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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Cycle #2: 4th Round of Bloodwork and U/S

I went on Saturday for the 4th round of bloodwork and u/s and it wasn’t good.  The u/s technician couldn’t get a good view of my left ovary (the one that always seems to be difficult to see) and after about 20 minutes of rooting around, she basically said either she can’t see them or the follicles aren’t there.  She did say she couldn’t see the entire ovary and that she “did all the tricks she knows” to get a good view but couldn’t.  I basically said WTF but in not so many terms and she said she’d note her report that she simply couldn’t see the two follicles and would provide the one shot she got to the doctor.  Thanks, lady, you’re the best. 

I then went and had blood drawn and seriously, my arms look terrible.  It went without issue and actually is the only place that I don’t have a bruise – unfortunately I was in the Waltham office so I won’t get that phlebo again tomorrow.

Oh ya, about tomorrow – I got the call around 2:00pm and Dr. Zimon wants me to go in tomorrow (Tuesday) for a 5th round of bloodwork and u/s.  Seriously.  My estrogen level was 90, so it appears to be on the rise.  I’m absolutely exhausted emotionally.  I’m trying to take the approach of if I can’t control it, I have to let it go, and it seems to be working.  I *did* burst into tears in the car, but quickly composed myself and went on with my day.  I didn’t let it ruin my weekend and I actually had a wonderful weekend with friends.  Chris came home Saturday night and I fell asleep in the crook of his arm – I have to try and live this week with inner peace and not chaos.  Chaos is not good for me and I can’t imagine it’s good for TTC in general.

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Cycle #2: Discussion with Dr. Zimon

So – I finally spoke with Dr. Zimon (after freaking out because I missed her call by literally a minute and then they were being ridiculous about transferring me directly to her when I called back).  She made me laugh with, “well you’re probably wondering what is going on…or actually what isn’t going on in there…”  She said people on Clomid sometimes have 35-40 day cycles, so I’m still right there in the middle of my cycle, but she really doesn’t know what is going on.  She is not concerned about my estrogen dropping (what I considered a drop apparently is what she considers staying the same).  She did say that sometimes PCOS women can have follicles that turn to cysts rather than grow as mature follicles and we’ll see if that is the case.  She thinks that tomorrow will show us some more information – I asked if tomorrow was the deciding factor and she said depending on what shows she may have me go in one more time. The good thing is she is the doctor on call so she will be the one actually looking at my results – that made me feel better. 

She did ask if I was getting frustrated with this cycle and I said a bit, but more because I don’t understand why it’s so different than how I responded the first time.  She admitted that she truly doesn’t know why this time is so very different but that it’s all sort of pieces to the puzzle.  I think she was going to offer me to opt out of this cycle if I wanted to but, goodness, I’ve come this far…what’s another round or two of bloodwork and u/s?

She wrapped up by saying that if this doesn’t work we’re going to have to sit and decide what to do next.  I asked what that typically entails and she said fertility injections – basically stronger drugs to help me respond. She knows I can respond as they confirmed ovulation last month so we just need to get there again.

Chris is probably going to lose his mind because he thinks the answer to “what do we do next?” is IVF.  Pray for me while I give him this update…

But seriously, Dr. Zimon is so nice.  She just is normal and not doctor-ish and as much as I may get frustrated that it’s like Ft. Knox to reach people there, Boston IVF is dedicated to its patients.  Nurse Karen really pulled through in arranging my conversation with her and it makes me feel better knowing that she, too, has thought about “what next?” if this doesn’t work out and she, too, sees that we need to fast track and get this done.  GET ‘ER DONE.

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Cycle #2: Third Round of Bloodwork and U/S

Nurse Karen called yesterday afternoon after I went for my third round of bloodwork and another pelvic u/s.  Because I had been stuck on the left arm twice in less than 5 days, I asked the phlebotomist to try my right.  Well, I am now sporting the biggest black and blue – it is about the size of a golf ball!!  The pelvic u/s was the least painful I had – the technician was really great.

The results were not as glorious:  my left ovary has two measurable follicles, 15.1mm and 14.0mm, and a few less than 12mm and the right has a few less than 12mm.  My estrogen is 61.3 which is low.  I am scheduled to go for a fourth round of bloodwork and u/s on Saturday.  I started asking questions and Nurse Karen suggested that I schedule a call with Dr. Zimon, so I left a message with her administrative assistant to schedule the call to see if we should even continue with this cycle.  I don’t know – this just doesn’t seem right at all.  *sigh*  I asked if there was anything additional I could take to stimulate growth and she said no.  This is so exhausting.

I am waiting to hear back from Nurse Karen as they tried scheduling me for Monday and that just isn’t acceptable to me.  Monday would be CD21 and I need answers now as to whether this is something that is common or is it something we should be concerned about.  I am worried that my estrogen is dropping and that we’re now, today, on CD17.  I just need some answers from Dr. Zimon as to whether this could turn into a viable cycle or if we’re kind of spinning our wheels here.  I don’t mind making the continued efforts if it’s worth it but I’m a bit alarmed right now and I think I’ve given it enough go arounds (3 rounds of bloodwork and u/s with a 4th scheduled).

We shall see – the good news is that if this is a viable cycle, Chris will be home on Saturday night so he’ll be able to continue the process with me.

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Cycle #2: Bloodwork and U/S results

The nurse called (and not my normal nurse…) and my estrogen level was 75.3 which is “right where they want to see it” and I had two measurable follicles on the left ovary (14mm) and one on the right (around 12 mm).  But, because they’re not at the ideal size, Dr. Zimon wants me to come back on Monday morning for another round of bloodwork and another u/s to check their growth and see if we can trigger.

I have to cancel my business trip to Chicago as if things go right, I’ll be triggering and getting the IUI next week. 

I cried – and I really shouldn’t.  I just don’t understand why my body is reacting differently than last time – I don’t know if that is bad / good / neither.  All of this is just a lot.  It really is. 

EDIT:  I had called and left a message with the nurse and she just called me back.  She said it is completely normal for each cycle to be different.  She also said it is more ideal to have 2-3 follicles (obviously not ideal to have 5-10) and yes, it slightly increases our chance of multiples.  I asked about my progesterone level and it was less than 0.2 which means my body isn’t ready to ovulate, either.  She said this cycle is looking good – I just wish I could be excited about it but of course I’m so consumed by work and other things…

It’s been a rough week emotionally.  I feel like I’m in this turbulent place where everything in my life is swirling around and out of my control.  My chest is constantly tight, which means my anxiety is high.  This is not easy – none of this is easy.  The “innocence” of trying to become a mother, getting pregnant, the whole thing has been stripped from me because of this process.  I am grateful for modern medicine and all of the people who are trying to make this happen, but part of me wants to just run away to an island and escape it all.

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Cycle #2: CD11 Bloodwork and U/S

I went in this morning for my bloodwork and another round with the pelvic ultrasound to see how I was progessing from the Clomid.  This was the first time I got my blood drawn by this lady and it didn’t burn – which was a good thing!  The u/s was next and the woman was very nice – again it was difficult to get at my left ovary, but she had me push down which makes it a bit easier.  She took a bunch of pictures of my uterus and then of both ovaries.  When we were done she told me that I had a bunch of smaller follicles less than 12mm on my right ovary and I had some of those on my left but two follicles at 14mm each which looked good.

I left and headed to work and now I’m just waiting for the call.  14mm is kind of small compared to what they typically look for when on Clomid (18-20+), but they grow 1-2mm a day so I think they’re probably going to have me hold off on triggering.  Of course, I’m nervous because I am concerned this isn’t a good sign (why aren’t they as big as before?) but also because I am scheduled to fly to Chicago for work on Tuesday morning.  I know what is most important, this process, but it doesn’t make it any easier when I have other things going on that this is impacting. 

So – now I sit and wait for the call.  We’ll see what my P4 level is and if it is on the rise, which indicates preparation for ovulation, as I’m sure that will contribute to their decision as to if / when I’ll trigger.

More to come…and yes, two follicles means an increased chance of multiples…yet another thing to stress about!

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Cycle #2: CD7

So, tonight is my last day of taking the Clomid.  This time, the only real side effect I’ve had has been wicked hot flashes – I now understand what it will be like to go through menopause and holy cow, it is not fun!  No motion sickness this time, which is weird but I’ll take it!  My usually small fuse has been a tiny bit smaller, but nothing completely unreasonable and that could be caused by other things (stress with family, husband returning to his previous job, stress with work, etc…) so I can’t throw Clomid under the bus.

I don’t really know what to think – I feel pretty jaded by this whole process now and so I’m having less emotions about it and more numbness.  I am not sure if that is bad or good but it is what it is.  Also, life has been so hectic that I haven’t had as much time to think about it as usual so maybe that’s where some of the lack of emotion comes from.  I’m sure the results of the bloodwork and pelvic u/s on Friday will set off a flurry of emotions depending on the outcome.  I am really hoping that a) the Clomid works and my body is making a nice follicle or two, b) my body shows signs of ready to ovulate on Friday, and especially c) that the IUI can move forward and it can be done on Sunday or Monday so I can fly out on Tuesday for work.  CUTTING IT VERY CLOSE.

Other than that…same old, same old…  Looking forward to more concrete information on Friday.

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Cycle #2: Never question AF, CD1, and the plan

Seriously, I’ll never question the abilities of Aunt Flo again.  Holy shit.  I went to the Red Sox game last night (which is a whole other topic I’d like to forget…something happened to them when they left Spring Training i.e., they FORGOT HOW TO PLAY) and I started spotting again.  When I got home, it was heavier and when I woke up this morning it was just – wow – she’s here and she’s here with PRIDE. 

Ahh, PCOS, you’re freaking ridiculous.

So, I called Nurse Karen to see if we’re counting last night as Day 1 or today.  I suck at this whole cycle count thing.  But the good news is – we get to start the party again!!!!  Clomid and Ovidrel – here I come!

I spoke with Nurse Karen and we’re classifying today as Cycle Day #1 (CD1)!  So, here is the plan for our second cycle:

– Take two tablets (100mg) of Clomid starting on Thursday, 4/14 through Monday, 4/18 (CD3-7)
– Pelvic u/s and bloodwork on Friday, 4/22
– Ovidrel trigger TBD
– IUI procedure TBD

The funny thing is, if my body reacts similar to how it did in the first cycle, I would trigger on Friday, 4/22 and have the IUI on…Easter!  Maybe the Easter Bunny will bring me a sticky bean?!

Of course, Chris’s consent to thaw form expired a couple of days ago so he has to sign a new one and get it notarized before he leaves on Monday, 4/18.  Since he’ll be gone through 5/1 or 5/2 for in doc in Cleveland and training in Dallas (my husband is a pilot who was recently recalled from furlough to his position with Flight Options – a fractional operator), we’ll be using the frozen spermies.  He doesn’t get in from his last week with Cape Air until Thursday evening so he essentially has Friday to wrap all this crap up.  He’s stressed but we’ll get it done.  I am now so grateful that we decided to freeze his sperm – and there is no statistically relevant data to show that frozen sperm is any worse (or better) than a live donation.

And, because this is how my life works, I am scheduled to fly to Chicago on Tuesday, 4/26…  Here’s to hoping it all just “works out” and the IUI procedure happens before Tuesday.  I’ve already alerted my boss to the fact that I may have to change my flight to the afternoon on Tuesday or cancel it altogether but I really want to be on-site for these meetings.  We shall see.

And here’s a video with my RE – I have to put all my trust and faith in her that she will get me a sticky bean.  Positive thoughts…

http://www.youtube.com/watch?v=O70qZjXOxD0&feature=related

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