TWW: Delicious Distractions

Today's two week wait distraction comes in the unexpected form of absolutely delicious, deep dish, chocolate chip cookies. It all started at about 10:30pm when, still full from a dinner of lasagna, salad and rather good red wine from BevMo's sale, E turned to me and asked if there was any way I could make him cookies. Home made, deep dish, chocolate chip cookies, to be precise. Was there any way I might have the supplies to make them now?

I've never been one to turn down and opportunity to bake and as I told E, I've never had a kitchen that didn't have the most basic baking ingredients in stock. Chocolate chip cookies, I told him, definitely fall under the basic ingredients category and I happened to have another muffin top pan sitting conveniently nearby in the shopping bag I hadn't yet unpacked. Muffin top pans are some of to favorite kinds of pans and I've developed the habit of buying one every time I see them. This new one was number 4 in my collection. 

It took me a few minutes to gather the supplies and start mixing everything up, but by 11:30, three trays of deep dish chocolate chip cookies were wafting their chocolatey aroma throughout the house. This time, I used the traditional Tollhouse chocolate chip cookie recipe and made 18 cookies using a muffin top pan with 6 cookie spots. Each depression got a very generous tablespoon of cookie dough and it ended up being the perfect amount. 

They were absolutely delicious. Crisp on the outside and soft on the inside, with warm melty chocolate chips throughout. E had inhaled two before I got the second tray out of the oven. They're definitely an easy crowd pleaser and were an excellent distraction for this evening. 

Today was a long, hot day. E was off work, a rare Saturday off day that also happens to be his only off day in a 20 day stretch. Milou had agility class, which was somewhat less fun than usual given the miserable heat, and E and I spent most of the day attempting to stay cool and nursing giant Jamba Juice smoothies. I know the acupuncture diet says no cold food, but I couldn't even look at a hot meal until the evening. 

I also found out that one of the women on an infertility board I frequent just got her BFP. She also had 6-7 eggs this month so I'm taking it as a good sign that 7 eggs is this cycles lucky number. Only 6 more days until I can start testing and I really, really hope this is it. I've been crampy and bloated and of course my boobs are sore but I don't want to read too much into it because it's probably all from the progesterone in the Endometrin. Thanks Endometrin! You know how I love you.

A Loooong Morning

At 6:45am this morning I found myself driving around in circles looking for parking. There was a massive construction zone in front of the hospital and my usual parking place was "No Parking" till after 8am. I ended up finally parking up the street at a meter that didn't start till 8, but was happy to accept every silver coin I had to get to 2 hours in case I wouldn't be able to come back down.

The ground floor was empty, not even the security guard was there, and I went up to the third floor lab to find that dark and deserted too. Not only was the floor empty, but the lab was closed on the weekend, despite what the Phone Nurse had told me yesterday. I was not at all amused and went up to the next floor where my RE's office is to ask one of the nurses if I should try another lab. This is what I saw when I stepped off the elevator:



As you can see, that door is clearly locked. There wasn't a soul on the floor to ask and even the door to the stairs was locked. I pushed the call button to get another elevator back down and the cabin was full of cheerful construction workers who were happy to joke about my appointment screw up but who said they weren't planning on unlocking the door until 11am. Well, Fuck.

I got back down to the ground floor and decided to try the medical offices next door, which I knew would have an open lab on the 3rd floor and hopefully someone I could talk to. Thankfully the lab was open, if busy, and I was able to get my E2 drawn by 7:30am. The techs were really nice but had no idea when the neighboring building would be opening back up so I went back to the ground floor and just as I was leaving, I saw a security guard who was heading out the front door. She was exactly the kind of person I had been looking for and she told me she was on her way now to unlock my floor! Yay!

We walked back over and as she was letting me in, one of the nurses showed up. By the time I had sat down in the waiting room, 3 couples who were clearly doing their IUIs today rushed in. Three more nurses followed them and another 3 couples, packing the waiting room and making it look as if the place had been open for hours.  Everyone was quietly talking to their partners but it was obvious they had been super worried when they couldn't get in. Normally Saturday is reserved for IUI procedures and I was the only one there being checked.

My ultrasound showed that my 7 follies are still in excellent shape and have grown so quickly over the past day that they surpassed our wildest expectations. Normal growth is about 1-2mm per day, but my biggest follicle had boomed from 15mm to 19mm with several 18mm and 17mm friends to keep it company.  The dominant follicles are starting to edge out and steal resources from the smaller ones, Nurse C made a joke about survival of the fittest, and I think the smallest two are now 12mm and 13mm. I was a little bummed they didn't get a nice boost in growth but it's normal progression once the dominant follicles get this large. 

My E2 came back at 1476 which is fabulous, that's 210 for each of the 7 if you assume they're equal which they're probably not. I think those bigger 19, 18, 17 follies are probably putting out more than 200 now. I'm waiting now for confirmation that I'm triggering today and am planning on the IUI happening on Monday!

So excited! We should be triggering with several mature eggs, I really think this is our month!

Cycle Acceleration!

While on my way to acupuncture this afternoon, I got a phone call from one of the nurses in the Kaiser infertility office. She had my marching orders for the next couple days and wanted to give me my instructions. I was driving so I had her on speaker and was listening for confirmation of Nurse C's instructions when this phone nurse said something completely different.

To Recap, Nurse C's Instructions:
During my appointment, Nurse C said I would require at least a couple more days of stimulation and had me order 10 more vials of Menopur. She guessed that we would be doing my IUI on Tuesday or Wednesday, and that I would be triggering on Sunday or Monday, with another appointment to check growth on Saturday. I would be continuing with my 6 vials of Menopur.

Phone Nurse's Instructions: 
Take the usual 6 vials of Menopur today and trigger on Saturday, with an IUI schedule for Monday. There would be no need to come in on Saturday.

This information did not at all jive with what Nurse C said. My E2 was good, yes, but with 7 follicles it was not the 200+ per 18mm follicle that we're looking for. It did not seem like a good idea to skip Saturday's ultrasound, this cycle and those follicles are too important to screw up. This also meant that we needed to have our donor vial on hand stat so I called the bank and placed our order over the phone. I'm so glad they store purchase history and credit card info, I never would have been able to place the order if the customer service rep didn't already have all my info in front of him.

When I got to acupuncture, I shared my concerns with my Acupuncturist S. Since she's a Certified Nurse Midwife at Kaiser, who has been there so long that she taught most of the OB/GYNs how to deliver babies (including my OB/GYN who is now the head of the department), she has an excellent relationship with most of the doctors, including Dr. K, and also happens to have her personal number. While I was on the table, having a treatment on my back this time, she gave Dr. K a call and talked over my procedure with her. I'm not sure if Dr. K had missed some notes or if she wasn't completely aware of the instructions given by Phone Nurse, but she agreed with me and S that I should be monitored on Saturday. At the very least, this would give us confirmation of the correct time to trigger so as not to leave viable eggs behind. I am incredibly grateful to have S on my team and feel much better about moving up the timeline as long as we check and make sure my eggs are mature first.

The new plan is to take 6 vials today, which I just did, and go in for another E2 draw and ultrasound at 7am tomorrow. I'm really not going to enjoy leaving the house before 6:30am but it's worth it to me to make sure these follicles are mature. If everything checks out, I have my trigger ready to go for Saturday and E has a rare day off on Monday. If they're still looking a little runty, I have more Menopur ready to go to give them a boost. Our vial will be picked up tomorrow and will be good and frosty for 5 days which gives us plenty of time. Whatever happens, we're prepared.

Slow and Steady

I just got out of my appointment and the follies are looking excellent. All seven are still plugging along, just at a slightly slower rate since the decrease in Menopur. I think the largest was 15 and the smallest was 13 so they're developing together, nice and even, but they're not quite ready for triggering.  I'm very pleased with their growth but but a little bummed that we'll need more Menopur like we originally thought. I thought we'd get off easy this cycle!

I just picked up two more boxes, another 10 vials, and got my Ovidrel trigger too just in case. If they need me to trigger on Sunday, the pharmacy is closed over the weekend so  I'd have no way of getting it. I will probably be back in for a rare Saturday appointment tomorrow morning depending on what Dr. K decides. If I don't trigger on Sunday (I don't think I will), they're thinking Monday might be the next contender.

My E2 levels came back this time at 926, an absolutely beautiful number, which if you average it out is about 132 per follicle. I'm sure they're not all in the 130s, probably more like 100-150 given the range of growth, but they're all on track and I have no reason to suspect that they won't all be ready to ovulate by the time I trigger. I love seeing those little follies on the screen, they show up as large, round, dark circles which is such a nice change from the empty, blurry grey ovarian tissue we saw last cycle. 

What a tiny order! This is the smallest one I've bought yet, it was only $730. What a bargain!

Although the appointment went well, the blood test this morning was a little hairy. I didn't have my usual phlebotomist and this new one didn't take my warning of difficult veins seriously. She tried first on the left, which is nearly impossible to find, before giving it up as a bad job and moving to the right. The right was already a little bruised from the draws on Monday and Wednesday and she only made it worse by repeatedly poking me and wiggling the needle around in my arm. It wasn't super painful, but was enough to raise my blood pressure up about 20 points as we saw when I went up to the nurse after. I usually have low pressure, especially in the morning, with a systolic reading around or below 100. My pressure today was 126/67 whereas Wednesdays reading was 103/60, already 4 points higher from a good blood draw than my usual haven't-been-stuck-with-needles pressure.

A nurse should be calling in the next couple hours to give me instructions on the Menopur and let me know if I'm going in Saturday. I'm predicting now that they're going to keep me on 6 vials, have me come in Saturday, but not trigger until Monday. I received a wonderful offer to hang out with my friend M, Roxie and Deano's mama, but my acupuncture appointment is smack in the middle of the day and doesn't allow for any other plans. Although I'd much rather hang out with M, it looks like I'll be spending the rest of the day driving to and from the acupuncturist in horrible Friday traffic. All this acupuncture had better be worth it in the end!

IUI #2 Is On!

I got a chance to speak with my RE today and she is recommending that we move forward with another IUI for this cycle! This means that if everything goes well and they continue growing, we'll be triggering with 7 mature little eggs in the next few days.

Seven follicles might seem like a lot for your average person and I can definitely see why. I have no intention of becoming the next octo(septo)mom and the potential for 7 little embryos to implant seems crazy. Most doctors suggest you trigger with one or two eggs, if you're okay with the possibility of twins, and might even cancel a cycle that showed 7 follicles. For us, this is not the case.

Back when we were first discussing IVF vs IUI, our RE Dr. K said she would be thrilled to see a 30% fertilization rate from my eggs. I'm only 27 but we don't know what shape my eggs are in because of the FXPOI, and from what I've researched, there's definitely a drop in quality in cycles where you produce tons of eggs. Someone without FXPOI might see 7 out of 15 eggs harvested fertilize and maybe 5 might make it to day 5 for freezing. I might be lucky to get 2 out of 7 and we're expecting those same odds, if not less, for IUI since the sperm won't be hand delivered to their eggs.

My hope is that with 7 potential targets for our sperm to hit, we might get super lucky and have 2 fertilize and implant. Three would give us better odds, but it's probably too much to ask for. Statistically, if our 50% odds held, one embryo would have Fragile X and the other would be healthy. Unfortunately, we all know that statistics don't hold up in small sample sizes. With two embryos we would really be just as likely to get two affected fetuses as two unaffected fetuses, and my fear is that we might end up having to terminate the whole (potential) pregnancy.

I have been mentally preparing myself for a TFMR (termination for medical reasons) since I got my Fragile X Premutation diagnosis, and although it's horrible and gut wrenching to even think about, I think it would be a lot easier to cope with if we get to take home a baby at the end. With a twin or triplet pregnancy, assuming we can get pregnant at all, I would be incredibly happy to end up with just one healthy baby. It would be horrible to have to terminate one or more affected fetuses, but we'd still get one child in the end so it would all be worth it. Getting pregnant with an affected singleton, or affected twins, having to terminate and come home with no baby, would be devastating.

For now, I'm trying to stay positive as usual, hang with my fuzzy babies, and send lots of good vibes to my follicles. I took 6 vials of Menopur today in a single injection, boy did that burn like hell, and I'll have my next appointment with my RE or nurse tomorrow morning to see how the follies are growing. They'll either be nice and mature and (just about) ready to trigger, or not quite grown and I'll need to continue stimming for a couple days.  I think I have 10 vials of Menopur left so I could do one more day of 6 or 8 vials before buying more, or two days of 5 vials if she wants me to reduce further. I'll also have acupuncture a couple hours after my appointment with Dr. K so I'll ask my acupuncturist S to do everything she can to increase blood flow to my ovaries and uterus. Fingers crossed for good results!

My waiting buddies. They're sleeping so sweetly because they jumped up on the counter while I was on a conference call and ate the four bowls of food I had laid out for dinner. Or more accurately, Fuckie(the white one) ate three bowls of dinner while Cillian ate his own. Now I get to defrost more food for the other two hungry kitties. Thanks Fuckie.  

SEVEN

I am in so much shock after my appointment this morning that I feel like I might cry. I can’t believe it, but we have SEVEN, SEVEN!!! follicles! At the beginning of this cycle, we were told not to get our hopes up for more than 1 or 2 and BAM! SEVEN beautiful, perfect follicles! I have 5 on the right, and 2 on the left and there might even have been another hiding on the left since it’s tough to get a good picture because your colon gets in the way. They looked like little bunches of dark grapes on the screen, I couldn't believe it when I saw them.


This is more than I ever thought my body would make. With FXPOI, 7 follicles might as well be a million and you’re lucky if you get even 1. After tons of Menopur injections yielding only 1 follicle last month, we figured this cycle would be, the nuclear option, would be a hail mary to see if I was even capable of making multiple eggs. I hoped that maybe 3, or secretly even 4 out of the original 5 small follicles would continue to grow, but I never dreamed it would work this well. I'm over the moon, completely overwhelmed and so, so hopeful.

They’re all growing at the same rate, between 10-14mm, and my E2 was 537 so all this Menopur is paying off! This is fabulous growth after only 2 more days of stimms and she didn't bother putting in another order for more Menopur, I might not need it! This makes the 2 daily injections, the bruises, the stomach pain,  the crazy bloat, the blood draws and early mornings all worth it. We could really have a shot this month to get a baby.


I am waiting on my call back now to see if I’m going in tomorrow or Friday morning and E and I need to discuss our options. He’s leaning towards doing IUI and hoping for multiples, with the hope that if we got pregnant with twins or triplets at least one might be healthy and unaffected.  I do agree it would be a pretty good shot, but I’m hesitant to lose the chance to potentially harvest 7 eggs. We could always follow the same protocol next month if we’re unsuccessful this month and harvest then, but it almost seems like too good an opportunity to pass up!

Either way, I’m so hopeful that this will be it!!