Thursday, September 25, 2008

IVF#3 - CCRM One Day Workup

Hello Everyone!

We just got back from Denver and what a whirlwind it was!!! Sorry for the late update, but I have been completely wiped out. I don’t know if it was the elevation change (4500 ft higher than home) or a 6 hour non-stop workup with no food/water, but both of us were pooped our entire trip.

My cd3 frozen blood serum made it through security and into the hands of CCRM, hooray! Can you tell I’m proud?

Our workup was Tue @ 8am. This is pulling up to CCRM, Kerry was getting a kick out of how giddy I was.

I guess when you’ve done the amount of research I’ve done on this place, it becomes pretty cool to finally see it in real life. This entire building (3 levels) is all CCRM, no IVF clinic has this size of a building without the success rates to back it up. It was beautiful inside. Here’s me standing by their waterfall.

We started off with the IVF nurse consult. As soon as they called us back, I proudly handed her my serum, mission accomplished! They assign a nurse and want you to build a relationship with them as you will be working with them throughout the entire process. I was hoping and praying to get a nurse that gives details. When my results come in, I don’t want an “everything looks fine”, I want to know my exact numbers etc. I’m anal and analytical and Kerry knows that about me, so he proceeds to tell our nurse Kathy our situation and how stressed out I get if I don’t get details and to please give his wife the details so that he can be spared. She then tells us that we are a perfect match because she’s very detailed and loves to explain everything thoroughly. I love her! We spent so much time gabbing that we got behind and she had to ship us off to our next appt with the business office. Here we basically signed over our entire 2009 income in 5 minutes.

Next they sent Kerry off for a semen analysis and an antisperm antibody test and me off to complete some procedures. I started off with an intra-vaginal ultrasound where she thoroughly looked at my uterus and ovaries. Other than a small cyst on the top of my uterus that wouldn’t affect anything, she said everything looked great. My left ovary was showing a 15mm dominant follicle that will ovulate soon. My antral follicle count was 10-12 total and she said that was really good considering my situation. She then continued with the Doppler blood flow test, still using the intra-vaginal u/s, she finds the uterine arteries and watches the blood flow to my uterus. All I can hear is this loud swooshing sound which was my heart beat. She kept coming up with different readings so she hung out in there for at least 10-15 minutes, I was about to charge admission. It was becoming quite uncomfortable as she moved the wand at different angles, not to mention all the pressure it was creating. I swore if she didn’t get out of there soon, she was going to get a little surprise. They want the readings to be less than 3. My left artery was 2.63 and my right was 3.43. She said it was borderline, I was happy with that. Next was my hysteroscopy with Dr. Schoolcraft. This would be my first time meeting the guy that I have done so much reading about. He was really nice, quiet and humble. The hysteroscopy was by far the worst part of the day, but very quick. He inserted a speculum, cleaned my cervix with iodine, injected some lidocaine, dilated my cervix, injected CO2 gas, inserted the scope, viewed my uterus and did a trial embryo transfer all in no more than 2 mins. I would have loved to seen the look on my face when he said he was all done, $625… 2 mins!!! The pain was a little intense but it was so quick that it wasn’t too bad. He said everything looked great. So which one of us, me or hubby, would you say got the crap end of the deal? You be the judge.

We then went to our regroup with Schoolcraft. It was nice to finally get to talk to him “face to face”. He had no test results at this time other than a great looking uterus, so we unfortunately did not receive the details I wanted like what protocol he would put me on. He did make the observation that I’m a bizarre case, not his words, but he said things didn’t add up with me. My husband could have told him that for free. He said with my high FSH and low ovarian reserve, he’s really surprised by the quantity of eggs that I produce and really surprised by my outrageous estradiol level. I basically have the diagnosis of a poor responder but respond very well. He reiterated a lot of what we discussed in our phone consult so there wasn’t much new stuff said. He did suggest some additional testing back home that I’ll need to complete before I cycle, oh yippee, more tests! He’ll have more answers after he sees all my test results.

We returned to nurse Kathy for our consult part 2. We spent the entire time going through paperwork and signing consent forms. It was a tornado of information and even I was overwhelmed. I cannot even imagine receiving all of this if I’d had not been through this 2 other times. Total info overload, but incredibly thorough.

Our last appt was with the lab to draw blood. They will be testing both of us for Hep B, Hep B Core, Hep C, HIV I&II, RPR (Syphilis) and female antisperm antibodies. We have already passed all this testing from our first IVF, but required to do it again.

Here are the additional tests I need to complete back home:

Blood work: Thyroid, Varicella Zoster (chicken pox), CBC (complete blood count), Fragile X (mental retardation) and a Chromosome Analysis to see if I can produce normal eggs.

Procedures: HSG (inject dye into tubes to make sure open), Mammogram and 8 sessions of electro-acupuncture to improve my uterine blood blow.

I suddenly feel overly compassionate towards lab rats.

Wed we treated ourselves to a vacation day. We went hiking in Red Rocks Park. It was beautiful. They have a natural amphitheater there that was really cool. The increase in elevation totally came into play here. We were so out of breath at the slightest incline, we felt fat and out of shape, great for the ego.

We had to return to CCRM today so that Kerry could give a semen sample for a frozen backup just in case anything would happen like missing his flight during egg retrieval. We then had to scramble to the airport. Kerry went on to Las Vegas for training and I came back home to Nashville. Ahhh, oxygen, I can breathe again!

CCRM called after I returned home and gave me a few of our test results:

Semen Analysis, reference range is in ( )’s:
Volume 3.3 ml
Concentration: 25 mil/ml (>20)
Total Count: 82.5 mil
Motility: 22% (>40%)
Motility Rate: twitch to 1+ (2-3)… this is the biggest problem
Morphology: 2% normal (>4%)

Antisperm Antibodies:
IgG: 44% head, 0% entire, 3% tail, 0% mid
IgA: 7% head, 0% entire, 1% tail, 0% mid
I don’t really know the difference between the G and A antibody, but head is the worst place to have antibodies. They said it was a very good thing that the entire sperm wasn’t covered in antibodies. I guess this adds up to 55% antibodies and they want it below 20%. His last ASA in Sept 2006 showed 64% antibodies, so I guess this is slightly better news. Fortunately IVF bypasses this issue.

CD3 Blood Work:

FSH: 12.1 (less than 10)… this is elevated, but I’m quite happy with it as it was 12.48 8-months ago, so very thrilled it hasn’t gone up!
E2: 26 (less than 50)
AMH: 2.0 (greater than 1.5)… this was a new test for me, it stands for anti-mullerian hormone, it’s a test for ovarian function. The nurse said 2.0 was great and means I will respond well to meds and therefore they can give me gentler dosages… yeah!!!! Guess this explains why I respond so well despite the high FSH. If only my local clinic would have tested me for this, they wouldn’t have put me on a bazooka of a protocol on max stims.

I’ll send out updates as I get in more results. If you’re still reading, I commend you for hanging in.

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Thank you for your comment! Hugs, Kerry and Jill