Black Outs and Trigger Shots

I'm currently sitting in the waiting room of my RE's office. I should be going in for my 4th monitoring ultrasound in a few minutes but the power just went out to the whole block. Living in Southern California, losing power is not exactly a shocker in the summer.  It's ridiculously hot right now and a city block with at least 6 hospital buildings must draw an insane amount of power.

The back up generators clicked on almost immediately and now the nurses are trying to get the stubborn computers back up. It sounds like half the building is without computers which makes patient check in an interesting experience. Three different nurses have now called for the same person who I'm pretty sure is already back in a room. 

Lucky for me, I was able to get my blood drawn before the power went out. My right arm which I use for blood draws 99% of the time is a little battered and bruised so I asked the tech to use my left with its more stubborn veins. I'm starting to make friends with the tech since I'm there basically every day, and I was super impressed when he got it in one go.  The vein on that side is really deep and hard to find but he only left a tiny bruise. 

Veeeeeeiiiiinnnnnssss

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Damn, I had typed up a whole post but it didn't save when I put my phone down for my exam. The appointment this morning went well, but it was conducted entirely in the dark.  The nurse led me down the dark hallway and into the exam room, lit only by the screen on the ultrasound machine. It actually felt a lot like my acupuncture appointments, minus the candles and soft music and I was afraid I might fall asleep since it was still so early.

Everything was a little awkward since the table was electric and the back up generators didn't provide power to lift it up, but we made it work. The "group of follicles" on my right has been reclassified as a cyst (as I had initially thought) but it's very small and isn't a big concern. The mature follie on the left is a perfect 20mm and has several too small 9-10 follies behind it. There's also a 13mm follie on the right, but it's pretty small too. Dr. K said not to discount it entirely, so we're calling my total loot a follicle and a half. My estrogen supports that at around 280 so I was given the all clear to trigger tonight!  I'm nervous and excited all rolled in one, I need that egg to have my healthy X chromosome.

In the midst of all this infertility chaos, my best friend J is marrying his wonderful fiancee, C. I'm the Best Woman in their wedding and have felt awful about my infertility crap interfering with their wedding plans. Luckily, our IUI will be done before the wedding but it's still on the morning of the Bachelor/Bachelorette party, and I'm going to have to sneak away after the rehearsal but before the rehearsal dinner for some quick acupuncture. I'm so excited for them to tie the knot and the ceremony should be intimate, personal and beautiful.

AZFb Microdeletions and a Hysteroscopy

About a week ago E and I went to his follow up urology appointment and received the terrible news that he has a complete AZFb microdeletion. I've started to post a handful of times, but knowing that information hasn't provided us with the answers we need.

The AZF region is located on the long arm of the Y chromosome and there are three segments, the proximal, central and distal, or A, B and C.  Keeping in mind that these microdeletions are extremely rare, deletions in the B region are the most uncommon and have the worst prognosis. After getting my hands on every AZFb paper I could find, the literature concludes that men with complete AZFb deletions do not produce sperm. Men with C region deletions usually have low but usable counts, but B region deletions are an end of the line sentence.  Although E did have several 0 or near 0 semen analyses, he also had a 10 million, 23 million and 2 million, so he is very clearly producing sperm.

(Source)

 
This leaves us with three possibilities:
- The genetic test was wrong, which is unlikely
- All the semen analyses were wrong, which is unlikely since they were done at 3 different labs
- E is an anomaly about whom they will write papers

We just repeated the genetic test but still need to schedule an appointment with the genetic counselor, and have a more detailed semen analysis done at a fertility clinic. We know if we were able to use E's swimmers that we'd have to select for girls, but I'm sure the counselor will want to go over it with us. That and the likelihood of donor sperm, which we are already prepared for.

For me, I had my Hysteroscopy done today, and while it was worse than I was expecting, it wasn't horrible. After the HSG I was picturing the Hysteroscopy as fairly similar, a little catheter threaded up, a numbing injection this time which I was sure would hurt, but nothing too terrible. Instead, there were at least 8 local anesthetic injections into my cervix and let me tell you they HURT, way more than I was expecting. I could feel those suckers all the way down my butt and thighs and they made me shake all over.

Then came the manual dilation of the cervix. Here I mistakenly assumed that since they'd done all those numbing injections, I wouldn't feel anything. Yeah, that was TOTALLY WRONG. I felt every single second of that and it hurt like a bitch. They ended up having to do it multiple times, including one time after they'd tried to put the camera in and it wouldn't fit. Once the camera was actually in, it wasn't horrible and it was pretty cool to see the inside of my uterus on the screen.

During my saline ultrasound, the doctor had seen a little piece of something could be a polyp but she thought it was more likely to be a bit of dislodged lining. It did it fact turn out to be lining, as I had a thick, fluffy lining, despite the progesterone I'd been taking for two weeks to thin it out, so no surgery necessary. Basically everything was normal, normal size, shape, color, it had perfect blood flow, no endometriosis, no polyps, a great lining, basically nothing physical that would prevent an egg from implanting.

At the end of the procedure, the doctor gave us a little print out of shots of my uterus. It felt like a stand in because we don't have a baby for ultrasound pictures, but we took it home for our records. You can't really see anything, just pink walls and fluffy lining.  It's scintilating.

Behold: My Insides

We also had a good chat with our doctor about possibly going with her clinic, since we have to go outside of Kaiser for IVF. I like that she is already familiar with our case and knows how the Kaiser system works, but we'll have to see if it's a good fit once we've met with the genetic counselor.   

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.