tomorrow night. Otherwise, I'm thinking Sunday.

I'm feeling much less depressed now, which is why you got treated to two posts in one day :)

Yeah, what a treat, right?

Depressed

Today I'm just depressed.

Plain and simple.

It is times like these that I am left wondering what the hell I did? Why does everything related to creating a family have to be so hard for us?

I look around and see families everywhere. True, some of them may have struggled to get there, but the vast majority did not. I know the statistics. I think I fall into somewhere around 0.05% of the population in terms of fertility issues.

Everything is hard for us related to this. I try to look on the bright side and realize that in many other areas of our lives everything is easy. We have good jobs, we have a home, we have food to eat. Yay!

But sometimes it doesn't make up for the 100K we're spending, the waiting, the feelings of being passed by, the feelings of utter hopelessness, the chaos, the feelings of body betrayal...you name it, we feel it.

Mr. LastChance calls it "being kicked in the teeth repeatedly." So he's not at all surprised that AF is this late, and possibly ruining everything. He expects nothing less, really.

And then there's me, the stupid eternal optimist, always hoping, always wishing. But we still keep getting kicked in the teeth.

I'm about to go for my suppression check. Yeah, I figured I'd keep the appointment. I'm going out of town tonight for something very important. If I end up needing bloodwork I'll have to punt and find some lab willing to do stat levels AND fax the results to my RE.

The fun never ends, eh?

F'ed

I'm feeling rather f'ed right now.

No AF.

I talked to my back up nurse today. She was all "well it's because you were on prometrium that it's taking so long." Then why the hell did they put me on it? I took the last one Sunday night. I guess I thought that would cause a rather abrupt drop in my P4 levels and AF would come on, in spite of the lupron. 'Fraid not.

Not to mention I've been using Prometrium for the last 4 or 5 months to help with my lining issues...and still always have a 26-27 day cycle at the longest. So now THIS??

I went to acupuncture. Drank some awful herbal tea he prescribed. Nothing.

Today I found out that emmenagogues are supposed to help bring on AF by softening the cervix amongst other things...the two the brilliant internet recommended were ginger and parsley. So I made the tea, and guzzled it. I'm now nauseous. We'll see.

And when did my clinic start a RULE that you can't start stims except on certain days of the week? WTF? So if things don't start happening soon, I'll be delayed by over a week. And that, folks, will mean I'm out.

There is simply no way I can get that time off from work again. All those patients they rescheduled already once...well they're not going to reschedule them again.

I went jogging. I wore white. I went to work today with no AF armour just so I'd be caught unawares.

NOTHING IS WORKING.

So I've been sitting around crying, yelling, and basically having a tantrum.

I have worked so hard for this cycle. No sugar for over two months. Massive amounts of healthy food, good protein. I secured all my meds. I found good flights. I got all that time off.

And now, yet again, my body is failing and f'ing me over.

I'm sick of this.

ARGH

No AF yet.
Sigh.

I don't know when the last possible day she can show up and I can still start stims THIS Saturday.

I know you're supposed to remain flexible through this process, but the way I had to work my work schedule--they had to reschedule 28 patients already to accomodate these dates (my schedule books out ahead of time) and I will be SO MAD if I am stuck with no work/no patients and am here, rather than there. Not to mention the flights, some family matters I really need to attend to out of town (which will then screw up my local monitoring if it gets pushed back)...the list goes on and on. Keeping an IVF secret also makes schedule snafus extremely hard. Do you think if I bitch and moan enough that will bring AF on? 'Cause I'm giving it my level best here.

I wonder if my acupuncturist can do anything to bring her on? I'm desperate people.

I hate Lupron.

Waiting...

So right now I'm just going to be waiting. Waiting on good old AF to appear.

They didn't put me on BCPs this go around, but I am taking prometrium every night on the recommendation of my RE...she hoped it would help with the hyperplasia. So I am so hopeful that after I take my last one, the sudden drop in progesterone will bring on AF. But then there's that damn lupron effect. All we can do is wait and see. Plane tickets are bought, but can be moved. The biggest issue is my work. Since I'm remaining anonymous I won't go any further, but suffice it to say that schedule changes at my work can be tricky.

Mr. LastChance isn't rushing right out with me this time due to his work. I'm actually going alone and this freaks me out. I guess we're really codependent. I can admit that. Whatever. I wish he could go with me, help me get through the airport with meds, help me pick up the rental car, etc. etc. but he'll join me soon enough. He is an important part of the picture, after all.

Those of you who have gone recently and used Price.li.ne...how soon? Am I already too late? Send me an email at lastchanceivf@gmail.com and give me the scoop. The cheaper we can do this, the better. I haven't got a rental car OR hotel yet...because I didn't want to prematurely book and then have AF screw me. After all, AF has been screwing me for years so why would she decide to be nicey-nice and cooperate now?

What a boring post! It's weird trying to be completely anonymous. I can't post fun pics of the weekend, mention anything else personal, etc. Oh well. Maybe blogging isn't really that fun when it's anonymous. I thought it would be more freeing.

But you guys know me...I'm sure I'll start unleashing soon enough!

The games have begun!

Well, I took my first lupron shot today anyway.

I took it in the morning, then received an email from my nurse that I am to take it in the evening.

Chalk that up to one more thing different than the previous four IVFs...I was always a 'lupron in the AM' kind of gal. Mr. LastChance and I would sing a stupid song about "doing the Lupron dance" at 6 am on the dot.

I decided to do my initial monitoring with my regular gyn rather than my old RE. I just don't want to deal with my old RE anymore. My gyn is awesome--he talked to me on the phone and kept saying over and over "anything you need, just tell me!" What I need is him to see no cysts next week and then to see a picture-perfect early stim response the week after. Sigh. He's no miracle worker. I just want everything to keep on schedule--is that so wrong?

Strangely, this time, aside from a teeny bit of anxiety, I'm much more relaxed. I told Mr. LastChance today that I just want to get out there, get it done, and get back. Like a business trip you know you have coming up that could be exciting, could be something great, but really, you just want to get it behind you.

Yup, that's me.

Not to say we're not excited--we are. I promise. It's good to be doing something again.

But I can unequivocally say that this is it, hence the blog title. I cannot do this anymore. I am at the end of the fertility treatment road. I know I have said that before but this time, I feel so differently. They always said when you were done you'd know.

And for once, that doesn't frighten me. It feels okay. Even if the outcome isn't what we want.

Who knew?

The skinny

Obviously we wouldn't go into this, our last foray into IVF, without demanding some major changes.

The past six months have involved a LOT of research on my part. I am lucky to have full access to almost any medical journal, and believe me, I have been a'readin' and a researchin'. My RE and I have been emailing back and forth, faxing journal articles to each other, etc. etc.

I figure you might want the skinny on the changes, so here goes:

Back to long lupron but no BCPs. I've done this protocol before and had the best embryos from it (though obviously it didn't work, duh) but was possibly oversuppressed on BCPs. So out with 'em.

I'm only adding menopur if my endogenous levels of LH are below a certain level. And even then, we'll add later rather than sooner.

Growth hormone. Controversial? Sure. But why not? I'm already looking forward to feeling like the Incredible Hulk.

A freeze-all cycle. My lining has issues...namely, endometrial hyperplasia. Which, in case you didn't know, is exacerbated but unopposed estrogen. Gee, guess who has soaring unopposed estrogen levels during all her previous transfers? Oh yeah, that would be me. So we'll freeze whatever we get, go home, have a cycle, do a D&C (scrraaaaaaaape), and then go back for a transfer. More to come on what stage we'll be freezing...still some debate on that.

High protein diet. It turns out my RE believes vegetarians do worse on IVF. Who knew? Oh wait, I'd been told this before but just figured I was getting enough plant protein. Turns out I was pitifully under-proteined. So now I'm bulking up on whey protein drinks daily, in addition to beans, peanut butter, eggs (every now and again), couscous, etc. My intake is anywhere from 65-90 grams per day.

No sugar. EGADS. Let me type that again: no sugar. This has been tough, especially because of my hobbies. My RE recommended cutting out all sweets/refined sugar (though not carbs thank GAWD) for two months prior to the cycle. I've made a couple of interesting desserts with agave nectar (which is all natural and doesn't cause the blood sugar/insulin spike that refined white sugar causes) but mostly, I just gave up desserts cold turkey. And discovered that bananas are really sweet and make a delicious dessert! Can you overdose on bananas? I am feeling like a monkey many days.

Acupuncture. I started this after our last failure with the stupid hope that the Eastern way would cure me. Sadly, no natural pregnancy ensued, but my RE feels that I should definitely continue the acupuncture and the herbs. I am going weekly now.

Supplements: nothing super new here, but I'm doing the following: royal jelly, Larginine, CoQ10, omega 3 FAs, melatonin, and of course folate.

Don't think Mr. LastChance has been left out. He's still on mega antioxidants but this go 'round they'll use MICSI instead of plain ole ICSI...meaning they'll magnify his sperm 600,000 times (YIKES) to look for some tell-tale craters in the head (ewwww) and weed those guys OUT.

So this was a technical post, I'm sorry. I know it's boring. But it is what it is.

And yeah, even though we're going into this with a totally different attitude than ever before (for real, ya'll!) I'm starting to get just a wee little teensy tiny bit anxious. I mean, what the hell are we doing? Are we certifiable? Nuts? Just looking for a way to waste 20K fast?

I'm not sure, I'm really not.

But our flights are booked...two weeks from THIS Wednesday. Egads.

Wheeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee!

IVF, take 5

How did we get here?

Scratch that. It really doesn't even matter anymore. The fact is, here we are.

I'll use this to anonymously chronicle this journey--our very last chance with IVF. I won't use my real name or any other identifying information. I won't post pictures. This blog must remain anonymous, so do not share it with anyone who will "bust me." I just can't take that. If you know who I am in real life, keep it under wraps. Please. If you comment and use my real name or something else identifiable, I'll delete it. Geez I sound like a real biyatch don't I? Sorry. Those of you who struggle with IF, who struggle with how long to keep going down this road, who struggle with explaining yourself, justifying your reasons for continuing this pursuit even when the odds aren't great--well, you get why I have to stay quiet on the home front.

I just need this place so much. You all know why.

Support is essential.

More to come. Of this, you can be sure!