Today, I'm sharing a cartoon that was published on NPR. While our stories are a little different, Lauren didn't find out until she was pregnant that she AND her husband were both carriers while I know in advance, I can't help but relate to every carrier of a genetic disease out there. There are so many stories, so many diseases, but they all share the same core elements: fear, hope, despair, waiting. I feel like being a carrier takes so much from the experience of pregnancy or TTC. You don't get to worry about planning baby's birthday, or whose eyes or laugh baby might have, you're too busy agonizing over whether you can even get pregnant and if you do, will you have to terminate because of a tiny genetic typo? Lauren's typo, the mutation for CF, is 3 missing base pairs, while my Fragile X repeats look like a cat walked over the keyboard while my code was being written. CGGGGGGGGGGGGGGG. Whoops, but there's no backspace.
Spoiler: Lauren's story has a happy ending, and while I'm not a fan of her "everything works out in the end" message because, honestly, a lot of the time it doesn't work out in the end, I do appreciate the light she's shedding on carriers of genetic diseases. For her future comics, I'd love to see something about TTC with the knowledge that you might have to terminate multiple times or have a child with a serious genetic disease. Or a comic about parents who have lost a child to a horrible genetic disease and are trying to heal and decide how to go on. Or one about those of us whose genetic mutations come with a side of infertility and how just getting pregnant is a constant struggle with fertility drugs and the insurance companies, with testing and waiting, with no guarantee of a healthy baby. Those topics are all a little heavier, less palatable than "it all works out in the end", but like so many things, one step at a time. One ray of light at a time.
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.
As part of my two week wait campaign of distraction, I've been spending a little more time each day checking out the news. Yesterday, I came across something I absolutely had to share.
Although E and I don't have any children yet (come on blastocysts!), we hope to someday have the privilege of raising a daughter. Raising strong, self-confident children of any gender is no easy feat in today's society and, too often, children are measured by and pressured to conform to gender stereotypes. Our girls are growing up feeling less than their male counterparts, and our boys are being told it's not acceptable to be nurturing or self expressive.
I know this video is part of a campaign by Always (yes, that Always) but I couldn't not share it regardless of its origin. So many unlikely companies are starting to tackle the inequality in gender stereotypes and it's incredible to see. Here's another good one, by Verizon! about nurturing our children's intelligence, especially our girls, instead of just their appearance.
It's heart breaking to see how quickly a girl's sense of self efficacy is
worn down as they grow into adulthood. I sincerely hope that when my children reach adulthood, they will have done so without the steady stream of gender shaming that so many children grow up with.
Rock on Girls and Boys. You are stronger and smarter than you know.
This morning marked the beginning of Endometrin round two. Oh most hated adversary, we meet again at last. I knew this day would come.
dun Dun DUN!!!
I know that this particular medication shouldn't be a big deal, it's not an injection or something particularly painful, but it's still, by far, the most obnoxious medication I need to take. Let's run through the side effects according to the manufacturer:
mild nausea, vomiting, bloating, stomach cramps;
diarrhea, constipation, bloating;
dizziness, drowsiness, tired feeling;
pain in your vaginal or rectal area;
pain during intercourse;
loss of interest in sex;
breast pain, swelling, or tenderness;
joint or muscle pain;
increased night-time urination; or
vaginal itching, burning, or discharge.
If you look carefully, many of these symptoms mimic early pregnancy symptoms. A super cruel joke to play on the woman who is desperately hoping to find out she's pregnant, examining every cramp and hiccup as a possible indicator that this cycle was a success. Others are just horrible sounding, and I count myself lucky that I only experience the mild ones. Last cycle I had to deal with bloating, cramps, tiredness, all the time peeing, crazy sore boobies, and the lack of sex and general grossness that comes with having a pill up your ladybits that dissolves throughout the day, necessitating the wearing of panty liners. Can we saw EW? EW.
At least my injections were a brief inconvenience, a moment of pain that was mostly gone in under a minute. Twice daily Endometrin, on the other hand, is the gift that just keeps on giving. For a minimum of two weeks, and a maximum of 10 weeks if I do get pregnant. This is one medication I could seriously do without, if I wasn't willing to do anything possible to get and stay pregnant.
Little cells that should be dividing in there, this is all for you. E, I apologize for the lack of sexy time in your future. Only 8 more days till I can pee on a stick and hopefully find out that we're pregnant (if it's not too early), making all of this worth it. I can't give headspace to the next leg of our journey if we are successful, so I'm focusing everything on that positive test.
Update: I took an HPT this afternoon and got a clear negative, which means the trigger is flushed out of my system. Any positive we get should be genuine from here on out!
I started acupuncture at the same time as my first IUI, including the acupuncture diet. I've posted about it before, it's fairly restrictive, cuts out all white flour and sugars and emphasizes proteins and veggies. My breakfast on this diet was usually soup or eggs, or more specifically, egg whites with some whole eggs mixed in. Eggs were never my favorite food, especially after I burned out on them doing the Atkins diet in 2004, and I never ate just egg whites. Still, I figured it couldn't be too bad and started eating them on mornings where I didn't have soup, 50% whole egg and 50% egg white from a carton.
Scrambled Eggies
Some days, I ended up with a really awful tummy ache, complete with nausea and frequent trips to the bathroom. It would start about an hour after my breakfast and last 3-6 long, uncomfortable hours. I blamed it on the Menopur (it's so many hormones) on the herbs (I took them on an empty stomach) and on the prenatals and vitamins (lots of people get an upset stomach from prenatals). I tried to eat lots of acid absorbing foods like rice cakes and wheat toast just in case it was from not eating a lot of carbs, but nothing helped. I'd just have to wait it out, feeling wretched and telling myself it was worth it if we got pregnant. I'd spend these days working from home, usually curled in a ball and miserable. Ugh.
This morning, it happened again. I made scrambled eggs and turkey bacon for breakfast at 10:30 and by 11:30 my stomach was starting to hurt. I assumed my curled-ball position and prepared for a miserable time when I realized something didn't add up. I hadn't taken any Menopur, acupuncture herbs or my vitamins today. In fact, the only thing I'd had was the eggs and turkey bacon. And then the light bulb went on. I only get this horrible stomach ache on days when I have eggs for breakfast. The worst stomach aches were from days when I had organic, cage free eggs mixed with egg whites for breakfast, on an empty stomach. It's not the hormones or the vitamins or anything else causing the horrible stomach aches. It's the eggs. An egg intolerance, or more likely and intolerance to egg whites. Ding Ding Ding.
Adding this photo was an entirely necessary edit.
Trying to be healthy and follow the diet, I've been making myself miserable and sick. I've never had a problem with eggs cooked in something, like egg noddles or baked goods, but on their own they now leave me a miserable, stomach clutching mess. Egg intolerance or sensitivity, unlike an egg allergy, is apparently developed later in life. They usually result in a mild IgG reaction, like my stomach ache, nausea and upset stomach. It all makes so much sense and means that I got really lucky and had very few actual symptoms from the Menopur.
No More Eggs for Breakfast
Next time I see my doctor, I'm going to ask for an egg sensitivity test to egg whites and egg yolks. If I'm lucky, maybe this is just a temporary sensitivity that will go away, eggs are such an easy source of protein, it would be a shame to cut them out even if I don't love them. In the meantime, I'm striking plain eggs from the menu. I'm hoping that at 2DPIUI, several little eggs are fertilized and starting cleavage or compaction, unaffected by my miserable stomach. Come on little ones, I promise things aren't always so upset in there!
Embryogenesis, hopefully my little ones are fertilized and dividing as above in day 2!
This cycle we went with the "Nuclear Option" and bombarded my ovaries with the maximum dose of Menopur. It was a big, somewhat expensive, gamble but it paid off and I ended up recruiting an unprecedented 7 follicles! I really think this is going to be our lucky cycle. If not, I think we'd definitely follow this protocol or a similar one again since it produced such good results.
Here's the protocol we followed this cycle:
CD 1: No Meds CD 2: Base Ultrasound, 6 antral follicles visible (Acupuncture) CD 2 - CD 11: Birth Control Pills CD 12 - CD 14: No Meds CD 15 - CD 18: 8 vials Menopur, 600ul, divided into 2 doses daily (Acupuncture) CD 19: E2 220 and Ultrasound, 5 small follicles visible CD 19 - CD 20: 8 vials Menopur, 600ul, divided into 2 doses daily CD 21: E2 538 and Ultrasound, 7 maturing follicles visible, 10-14mm CD 21 - CD 23: 6 vials of Menopur, 450ul CD 23: E2 926 and Ultrasound, 7 maturing follicles visible, 13-15mm (Acupuncture) CD 24: E2 1476 and Ultrasound, 7 maturing follicles visible, dominant follies 17-19mm CD 24: Ovidrel Trigger Shot CD 25: No Meds CD 26:IUI #2, count 148 million with 70% motility (Acupuncture) CD 27: Acupuncture CD 28 - CD 38: Endometrin twice daily (Progesterone Suppositories) CD 30: Acupuncture CD 37: Acupuncture CD 39: Pregnancy Test
I had another acupuncture appointment today, CD 27, with a different acupuncturist since S was unavailable. I've seen her once before and she's also really good, with a little more emphasis on the Chinese MEDICINE aspect and a little less on the mind-body-spirit thing. It might be because I told her about my background in Science and she is tailoring her approach to my needs. Either way, I appreciate it! Her needles always hurt a little more because she places each one very precisely, but I can tell she's hitting the points when I have a reflexive twitch or feel increased blood flow to the area. This time there were 5 needles in my ear, which is apparently a point for the uterus. Crazy cool stuff.
Looking at the schedule all laid out, there's no way I'm going to be waiting the whole two weeks to test. I'm thinking I'll test for the trigger in a day or two to make sure it's flushing out and then test for a positive at around 11 days, July 4th. A positive would be such a nice Independence Day surprise!
IUI number 2 is complete and I feel super psyched and so hopeful about this cycle! It's been a long day for E and I, we had to be up early to meet the nurse at 8:30am to deliver our cryotank. She took my vitals, had me sign the consent form and then gave us about two hours to kill. Since we didn't want to sit around in the waiting room, we drove to the nearby coffee bean and had some breakfast. I'm absolutely in love with their chai latte with almond coconut milk, it's delicious :)
After breakfast it was back to the waiting room to wait some more. They were running really behind today and had a ton of patients to see. We finally went back to a room and Nurse C joined us with her trainee nurse, Nurse M, who will be replacing Nurse C when she retires. She's really nice and I enjoy her bedside manner a lot, but she's not quite as good as Nurse C. Nurse M put my speculum in wrong, OW, and Nurse C had to reposition it and take over the IUI later when Nurse M couldn't get the catheter in.
Before we got down to business, Nurse C asked us to confirm our donor number and make sure everything was labeled correctly. Our count this time was phenomenal, 148 million with 70% motility post thaw! Last cycle was only 50 million with 50% motility so I'm feeling much more confident about our swimmers this time. Come on boys (and girls!), you can do it!
Our tiny vial, this thing cost $850
Nurse M tried to insert the flexible catheter but seemed to have difficulty with the internal portion of my cervix. It was pretty uncomfortable, though not painful, to have her poking around and I was relieved and felt much better about Nurse C taking over. Nurse M had the speculum jammed straight in, instead of following the natural curve of your body, and I didn't realize how poorly it was positioned until Nurse C adjusted it down and my legs dropped like 6 inches. She swapped the catheter out for a stiffer one, popped it right in on the first go and said
"Here we go! There go your little guys, and gals!"
This time, we chose to inspire our swimmers with the classic 80's movie soundtrack of Look Who's Talking while I laid with me knees up for 30 minutes:
I hope they were inspired by the Beach Boys to follow the trail leading them towards all those eggs. I was a little worried about when I would ovulate and whether it had happened or not, I know many women say they can feel ovulation when they are releasing multiple eggs and I hadn't felt anything. Nurse C told me not to worry about it and she was right, as I'm typing this now at 6:30 I can feel definite uncomfortable cramping on the side where I have 5 eggs. It's starting to hurt so I'm hoping those follies are all rupturing and releasing their eggs!
After the IUI, E and I went and stuffed ourselves at The Smoke House. It's a decent steakhouse, not super high end, but full of that old school-red-booth-dim-lighting steakhouse charm. I had a little fillet with mashed potatoes, spinach and insanely delicious garlic bread while E had BBQ ribs and chicken with mashed potatoes and corn on the cob. It was indulgent celebration lunch, a little off diet, and it filled the time gap between our IUI and my acupuncture appointment. We used to go all the time for celebrations when we lived in The Valley and now I drive past it on my way to acupuncture and long to stop and order that garlic bread. I was so glad I got my fix at last :)
With my tummy full to bursting and my eyes heavy, acupuncture was wonderful as usual and I slept from 2:00pm-3:30pm. S is feeling really good about this cycle too and told me that Dr. K called and asked her what on earth she was giving me to grow so many follicles so big! I love that my whole team is so supportive, it makes me feel well taken care of. While I was asleep with my needles in, E went down the street and treated himself to an ass kicking 60 minute massage where they bent and twisted him like a pretzel until he felt amazing. I'm going to have to go and try this place myself at some point, he gave it a glowing two thumbs up.
I start my most hated Endometrin on Thursday and thus begins the dreaded two week wait. My blood test is scheduled for Sunday July 6th and I can already tell I won't be able to wait to test this time. I have acupuncture again tomorrow to help the egg and sperm find each other and then another session on Friday to help encourage implantation. I'm trying to focus on work to keep myself busy while also being careful not to stress or overexert myself. The gym is off limits, I'm not supposed to lift heavy things and I've already been tested today when I went to move a piece of furniture and realized it fell under the category of "things I shouldn't be doing" ugh.
It's going to be a long two weeks to find out that this cycle was a success. I really think we did it this time!
We are a go
for triggering tonight! I will be taking my Ovidrel at 10pm tonight and then I'm done with injections! I love that the syringe comes pre-filled, it's such a nice change to not have to mix a million little powders.
Ovidrel ironically next to my eggs
We need
to be at Kaiser for our IUI at 8:30am on Monday so they can start prepping the sperm. Whether you give a fresh sample or a frozen one, they need to assess the sperm for washing and confirm that the counts are sufficient. The IUI itself will probably be around 10:30am and then I'll be heading to an acupuncture appointment to encourage those swimmers to swim, baby, swim!
We have our sample on ice, ready to go and I'm definitely feeling like the time is right physically. I finally have enough estrogen in my system to get some decent, trackable EWCM and I'm actually debating taking an ovulation test tonight before I trigger and tomorrow to make sure I'm not ovulating too soon on my own.
OPK Cheapies. I still have toooons of these from TTC naturally
I might be extra bold this cycle and test out my trigger to see how quickly it leaves my system. I'm feeling really good and positive about this attempt and I might be up for testing a bit early this time! I just want to make sure I won't be getting false positives from the HCG in the trigger.
Send good vibes and positive thoughts to my follicles for me, I need these little buggers to yield healthy, unaffected embryo(s)!
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!
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.
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!
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.
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!
Today was another tough day physically, I don't know if it's the Menopur or the acupuncture herbs/diet but I've just felt rotten. Stomach ache, nauseous, bloated, tired, sore back, the whole rotten spectrum and the stomach ache/abdominal pain is definitely the worst. I suspect it's probably a combination of both which makes it nearly impossible to get rid of since I can't stop taking the Menopur or the herbs. I've tried eating bread, taking advil, eating more bread, curling up in a ball, drinking tons of water and I finally capped it off with some soup which seemed to help the most. I'll try eating a more normal meal for dinner and see if I can banish whatever this is for good.
I will probably mention it to Nurse C tomorrow morning just in case it might be mild OHSS, but I doubt it very much. OHSS usually comes with loads of eggs, 20 not 5 teensy ones, and I haven't taken the trigger shot this cycle so I don't have any HCG in my system. My ovaries also don't seem to hurt, probably the only part of my stomach that doesn't, and they looked perfectly normal sized at my last appointment. It's probably the shit ton of Menopur I've started injecting over old needle marks -_-
Despite feeling like shit, I'm still really looking forward to my appointment tomorrow. I've got everything crossed that those 5 little follicles are growing into 5 bigger follicles that will become mature eggs. I'm just not sure how much growth I should expect since we suppressed egg development with birth control first. Is this going to be a long and slow cycle? Today is day 6 of stimms, how much longer will I need to go? Once I inject my 4 vials tonight, I will have 22 left, or 2.5ish days. That's enough for tomorrow (Wednesday), Thursday and Friday morning, bringing me to 8 and a half days of injections. I'm ready to buy another 20 if need be, but I hope we won't need much more than that.
This mornings ultrasound and lab work yielded some pretty promising results! It's too early to tell for sure because my follicles are still really small, but there were five little follies visible! FIVE! She measured two of them and noted the other three, but I was exceptionally pleased. All this Menopur hasn't been for nothing! My E2 labs were also really promising, 220 at first draw! Last cycle my E2 was only 68 at first draw so 220 sounds absolutely fabulous, there's definitely some good eggs developing in there.
I picked up 20 more vials for the next two days, another $1,158.01 on the credit card. The pharmacist ringing me up scanned the Menopur, looked at the monitor, her eyes went wide and she said:
"Uhh...are you aware of the cost of the medication?..."
"You mean the fact that it's $1200 for two days worth? Yup"
"OH GOOD, I didn't want to say it..."
The other pharmacist next to her looked over and commented on the cost too, but then she recognized the Menopur, smiled and said:
"Don't worry, it's for a good cause, and it will all be worth it in the end"
I know our bill is going to be crazy high this month, but I can't help agreeing with her. What's a couple extra thousand when it compares to having a child? If we're successful, it will indeed be worth it in the end.
I woke up to what definitely looked like a light period, complete with miserable cramps and since E and I are dog/house sitting, I had no pads and there is apparently not one single Advil or Tylenol in the house. Today makes day 11 of this month's "period," which sucks no matter how you look at it. It started as soon as I stopped the progesterone like it should have, but then I started the birth control on CD 2. I bled through CD 4, spotted through CD 7, and then thought it was done until I stopped the birth control. I was being too optimistic since it started right back up and I've been spotting CD 14 - today, CD 17. I feel like I should be looking this up or asking other people following an IVF-ish protocol if they've experienced the same thing, but biologically it makes sense. Stupid period, why don't you go disappear for 9 months -_-
After determining that I would need to go buy some supplies, I felt rushed through this mornings shot. I was running late to meet up with our old vet to pick up our animal's charts and had tried to stick myself three times before realizing that the needle must be a dud. It acted just fine when I primed the injection, but must have been dull or slightly bent since it absolutely refused to go in. Ouch. I'm now one needle short, since I had an exact amount, and am going to have to buy more next time I'm at Kaiser.
Won't you throw my ball for me? See how cute I am in this tiny bed?
Revisiting the topic of side effects, I can't tell if I didn't get enough sleep or if the Menopur is making me crazy tired. I feel drowsy, like I can't fully wake up, and I can't seem to shake it off. I tried napping, was unsuccessful, and have felt "ugh" and "blah" all day. I would try to put it more eloquently, but I can't summon the energy required to do so. Blah it is. Poor Milou seems to be feeding off my energy, she's been laying around looking at me all mopey and sad, even though she had her favorite class, Agility, today. Now I just feel guilty that I'm bumming out my puppy, completing the circle of "blah".
Blah puppy. Sorry Milou
Update:
I just administered my evening injection and was greeted with the
unwelcome sight of little round bruises :( I was really lucky with my
first cycle and managed to not get a single bruise on my belly. This
time I have one on each side to go with the little red pin marks from
the blunt needle and my previous injections. I really hope they don't
linger, the designated injection area is so small that I'm going to have
to inject on top of bruises if they don't fade quickly.
I don't often post about sports but there's no way I could let today pass without saying something. For the second time in 3 years, the Los Angeles Kings have won the Stanley Cup! Congratulations boys, you did it! The Cup is coming back home!
During the regular season, E works all of the Los Angeles Kings hockey games. He was there when they won The Cup in 2012 and got to celebrate with the team afterwards in what was an unbelievably memorable night. We've got pictures of him with The Cup and they're definitely some of my favorite "work" shots.
Unfortunately, this year was a little bit different. E worked all the regular season games, but since the post season games aren't crewed until we know they're happening, he was already booked by other teams by the time the post season came around. He was only able to work a couple of the Kings post season games, and was working the LA Dodger game when the Kings won The Cup tonight. He'll have to wait until next season to celebrate with our boys in black but that doesn't make the victory any less sweet. I'm pretty sure we'll be at their celebration parade on Monday, if my E2 ultrasound finishes in time.
Aside from the Kings killer victory, today was my second day of double injections and they seem to be going well. Still no weird side effects to speak of, and my skin isn't too irritated yet. Covered in little pin marks yes, but no bruising or redness. My only complaint is that it's a little crazy to go through this many vials of Menopur a day. I feel a bit like a walking pharmacy (Hey, wanna score a vial? I've got 8!) and although this cycle IS GOING TO WORK, positive thoughts!, if we have to do this again I'd definitely like to try Letrozole and Gonal F or Follistim.
I also got to enjoy some double relaxation in the form of acupuncture AND a massage. My acupuncture appointment was first and went off like usual, a weekly nap. Needles go in, I go out. I think I'm actually starting to get drowsy on the way to acupuncture, like I'm anticipating the coming nap. Instead of fighting traffic and heading home afterwards, I met up with my mother-in-law to do a little work and we ended up going for massages and dinner. She goes to the best Thai massage place I've ever been to and I had the pleasure of the strongest masseuse working on me today. It was incredibly painful to have her repeatedly digging her elbow into my shoulder blade, so much so that she had to brace me on the table at one point because I was arching off, but I know I'll feel so, so much better tomorrow. It felt almost like a battle of wills, can I take the pain or should I ask her to lighten up? Is she pressing harder because I'm not asking her to lighten up? Is this a test?
I survived my massage, just barely, and we capped off the evening with some delicious Italian food. I was well behaved and got my entree with whole wheat pasta, but I was sorely tempted by the deliciousness on the menu. I wonder if that's a symptom of the Menopur, the desire to hoover all food within reach? Soon, Italian goodies, once I'm pregnant I will eat you all.
This mornings injection, the first one of our second cycle, went pretty well. Mixing everything up was second nature at this point, and it was nice to only have to mix 4 vials at once. E is off work today, his first off day in forever, so he was able to keep me company while I did it. It was a really wonderful change.
The injection itself wasn't too bad, but I did feel a little out of practice. I felt that edgy sense of panic rise up for a second right before I stuck the needle in, but it was gone as quickly as it appeared. I need to try and remember how I sat last time for the most comfortable injection, the needle was a little uncomfortable in my skin and I couldn't tell if I was sitting wrong or just needed to desensitize myself a bit. It burned going in as usual, but like before it's nothing unbearable if I go slowly. I'll probably try a different position for my injection tonight to see if it helps.
4 Days of Menopur, so many vials!
To try and limit skin irritation, I'm going to trade off sides in the morning and evenings. This morning I injected on the right side, so I'll do tonight's injection on the left. Last cycle I did one side per day to give the skin time to heal, but that won't be possible with two injections daily instead of one.
I'm also unnecessarily concerned that I'll forget to do one of the injections. Last cycle I was so strict and focused it felt like tunnel vision. I'm trying to be more relaxed about this one. I'm "cheating" on the acupuncture diet, although I'm still faithfully taking my supplements and drinking my tea, and I'm trying not to stress about things. Tomorrow I have acupuncture and I go in for my E2 ultrasound and labs on Monday morning.
When I went in for my baseline ultrasound, a friendly nurse I haven't really worked with pulled me aside and informed me that I had neglected to fill out a necessary form. Apparently I had been listed as "single" in the computer instead of "married" and since I have a partner, they needed both our signatures for consent with the fertility treatments.
She started going through the forms, looking for the correct ones, and asked me to confirm that I have a partner or spouse. I automatically said "Yes, I'm married" without thinking too much about it. The nurse paused for a moment, looked at me, and then asked "Is your spouse male or female?" I have to say, I was so impressed and proud in that moment that I almost hugged the nurse. I know it's probably a standard question, especially when a donor is involved, but it's amazing how far we've come and I have such high hopes for the future. I made a point of thanking her, told her how much I appreciated it, and collected the forms E and I will have to sign.
In the wake of the Wisconsin same-sex marriage ban falling to the wayside like so many of it's unjust fellows, I have so much hope that my children will get to grow up in a world where people aren't discriminated against based on gender or sexual orientation. It's so close I can almost see it coming over the horizon.
Finally my round of birth control is done! I noticed a bit of cramping each day while on the pills, and as soon as I stopped them I started spotting. I was expecting it, I started on CD 2 just as my period was beginning, so I wasn't too surprised and I'm considering this the new starting line. Tomorrow is my 3rd day off birth control so I start my twice daily Menopur injections on Thursday. Menopur here I come!
These first 5 days of injections will determine how many eggs are recruited. We only have one shot at recruitment so these days will be the deciding factor on whether we do IUI or IVF. If we get lots and lots of eggs, we'll sign the USC Clinic paperwork with ninja speed, complete the cycle with them, and harvest those bad boys. I don't think we'd get more than 6, since they only saw about 6 antral follicles, but I would be ecstatic if we could get 6 embryos. Unfortunately, I think that's a little overly optimistic. Still, positive thoughts!
If we do harvest eggs, the next step would be PGD. This is where things get a bit complicated. There aren't many genetics labs that work with anonymous donor couples because we have no access to lab work. I found one lab, RGI, based on recommendations from other couples in a similar situation, and they said they could build us a probe with genetic profiles and blood from me, my sister and my mother, and two IUI samples from our donor. It would be tricky but it's not impossible, and I expect the biggest issue would come from Kaiser. My RE personally confirmed that Kaiser would cover PGD for me and E, but I'm sure there will probably be some sort of extra charge for semen instead of blood. I can't imagine Kaiser would cover that. This also means we wouldn't be able to change our donor, we're pretty committed to the one we've chosen, but I like the idea of being able to change our minds if we need to. What if his chemistry doesn't mesh with mine? What if we have no luck with this one? What if a better come becomes available?
If throwing the max dose of Menopur at my ovaries doesn't yield more than 3 mature follies, it's back to IUI for us. Last cycle we stimmed for 9 days, but since we're suppressing my ovaries first, we're anticipating needing to stim for 11 days before I can trigger and we can do the IUI. Either way, this will be our month!
Deano's awesome mama, my friend M, made him a killer smash cake for his first birthday. Blue velvet cake filled with yogurt and raspberries and covered in chocolate icing. Deano thought that chocolate icing was the best thing ever and he looked absolutely delicious wearing that cake lol.
I'm so glad I got the opportunity to celebrate with everyone, between work and all the fertility stuff we haven't had much time to catch up. I hope E and I can get off this infertility mary-go-round soon so we can get back to smash cakes, water balloons and good friends.
Yesterdays acupuncture appointment went very well, as usual.
S complimented me on my "positive spirit" and after about 5-10 minutes
relaxation, I dropped off into a deep sleep. This time I slept so hard I
didn't wake up until S had opened the door and walked in. It felt like I
had only closed my eyes for a second but somehow an hour had passed. I
got a new herbal formula to try out as well, it's less bitter than my
batch which is a nice change. It almost feels like I'm paying for a weekly nap, but I'm up for anything that helps.
As planed, I dropped E
off at the airport early this morning. He got home super late last night, near 1am, and I
have no idea how he's going to get through the weekend :(
He has to land, pick up his rental car, drive to the track meet, work the track meet which should go till 9 or 10pm, check into his hotel, build graphics and prepare for the game on Sunday, sleep at some point, check out of the hotel, drop off the rental
car, hop on a plane, get picked up, get his car, and go
straight to the next game, arriving about 4 hours after his call time.
It's gonna be a busy weekend for him and I'm already looking forward to
picking him up tomorrow.
I have a much simpler weekend planned, with a lot less running around. Milou has her Agility class today, I'll probably work and run some errands, but on the whole will be able to chill out a bit.
Tomorrow I get to pick up E bright and early, and it's also my last day
of birth control, yay! I get three days off while the hormones leave
my system and then it's on to the big guns. I don't expect two
injections a day to be very much fun, but the prospect of recruiting
lots of eggs is a really exciting one. The more targets we have, the
better chance we have of getting pregnant with a healthy baby.
Sunday is also a big day for my bestie M and her insanely adorable son Dean. Deano, who is quite possibly the cutest baby on two legs, turns 1 today and we'll be celebrating his birthday tomorrow :) Like his big sister, Deano practically radiates sunshine and exudes happiness out of his pores. He's an absolute joy to be around and I can only hope that E and I have kiddos have as awesome.
Today is 8 day of birth control, which means I have just two more days to go! It's been very dejavu taking it, I was on birth control for almost 10 years and the little cardboard pack definitely throws me back. The last time I took it I was in Europe in 2010 and E was proposing to me in Paris on my birthday. Before we left for the trip, I ran around like a nut trying to refill my prescription and get a hard copy of it, I was so unnecessarily paranoid that airport security would toss my pills if I didn't bring the prescription with me. Because obviously they've never seen birth control before and I was really using it to smuggle drugs. In hindsight, we didn't actually need it, E and I will never have to use birth control again. He's still teasing me now about the birth control, "aren't we trying to GET pregnant?" but he understands the process, even if it feels counterintuitive.
For this cycle I had to shell out $50 for a three month supply, the 10 pills I need and a whole lot of pills I don't. I shouldn't be complaining about $50 though, since I picked up just a small portion of the Menopur I'll need, 20 vials, and that ran me $1200. It looks like I'll need about 88 vials this cycle, 8 a day for 11 days, which is about $4800. Now that makes $50 seem pretty inconsequential.
Over the past few days, E and I have been trying to spend as much time together as possible. He has a really busy period coming up at work that will coincide with all my injections and monitoring and I'm afraid we won't be seeing as much of each other as we'd like. On Monday, we drove down to North End Bar and Grill, the Los Angeles Kings bar in Hermosa Beach, and watched the Kings eliminate the Blackhawks in game 7. It was so much fun, the bar exploded every time something happened and it was almost as good as actually being at the game. E will be working for all the upcoming games (where they'll win the cup!!) so I'm glad we got to enjoy this one together.
On Tuesday, E had a late call so we decided to take advantage of some AMC Gift Cards and went to see a matinee of X Men. I can't remember the last time we went to a movie, I never want to shell out the $18-$21 per ticket, and we don't take enough advantage of the $8 weekday matinees. It was a pretty good movie, completely reset the franchise, and we were able to squeeze in some lunch too before he had to go to work.
Wednesday E was gone all day, but yesterday he reversed his usual schedule and was home in the afternoon. He spent the morning building graphics for an upcoming track and field event and was able to finish up by noon. We celebrated with some In-n-out, definitely not on my acupuncture diet, a Netflix copy of The Hunger Games 2, and then had a surprisingly fun water balloon fight. I haven't played with water balloons since I was maybe 12 in summer camp, but when I saw them on sale at the store the other day I just couldn't resist. We stripped out of our jeans, filled up a big bowl each and had a fabulous time smashing the balloons on each other. Some of them were pretty tough, I thew a couple that literally bounced off E, fell to the floor and didn't break, even though I tried to fill them as much as possible to weaken the structure. Milou thought the whole thing was hilarious, although the hose we used to fill them was definitely her favorite part.
We capped off the evening with some delicious Bigg Chill frozen yogurt, also not on my diet, and watched a couple episodes of House of Cards. I'm really glad we were able to spend so much time together, E had already left for work when I woke up this morning and on Saturday morning I have to put him on a plane to go work that Track and Field event. I'll pick him up on Sunday morning with just enough time to say "Hello" before he turns around and leaves for the next event. He's actually supposed to be there at 6:30am but since his plane doesn't land until 10, he's going to be a bit late. Then he's working 16 out of the next 18 days, I'll be starting up my injections again, and will be back to living at the doctor for monitoring ultrasounds.
I'm off now to my acupuncture appointment, where I hopefully won't pay for my diet indiscretions too harshly. Between the frozen yogurt and the In-N-Out cheese, I fear for my phlegm points!
