17dp5/6dt - OB Labs

As I mentioned in my previous post, once we got our first positive beta we officially completed the protocol for our frozen embryo transfer. This is pretty standard protocol, I knew that our FET fee wouldn't cover our ultrasounds but somehow I got my wires crossed and thought that it would cover all our betas and hormone tests. That was a $450 surprise and both the clinic and I were hoping to avoid more expenses like that if possible.

Since E and I have Kaiser, our insurance should cover all prenatal care - labs, ultrasounds and appointments. However, since our plan is an HMO, they won't cover any outside care that isn't an emergency even when it's prenatal. Darn. The ultrasounds we can't get around because Dr. D has to check up on our little embie himself, but any lab can run blood tests. So, today Dr. D's nurse sent over a lab order and I had the pleasure of figuring out how to translate that order into the Kaiser system.

I think at a regular lab, I'd just hand this slip over. Not so at Kaiser :/

Unfortunately, my first and second choices for getting the labs ordered were unavailable. Both my acupuncturist (and Kaiser nurse midwife) and OB/GYN were out of the office today and wouldn't be back until Monday. My labs needed to be drawn on Saturday so that wouldn't work. My next option was to leave a message for the on call OB, which I did, but didn't feel particularly confident about it since I don't know them. After waiting a couple hours and not hearing back from them, I went for the last resource I could think of, the Kaiser infertility department.

Unlike most departments of Kaiser that prefer you contact them through the general number, the infertility department gives patients a direct line. While I was doing my IUIs with them, I never had to fuss with an automated system or tell the general system receptionist what I was trying to do. There was always a nurse or assistant on the other end of the line and there was one there today when I called almost a year to the day after my first IUI baseline appointment. I explained everything to them, that I had done IUIs there a year ago, moved on to IVF and now that I had a positive beta I was looking everywhere for someone to order tests for me. They were predictably awesome.

Two minutes on hold, during which two other nurses picked up to see if I was a new caller who needed something, and my labs were ordered. Thanks Kaiser Infertility. I should have called you guys straight away, IUI might not have worked for me but you've been awesome from the very beginning.

I hope these lovely dark lines translate into a super high beta tomorrow. I think we're shooting for something around 6,000 but I'm not completely sure. I think doubling times are supposed to slow to 72-96 hours from 48-72 hours between 5 and 6 weeks. 

Progester-Woah!

I went in for my progesterone draw this morning, fingers crossed that my progesterone decided to climb, at least a little. We had to go in early since the lab closes by 9:30am on Saturdays and I was moving extra slowly from the lingering shadow of a migraine. I had a feeling some head aches would be forthcoming from the hormones I started yesterday and they certainly didn't disappoint. After this many medicated cycles, it's pretty much a guarantee that high estrogen and progesterone will give me at least one migraine within the first 12 hours.

Still, I made it there in time and was finished with the draw in just a few minutes. I had gotten home, put in a new Endometrin and changed my pad (ew - I got lucky yesterday with a clean pad but last nights pill pretty much dissolved and fell out this morning. GROSS) and started prepping breakfast when the phone rang with results.

By today, they're looking for your progesterone to be 8 or above. Since mine was only 1.5 when they were looking for 2.0, I was a little worried it might still be low but all that anxiety, and the chocolate bunny head I ate, were for nothing! The nurse immediately said my progesterone looks great and told me my level was 15 today! This officially clears us for our Tuesday transfer and we're now just waiting on the lab to assign us our official time. Only 3 days to go until our frostie is home!

Gratuitous photo of Milou that a fellow agility student took today. Look at my lady rocking that tire :)

Ahead of schedule!

I went in for a CD 13 blood and ultrasound appointment this morning and got the extremely pleasant surprise that we're running ahead of schedule!

I usually don't ovulate until CD 17 but it looks like I'm on track for a CD 15 ovulation! As of today, I have an 18mm follicle, my estrogen is 160, my uterine lining is trilaminar and my LH is 6 which means it hasn't surged yet but is likely to do so soon. Follicles ovulate at over 20mm and grow 1-2mm per day so I'm set to go either Wednesday or Thursday.

This follie is actually so ahead of schedule that they didn't include LH in my original blood draw and had to add it in last second. The next step is another blood and ultrasound appointment tomorrow and depending on how high my LH is, we should be able to tell whether I'm ovulating Wednesday or Thursday. I'm fairly sure that surge numbers are 20+ so it still has a ways to go but when it happens, it happens quickly. I anticipate another appointment on Wednesday and maybe one on Thursday as well to confirm ovulation has taken place.

Clearly, my body is just as ready as I am to get this frostie home. This is shaping up to be an ideal cycle for transfer, we just need this baby to stick!

Round Two is a Go!

This morning I had my official baseline ultrasound and lab work to make sure the birth control has done it's job. The tech who was so good last cycle couldn't find the vein in my right arm and gave up after repositioning the needle six times. She prepped my left arm, which is my less cooperative side, but gave up without trying when that vein didn't pop up either. The only option left was my hand which always stings in the weirdest way, but is at least easy to find. 

According to the ultrasound, my ovaries are nice and quiet, successfully suppressed! My lab work confirmed the suppression so we are officially cleared to start IVF number 2!

Fist pumping kitty approves!

Although it's only been about 4 weeks, I think I'll call Reprogenetics for a progress report on Monday. I know the probe won't be finished yet, but it will make me feel better to hear that there's progress happening. 

In terms of protocol, my last birth control pill was yesterday so I'll start stims on Tuesday morning. I've got everything ready to go except my Novarel which I don't need for a couple of weeks. Everything is falling into place and I'm predicting a November 3rd retrieval date.

Deep breath, cross my fingers, and here we go again!

And Then There Was One

So today's appointment showed that I'm down to one good follicle. The opaque or weird follicle on my right ovary was actually a collection of small follicles grouped together so they looked like one larger follicle. There are now 3 follicles on the left ovary, but only one is growing and developing while the other two aren't really developing at all.

The big follicle, the one with baby potential, is about 15mm which is a decent size for CD8.  My estrogen was 185pg/mL so it is going up, but still isn't ready to go. I think each mature follicle produces at least 200pg/mL of estrogen so my labs confirm just the one viable follie. I go back in for more labs and another ultrasound tomorrow morning which should give me an idea of when we're doing the actual IUI.  I'm pretty sure Wednesday is now off the table and we're looking at Thursday or Friday.

One thing that's concerning to me - I ovulate by myself every month. That's one egg developing each month without help from fertility drugs. It takes a little bit longer, I don't ovulate till day 16ish, but I do ovulate. Now I'm injecting 6 vials of Menopur, like $300 into my belly every day, and I'm still only developing one egg.

Does this mean I'm technically not responding to the Menopur at all? What does this mean for us if we need to do IVF? If I can only get one egg off of this many hormones, how am I going to get enough for IVF with PGD?

Hopefully we won't need to go there. This cycle is going to work. I'm going to get pregnant with a healthy baby from that lovely little follicle on the left. This is going to work.

Jinx

At my ultrasound appointment yesterday, the nurse asked me if I was having any side effects from the Menopur I've been taking. Apparently it can cause cramping and a whole lot of other unpleasant side effects in many people. I was happy to report back that I felt just fine, no cramping, and the injections *didn't even hurt OMG yay!* as long as I did them slowly! I felt like I could ride off into the sunset on a rainbow shitting unicorn on because I felt great! *insert some rainbows, sunshine and glitter shit here*

Ha Ha. Not.

Yeah. Because that's not painting a big huge target on my back for fate.

So, naturally, the second I left the doctor's office I started to feel sick. Then I remembered that I had had some digestive upset when I woke up that morning, but I'd attributed it to nerves. I sucked it up, blamed nerves again, and went to my acupuncture appointment. I told my acupuncturist, S, all about the insurance woes and my low estrogen and she told me she'd already received a call from my RE, Dr. K, that morning.

Dr. K actually called S, personally, because she believes in what she does. Even though S sees Dr. K's patients and is a Nurse Midwife at Kaiser, S said she's never had a doctor personally call about a patient before. Dr. K asked her to please do whatever she could to help me, to try and get as much blood flow to my ovaries as possible because we have to help my follies develop and get my estrogen up or this wasn't going to work. This really choked me up, I don't know how my chances are looking for this cycle but I really love my infertility team. I couldn't ask for better, more supportive doctors.

With specific marching orders in hand, S began my treatment to clear out the cold and phlegm and get my blood flowing. I also told her about my weird stomach pain so she added on a stomach treatment for that. And for the first time ever, those needles hurt. She put the first one in my foot and my leg nearly jumped off the table. "I'm sorry," she said, "you're much more sensitive today. The Menopur can do that, make your skin much more sensitive". Ow.

This was the 4th time I've done acupuncture and the first time it's ever been uncomfortable. Each needle hurt a bit going in and was sore during my hour, although I was able to ignore it and focus on visualizing all my energy going to my ovaries. S strongly believes that you need to put positive energy out there so I'm sending every positive thought I've got down to those follies. Afterwards, the points in my left wrist and left foot were actually too sore for me to put my watch or sandals back on, another first. I usually feel relaxed and refreshed after a session, not sore.

Before I left S also told me that she had a patient who might have some extra Menopur. She had been planning to donate it to another woman who ended up not needing it so it might be available for me! This would be so, so wonderful, with the increase to 5 vials a day, I don't think the stash I just bought is going to get me through this entire cycle. I might also be one of those people who are slow to stimulate and require a couple extra days of injections, which would mean I'd definitely be short.  I should know on Monday if she still has the Menopur available.

As for the side effects, they continued for most of the day. S's stomach treatment worked for a couple of hours, but the general stomach pain eventually came back. I didn't feel nauseous, crampy, and I didn't have ovarian pain, my stomach just hurt. The injection was also much more painful last night, the needle itself was really uncomfortable for the first time and it took me a good 5 minutes to inject all the liquid. Even though the acupuncture hurt, I somehow wasn't expecting my injection to hurt and was completely surprised when I stuck the needle in and my skin went OWWWW. I hope this is a temporary side effect because I have at least 5 more injections to go.

Lab Results!

On Saturday we returned to the Kaiser lab for our multitude of tests. E submitted another semen sample and gave another 3 vials of blood, and I had the extreme pleasure of giving 11 vials of blood. The experience could have been horrible, but I got a wonderful tech who found the vein on the first try, even though she couldn't feel it. I'm so grateful for techs like her :)

Now that a couple days have gone by, the early results are starting to trickle in.  My TSH has come down to just below 2.5, which is still high for me but not as bad as we thought it was. It also turns out that I have the exact opposite blood type that I was told I have by Kaiser. In high school I donated blood at Kaiser for my grandmother's surgery, and a few days later was given a little card with my name and blood type on it. For over 10 years I've been living my life and telling doctors that I'm B- when, according to the newest test, I am actually A+. Mind blown. I'm not sure how a mistake could have been made at the blood bank, since I'm assuming my most recent test is accurate, but it will be nice to not need the RhoGam shot if/when we do get pregnant. I'm still waiting on the results of the other lab tests but they'll probably take a few weeks.

In even bigger news, we got E's 4th SA back and the results were totally startling! So far we've had a 0.65 million, a 0, another 0, and this last one showed 10 million! There was still no sign of any motility so we still don't know if we can obtain anything usable but the numbers were so shocking that E didn't believe them. Our doctor has suggested that its a one time fluke and we shouldn't get our hopes up but I've got my fingers crossed. We've been supplementing the crap out of his sperm with FertilAid for Men, Count Boost and Motile Boost and it would be great to know that they're actually working. His next SA, number 5, is on the 23rd and my tests are on the 26th so we're keeping our fingers crossed.