Cycle #3: CD12 Recap

BAH – I don’t understand what is going on.  I guess from my meeting with my RE I thought that taking the injectables would be a fast track to some good sized follicles, an IUI, and maybe a positive pregnancy test but that doesn’t seem to be the case for me – let’s do a little summary and rundown of where we’re at:

CD3-5
75iu of Gonal-F each night
Bloodwork and u/s on CD6:  E2 level at 71.9 / small follicles

CD6-7
75iu of Gonal-F each night
Bloodwork and u/s on CD8:  E2 level around 69.0 / two 5mm follicles

CD8-9
112.5iu of Gonal-F each night
Bloodwork and u/s on CD10:  E2 level at 90 / two 8mm follicles

CD10-11
112.5iu of Gonal-F each night
Bloodwork and u/s on CD12 (today):  E2 at 67 / one 9mm follicle on right ovary

Instructions
CD12-13
150iu of Gonal-F each night
Bloodwork and u/s on CD14 (Thursday):  TBD

I am so scared of not responding and what that could / would mean – it’s all I can think about.  I don’t know whether this is normal or not but based on their monitoring of me every other day and all of the overstimulation risks with injectables I just thought my body would BOOM react.  I asked the nurse (where is Nurse Karen I’d like to know?!?!?) if Dr. Zimon was concerned and she said not at this point because there is growth.  I’ve read on SoulCysters that many women will go in one day with smaller follicles and then like 2 days later they blow up so maybe that will happen?  I don’t want to overstimulate but I’d like there to be a nice, big, fat follicle (or two) there so this could be a viable cycle!

*sigh*

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Boston CBS News: Infertility Doesn’t Just Affect Older Women

http://boston.cbslocal.com/2011/05/26/infertility-doesnt-just-affect-older-women/#comment-107538

I guess when I first read this article and saw the newscast, I thought to myself “no shit”.  But that’s probably the wrong attitude to have and likely evidence that I’ve about had it with the misconceptions about infertility.  I should stop assuming that the general public is more aware of infertility and the struggles we face and put some work into educating about it.  I guess this blog is likely a good start, no?

I do appreciate that Dr. Alice Domar with Boston IVF is getting a lot of air time lately as I believe it’s providing a lot of information to the general public.  It’s interesting to note the link between stress and fertility – my therapist has been working through this with me as well.  It’s hard to reduce the stress from my job – so we’re trying to see where else we can impact it.  Yoga, Pilates, and the gym in general is a huge help.  I’d love to be able to take part in the Domar Center, but it’s quite the drive for me so hopefully I can take some of the concepts that Dr. Domar focuses on and get some benefits locally.

I hate that the newscast got the cost of the fertility treatment wrong – there’s a significant difference between $1,800 and $18,000 and the latter is the true cost.  I feel like people seeing that story or reading it may have more reason to cast infertility aside because, quite honestly, $1,800 is a sizeable amount of money – but us going through fertility treatment would give ANYTHING to only pay that much!  I am hopeful they do a correction to make sure that it’s very clear what the true costs of infertility can add up to.

Of course they brought up how MA has insurance coverage for fertility treatments.  Again, another blanket statement that isn’t entirely accurate.  I am considering sending the post I made for RESOLVE’s NIAW on busting the myth that insurance covers treatment.  Yes, for those companies based in MA and that are not self-insured, there are MA laws that mandate infertility as a health condition that require treatment coverage.  However, if the company is self-insured or based out of state, they do not have to abide by the MA state laws.  Many companies are self-insured these days – so although the law is better than none, it isn’t a blanket coverage for all MA residents. 

All in all, I’m 50/50 on this article.  I wish they could have taken the time to get the facts straight to provide an accurate portrayal of infertility.  I do like the education piece about how infertility is not only affecting older women, but women in general.  Again – education is key to spreading the word and educating the public on something so many people go through – yet so little people talk about.  Even in the comments section you can see the two sides of the story – with the uneducated reply saying this isn’t newsworthy and those responding in support of all of us who face this each day.  People will be people – we can only continue to arm ourselves with facts and spread them at every opportunity.

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Cycle #3: CD6 – Bloodwork & U/S and a Checklist

I went in this morning for my first round of bloodwork and u/s.  I have successfully completed three injections on Sunday, Monday, and Tuesday – well, it would be more accurate to say that Chris successfully did the injections and I just layed on my bed like a patient.  The man can fly airplanes AND give injections!!! 

My results came back:
– Estrogen was 71.9 (normal)
– Lots of follicles with two small measurables ones (5mm and 7mm)

Instructions:
– Two more Gonal-F injections of 75iu each tonight and tomorrow night
– Bloodwork and u/s on Friday morning

Although I’m not thrilled about going in on Friday for more bloodwork and u/s (I live  in a vacation town and traffic will already be a bitch and a half on my return drive), I am hopeful this process is working so far.  I asked the nurse (Not Nurse Karen) if these results are typical in the early injectable cycles and she said yes. 

In other news, I “came out” about my struggles with fertility to a few other friends this past weekend.  It was met with a lot of blank stares and not a lot of questions or comments.  The comments that did result were around me likely to have multiples and things I could try.  *sigh*  I almost want to print this out and pass it out each and every time I “come out”. 

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Cycle #3: CD1 – getting it started!

Well, Aunt Flo arrived today, which I kinda knew was coming since I’ve been eating everything I can get my paws on and I’ve been feeling just BLAH.  She’s loud and she’s proud today – UGH.  But, of course this means the start of our next cycle so YAHOO!!

I called Nurse Karen and she just called back with the low down:

– Evening of CD3 on Sunday, 5/22:  inject 75iu
– Evening of CD4 on Monday, 5/23:  inject 75iu
– Evening of CD5 on Tuesday, 5/24:  inject 75iu
– 8:00am of CD6 on Wednesday, 5/25:  bloodwork and u/s

Based on the results of the bloodwork and u/s, I’ll receive instructions that afternoon.

*sigh* – Here’s to hoping this makes my body respond.  MAKE FOLLICLES DAMNIT – but not too many so that we have to cancel.  Walking a very fine line here…  Please keep me in your thoughts!

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TLC.com Web Series: A Conception Story

I saw this link posted on Facebook as a new TLC.com web series called A Conception Story.

http://tlc.howstuffworks.com/tv/a-conception-story

I immediately set some time aside to go through and listen to all the introductions and review the blogs.  Not all of the couples are suffering from infertility, but some are suffering from secondary fertility issues and two have PCOS.  Just listening to the introductions and the feelings these women have had me nodding my head up and down with resounding agreement.  It’s amazing when you listen to the words that come out of someone’s mouth who has or is struggling with infertility – it’s like a whole new language that only we can understand and relate to.  There is an immediate connection to their journey, too, and I find myself revisiting the website to see if any updates have been made.

What I would really love to see is for TLC to make this into an actual TV series.  There are plenty of successful baby shows such as Baby Story, Baby’s First Day, Teen Mom, 16 and Pregnant (and don’t get me wrong, the masochist in me loves Teen Mom and 16 and Pregnant!) just to name a few – why not show all of America what 1 in 8 couples experience?  How amazing would it be for the couples featured to know that America was routing for them to be successful?  What would you give to have America as your cheering section?  That alone would be inspiration enough to keep fighting for the end result.

I absolutely suggest checking out the web series and marking it as a bookmark to keep checking in on these couples.  Unfortunately, there doesn’t appear to be a way to subscribe to an RSS feed or submit your Email for notifications.  But, I think that this will be yet another effort to highlight infertility and struggles with TTC and I am so hopeful for each of these couples.

Finally, I will admit that some of the comments to the post on Facebook shocked me – well, not really “shocking” but just complete ignorance.  One was a woman who said “can’t anyone keep anything private anymore”.  I was immediately infuriated and left the comment of “people with your point-of-view is why women like me have to fight for treatment and benefits coverage – not every person has an easy journey to their Baby Story”.  Again, it was just another person that walks around with the misconception about struggles in TTC and infertility and I felt that not speaking up would be me perpetuating the situation.  That is my goal, now, for whenever I hear a misconception about infertility – I’m not going to walk away with my head down.  Instead, I’m going to respectfully educate the misinformed and try and make for a more understanding world.  Imagine if all of us, 1 in 8 couples, did this every time we heard a misconception about…well conception?!  We could really make a difference – let’s continue the Myth Busting that RESOLVE challenged us to do during NIAW!

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New Baby Plan: Meeting with Dr. Zimon

This morning Chris and I went and met with Dr. Zimon to discuss the new baby making plan.  I know I’ve said this before but I honestly just love her – I love her demeanor and attitude towards the process.  We covered everything that we have gone through already – spontaneous ovulation in January, first cycle ovulation with Clomid, second cycle stopped due to lack of response.  She is extremely optimistic for us and said she is confident that once we’re done with her, we’ll be pregnant.  She also said that I’m young, my egg reserve looks fantastic, she’s happy that we know I *can* ovulate, my uterine lining has looked good in these cycles, and I’m continuing to work on myself by keeping healthy.  She gave basically three options of next steps:

1 – try Clomid again
2 – try a sister drug to Clomid called Letrozole, which offers different side effects but essentially works the same way by trying to trick the pituitary gland to work and make the ovaries do their thing
3 – move away from these drugs and take the “brain” out of the equation by going to low dose injectables, Gonal-F

She went through the pros and cons to injectables and this is what the break down looks like –

Pros:
– Increased rate of follicle growth
– Less side effects than Clomid
– No risk of uterine lining issues that Clomid can create

Cons:
– Increase rate of follicle growth could lead to overstimulation and a cancelled cycle
– Very close monitoring, so bloodwork and u/s every other day or daily
– 20% chance of twins
– Daily shots
– No unprotected sex due to risk of overstimulation

Although at first glance there are more in the Cons column than the Pros, they’re really more of a “could happen” and a “be careful” than a real suck situation.  The biggest thing she said is that she has to be all over me to make sure we don’t overstimulate while on the injectables.  If it looks like there is 4+ mature follicles, we may cancel the cycle as she doesn’t want to risk triplets or quads. We agreed to move forward with the injectables and will begin as soon as the insurance approves them and my period comes.  We’ll be inducing the period with Provera this time, which makes me happy as that is less time.  I’ll start on the lowest dose of Gonal-F and we’ll go from there – apparently while on injectables, I’ll trigger earlier than I did with Clomid again due to the overstimulation risk.  Chris scrunched his face when she said “protected sex” – hey, sperm can live 5-7 days and if all of a sudden I have 9 mature follicles and they release, I ain’t gonna be no octomom!! 

So – that is that.  I’m content and trying to remain optimistic.  Something has to give, right?  I keep reminding myself over and over to keep my eye on the prize – and that we only have to go through this horrendous experience ONCE.  I’m not going to be the type to do this again – just give me my one beautiful, healthy baby and I’ll be happy as a clam.  (And if twins result, so be it, right?)  One viable, sticky, healthy pregnancy is all I want.  And I’m doing all I can to get there.

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We can’t forget the men, too!

I was watching the Today show a few weeks ago and Marc Sedaka was on with his wife, talking about a new book he recently published called What He Can Expect When She’s Not Expecting.  He is a comedic writer and him and his wife have suffered through “sixteen artificial inseminations, ten in-vitro fertilizations, three miscarriages, and, finally, a gestational surrogate (‘womb for rent’) who carried their twin girls to term.”  While they were experiencing this he realized there were many, MANY books out there for women but barely any at all for the men who are experiencing it right alongside us.  That is what lead him to write What He Can Expect When She’s Not Expecting.

After seeing him on the Today show, I had an appointment later that afternoon with my therapist.  We discussed some of the frustration I was having with Chris understanding everything about the process and how I just wish he would pay closer attention or ask more questions so that he could understand this at the same level as I do.  I mentioned the book to her and she said, “Why don’t you buy it for him?”  I had mentioned the book to him that morning as well but didn’t think anything of it.  So, after my session I went to Borders and ordered the book.  As fate would have it, Chris came home two days later from work and was proud as a peacock to walk in with the book in hand – he had went and bought it himself and had already read a good portion.

I will fully admit that in the beginning we swung the pendulum the opposite direction and Chris was constantly asking me if I had this tested, and this looked at, etc…so I grabbed the book and said, “read these chapters as a refresher for what has ALREADY BEEN DONE, and the Clomid / IUI chapter on what is currently going on, and the rest is what could be in our future”.  I had created a monster!  But, with that cleared up, he continued reading up until yesterday when he finished it.

I’ll give all of you his review:

– Not as funny as I lead him to believe it would be (obviously this is my fault haha), but written in terms he could understand.

– He thoroughly enjoyed the Levels of Psycho and claimed I was approximately at Level 4.  Of course he did.

– He liked the interjection by the doctor which gave it a good balance between man code and doctor speak.

– He now has a better understanding of both the physical and emotional demands of IF and the treatment associated with it.

Here’s my review:

– We have less disagreements surrounding the issues of “why don’t you friggan understand this like I do?!” and “why can’t you just listen to me when I speak?!”

– He read a book in less than 6 weeks – that’s an accomplishment for my I Only Read Magazines and Then I Mostly Look At the Pictures husband.

– He was inspired by the ending, which he had me read last night.  I won’t ruin it for all of you but it did bring a tear to my eye.

UPDATE 5/17/2011:  CNN showcased Marc Sedaka through an interview with him about his book.

http://www.cnn.com/2011/LIVING/05/17/sedaka.infertility.husbands/

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RESOLVE Peer Group Meeting: May 4, 2011

In reviewing the RESOLVE.org website last week for NIAW, I noticed that they have peer groups.  So, I looked closely and was pleasantly surprised when I saw there was one right in my town and the next meeting was on May 4th.  I decided to go and check it out – I figured it couldn’t hurt anything by going and meeting some women who are in my shoes and/or have been in my shoes.  It was a small group with just the leader, myself, and another woman.  I shared my story and listened to their stories and we talked a lot about emotions, friendships, family, and general feelings of disappointment and frustration.  I think the three of us could have sat there for hours just chatting away – it’s amazing that something so terrible like infertility can create such an immediate and strong bond between women. 

I have to admit I was nervous, though – have those of you who have IF ever noticed that when you’re in your RE’s office waiting room, no one looks at one another?  Everyone keeps their heads down, no one makes eye contact.  You would think that we would all at the very least smile at one another for it is only us who truly understand the trials and tribulations of IF.  But instead, there is almost like a hush and a feeling of shame when you’re sitting in these office waiting rooms.  One of these days I say I’m going to just sit and strike up a conversation with someone – but then I find myself doing the same thing…avoiding eye contact and keeping my head down.

I will say that I felt very comfortable with the Peer Group meeting – I am looking forward to returning next month.  In fact, the leader and I realized at the end of it we actually knew one another from her previous job.  It’s a very small world around here – which only lends itself to support the fact that one in 8 couples suffer from IF.

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eHow.com: How to Support an Infertile Friend on Mother’s Day

I saw this posted on Facebook from the Boston IVF page.  I read through it and thought it was interesting – although I don’t personally connect Mother’s Day with my struggle with infertility, I’m sure many others do.  But moreso I think that these “instructions” can be good for friends of those who struggle with infertility to use at any time while supporting them.  I’ve read a lot that says there are two types of women who struggle with infertility – those who are ashamed and / or do not want to discuss their emotions and feelings and those that crave and rely on the support of their close friends and family to get them through the struggle.  As you can tell and for any readers who are my friends and family – you know I fall into the second camp.  I don’t know where I would be mentally if it wasn’t from the constant support and encouragement of those closest to me.  Even if they don’t understand everything I am going through, they’re available to just listen to me rant or cry and they let me know they’re in my corner, cheering me on with love.  I’m very blessed to have the support system I do and for those women who are at the point of not knowing how you can go on with these emotions, I suggest reaching out and finding even just one person (other than your significant other) that you can turn to in times of frustration or saddness.  Don’t get me wrong, I have felt the need to “turtle” and shut myself off from everyone and that, too, is natural – as long as you bounce back from it.  There is something to be said about finding peace within yourself and on your own.  But, don’t be afraid of building a support system – having a cheering section during this process makes me feel like I’m not alone.

http://www.ehow.com/how_2213962_support-infertile-friend-mothers-day.html

Mother’s Day can be a particularly challenging day for women who are struggling with infertility. Your infertile friend needs support from those who love her, but she might not be able to articulate what she needs. As a friend, you might want to help but not know what you should say or do. Here is how to support an infertile friend on Mother’s Day.

Difficulty:  Moderately Easy

Instructions

1. Step into your infertile friend’s shoes. Imagine that you desperately want to become a parent but are unable to do so. You put your body through painful procedures but still fail to conceive a child. Meanwhile, people all around you seem to become pregnant with no effort, and just about everyone you know has at least one child. Most of your friends share the bond of motherhood while you feel isolated in your misery.
2. Identify the emotions your friend might be feeling. After you step into your infertile friend’s shoes, label the emotions and feelings that you felt. Those emotions likely include depression, grief, anger, envy and isolation.
3. Think about what would make you feel better. Remember a time in which you felt similar emotions, perhaps after a relationship fell apart or when you were unable to do something that mattered when all of your friends got to participate. What did another person do to make you feel better? What could another person have done that would have eased your pain?
4. Call your friend the week before Mother’s Day. After you are in a place to empathize with how your friend is feeling, call your friend. Invite her over for a visit or offer to take her out to lunch. Tell her that you would really like to spend some time with her that week.
5. Ask your friend to share her feelings. Talking about the pain can be very comforting to your infertile friend. You do not have to say any magic phrases to make her feel better. What your infertile friend needs the most is for you to “hear” her, empathize with her pain and still want to be around her
6. Invite your friend to call you through Mother’s Day. Offering your infertile friend a shoulder to lean on will go a long way toward comforting her through Mother’s Day.
7. Call your friend on Mother’s Day to ask how she is doing. Let her know that you are there for her if she needs you. 

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Cycle #2: 5th Round of Bloodwork and U/S – We’re calling a mulligan!

I went in this morning for the 5th round of bloodwork and u/s.  I started with the u/s and it was actually the least painful of them all!  I think I know what is going on – my bowel gets in the way of my left ovary.  And, well – here comes the TMI…I pooped right before the u/s and she had little to no issues in seeing either side.  Unfortunately, I’m not the epitome of regular so I can’t just make that happen each time.  Today I lucked out I guess – but my luck was short lived.  The u/s tech said I had none on my left and a 12mm on my right.  I knew right then and there that this was a done deal.  My lovely phlebo was next and she stuck me in her favorite space and it hurt and now I think I have a bruise on top of a bruise.  But, I didn’t even suggest the other arm which is now turning from shades of purple to shades of yellow and green… 

I left and just shrugged my shoulders and headed to work.  It is what it is. 

I got the call about an hour or so ago and Dr. Zimon wants to stop this cycle.  I’m just not responding.  Nurse Karen confirmed the 12mm on the right but nothing on the left.  I asked if my follicles were descendants of Harry Houdini – how could a 15+mm and 14mm just vanish?  She said that they could have been residual from my last cycle and they turn to cysts and shrink and disappear.  My estrogen was 63.8 so it’s seesawing and that’s another sign of no ovulation activity and that my body isn’t preparing for it at all.  So, I scheduled an appointment (as requested) to meet with Dr. Zimon on Thursday morning to discuss next steps.  I asked Karen and she thought the next steps would be low dose injectables, which is in line with my discussion with Dr. Zimon on Friday.  I asked if she thought I would have to induce a period and she didn’t know – she said Dr. Zimon will cover that during our discussion.  Chris is going to come with me so he can listen to everything she has to say and ask questions he may have as well.  Nurse Karen did seem very positive that we’d find something that works – as she said, Clomid is the first line of offense and we have many more options after that.  I’ll take all the optimism I can get right now and again, I truly do love both Nurse Karen and Dr. Zimon – they’re not screwing around or making me continue down a dead end path.  I read a lot of other people on various forums complain that their doctors don’t listen or aren’t forward thinking – some are on their 6th and 7th round of Clomid.  I understand some of it is financial but it does make me grateful for the care I do have. 

So – more to come on Thursday.  Until then, wine, margaritas, vodka…all options!

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