Sunday, November 30, 2008
E2: 6045 (up from 5519, really high, but much better than my last IVF where I went over 9000)
P4: 6.95 (I don't know what this should be but the nurse said it was good)
HCG: 284 (should be > 120)
I'm back from egg retrieval. Dr. Gustofson did my retrieval and he was great! We got 23 eggs!!!! (IVF#1=10, IVF#2=19) I was expecting a max of 19, so I'm quite pleased. Everyone was wonderful and it was a great experience.
The embryologist said the sperm wasn't too great and only had 5% motility. I'm hoping for a good mature/fertilization rate tomorrow. This is where we always go down hill fast. I'm praying they are able to work their magic in the lab as this is why we have come to them.
For those that aren't familiar with this process;
Day 0: Egg retrieval / Fertilization
Day 1: Embryos are 2 cells
Day 2: Embryos are 4 cells
Day 3: Embryos are 8 cells
Day 4: Embryos are called a morula
Day 5: Embryos are called a blastocyst
The standard is to do a day 5 transfer. This allows them to pick the best embryos and weed out the bad ones. It also allows you to transfer the embryos back in when they would naturally enter the uterus. Day 5 has a higher success rate. If the embryos aren't doing well or if there are only a few that made it, they will do a day 3 transfer. I was kinda bummed because they have already scheduled us for a day 3 transfer today, I guess based on our history, they really don't think we'll make it to day 5. Out of 29 eggs retrieved in the past, we have only had one embryo make it to 8 cells, all others were 5 cells or less. I would love nothing more than to finally get a blast. I'm still holding out hope.
I have an ultrasound tomorrow morning to make sure my abdominal cavity isn't filling up with fluid. I'll also get a call from the embryologist letting me know how many eggs were mature and how many fertilized. I'll send out an update with the results.
Thanks everyone!!! I'm off to bed for a nice post-anesthesia nap.
Friday, November 28, 2008
I was so nervous at today’s u/s. I watched the screen intently watching the sizes flash on the screen. Within a minute I was able to take a deep breath and relax, my follies had grown and even made up for lost time. After my u/s, I talked to my nurse and asked her if I made the right decision to delay the trigger and she said with full confidence “Absolutely!!!”. That made me feel so much better. After seeing my follie sizes, I knew it is definitely time to trigger now. I asked her if I would tonight and she said we would have to wait and see what my e2 was. This made me a little nervous because if I don’t trigger tonight, my follies will be over mature.
I was due for my morning shot while talking to my nurse but I was out of Menopur. She went and got a vial of Repronex which is very similar to Menopur and said she would give me the injection. I didn’t realize until she started making the injection that it was a big intramuscular shot, yikes! She had me bend over and gave it in my hip.
Next I went to my 4th and final electro-acup appt.
The ccrm call always comes in around 3pm. But today, it didn't come till 5p. I was on pins and needles waiting to see if I would trigger tonight and it seemed like an eternity for that stupid phone to ring. It was the same nurse that I freaked out on yesterday. She started giving me instructions and wasn't saying anything about triggering. I was praying I wouldn't have to freak out on her because they weren't going to trigger me. Finally she said the magic words, we're triggering you tonight. Hallelujah!!!
I trigger tonight at 10:45p. Kerry will be giving me this honkin shot in the hip, our nurse gave him a target.
Here's my complete results from today (day 11):
E2: 5519 (up from 3896 yesterday, yikes!!!)
Follies: 14.9, 15.5, 16.3, 17.5, 17.9, 18.3, 18.7, 19.3, 19.4, 20.0, 20.8, 22.7
CCRM is pretty concerned about my high e2 and are going to be watching me closely. They don't like it to go over 4000. I go in tomorrow morning for a blood draw to see how much my e2 goes up after trigger. Last cycle I went over 9000. My egg retrieval is Sun @ 9:45a. I will go in for an u/s on Monday to make sure I don't fill up with fluid. If they feel I'm at too great of a risk for OHSS, they will force me to do a freeze all cycle. This means they would freeze all my embryos and send me home. I would have to come back another cycle for a frozen embryo transfer.
After 3 cycles and having my e2 go out of control on all, I think I have proven that I am definitely not a poor responder despite my high fsh. It's frustrating that it took 3 cycles for them to come to this conclusion.
Thank you so much for hanging in there through all my ups and downs.
Thursday, November 27, 2008
I was back at the hotel sound asleep when ccrm called. I jumped up and answered it completely out of it. The nurse starts giving me instructions to trigger tonight. She might as well thrown a grenade at me. I panicked and said noooo, it's too early, my follies are too small!!!! I asked her who made this decision and it was Dr. Gustofson, not Schoolcraft. I begged her to let me talk to a Dr. because this is my last chance and I can't be triggered too early like I was on IVF#1. I asked if there was any way she could talk to Schoolcraft and make sure this is what he would do. She said she would talk to Dr. G as Schoolcraft is out and then call me back.
She called me back a few minutes later and said Dr. G was ok with me stimming one more night. He had made the decision to trigger me because my e2 had plateaued. It had only gone up by 96 to 3896. This was definitely a first for me, I've never had my e2 do anything but jump by leaps and bounds. So then I started panicking about that. Was I making the right decision to not trigger now. What does plateauing mean, have we starved my eggs, have they stopped growing because they died off??? The nurse said that the doctor would not have been willing to delay the trigger if he felt it would be detrimental to my cycle. My head was spinning.
I was instructed to take 75 Gonal, 1 Menopur tonight and 1 Menopur in the morning. I'm to come in for a day 11 monitoring visit in the morning.
The nurse called back a few mins later and said Schoolcraft had just called in and she discussed my situation with him. Schoolcraft said he understood why Dr. G wanted to trigger me and that he is fine with having me stim one more night. The nurse then reiterated that Schoolcraft would not have let me do anything detrimental to my cycle.
So now that weight is on me, did I make the right decision begging to stim another night? The fear has kicked in overdrive, I can't escape it. Will my follies be rescued by the stims tonight, what will I see on the u/s in the morning, will my e2 pick back up showing some growth?
This was not the Thankgiving I imagined. I've shed so many tears, I've hyperventilated, I've almost thrown up. There is just too much weighing on this, I've been through so much, all the injections, all the money, it just has to work!!! Please God, let me be a mom!
I was in no condition to go out to eat, so we stayed in as the hotel was serving Thanksgiving dinner. It turned out to be microwaved fried chicken and instant mashed potatos. It was pretty disgusting and I couldn't eat it. I ended up having an apple instead. On the positive side, at least I won't have to spend the next 3 months taking off the weight.
I guess the roller coaster has taken off. This has turned into a Kingda Ka ride. This is a roller coaster in Six Flags NJ. It is the tallest and fastest roller coaster in the world. It goes from 0 to 128 mph in 3.5 seconds and literally goes straight up in the air and then straight back down.
I'm a roller coaster buff and even I nearly dirtied my britches. See for yourself; I'm above the K on the left and behind the guy's hand on the right, Kerry is next to me:
I kinda resemble the guy from Scary Movie!
Here's my complete results from today:
Follies: 11.2, 12.3, 12.8, 13.0, 13.8, 15.1, 15.3, 15.8, 15.9, 16.2, 17.3, 17.5, 18.8, 20.4
Trying to remain positive...
Wednesday, November 26, 2008
E2: 3800 (up from 2386 yesterday, so much better than last 2 IVFs, but still creeping up there)
LH: 1.5 (good)
P4: 0.4 (great)
They counted 14+ follies at 12-17mm.
I addressed my concern of having a history of e2 going sky high at my appt. On the call, they said no Gonal-f tonight and drop down to 1 Menopur in the morning. Gosh they are on top of things here! I have a day 10 monitoring appt tomorrow morning. Looks like I'll trigger either Thur or Fri and have egg retrieval on Sat or Sun.
I was told to drink tons of water and eat lots of protein and salt. So we're going to a steakhouse tonight. They have live music and a dance floor which is just going to drive us bonkers to not be able to get out there and dance. Kerry said, you know it's going to drive me crazy to not be able to dance with you. I said, well, I can do a little dancing as long as I don't shake my egg makers too much. He laughed and said, yeah, instead of your money makers, or shall we say money spenders. He's got that right!!! We've already spent the kid's college and wedding fund before the little one has even been conceived.
Tuesday, November 25, 2008
E2: 2386 (shot way up from 720, but still ok)
LH: 1.24 (great)
P4: 0.64 (great)
Lining: 11mm (great)
Last 2 IVFs my E2 on day 8 was 4245 and 4385, so I'm doing much better this time!!! I just hope it stays under control.
Tonight they are lowering my gonal-f for the first time from 300 to 150. They are keeping my menopur at 2 vials. I have monitoring every day from here until trigger. My tentative egg retrieval is Sat.
My date for the rest of the week...
This photo reminds me of a funny story from IVF#2. Kerry and I were sitting in the ultrasound room waiting for the tech to come in. We were talking about how unnatural IVF is and how you are robbed of conceiving through love. I then pointed to the wand and said, you've been temporarily replaced. Kerry then held up his hand and said, that's ok, you've been temporarily replaced too. We laughed so hard. When your circumstances suck, you just have to laugh at it.
Monday, November 24, 2008
After monitoring we headed up to Boulder, then Estes Park and then spent the entire day in Rocky Mountain National Park. It was a great time, though extremely cold at certain elevations. We did some hiking and then we just couldn’t resist doing a little boulder climbing. As a youngster, you could always find me at the top of a tree or on the roof of a house, if it could be climbed, it was climbed. I was very careful to not jiggle my ovaries too much, but it was the best time ever, stress-free, no worries, just the two of us enjoying being a kid again. I thought I would share a few pics from our day…
CCRM called with my results while we were in the park where I had no signal. The message only said to continue my same dosages and that was it, no results!!!! I finally just now got my results and I’m oh so happy!!!
Day 6 Last IVF:
E2: 1074 (way too high)
Day 6 This cycle:
E2: 720 (perfect!!!!)
LH: 0.58 (perfect)
P4: 0.2 (perfect)
Lining: 7.6mm (perfect)
Eggs: 19!!!! (Geesh, I did some serious growing from 10 eggs 2 days prior)
On another note, electro-acupuncture is going well, whew! It wasn’t painful at all, very relaxing actually. It feels a lot like the muscle stims they put on you in chiropractic. I have a 7:45a monitoring appt tomorrow followed by a physical. I’ll send another update as soon as I get my results.
Friday, November 21, 2008
As a comparison, this was Day 4 on IVF#2:
Lining: 6mm (good)
E2: 668 (way too high)
Eggs: 11 less than 10mm and 2 micros for a total of 13 eggs (good)
Here’s today’s results:
Lining: 7-8mm (good)
E2: 252 (good)
LH: 0.6 (good)
P4: 0.2 (good)
Eggs: 7 @ 8mm, 1 @ 9mm and 2 smaller ones for a total of 10 eggs (good)
I think I’m off to a great start and am very happy with the results! I have acupuncture tonight, it will be my first time having electro-acup so I’m a little nervous. My hubby arrives tomorrow morning, yippppeee!!!! My next monitoring appt is Sun. That’s it for now.
Monday, November 17, 2008
What a crazy, crazy day! It started off with frantically trying to find someone that could do my ultrasound today, I had no luck. Then Kerry called back the clinic that had just told me they had absolutely no availability, he begged them and said “it will take you 5 minutes to wand my wife”. I immediately took the ostrich pose.
He actually got me the appt, now I would have to face them. Next I had to schedule blood work, no problems there, but I needed to get there like right then. My ob/gyn has bent over backwards for me throughout this entire process, I asked for it, she prescribed it. I just had to do something nice for them. So I ran to the kitchen and mixed up a batch of cookies, threw them in the oven and ran to blow dry my hair. As soon as the oven when off, I grabbed the cookies and ran out the door. I got my blood drawn and they were so thankful for the cookies. I rushed back home and worked for a few hours and then ran to my ultrasound. They were so nice, and thankfully I was so frazzled from the last few days that I totally forgot about my husband’s conversation with them.
So for my results…
Estradiol (needs to be less than 50): less than 20
Progesterone (needs to be less than 1): 0.54
Ultrasound: no cysts, 2 micro follicles
I faxed this off to CCRM and got the call that everything looks great and I can start stims tomorrow. What, tomorrow??? I busted my tush getting everything done today so I could start stims tonight and get off this lupron before it over-suppresses me. But they want me starting stims with a full day, meaning menopur in the morning and gonal-f/lupron/dex at night. Oh well, what’s another day at this point. This will be my new regime starting tomorrow and will continue for about 10 days:
Next I had to book all my travel and schedule my first monitoring appt. Thankfully this went well and I got some great deals considering this was last min. I fly out Thur Nov 20 at 6am and my first monitoring appt is 9:30a Fri @ CCRM. OMG, OMG, OMG, it’s finally here!
Saturday, November 15, 2008
Friday, November 14, 2008
Auntie got revenge! I only wore that white outfit long enough to take a pic for a joke, well now the joke is on me, she in turn only spotted long enough for me celebrate and announce her near arrival.
I woke up this morning really hoping to find AF and instead I found that I still have a high basal temp (meaning my progesterone is still up there preventing AF). I took a pregnancy test this morning so I’m definitely not preggo. Once again I had to cancel my suppression check, now my travel plans are officially derailed. My next suppression check is scheduled for Tue Nov 18, this is the earliest I could get in. So now it’s time to switch gears. I need AF to stay away till Mon morning.
My goal is to just make it to Denver before I end up in a loony bin! Thanks for hanging in there through my crazy reality.
Thursday, November 13, 2008
Well I had to cancel suppression check today. Still no sign of Auntie Flo! Technically I'm not late according to my normal cycle, but I'm late according CCRM's calendar which is messing up my travel plans. I've found that delayed menses is a very common side effect of lupron, great. So now I sit at the mercy of my aunt, the one that has been nothing but a pain in my uterus since I was 13.
I do have another suppression check scheduled for tomorrow so I desperately need her to arrive by morning in order to stay on track.
Desperate times call for desperate measures... it's time to pull out the big guns... on my way to the mall. (That's a pregnancy test in my pocket)
Wednesday, November 12, 2008
Today I went to my 4th acupuncture appt and I had this new guy who I’ve only seen one other time. In addition to the uterine blood flow points, he said he wanted to do several stress points because he could tell I’m stressed out. Then he asked me to undress down to my panties and bra and I said “are you SERIOUS???”. I’ve done acupuncture for a year now and have never been asked to remove clothing. He said that since I had stretchy pants, I could just pull the pant legs up but he needed to get to my entire back for the stress points. He left the room so I could remove my shirt and have time to lay on the table. I thought, well, I’ll be laying on my stomach, he’ll only see my back, so I took my shirt off. Then I had a panicking thought, when was the last time I shaved my pits??? I took a quick peek and Ohhhh H E double hockey stick NO, that shirt was going right back on. He walked in and I was lying on the table with shirt on but hiked up and I said, sorry dude, the shirt stays.
So tomorrow is my suppression check. This is where they’ll ultrasound my ovaries to make sure they are nice and quiet, no cysts. They’ll measure my uterine lining and hopefully count micro follicles. They’ll check my estradiol and progesterone. Estradiol should be less than 50 and progesterone less than 1. With this particular protocol, you have suppression check the day of or day after you start your period. I’m fearing this more than anything, getting wanded while on your period has got to rank up there on the scale of humiliation. I’ve chosen to view this as a warm up to pushing out a baby. If I pass, I get to start stims. One big problem, there is no sign of auntie flo in sight. I was thinking, they are putting my body in a menopause state, doesn’t menopause mean no period? For the past 3 years I’ve begged her to stay away, now that I’d appreciate a visit, she’s flown the coop. I’ve tried teasing her with the home pregnancy tests, that usually always gets her attention. I guess I need to put on my sexiest undies, some white pants and go to the mall with no protection. You know me, I have a backup plan. I have another suppression check scheduled for Fri in case auntie is late, but she’s pushing it because I need to start stims Sat in order to not interrupt my travel plans which is to depart Monday. I already have the hotel booked and have a travel agent standing by ready to book a last min flight/car as soon as I say go.
Tonight will be my 8th lupron injection and I feel pretty darn good. If this is menopause, yeahhh…I can handle it.
Hope to give you suppression results soon…
Thursday, November 6, 2008
I have been left feeling condemned, I have had no sleep, this has caused me a painful amount of stress and I’ve been crying my heart out. Starting lupron was not something I took lightly. I spent hours researching every aspect of this situation, I consulted my ob/gyn, my IVF nurse and other IVF patients. My ob/gyn said my progesterone (aka p4) levels were on the high end of completely normal as did many lab references online. I found countless women that had elevated p4 that were not pregnant. P4 levels do not predict pregnancy especially before implantation. A hike in p4 induced by pregnancy can only happen after implantation has occurred and after it has secreted hcg to tell the corpus luteum to pickup its p4 production. My p4 was elevated before implantation was possible. If my p4 was elevated because of pregnancy, that would have meant an extremely early implantation that would have had time to spit out hcg to call for more p4 resulting in something showing up on the beta (btw was < 0.5). Some of the more likely causes, acupuncture/chiro that has increased blood flow to my reproductive system or possibility of ovulating more one than one egg. Also, since I’ve never had a baseline p4 done before, how do I know that this isn’t normal for me?
Now is it absolutely impossible that I could be pregnant? No, but highly unlikely. The only sign that pointed to a possibility of pregnancy was the elevated p4, one that has now been found as not an indication of pregnancy. I have never in my life been pregnant, we’ve tried for 3 years, we’ve failed 2 IVFs, Kerry has extremely weak sperm that are rated as twitchers and are covered in antisperm antibodies preventing their ability to swim or penetrate an egg. We were only together once this cycle and I immediately went to the bathroom if you know what I mean, it was also 4 days before ovulation which would make it even more difficult for Kerry’s weak sperm to survive that long. I could go on and on with all the obstacles against us but the point is, it would take a miracle for us to conceive naturally, a miracle that I would die for. So if this was God’s timing to give me that miracle, I don’t think he would have allowed the beta to be negative. I prayed all the way from the phone call to the beta that if I was pregnant, please reveal it to me through this beta before I start Lupron or guide CCRM to cancel me. I don’t think it’s his nature to perform a miracle and then allow everything to fall in place to blow right through it.
My previous email/post may have contained humor as I always try to make the best of the situation handed to me, please keep in mind that you did not experience the behind the scenes, the emotional roller coaster, the extreme stress, the research, the decision making. This was not a simple solution of just waiting a few days to make sure I’m not pregnant and then just continue on. If I wait, that means it will be Jan/Feb before I could cycle again. I have invested an incredible amount of time, energy and money into this situation. To someone who wanted to be pregnant 4 years ago, delaying is painful especially when my issue is age related. At the same time, the last thing I want is to Have to do IVF, pay all this money and go through all these injections and surgery, so I took this very seriously. The other issue is that no matter which month I do IVF, it will be the same protocol where I’m faced with starting lupron after ovulation.
This whole situation occurred because my IVF nurse had the responsibility to be overly cautious and she’s the same person that told me to go forward with the lupron, they would not have told me to continue if they felt that I was pregnant. After all that I’ve been through, who do you think would be the first person to be the most cautious/concerned about this situation, that would be me. I am so sad right now. I have this sick feeling like people think I’m out to abort my baby. I cannot bare having to deal with these thoughts in my head each and every night I have to inject. These are hard times for me, a time when I need your full support and comfort. My husband has assured me over and over that we made the right decision. Please let me know you are on board with me, I need to hear it. I want to be excited about this journey. Love, Jill
Wednesday, November 5, 2008
So my beta just came in and I’m NOT preggo, so if you’re holding your breath, go ahead and breathe again. My ob/gyn was completely baffled why they ordered a beta at this stage, even if I was preggo, it would be too early to tell because implantation hasn’t even had time to happen. I agree, I think my IVF nurse was just being cautious thinking that if my progesterone level was induced by pregnancy, then it would show up, plus Lupron is not safe for pregnancy.
Now I’m getting in line for the adult roller coaster, the one that ends in Denver. Just waiting to see what my IVF nurse wants me to do next.
Thanks for being excited for me even if it was only for a day. It was the first time in my life a doctor/nurse thought I was pregnant, so even though it was emotionally draining, I got to experience just a touch of what it would feel like for someone to say “you’re pregnant” and it was the most amazing feeling. Moving on and looking forward to hearing it for real.
I'm also doing chiro 3x and acupuncture 2x a week to resolve my low uterine bloodflow.
Two differences with CCRM over my local clinic:
1. They insist that the Lupron is name brand, local uses generic.
2. They use Dexamethosone, local does not. This prevents the excess secretion of male hormones from the adrenal gland.
This little tiny vial costs $497 and it's only a quarter filled, can you believe it? Fortunately because it has many other uses, my insurance paid for it and I only had to pay a $25 copay.
Tuesday, November 4, 2008
Please pray for me, this would be an incredible miracle.