CANCELED!

We've decided to cancel our IVF. I went in this morning for my last ultrasound monitoring appointment and what started as 6 good looking follicles during ultrasound #1 and then turned into 3 o-kay follicles during ultrasound #2 is now only 2 follicles with a smaller one at 14.5 mm that MIGHT grow a little and release with the trigger shot but that's a big maybe. So, 2 follicles is not worth the almost $10,000 that we would have to pay to go forward with an IVF. Oh yeah, and the uterine lining has shrunk ... it was 8.3 mm on Wed and only 7.8 mm today. Yes, there can be some variability due to operator error but I could tell right away that it just didn't look as full and vibrant on the screen as it did on Wednesday and my doc remeasured it 3 times to be sure and all 3 times it was b/w 7.6 - 7.9. I'm completely baffled at this point.

It's a total bummer, obviously, but strangely, I'm kind of numb to it. I was pretty down on Wednesday when it was obvious that this IVF wasn't progressing as we had hoped but since then I've just kind of lost any emotion I had (and this with an extraordinarily high estrogen level). I can't explain it but I think I'm just so done with all of this BS that I no longer have the capacity to care. I've dealt with so many curve balls and frustration over the years that I'm just DONE. 

Dr. K had me go ahead and get one more blood test to check my current E2 and P4 levels. If they are o-kay, we are going to go ahead and convert this cycle to an IUI instead, since I do have 2 good follies (a 27 mm and a 19 mm) and a decent lining. Who knows, 3 of them have resulted in conception in the past ... maybe we'll get another (preferably one that sticks around).

If, however, the IUI doesn't happen or doesn't work, we are going to wait until after we go to Bali later in the year to try the microdose lupron protocol. That will give us some time to recover a bit from what we have already spent and replenish my supply of fertility drugs. {SIGH}

Oh, I do have to give kudos to my honey though, he's been so sweet and attentive during all of this and willing to do WHATEVER was asked of him! This morning, when I called him with the results, he was really compassionate and he said he's really proud of me and thinks I've been doing a really good job and that with all of the appointments and shots (not to mention the horrible bruises that are all over my stomach!) he is really impressed with how well I've handled everything. That choked me up more than anything!

Pretty Lame When No-one Shows Up to the Party

You know that feeling when you've spent a ton of time and money cleaning your house, decorating and cooking and you get a lame turn out for the party you were preparing for? Well, that's kind of how I feel right now! Remember that party I was supposed to be having in my recently remodeled uterus? Yeah ... that's not really happening!

I went back today for my 2nd ultrasound monitoring appointment and only the 2 largest follicles have grown much and the 2 smaller ones have actually gotten smaller (grrrrr)!! it's looking like, at the very best, we may only be able to hope for 4 eggs (and that's assuming they're all mature/viable), MAYBE 5, but that's doubtful! I just don't know if it's worth moving forward with this cycle or not (for IVF).

Dr. K said we might consider cancelling this cycle and trying a different protocol. Although, he did admit that he just doesn't know if we can expect another cycle to turn out any differently! The pattern of one follicle growing quickly and really outpacing the others is very consistent for me, so I really don't know that I trust that anything will be different with a different protocol. The really frustrating thing is there is nothing, to date, in any of my tests or bloodwork results, to suggest that I should be such a poor responder to ovarian stimulation, so what the heck is the deal?!?

While typing this Dr. K called with the results of my blood work from today's appointment. The estrogen (E2) results were nice and high and the progesterone (P4) results were nice and low. He said he's happy with the results and that he's encouraged that my estrogen is high, because, typically, there is a positive correlation with high estrogen and egg quality. So, in general, that means that although there aren't many eggs, they seem to be producing good estrogen. Since my P4 is still well within pre-ovulatory range the plan is to continue with the meds tonight and tomorrow, with a follow-up P4 test tomorrow to make sure it's still on the low side, and then go back in on Friday for another ultrasound to see if any of the smaller follicles catch up.

Dr. K did say that he doesn't feel this cycle is bleak and that although the response isn't what we had hoped for, there is still a good chance for success, although the likelihood of having anything to freeze is very, very low.

Friday is the crossroads: if there are 4 follicles or less we have to make the decision whether to go forward with the egg retrieval (low numbers) or cancel and sacrifice the $1000 in u/s and office visit fees + a week's worth of stims (~$2500) that we've already spent.

IVF = Bad Gas Mileage

IVF is not very gas efficient, that's for sure! Once the meds start there are ultrasound appointments and blood draws, typically, every couple of days. With my Dr's office being located in far south Austin (off of Ben White Blvd) and my office being located in far northwest Austin (Parmer and RR 620), I'm definitely putting a few miles on my car running back and forth to appointments and spending far more time than I prefer in Austin traffic as I traverse the city, often times during rush hour.

At my first u/s monitoring appointment (Monday, 7/11) there were 6 actively growing follicles, which measured: 16.5, 12.8 and 9.8 on the left and 15.5, 16.8 and 11.7 on the right (they are considered "mature" and possibly ready to go when they reach 17+).

I'm not thrilled with the response so far but I'm trying to remain optimistic. There were 8 follicles during my initial antral follicle count so I was hoping to get at least that many mature follicles and maybe a couple more but so far it appears there are only 3 on each ovary actively growing.

Since there are a couple of follicles outpacing the others in the cohort (i.e. the 16.5 and 16.8), Dr. K had me go ahead and start my Ganirelix shots as well, which will hold the larger follicles at bay while the smaller ones catch up. I'm hopeful that the Ganirelix may also allow the recruitment of another couple of follicles, but we'll just have to wait and see. With the addition of the Ganirelix that makes a total of 5 shots in the belly every.day. Fun times!

I am, however, pleased with the endometrial lining, which was 7.4 mm. I've had trouble in the past even getting the lining to grow to 7 mm, so to be at 7.4 mm after only 3 days of meds is pretty exciting! Dr. K was really pleased with that as well, he also said the overall shape and look of the lining was a lot better than in the past, so hopefully the delay for the hysteroscopy is going to pay off!!

Next appointment is Wednesday (7/13).

Let the Party in My Ovaries Begin!

The results of my repeat estrogen tests on Tuesday (7/5) and Thursday (7/7) were both less than 50 so I started taking my IVF fertility meds this morning! The goal is to stimulate multiple follicles to grow simultaneously so that we will, hopefully, have a good number of mature eggs available for retrieval. I uploaded a picture of my stimulation meds to give an idea of how many drugs are involved in this process.  I will inject all of this (2 injections in the belly twice daily) in 7 - 10 days, pretty staggering!

I'm Good With Perfect

Well, it wouldn't be me if there weren't a few curve balls. I went in Friday 7/1 for my baseline ultrasound and bloodwork, with the anticipation of starting medical stimulation the following day. Everything looked great on the u/s but my  b/w results revealed an elevated estrogen level. Dr. K wants to see it below 50 and it came back at 70. So, instead of starting stims on Saturday, I went back on birth control pills for a few more days of additional suppression.

Needless to say, I had a bit of a freak out when I got his phone message b/c I felt like I had JUST gotten myself into a really positive frame of mind and then I was delayed again! 

However, I talked to my Dr the next day and he made me feel a ton better! He said this is not out of the ordinary at all and that I shouldn't feel like something has gone wrong, rather I should just think of it as the first step in the tweaking process to make sure everything is perfect. As I said to him, "I'm good with perfect". He said he even thought about going ahead and starting me b/c my levels were not that elevated but he didn't want to look back and wish he had done anything differently.  

So, I'm back on BCPs for the next several days then I'll have my estrogen level checked again. If the results are at an acceptable level we will move forward with stims, likely by the end of the week, but if not I'll stay on BCPs for a while longer. I guess this is another test in just "trusting" my doc!

All Systems Go!

The seemingly never ending month of healing after the hysteroscopy procedure finally ended and I went in yesterday for a follow-up saline infused sonogram to make sure everything healed properly. I was sooo nervous b/c the last SIS was so incredibly painful that I kept going back and forth between feeling like I was going to vomit and being on the verge of passing out. However, yesterday's exam went great, with very minor cramping, and everything looked "perfect" (in the words of my Dr). He said they like to see a nice paisley shape with no scar tissue and sure enough mine was a smooth, picture perfect paisley! HOORAY!!

So it looks like we are "All systems Go" for IVF #1 Take 2! I will continue to take birth control pills for another 2 weeks (this is to "quiet" the ovaries and help them to respond better to medical stimulation) and then my baseline bloodwork and sonogram is scheduled for 7/1. I'll start medical stimualtion a couple of days later for 8 - 10 days and then the egg retrieval and egg transfer will likely be sometime during the 2nd week of July.

I'm equal parts excited and nervous, which I know is normal. However, I've actually been having some second thoughts. Lately, I've been able to really step away from the pressures of trying to conceive and I honestly feel like the "fever" has passed a bit and I've been sooo much happier. As busy as I've been recently, I've also been having a lot of fun and really enjoying my freedom and independence. I've been exercising more again and generally feeling much more like my old self. Sadly, I haven't felt that way in a very long time.

In hindsight, I now realize what a horrible grip infertility had on me and how truly depressed I was. I DO NOT WANT TO GO BACK THERE!!! I'm absolutely terrified that this process is going to cause me to stumble and relapse and I have no interest in going back into that deep, dark hole that I was in previously. I'm just hoping and praying that I can take this "detached" attitude that I've developed with me through the process and, come what may, just keep going when it's all over and done with.

Frankenuterus

Last Friday I went in for my post-op appointment and to have the uterine balloon/stint removed and, as always, it was ... interesting.

When my Dr tried to remove the saline from the balloon he wasn't able to get anything out of it, so he went ahead and removed it (which hurt like a {fill in your favorite explitive here}) and it was completely empty! Obviously, I was a bit frustrated that I suffered with mild cramping and other unpleasantries throughout the week, basically for nothing, since the balloon wasn't fully inflated while the lining was healing/regrowing. 

Perplexed, Dr. K filled the balloon with saline to see if he could identify the leak and we finally determined that it was the valve at the end of the catheter; each time it got bumped a drop or two of saline came out. However, Dr. K did say he felt like the balloon still helped, even though it wasn't fully inflated b/c it created a physical barrier to keep the uterine walls from touching while they healed. We are going to do another SIS in a few weeks to make sure everything healed up properly. Yay (said with dripping sarcasm). 

We also reviewed the pictures that he took during the procedure where he identified and removed some scar tissue that was creating a "wall like" structure at the top of the uterus near the opening to the right fallopian tube. We looked back at the pics from my previous hysteroscopy in Jan 2010 and an SIS I had done in July 2010 and nothing like that appeared, so it is baffling as to where the tissue came from. He told me that he can't explain it and if he hadn't seen it with his own eyes he would think it was two different uteruses! OF COURSE it would be my luck to have the most unique uterus known to modern science. As I told the Dr, apparently I have a Frankenuterus! Grrrr. For what it's worth, Dr. K. didn't agree that it is a Frankenuterus but he did admit that what he found was strange.

Oh well, onward and upward, hopefully this is just the remodeling my uterus needed to create the perfect habitat for a thriving embryo!