Absent

Sorry I've been absent... This month has been busy. And now, in just a few days my husband will deploy for a ~70 day stint to the Middle East. I've been spending all my excess time with him... We even went this weekend to a lovely, luxurious mountain cabin in south-western NC. It was magical, and so perfect. But now we're back and counting down the days.

I did happen to do the Clomid Challenge Test this month, and I am so very pleased at how my FSH is looking.... On CD3 it was 7.34!!! Now, you all know I've been worried as I've only ever seent these numbers go up... And I know all the stuff about there that you're only as good as your worst FSH, but I don't have the profile of a high-FSH'er and now, with such a good number (for me) I'm thrilled. This past month I specifically prayed for a pregnancy and for my FSH numbers to be "fixed." I think I at least got that answered. Previously, I'd just worried myself sick practically about it. Then I figured, gosh I should pray! I'm so glad.

I had my second HSG (hysterosalpingogram). If the doctors (yes, the first one had such trouble he called another one in!) hadn't taken 25 minutes finding my cervix, it would have been "a breeze." I was really worried about this, because my last HSG was terrible. Not the procedure itself, that felt like an IUI. But the post-HSG was so painful, for about 22 hours. At one point I neraly couldn't walk right after it. This time? The dye was in and out before I even knew it! I hardly felt it. Both tubes open, uterus looks good. Same as last time. I have no idea why you have to do it pre-IVF because they don't care about the tubes anyway. Whatever! It's done.

We have to get our check out next month for IVF. The clinic "appears" to have changed their prices, but what they've really done is charge up front like you're doing ICSI, and if you don't end up needing it, they refund you that portion back. I want to discuss with the doctors whether to do it or not, but I lean VERY strongly towards it, because we had a lot of our eggs fertilize "abnormally" (i.e. multinucleated). Basically, to recap:
17 Eggs Retrieved
15 Eggs Mature
12 Eggs Fertilized
8 Fertilized Normally (4 were multinucleated)
This is an 80% fertilization rate, but only 67% normal fertilization. J has a lower-that-we'd-like Morphology, and that's something an Embryologist can look at to choose the most perfect looking sperm. This of course is just my opinion, that's why I'll have these stats in hand and talk to the RE's there and see if doing ICSI will help at all. Gosh, even if it'll just help those 3 eggs that didn't fertilize to fertilize, that's 3 more embryos to get a chance to grow.

I did hear from the clinic that their baseline dates start from the week of April 7-28. I think I'll be in the week April 21-25. If their baselines are still on Thursday, then I will very easily be able to predict EVERYTHING about the cycle (I actually had a spreadsheet for the IVF #1 before I actually did it, predicting if my baseline was such-and-such a date, & I started stims on such-and-such a date, then here's my predicted Retrieval/Transfer date. I was EXACTLY right.

Now, of course, I am due to ovulate this week (clomid always makes me late, the later I take it, and for the CCCT I took it CD5-9, so probably CD16-18 O date). So we'll have a chance at pregnancy, but I am just going to pray and hope.... It would be so nice not to have to do IVF again. But I'm ready, if it comes to that. At least I'll know this was our last chance before that. I actually never have minded IVF, and if it were closer I'd go so far as to call it pleasant (booking airfare and rental car, being out of my home, being away from my husband, all make it not fun). But anyway, I'll take delight in "shooting up" again.... And pray I get a live baby out of this.

After 5-8 (don't want to count) pregnancy announcements these last 2 weeks from people I am close to or acquainted with, I've decided to just stop thinking about it. People get pregnant, I'll don't think I'll ever be one of those people who get pregnant their first month trying, and can be uber-excited and not fear miscarraige, but it's life & I've gotta deal. It's my crisis, no one else's. Can't expect understanding from women- except from you my dear online friends!!! I cherish your support so much!

IUI #3 Failure

So uh, IUI #3 was a failure. I didn't expect it and yet I did. I tested two days ago and the presence of one red line told me everything I needed to anticipate. Combine that with a drastic temp drop and it was confirmed. I splurged on a Venti (I never get Venti) Cinnamon Dolce Latte. And wine. And a martini. Two actually. We were at the beach for vacation, which is loads better than being at home trying to work with such news.

Three days before my IUI, when I was at WH, Dr J told me "Now you know, the increased chances are only with only Gonal-f, not Gonal-f and clomid combined." Huh, I didn't know that. Not that I would have changed anything, I was too afraid of being canceled, having only every tried clomid and had great responses. So, I guess I was expecting this. Next time though, I'll go to Gonal-f alone, if I have any say-so.

IUI #2 Blood & Follicle Update

The appointment went well. These are CD4 Levels:

E2: 38.5
FSH: 7.2
LH: 9.5
Left Ovary: 6 less than 10
Right Ovary: 5 less than 10

I am going in the Monday after Thankgiving for my next blood/ultrasound. 95% chance I won't have ovulated yet, and they'll prescribe the HCG shot for that evening and the IUI for Tuesday morning. That would be perfect, in my opinion. The alarm clock was 15 minutes fast this morning (accidentally) so I actually left the house at 4:45. Oh well. I got #1 again for ultrasounds. :)

The lady in the lab that took my blood was not good, however! I felt the needle go in WAY too far and it hurt immensely throughout the draw & upon her taking it out. She even asked if I was ok (never had that before). Did she know how bad she was? I even have a bruise, that's a first! The doctor (Dr. M - a good one, but not my favorite) said the usual procedure is to go through 9 IUIs before getting on the IVF list!!! That's a lot! 3 Clomid/IUI, 3 Clomid/Gonal-f/IUI and 3 Gonal-f/IUI.

He did offer to, on an individual basis, consider the fact that we're moving and put us on the IVF list, which is a 12-18 month wait. J & I will pray about all this. Flying back here for IUIs may be more expensive than just doing them in GA. I just don't know. Good thing God promises wisdom for those who ask!

IUI #1 Completed

Last news I got was that we had to move in December, so we only have two more cycles at WHMC! When I went in for my CD12 monitoring, I (fortunately) got Dr. J (the bestest, most understanding and accomodating), and he agreed my next two cycles can be IUI's! Hooray! The morning monitoring was interesting to say the least. I got #1 for Ultrasounds, but the residents had screwed me up by telling me last week NOT to get my blood drawn. Come to find out, I had to get it done. By the time I found that out, about 10 people already had lab #'s. So I waited a while, I think I was the last ultrasound of the morning monitorings, but I was out by 8ish, so no big deal. I'll know better, my instinct told me to just get a blood lab #.

Here were my CD12 numbers's:
E2: 1011
FSH: 3.4
LH: 12
Left Ovary: 14.5, 17.9, 16.4, few less than 10
Right Ovary: 14, few less than 10
Lining: 8.4

As this was Thursday, the doctor said he'd either want a Saturday (CD14) or Sunday (CD15) IUI. He told me to come in tomorrow to see if my LH was surging yet, and if it wasn't we'd do Sunday. I came in Friday (CD13) and got:
E2: 1447
FSH: 2.8
LH: 12

I picked up my HCG shot (Novarel) and was given instructions on using it. WH is doing studies on pregnancy with 12hr or 36 hr post-trigger IUI's. I'm in the 12-hr group, so J gave it to me intramuscularly on Saturday night. I was anxious leading up to it, but the dr called that night to make sure I felt ok (see why I love him?). J did so well (precious husband) that I didn't even feel it, though I did ice the area for 10 minutes beforehand and sang loudly as he injected it. Still, months ago when I mentioned the future possibility of needing him to give me shots, he insisted he'd never do that. When it came down to it, he agreed. Much better than giving it to myself (the doctor wasn't in favor of it for this shot my first time)

Sunday morning was the Big Day: my IUI. Everything went perfectly, and it was only slightly painful cramping for an hour or so. A resident dr and my fav dr did the procedure. Later, when all the follicles were releasing their eggs, my left ovary hurt immensely for the rest of the evening. It was the one that had 3 follicles. I was so very glad to know what was going on and that everything was timed so perfectly. Although - for what it's worth, I chart religiously and my temp shot up that morning. I imagine I already ovulated at least the biggest egg. I asked the doctor about it but he said it should be ok. I'm a little upset they don't do ultrasounds or blood draws on the IUI day, but I guess their philosophy is, we're going to do it anyway, why waste the resources? Sperm count post-wash: 95 million, 55% motile.

I also want to mention, I know I've expressed frustration with the military infertility clinic here. Well, 3 visits ago, for my hysteroscopy and baseline ultrasound, I got another of the 4 staff doctors, but one I hadn't met. I have finally learned who the staff doctors are, and who the residents are, and that the only people with authority and real knowledge are the staff doctors! Anyway, I got Dr. J and he was completely different than the others. Very willing to work with us, initiated asking me how long we'd be in San Antonio, and offered to put us on a faster track since we wouldn't be here long. He's not all caught up in the schedule of how things should go, he calls me personally to verify or inform me of things, and he is sincerely kind and personal. Plus he's good. He answers every question I can think of. So I'm thrilled. From now on, I'm going to try to get appointments with him. So here's hoping for some good news in 2 weeks. But if not, we shall try, try again.

ER Visit!

I So know I'm not the only one on on an unmonitored Clomid cycle, but I have been warned it isn't safe. I have asked to be monitored this 2nd cycle, but the doctors refused. Now I'm mad.

First off, let me say that on Friday J and his 2 brothers left for a wild boar hunt. They were out where there is no cell service, and the little cabin only runs on a generator (no toilet, even), so no phone whatsoever. His 15 year old sister C was staying with me and we'd planned a fun few days. The boys weren't to return until Sunday evening.

I went to bed Friday night with strong lower abdominal pains. Felt like gas. I slept and awoke at 2:45 in severe pain. I went to the kitchen for a Gas-X and my vision got black for 5 seconds. I held the counter. Then I reached up for the medicine.... The next thing I know I'm lying on the kitchen floor, staring at the ceiling, not knowing how I got there or how long I was passed out. I headed back to my room and again, thinking "I've got to lay down", and I wake up to find myself on the closet floor, stairing up, wondering how and why I was there (again, I'd passed out).

I didn't know why I was passing out. I went to tell C what was up. I called a hospital who told me they couldn't give medical advice. They gave me a nurses line to call. The nurse said it was serious and I should come in, but not drive myself. C can't drive a stick, and all I had at that point was one. I didn't want to call any friends at 3 am, and they all live at least 15 minutes away. So I called the ambulance. I have no idea whether TriCare covers that, I tried to look it up, and it looked like they might. I was relaly hoping J wouldn't get upset at me for calling an ambulance!

I was taken to a hospital and the inital thought by the doctor was that my ovaries had ruptured cysts on them. The dr was angry I was on unmonitored clomid (100 mg, which I think you should start out on 50mg) and said it was irresponsible. I have to agree, even though I know it's cheaper to not monitor people & I'd already done one cycle just fine with it. The hospital gave me an IV with Demerol and fluids and something else. The Demerol made me see two of everything and loopy. C read to me and I kept thinking I was saying gibberish. She says I said nothing but moaned.

I had to have a CAT scan to ensure my appendix was ok. It was, but they said I had a lot of fluid and a little blood in my abdomen. That was the cause of the pain/swelling, and I passed out from pain, they said. They sent me home after 9 hours, but told me to follow up with an OB-GYN on Monday (they're all off, so I'll go Tuesday). They said it could have been a ruptured ovarian cyst, and unrelated to the clomid, we're not sure. It seems highly unlikely that I as a healthy female who's never had any pain or trouble with my uterus/ovaries/etc would all of a sudden have a cyst burst.

Right now I'm mad at the dr's at WH for their irresponsibility in this. I'm mad I went through this (almost) all alone. I'm upset J wasn't there for all my pain.

***UPDATE: So I finally broke the news to J as they drove away from the ranch. He took it TOO WELL! He was so calm, I got so upset that he just didn't care! However, he was inwardly upset but just didn't know how to react, he told me. Monday we took the siblings to the RiverWalk and had a grand time. I was in mild pain, and did end up getting a 102 fever that evening/night.

The dr's appointment on Tuesday was a joke, at first. For some reason the files didn't show why I came in - they thought I was just coming in to bug them about the HSG results! All I got this time was a resident dr and they have no authority at WH! She kept trying to tell me that the clomid could in no way cause my ER visit and blah blah. I started crying and basically told her I couldn't stand for this to happen again and I needed answers. J says she looked out of her league & she went off to get one of the staff dr's. He immediately said "Let's do an ultrasound." And he found a "hemmoragic corpus luteal" cyst on each ovary about 2cm in size, and blood/fluid in my abdomen. He said I'd released eggs from both ovaries, and I don't know why they were hommoragic. I had to press for options to keep this from happening agian. He said I could now go on 50mg Clomid, rather than 100, and be monitored! Yes! They didn't have the HSG results back.

And The Results Are In.....

Unexplained Infertility. How interesting is that?

Here are my Cycle Day 3 (CD3) blood levels (info obtained here, though don't consider it the "Bible"):

FSH (Follicle Stimulating Hormone): 6.6 - A Bit Disappointing (On CD3 it's a gauge of ovarian reserve. Under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stmulate)

LH (Lutenizing Hormone): 8.4 - That stupid webpage said it should be less than 7! I looked extensively & can't find out why the devil this is. Arg.

E2 (Estradiol): 60.1 - Should be 25-75, levels on lower end better for stimulating, abnormally high levels may indicate a cyst or diminished ovarian reserve.

Here are my Cycle Day 10 (CD10) blood levels, after CD 5-9 on 100 mg Clomid (The Clomid Challenge Test):

FSH: 7.4 - I think agian, should fall within parameters of CD3 level. Darn.

LH: 26.3 - LOL. Look for 25-40 on surge day, which was on CD 16 for me this time. whatever. LH surge leads to ovulation within 48 hours.

E2: 620.3 - LOL again. 100mg of Clomid sure affects me! Look for greater than 200 on surge day, which again was 5-6 days from now!