The plans.

OK, another swell conversation with Dr. M. That is said without any sarcasm, I promise.

She started off reading me my embryo report again. At first I freaked--she said "8 cell 3+, 6 cell 3+, 4 cell 3+" and I was like: WTF happened to the other 8 cell, and the other 7 cells...but then she just wasn't finished. I stopped hyperventilating and let her keep going. She was just reading them in the order in which they're numbered. I guess I have PTSD regarding embryology reports or something...

I'll just hit he high points. She said her 'gut feeling' is to transfer the top four.

Which is pretty much what I expected. Now, I'd love to be that girl for whom they say: "Oh no! Only two! Your embryos are so beautiful we wouldn't want to risk any high order multiples." But alas, I'm not that girl. But she did reiterate that these are considered "good quality embryos." I made sure she double checked the name on the report, as the words "good quality" are rarely associated with any of my embryos.

She talked briefly about trying to culture them further, but we both agreed that it took a damn near miracle to get me this far so we wouldn't do that. I asked her if she really believes that some women who get pregnant with day 3 embryos might not have been able to get those same embryos to blast in culture. She said absolutely. Even with one of the best labs in the world. I told her that it's hard to be going to CC.R.M. and not doing CGH normal blast transfer and she chuckled. She said that a couple of years ago they tried to push everyone to blast and sometimes women would have nothing to transfer. But those same women would come back and do day 3s and succeed--and deliver genetically normal children. Whatddayaknow? So I felt better. A smidgen anyways.

This month is just a 'rest' month. Rest and chart my ovulation, email her all the specifics, and she'll work on a calendar for my biopsies and transfer. Then she asked if I really wanted to possibly do a transfer in November or December, depending on what happened.

Because of the holidays.

She said she would never want me to associate the holidays with a bad outcome, if indeed this didn't work.

Hahahahahahahahahhahahahahahahhahahahahaha!

Ok sorry. I'm back. I told her that with four 'bad transfers' behind us we've pretty much covered all the seasons/holidays! Really. Not something I'm particularly worried about. However, you all have permission to gently remind me of that if this goes belly up and I'm bitching about Thanksgiving and Christmas :)

I don't have to get another hysteroscopy or another HSG--apparently the one I had done a few months ago (HSG) is sufficient. Surprised me, honestly. She won't do Lupron and she'll barely have me on any estrogen at all...she does not want to chance me getting too thick (in the lining department, not the skull--too late there). There was something in the conversation about forcing ovulation with a trigger to time things easier but honestly I couldn't keep up.

We joked around about risks of transferring four. I told her if we had a major success she could write a paper about me--not that you ever want to be the subject of a medical journal article. She also told me to just email her directly, not go through my nurse because--wait for it!--she's out on maternity leave. Gag. Oh wait--other people are allowed to reproduce. I forget sometimes.

So that's the haps. I guess my blog will be pretty boring...in terms of what we're up to IF wise. You know I'll still be writing and ranting and baking and eating and running and volunteering and hanging out with friends and watching TV and just living life and probably blogging about all of that too.

All in all, a good conversation. I'm comfortable with the plans. We're on the same page...me, Dr. M., Mr. LastChance, and the embryos.

Oh yeah--if you get a chance, stop by my old stomping ground because there's some fun stuff there, too--you won't be disappointed.

EDIT: She did mention the swine flu. She said they are trying to get the vaccine and she had just read a report that it was being recommended for pregnant women in all trimesters. She also said that if I could get it before the FET that would be good. So we'll see.

Bellyaching...

Mr. LastChance and I just finished watching Project Runway. It's one of our guilty pleasures and it has been a long time waiting for this season to finally get going.

Tonight the challenge was a new one--design a maternity look for Rebecca Romijn.

sigh.

When I was little I used to play 'pregnant' and put a pillow under my shirt. When Mr. LastChance and I started trying and knew a pregnancy was justaroundthecorner I would sometimes show him what I'd look like by doing the same thing--and he would always grab me and say how adorable I was going to look.

sigh again.

I've been told before that pregnancy isn't necessarily fun...that the body changes in ways that are kind of gross and unattractive, and that things are never the same. I've witnessed this up close and personal. I can grasp that concept intellectually. But it doesn't mean I don't want my chance. I happen to think that a healthy pregnant woman is beautiful. I want to be that healthy pregnant woman.

When I watch things like tonight's episode of PR and see all those pregnant bellies (which were really ridiculous looking by the way--stick skinny models with a fake gigantic belly sticking straight out) I am reminded of how normal it is to assume you will get to have this experience. All the judges were females and they all laughed and told the contestants that they had all been pregnant so they really knew what they were talking about! It was said so naturally, so lightly, but it stung me.

It doesn't matter that we have other options to consider that we're excited about. Options that don't involve a pregnant belly of my own.

It doesn't take away from my longing for that. It doesn't take away that bellyache.

Please please please don't let next week's challenge be designing some designer newborn duds or matching Mommy and me outfits--or Mr. LastChance and I will have to find another guilty pleasure!

Up tomorrow: my first consult with Dr. M about the upcoming transfer. I've got my articles ready, my list of questions written out....does anyone have any thoughts on the swine flu?

Can I get some rest around here?

So the dreams have started.

Two nights ago and I had the most wonderful, glorious dream. I was pregnant.

Now some of my happiest moments over the past four plus years have been in my dreams. Literally. I've had so many incredibly realistic 'positive pregnancy test moment' dreams, 'big belly dreams', 'delivery room dreams'...the list goes on and on.

But two nights ago, I dreamed about transferring those little embryos and having them actually stay around. I dreamed about seeing my ob/gyn (the super sweet man who didn't charge me for my ultrasounds before going to CC.R.M.) and giving him a huge hug in celebration and telling him I would finally, finally be his patient for a pregnancy and delivery.

I woke up in total bliss.

Last night I had the opposite dream.

I dreamed we got the negative call. I've endured four of those "I'm sorry your beta is less than two. Stop all meds. Your period should start soon. I'm sorry your IVF failed...AGAIN" calls.

And in the dream I remember thinking about those embryos and how I was so shocked that none of them decided to stick around.

When I woke up I was in a total panic. I was all sweaty and dissheveled, the sheets all twisted around me. And then as I came to I exhaled when I remembered: yay, we haven't had a transfer yet! We still have embies!

I need good sleep. I need good rest. I cannot endure back and forth dreams until we get to transfer and either the dream or nightmare comes true.

I guess I'm surprised about this go-around. I went in with such a different attitude. An almost blase attitude...you know, if it works it works, if it doesn't it doesn't. Finito. Done. Never have to do another fertility treatment again.

But damn, I guess I really really want this to work.

I wonder what tonight's slumber will bring?

Fear

It was bound to happen.

First hope came crawling back, begging for a second chance.

Now I find fear clawing at my back door again, desperate to get in.

Damn emotions.

I've been thinking about our embryos. Six normal looking embryos. More than we've ever had. Good stuff for us.

But vitrified on day 3.

Not grown to blast. Not biopsied and sent for super high tech genetic testing.

Just plain vanilla day 3 embies.

Should we have pushed? Should we have chosen to do genetic testing?

I don't know, I don't know.

I've been reading blogs like crazy--blogs I've never ever read before. I keep 'happening' upon stories of successful day 3 transfers. Which then leads to me thinking: "Ok, day 3s can work." I know some beautiful day 3 transfer babies in real life, for God's sake--I know they can work. But being in the world that is CC.R.M. puts me around a lot of ladies doing CGH blast transfers. I feel like I'm out of my league completely.

So then fear starts creeping in. Why would it work for me?

And then the complete opposite--if we transfer four, what happens if three take?

At which point I usually start laughing manically in my head (not out, loud, I'm not that crazy.....yet) thinking: our odds are low that only one would take, why in the f would I be worried about multiples?

At which point maniacal self starts doing that whole "wouldn't it be just like us to just want plain vanilla and wind up with wild triple fudge ripple stripe with nuts and cherries and whipped cream?"

I think I'm cracking up and I know I'm rambling here.

On a different note, I'm still full-on sugar. I can't help it. It's been such an overwhelmingly good feeling to know I can at least eat what I want for this week or so without feeling guilt or panic that I've just ruined my egg quality. Plus all this back and forth arguing in my own brain tends to bring out some stress eating...

oh the joys of the last chance ivf!

What in the world?

What in the world is this feeling?

This feeling of--'hey, everything didn't go to crap'.

Yes yes yes, I know that we're not celebrating an actual pregnancy, an actual implantation of an embryo. I know--full well--that we're still not even at the starting line and that when looking ahead at our lane, we have more hurdles than most.

But usually--at this point--some type of devastation has ensued.

Let's recap:
IVF #1: Oh how naive and stupid I was! I really thought all you had to do was IVF and you'd be pregnant. I resented doing IVF but I still embraced it. At ER we had 11 eggs. When my RE called to tell me that only 6 were mature I was disappointed; but 5 fertilized. When we went to transfer and we only had two that were even on-target we figured: oh well, none to freeze but what can you do? We've got two! We'll probably get twins.

OK, so I lied--there was no early devastation, IVF #1 was more or less about blindly stumbling along, not really undertanding the process, and just believing that--above all else--it would work. The devastation only came at the end with the BFN.

IVF #2: 15 eggs retrieved. We danced around the house, guessing how many embryos we'd have (we both guessed 10!) and couldn't wait to get that fert report. That's when devastation ensued: only 6 were mature again, and 4 fertilized. We again had two that were transfer worthy. BFN. Rinse, lather, repeat.

IVF #3: We were grizzled and weathered, but still, expecting it to f'ing work. Nine eggs retrieved. Devastation number one--including hideous sobbing in the recovery room because they had been counting on at least 14 and I knew--finally--that for us it was such a numbers game. The embryologist called me at home later to say that 8 of the 9 were mature so we suddenly felt 'back in the game'--but it was short-lived. The next day's call the nurse said: "Only one fertilized...but believe me, some women would be happy with that." I kid you not. Maybe some women would be happy, but we were most decidedly not happy. I swore I was through with IVF, I was through with REs, I was through. Amazingly there was a little 6 cell not-great embryo to transfer. Something felt eerily familiar.

IVF #4: Our first with CC.R.M. I've got a little confession to make: we had dusted ourselves off and knew this was the place. It was going to work. It had to. They were the mecca and we were paying mightily for their services. 20 eggs were retrieved! No devastation--instead that ill-fated Target trip where we lovingly fingered baby clothes! The doctor telling us to be ready for a day 5 transfer with leftovers to freeze! My oh my was that a fun 24 hours! The fert report: 12 mature, 2 fertilized. More hideous sobbing in public. Truly, devastation. One good embryo plus one more thrown in the mix were transferred.

So yesterday morning, when I woke up and came out of the sleep-induced fog, I waited. Waited for the flood of the horrible freeze-report to wash over me and remind me that we really don't have a chance in hell for a biological child.

But it didn't.

For once it didn't.

And while I didn't get up and do any dances around the house--maybe if we'd had eight 8-celled grade 4 embryos?--I did allow myself to smile.

And hope.

And at least--for now--until we get to transfer and see these little guys all the way through to the end--I feel some peace.

So Mr. LastChance and I decided to ride this wave all the way to the shore, because why not?

PS. The blizzard was divine. As expected. I also baked a dozen chocolate croissants yesterday. But honestly--I think I'm going back to the no sugar me pretty soon...
Again, let me say: what in the world??

I'm exhaling.

I've been running around all morning with my cell phone and home phone attached to me. If they rang my heart lurched.

Dr. M just called--she had the report.

It's the best we've ever had!

So 6 will be vitrified. Oh GAWD, I forgot to re-confirm vitrification...but I know we discussed this and would they even slow freeze anything anymore??

At any rate, I forgot to tell you that we found out one of the late-ICSI's fertilized which gave us seven total, and 6 were still dividing today. For us, that's huge.

Now, none of them made the 4 grade. Boo. But, they were all 3+ which Dr. M assured me was still considered "good and strong." Less than 15% fragmentation with nice even cells. CC.R.M. are tough graders, too. I did some quick Medline research and found that truly less than 15% fragmentation isn't considered significant...and I need to just let it go anyway.

We had:
2 8 cell
2 7 cell (although one of these is the late ICSI so to me that means it's 'ahead' and I don't know if that's good)
1 6 cell
1 4 cell.

OK--we'll take it!

And yes I know that many of you have had stellar day 3 reports and then not many blasts...I know this. I know the 4 cell is behind. But for us, this is good. It's all we have and we're happy.

Dr. M said that our real question will be: how many to thaw and transfer? I can tell you my gut response: the top 4. I really don't want to drag this out.

We also briefly discussed the endometrial biopsies which we'll definitely be doing instead of the D&C.

But one step at a time.

Tonight Mr. LastChance and I are going to volunteer at the downtown homeless shelter where we're regulars (volunteers, not guests, although with all our IVF expenses...). We haven't been in two months because of everything going on in our lives.

Tonight we will serve with more gratitude in our hearts than usual.

I know these embryos have a chance. I know it's small, but they have a chance.

Our last chance.

EDIT/UPDATE:
John, the head embryologist just called. He's the guy who did half of our ICSI...as he said, because he knew our history and wanted to give us as much help as possible. In fact, he said, and I quote: "We did everything we could think of."

Which begs the question--why not do everything EVERY SINGLE TIME? But I digress.

He clarified that there weren't two late-ICSI, there were just two that initially didn't seem like they had fertilized but clearly had when they checked today. One was 7 cell 3+ and the other was a little 4-cell 3, the worst one.

So really, from the initial 8 that fertilized we had:
2 8 cells
3 7 cells
1 6 cell
2 4 cells.

He said that 3+ is still considered "good quality" (his words). He also said that fragmentation in the range of <15% doesn't affect implantation. Which is what I read in some journal articles...once it gets over 20-25%, and particularly over 35% is when they see major differences in implantation rates.

I thanked him for all his help and breathed out again. When I saw that CC.R.M. number come up I thought for sure they'd given us the wrong results or something.

I'm going to eat a huge freakin' M&M blizzard tomorrow--you know, since I gave up sugar for those little eggies!

Well, the good news had to end sometime, right?

It is, after all, Mr. LastChance and I.

So the embryologist left their message. 26 retrieved, 18 mature, 6 fertilized normally.

From 18 to 6--pretty sad eh?

But you know what? I didn't even cry. I told you I had a better attitude this go around.

Two more matured and they ICSId them today, so we'll see how those look tomorrow.

Here's the kicker: after five IVFs, that's the MOST embryos we've ever had from one cycle. So see? It's not all bad.

And if two or three of those grow into good embryos we'll be happy.

I waited this long to post because Dr. M said she'd call tonight to touch base. No call so far, and it's now 8 pm CC.R.M. time. Hmmmmmm...another poor fert report and she doesn't call? Just kidding. She's been more than available to us this go around. And really, what can she add at this point?

All I can hope is that this time, the eggs looked better, so maybe we'll have better embryos. And maybe we'll transfer them into a more hospitable uterus, one that isn't hyperplasic with unopposed estrogen, one that's been roughed up a wee bit by an endometrial biopsy or two.

You don't have to blow sunshine...I'm really ok. Mr. LastChance cheered and said: "It's three times as many as we had last time!"

This is why I love him.

So it didn't turn out to be a miracle cycle, but it is far from over.

I couldn't wait!

Last night when we landed I saw I had a VM.

It was Dr. M.

She had already talked to the embryologist--and 18-19 were mature! These are stellar maturity rates for US.

She also said the eggs looked "much better" and the polar bodies were not fragmented. Last go-around our polar bodies were all fragmented--some severely. While there is mixed data on what this indicates it isn't normal and who wants fragmented polar bodies? Not us.

As she said on the phone, it is one hurdle and we still have many to go. We've had a bad fertilization report when the eggs were mature in the past (on IVF #3 and 4, but 4 was the one with the ugly polar bodies) but our first two IVFs, almost all of the mature eggs fertilized...so here's hoping.

That's the phone call we get today.

It was so nice of her to call and leave us that message! She herself sounded relieved, if not a teeny bit excited.

They let some (maybe all?) of the eggs sit in culture for a couple of extra hours to help...of course I googled this last night, exhausted as I was, and it kind of freaked me out because it is usually better to ICSI/IMSI sooner rather than later...but again I'm trusting their noggins.

I'm back at work. Exhausted, sore, swollen (that's what 2+ liters of IV fluid will do to you) but back.

Stupid dog love--especially when you've been away nearly two weeks--is the best.

More to come....

The report..

I can't even be clever in titling because I'm using the ten minutes I have before boarding our return flight to post.

26 eggs.

Jill, you were this.close with your guess!

Of course, we've crashed and burned on fert reports so we're just cautiously optimistic. Happy there is a decent number with which to start.

The embryologist was really nice. He told us our egg number and then said: "Well, it looks like we're pulling out all the stops. MICSI and plus two embryologists are going to work together on your case. We've got a couple of other ideas to help with the maturity/fertilization issues."

We'll take all the help we can get.

I made it out to CC.R.M. at 2:45 and caught the Super Shuttle at 3:25 at our hotel. I was sore but I made it.

I've eaten a lot of junk because--the eggs are out! The eggs are out! I'm so glad to have them OUT OF ME. Phoebe would be so disappointed in my diet this afternoon but I promise to get right back to it pronto pronto. But a girl needs a little indulgence after this crazy ride.

I also had the extreme pleasure of meeting one of my blog followers and fellow CC.R.Mers yesterday--and she was all the way from Ireland! It was awesome and I'm wishing her only the best of luck!

OK. I haven't had any sweets yet--but a ChickFilA brownie has my name all over it...saving it for the plane.

Thanks ladies, for all the love and support, I really really mean that.

A celebration of many 'lasts!'

Mr. LastChance and I celebrated the fact that he administered, and my keister received, the last trigger shot of our lives.

We almost celebrated at 1:16 am the other night but held off because--yup--we did a booster trigger yesterday just to 'do something different' (my RE's words.). Estrogen stayed at 6700 or so because Antagon took it down and then the trigger took it right back up.

Anyhow.

While waiting for our shuttle bus to take us to our fourth hotel (ridiculous, I know, but we managed to never pay over $40 bucks a night at nice hotels via Price.line--thanks Jill!!) we were soaking up the beautiful Colorado weather and sunshine and reflecting on this journey.

Not just this journey--this wild ride that thus far has encompassed IVF #5--but the whole bloody, grizzled, four+ year journey that has seen us seeking that blasted second line.

If anyone had seen us from the outside they would have imagined we were just a couple talking about something happy and light. We were holding hands, we were laughing--we were, in fact, being happy and light. Even while discussing the fact that this journey has separated us from 90% of the world, and that in so many ways when we're around our fertile friends and their beautiful children or just out in the world, we feel at odds, we feel different. We feel separated by this invisible chasm that runs so deep and wide no one who has not been on this side will ever, ever, understand it.

Different, that's us. But then again, we always wanted to be different. Be careful what you wish for.

But we weren't crying or screaming or pitching a fit while we were talking.

It's that relief. That sheer exhilarating relief of knowing we will never be in the midst of this again.

We reveled in the fact that, for the most part, we've always been on the exact same page regarding treatment. There has never been a time when one of us has said yes and the other has said no. There's never been a time when one of us has wanted to stop and the other has wanted to push forward.

We can, at least, be thankful for that.

But really, for so much more.

I guess it's true of so many struggles in life--if you have a good, solid partner in life you hunker down together, hands, hearts and souls united, and emerge on the other side a stronger unit. I know that's the case for us. Some days I'm not sure how we got so lucky in that regard.

Lucky? Did I just use the word 'lucky' related to our infertility struggle?

By God, I did.

And now I'm tearing up because we are almost there.

Please God, please please please let there be some good eggs (we'll take even just one!) in my ovaries today. Please let them fertilize...please let us be, for once, not different. Just normal. Just plain vanilla regular no sprinkles on top normal.

Please.

Triggering, but not without drama!

I'm writing this down to record all of this...you know, for the book.

So after waiting around for hours and hours and paging the nurse they finally called with my trigger time.

3:30 AM.

Um, I don't think so.

That would put our retrieval at 2:30 pm on Tuesday, when we were supposed to be on the last flight out at 7:15, leaving our hotel on the SuperShuttle at 3:15.

I started babbling to the nurse about how that wouldn't work and she told me that "everyone had a sob story about why they needed their retrieval at a certain time."

Oh really? Is everyone doing a freeze-all and leaving right away? Dr. M knew we were flying out the same day and said that while it wasn't highly recommended, people do it all the time. She knew we needed the earliest retrieval possible.

Then the nurse said that they had nine retrievals for Tuesday, so they were just really really busy. And she'd already called everyone else with their trigger times and retrieval times, so I guess we were dead last on the list.

OK. It's not my fault they're a huge clinic and accept so many patients cycling at the same time that they have nine retrievals on one day. Not my fault. And it was ridiculous to think that they couldn't get to us in the morning.

I asked if I could talk to Dr. M myself and see if we could figure something out. She said "She doesn't have a magic wand regarding scheduling." Hpmph. Maybe not, but I can guarantee she'd try to run interference for me.

Geez this nurse was on my nerves! In the background Mr. LastChance was going ape-shit crazy because we were both seeing all our hard work at rescheduling our own jobs, at re-doing flights, re-doing SuperShuttles, re-doing everything just going down the toilet.

Finally the nurse said she would call another patient back and see if we could switch. Which apparently wasn't that hard as she called back ten minutes later and said "Would a 12:15 retrieval work?" We jumped on it.

So yeah, I'm going to be out of CC.R.M. at 2:15 to catch at 3:15 SuperShuttle to catch at 7:15 flight. I know we can do it.

But ummmm, the estrogen was 6723. I've never had it this high at trigger before. EVER.

And suddenly I have visions of OHSS swirling around in my brain--you know, because I cannot.be.sick.this.week. with work.

They're still giving me the full dose of HCG. When we asked about the booster (although with an E2 like that I seriously doubt it) the nurse backpeddled and acted like she didn't know anything about that...which to me means she didn't talk to Dr. M specifically about my case. Because I know full well Dr. M would have mentioned it, whether we were doing it or not.

So she said she'll call Dr. M and call us back. Ummmm, yeah you will. We still haven't heard.

So...aside from eating salty food and drinking Gatorade (though I need to find something like that with no sugar in it) what else? No exercise, I've read. No sex. No heavy lifting (sorry Mr. LastChance, you'll be the Sherpa for sure in the airport tomorrow!)....

I can't believe after all this my E2 went up that high.

Trying to channel some peaceful energy here....

ANOTHER EDIT/UPDATE:
When the nurse called back again, she said Dr. M wanted me to take a shot of Antagon right away and also to start Dostinex to help with the E2. I was confused--don't you give Antagon to prevent ovulation? And don't we sort of want to mature the eggs to ovulate and then suck 'em right out right before?
She said as long as Antagon is given before the trigger it's fine. So I'm trusting them on that...it's in me now. We had to catch a shuttle ride over to CC.R.M. to meet the nurse with the meds. Geez. Her words were: "The more complicated the cycle the better it turns out!" Yeah, right. I've been funky from the get-go and it hasn't served me well...yet.

Sunday musings...again

Thanks for hanging in yesterday.

We got to get together again with Phoebe! To steal a phrase from Jill, we went on an 'ovary friendly' walk at Cherry Creek Park and then went out for delicious Indian food. It was such a fun visit!

So today's ultrasound showed we had four over 20 and a bunch more between 17 and 19, and then of course a ton more behind that. It doesn't really matter what anyone else says, I'm triggering tonight and then showing up for an egg retrieval 35 hours later! Seriously. They're as ready as they're going to be. But just as an example of different tech's measuring differently...today's tech measured the biggest one at 22 not 27 like yesterday. It's all so subjective. I will be very interested in finding out my estrogen for today and also whether she'll let me do the big trigger tonight with a booster trigger twelve hours later, all in the hopes of more mature eggs.

Speaking of today's tech...I remembered her so clearly from our last CCRM adventure. She was the tech who went in to the transfer room with us. If you'll recall, our transfer last time wasn't the happiest of experiences. I'm sorry for that, but I was still in post-traumatic shock from our fertilization report and feeling dropped by our doctor.

It was election day--a day full of hope. A day I wanted two miracles to occur.

But it was also a day that was supposed to be different for us. We were supposed to have had lots of embryos growing, lots to choose from, not doing a "transfer whatever we had." And even though the embryologist called one of our embryos "highly implantable" I was so sad that day.

I started crying when I got positioned for the transfer. My heart was breaking at the realization that all of our planning and hoping and dreaming had come down to that moment. The doctor, a male, seemed a little bewildered if not a little uncomfortable with my tears. The embryologist didn't seem to notice. But the tech, she noticed.

She kept rubbing my leg and patting me and handing me kleenexes and asking me if I needed to wait. She was so kind and gentle.

So today was the first day I had her this go around. I decided to tell her how I remembered her kindness and how much it was appreciated. Of course--with an estrogen of over 6,000 you know what happened. I started crying all over again! She gave me a big hug and got teary herself.

If we get to a transfer this time, it will be different. My expectations are different. My heart is different. But I will also accept comfort and kindness from those around us in this big machine known as CC.R.M. It's what gets you through sometimes.

I need your help!

OK.

This morning's u/s didn't really put us at trigger mode...which I'm sort of unclear on because yesterday there were a bunch of 19s and 18s and one over 20, and of course a bazillion other ones as well. I coasted last night on GonalF because of the high estrogen.

Today, the tech (a different one than yesterday) measured a gazillion on the R: over 25 I think total, while many were 20-something by smaller (like 24X15 or whatever) when she printed out the little report it said only one was over 20, all the way at 27! and everything else was under 20, and it didn't seem like they moved much. So the nurse and tech said "Oh you won't trigger tonight." I asked if any got smaller and the nurse looked at me like I was crazy and said "they don't get smaller."

Then the nurse said that the doctor on call would review and give me my evening doses...but that of course is NOT Dr. M. When I spoke to Dr. M on Thursday she said she would personally review my numbers and chart today to make the decision on triggering (mainly on trigger dose I thought) so I tried to tell that to the nurse and she looked annoyed. I refuse to have my case handed over to a different doctor at this phase of the game.

I know maturity is an issue. But quality is an issue too. Dr. M said that stimming for 14 days (which today would be 14 days) is really the max before you start to see reduced pregnancy rates (which I assume means reduced quality, duh) but yet here I am, not a clear-cut indication for a trigger. I'm sure my estrogen fell a bit with no GonalF last night so that might give them the wiggle room to stim one more day (or coast??) but honestly I just don't know if I can get another day off of work.

Correction: I'm sure I could get it, but they won't be happy. And yes I know that at the end of this, our last hurrah, one more day off of work shouldn't make the difference. But it's more than that....

So now I sit and anxiously wait (what else is new??) for the estrogen numbers and a call from someone...already anticipating I'll have to page my doctor. If we trigger too early we risk immature eggs. If we go longer we risk crappy egg quality.

What to do?? What to do??

EDIT: So Dr. Minjarez called. She wants me to go one more day, but she was totally understanding about my work situation. So after we hashed things out, compared this cycle to IVFs #1 and #2 which had low maturity rates and likely triggered too early...I told her to hold on and let me call work. She wasn't concerned about one more day of practically no stims on quality...as technically today would be the 14th day.

I called my practice administrator who's been an angel through this. She said "Are you kidding? Chance the cycle because of work???"

Then I gulped and dialed our head endocrinologist, my big boss. I hated to bother him on the weekend but I told him what was happening and he said: "You go for it Ashley. This is big."

I nearly cried. OK I did tear up, but that's because my freaking estrogen went to 6300 despite coasting. Although as Dr. M pointed out, I really didn't coast because I'm still getting the microdose.

So, we're going one more day. We already changed our flights...again. We're about to Priceline for another hotel...one day at a time. I cannot stay beyond Tuesday, that much is decided. We will trigger tomorrow regardless.

I just want to go home, but with some good eggs staying behind in the lab!

The Peanut and the Whale

It's really funny seeing your follicles on ultrasound sometimes. My right ovary is so full they're all getting squished into weird shapes--the u/s tech said: "Look at that giant one! It's shaped like a whale!" Then there was a peanut and an odd assortment of other shapes. They grew again, quite a bit. The nurse who looked at the chart said they might trigger me tonight but I seriously doubt it. Only one was over 20, there were others at 19 and 18, and still a few at 15-16...but I'd honestly rather see several at or over 20 and I think Dr. M feels the same.

We went ahead and made our return flights for Monday night assuming a retrieval Monday morning. Yes, I know it's not fun to fly the same day as a retrieval but we really have no choice. I simply cannot miss another day of work. If we end up triggering tonight and retrieving Sunday we'll do our level best to get home Sunday night but alas, there are no more Southwest tickets available so we'd have to save our credit and pay through the nose to fly with someone else. Oh well, what can you do?

In the meantime, we'll see what the estrogen does. I am going to call my nurse in a second to see if they can call me as early as possible if they do decide to trigger tonight so I can let my work know about canceling my schedule Monday....they've been so great but I'd love to give them as much lead time as possible. I think if the estrogen shot up they might be more inclined to trigger too...

Today we're moving hotels. Boo. We have fallen in love with our little "home away from home." I've been here nine nights, I can scarcely believe it. We got a great deal on Price.line and then when we used Price.line again got a different hotel but for a similar deal so at least it's fairly cheap. Not that cost is an issue at this point....see flight cost reference above.

So we've been taking the shuttle from our hotel tons. We've been chatting it up with the driver. Today I just asked him if he had any children--he's in his mid-50s or so--and he said, sadly "No, we were never blessed. We did all the treatments too...at one point I was giving my wife two injections per day."

My heart just sank for him. He said that, while they've adjusted to being childless, seeing babies still "tugs at his heart strings." I teared up and could only nod.

I can only imagine what the fertility treatments were like ten and fifteen years ago, the super low odds of success, the stress of the unknown.

Who knew? Me and the shuttle bus driver...fellow infertiles...although seemingly so different, we're more alike in ways most people will never, ever know.

UPDATE: Well, my E2 went to 5998 in one day with almost no meds. I didn't even get the other numbers. So I'll only get microdose Hcg tonight and no GonalF. I get it. The funniest part was my nurse called and said: "OK, so she doesn't want you to take any GonalF tonight. But she wants to know what you're really going to do..." Ha. I guess they think of me as a rogue patient or something. So, all that hope of my E2 not going out of control...I guess that didn't happen. I guess I'm glad it didn't go so high at the beginning, but should I be concerned about the high E2 ruining my egg quality?? Yikes. Not that I can do anything about it now. I guess it should fall a little bit tonight.....

Whew.

They grew! They grew!

After our u/s we went and saw Dr. M and she poked her head in, carrying my enormous freakin' chart, and said "Whew! I'm very happy with the progress."

So while we're still not to trigger size, at least they're moving. At this point we're thinking 7-9 on the right and 4-5 on the left will be good. I'll take what I can get. Yes, I know it's a numbers game--especially for me. But maybe, just maybe, the quality is better this time. I'm hoping my E2 doesn't go up too much so she'll let me take a decent dose of FSH tonight. I got her to agree not to coast me...I just don't think coasting is that great.

Yesterday's attempts at relaxation must've helped...the massage, the nap, the reading, and then a fabulous dinner with Phoebe! We went to a great little Vietnamese place recommended by Brenda and it was delish. The company was even better. The women I have met throughout this journey are always the best.

So today is another day of relaxing. I'm a little freaked out about having to push to a Monday retrieval (our best guess is that we'll trigger on Saturday) because of work...having to have my work reschedule all those patients again, some of whom were rescheduled from the previous week (this week). Argh. Plus I'm supposed to have a meeting with our head endo about some big stuff coming up, and naturally that was scheduled for Monday. But what can I do?

I'll post the numbers later on...not that anyone is on pins and needles waiting for my numbers, but I cannot help being obsessive just a little bit.

ETA:
E2 went to 4338 (whoops). Higher than I'd like, so she's only letting me take a smidgen of GonalF tonight. 37.5...how in the world will they grow with that little stimulation??
P4 good at 0.7
LH down to 1.4

Wednesday--how is it already Wednesday??

I can't believe I've been out here a whole week. Tell that to my follicles.

They're stubborn. They really didn't grow on the right--AGAIN. The left ones are growing better. The u/s tech said "maybe we'll just go for the ones on the left." Ummmm, yeah. Shut up. I'm so sure I'm just going to ignore the ovary with 14-15 follicles.

My E2 went to 3388. So it went up, but not by much. My nurse said they'd be much more concerned if the E2 had gone down or plateaued. They're upping my GonalF tonight back to 150 and I'm continuing with the microdose HCG. We'll meet with Dr. M tomorrow right after the u/s. My nurse swore she wasn't really that concerned....but I'm fairly sure it's not in their protocol to say: "Yup, things are sucking. We're all really worried, this cycle's in the crapper."

LH went to 1.6 and P4 is 0.8.

So....today has been stressful. There were tears after the u/s tech's comments and then the nurse who did the immediate consult (not the nurse I talked to on the phone later with the lab results) said something about having really pokey follicles and told me to relax, get a massage, go shopping, etc. Well, I did get the massage. We'll see what happens next.

I'm trying to keep that attitude of: it's a vacation with a chance of embryos. But it's so hard when you get out here, when you do so much to get ready, when you think think think you might have a smidgen of a chance, and then things stall out.

Mr. LastChance has been so supportive and sweet. He was like: "Get the massage! What's another 35 bucks on top of 80,000?" He's right. Maybe I should've gotten the full hour!

I don't know why this has to be hard. I am so envious of folks for whom IVF works--the first time. Obviously I'm envious of people who never even have to set foot inside a fertility clinic, or even think about anything outside of their own bedroom when it comes to having a baby, but that's water under the bridge now, right?

This is my life.
These are my ovaries.
This my journey.

Thanks for coming along for the ride.

Second post of the day

The one with the numbers:
E2 went to 3140, so at least it didn't double from yesterday.
P4: 0.9
LH: 2.3 (down a wee bit)

I talked to my nurse about my freak out. Her words were: as long as the E2 goes up and we see some growth we're fine. It doesn't mater how long it takes the follicles to get there as long as they do get there.

My biggest ones are just at 14 mm. Usually I need to see several at over 20 to before trigger to help with maturity. We did that last cycle and still only wound up with 12/20 mature and only one was post-mature. Of course, this time we're adding microdose HCG for maturity and will probably trigger with a whopper HCG dose...so maybe we won't have to get them all to 20? Who the heck knows.

I'm a little calmer. I always stim a long time so really this isn't anything new. Although the E2 is rising, at least it has risen in a more slow, controlled manner and not all crazy high from the beginning. And maybe this slower rise won't "fry" the eggs? Not really sure on that one, but I'm hoping anyway.

I got a haircut today. It was so nice...I love a head massage! I'll take anything calming I can get right now.

Thanks for hanging in.

Just when I start getting comfortable...

Last night I went to acupuncture on the advice of my RE. She said to tell them to "spur the follicles along." It was a really great treatment. And when I got back to the hotel, wouldn't you know, my right ovary started to ache. I mean really really ache. I told Mr. LastChance that she must've sent them into a growth spurt!

So I happily went to my morning u/s only to find almost no growth. Some growth on the left, but hardly any at all now on the right...in two days. Freak out is ensuing.

Yesterday Dr. M said that she'd add microdose Hcg to help grow them, so I'm expecting that call any minute now and I'll make a fast trip to Todd's before I have to turn in our rental car. Now I'm wondering if I need the Menopur??

Just when I got comfortable....CRASH.

Be honest...should I be completely freaking out? My estrogen has been going up nicely, so why aren't they growing?

I feel this will be a two-post day.

EDIT to add: Dr. M did add microdose HCG and I already went to Todd's to pick it up and shot up that first dose. Please grow follies, GROW!

Howdy howdy!

Greetings from Colorado, the land of eternal wandings and blooddraws.

So you know I was worried about the LH being 2.5 yesterday...so I held off on my Menopur this morning. I called my nurse and she encouraged me to take it but I reminded her I would be seeing my doctor today and could we just discuss it then?? She said that while she recommended it, I know my body best, etc. That was nice.

Fast forward to this afternoon, meeting with the doctor. Did I mention I really do like her?

E2 came in at 2300+, P4 at 0.9 (I think) and LH had gone to 3.0.

I confessed that I hadn't taken the Menopur and asked why my LH was continuing to rise? She said it was a natural part of the process, that as the estrogen rose and the FSH receptors were stimulated, the LH receptors were too. I tried not to agonize that many other fellow patient's haven't had this rise...and she also said that it is better to go up rather than to start high and fall (which I have read several times). So, I breathed out.

She said she would hold off on Menopur for now...and only add it back in if the E2 plateaus or (horror) drops. She's keeping me at 150 units of GonalF and nothing else but Lupron for now.

The follicles are growing kind of slowly...so we're going to see what tomorrow's u/s brings and if they're still poking along, we'll add microdose Hcg to help mature them. She also recommended I go to acupuncture (not for blood flow, my poor uterus is already lining at 15 mm!) but for follicle stimulation. Luckily I got in for tonight at 6 pm. Whew.

We had a great conversation. She really does seem to be on top of my case, as it stands. Maybe I'm a challenge to her? No matter, she wants to regroup with me again on Thursday. I love love love having all these face-to-face conversations with her, and I told her so. She treats me...almost like a colleague. She recognizes I'm at least in healthcare, in regular endocrinology, so maybe she doesn't think of me as a total dolt.

She guesses a trigger on Thursday or Friday, though I would be surprised if it was Thursday. She also suggested doing a higher dose of Hcg trigger--and wouldn't you know we goofed up and ordered TWO Novarel triggers. She said "Perfect." We're all set.

So...exhaling again...looking forward to acupuncture in a couple of hours...and then a nice work out at the hotel....and then tomorrow's report.

Thanks for reading and supporting guys. It really does help.

Sunday sanity!

OK here's the haps:
My E2 went to 1250 (yay! a nice rise, but nothing too dramatic), my P4 is fine at 0.4 BUT my damned LH went to 2.5.

Do I freak out? What to do, what to do? Dr. M swore that the amount of LH in Menopur isn't even enough to raise the blood levels of LH, plus she's lowered my doses the last two days and I'm only taking one little bitty ampule of Menopur a morning....but I'm a little bit frightened. True, most of the stuff I've read talks about not adding if LH starts off high and also that things are bad if LH is high and then FALLS, and that's not me, but you know me, it's not an IVF cycle if there aren't a few freakouts.

Today we went to Rocky Mountain National Park and hiked nearly six miles. The first three were uphill...literally the whole way. We were sucking wind. The altitude plus the climb was tough! But the reward was breathtaking. Gorgeous waterfalls, a beautiful lake, all surrounded by glorious mountains. And of course, the return three miles were a nice coast downhill so we survived.

After a delish dinner where I had black beans and grilled chicken for protein plus a ton of veggies we felt disgustingly full so we had to go swimming at the hotel when we got back. A few laps is all I could handle. And now, we're sufficiently pooped!

Tomorrow we'll meet with Dr. M again to discuss adding microdose Hcg to help mature my eggs, to discuss how my E2 is doing, to discuss our plans for the embryology lab, and just to touch base. At this point, I'm betting the ER will not be until Saturday. The follicles had all grown quite a bit in one day, and they're a nice cohort. Today's tech estimated 14-15 on the right and 6 on the left. I'll take them all as long as they're decent looking :)

It's weird guys. You know I said this is just a vacation with a chance of some embryos. Yes siree, I did say that. And I'm trying so hard to keep my hopes tempered with reality. But I keep feeling it...that little bit of hope creeping in. That little voice that keeps saying "You never know...this might finally be our chance...to be parents." Sigh.

Last night we went to do laundry (our hotel is fabulous but lacks a laundry room so we went to their sister-hotel) and there was a tiny baby sock (single) on the floor. It literally looked like a shrunken one of Lee's white socks. I picked it up (it was clean!) and marveled at it's tiny-ness. Imagining those little teeny tiny toes and feet, with their sweet baby smell, and feeling my heart swell up with the idea of possibility.

Hope.

Reality.

Hope.

Reality.

Hope??

Hideeeo ho...

Just moving along here. It's so weird to me, to have an estrogen that's not skyrocketing.

Today it was 736. LH is1.6 (up a teeny bit, should I worry?), and P4 nice and low at 0.4. The follicles are growing...still 4-5 on the left and 10 on the right. I'm guessing that will be it. I've never had disparate ovaries before, they are always usually basically the same. Shrug.

I decided to add chicken and fish to my diet to get some actual animal protein during stims in addition to the whey protein. It's been a little weird. I am vegetarian mainly for animal rights issues and so to just go right back and start eating chicken (and strangely having it taste just fine) has felt disloyal or something. I know Dr. M was happy. Who knows whether it will make a difference or not--I guess we'll see. I am really anxious to see what my eggs actually look like this go around.

Mr. LastChance made it last night! Yay! We played in Boulder today. We tried to go to Boulder Falls, which I knew would be spectacular because of all the rain they've had here. Unfortunately, all that rain forced them to close the falls. Boo. But nevertheless we found some trails, a raging creek, and some breathtaking scenery. If there are trails to be hiked, we will find them.

We just ate a big mid-day meal and dessert was included--one of those appetizers-entree-dessert one price deals. Mr. LastChance has a to-go some type of delicious chocolate chip pie with ice cream for on top. I am not allowed any of it--double boo! I have already made a list of what things I plan on eating post-retrieval when I will re-add sugar (but only for a few days, I've really decided this no sugar thing is really good overall):

An M&M blizzard. Oh yes.
A chocolate croissant from a local bakery. Divine.
A large Cherry Coke from Sonic. Slurp.
A chocolate doughnut. Really the most horrible thing for you in the world, but I'll take mine with sprinkles.

Sayonara!