It's a Numbers Game

Well, we may have a reason behind our inability to conceive. Doc has done multiple SAs in the past few months and all have been about average. The morphology numbers based on the WHO scale wavered around 30-35%, so not stellar, but definitely nothing to worry about.

Dr. P suggested that we do another sperm analysis using the Kruger scale, and we got the results back yesterday. Other numbers were good, but morphology was at 7%, meaning 93% were abnormal. Not great news...

So, being the anal person that I am, I went on the internet and did a whole lot of research. Seems that these morphology numbers are really subjective. Some docs put a lot of weight on them, others don't give a hoot. I also read that the Kruger scale is very strict, so not many men receive "normal" which is above 14%. That being said, Doc's wasn't even close to 14%.

We're not overly concerned about the numbers at this point because we're doing IVF and we've already decided to use ICSI, but I'm glad that this may give me a reason as to why things haven't been going all that well. Between his lower-than-average morphology and my lower-than-average follicle count, maybe IVF was our only option.

This also gives me some relief that maybe, just maybe, it doesn't have anything to do with lining or implantation or some random immunological issue. This gives me renewed hope that maybe, just maybe, IVF will work.

“Dum spiro, spero (Latin): While I breath, I hope."

Nervous!

Why am I so nervous?! I start the folli.stim and the men.opur tomorrow and I've got butterflies in my stomach. Does that make any sense? I mean, I don't even have to do anything but stand there and wait until Doc gives me the shots. So, what's with the case of nerves?

I think it might have to do with anticipation of this cycle really being THE cycle. I never felt this way with the IUIs, but I actually have some glimmer of hope this time around. Maybe things will work out? At the same time, though, I'm so scared of knowing the results at the end of tunnel.

I think I read in someone's blog (I'm sorry I forget who), but it was very poignant. She said that IVF was her last shot, her glimmer of hope and by going to IVF she was using up her last shot. I know exactly what she means...this is it. This is our last option. If this doesn't work, we can try IVF again, but there's no taking it the next level.

So, we're pulling the trigger tomorrow and we're going to give it our best shot. Speaking of shots...According to my calendar, I'll be taking the foll.istim in the AM and meno.pur in the PM. Nurse Sweetie emphasized that we need to take the shots at the same time every day. Not one hour later, or one hour earlier, but at the same time. What did you do when you couldn't be at home to take the shots? Did you take on the road with you?

No Spring Chicken

Let me just tell you, I'm no spring chicken anymore. I am so sore! After two full days of snowboarding, I'm still hobbling around, groaning about my sore quads, calves, biceps, and forearms (why are my forearms sore?).

Overall, it was a great weekend, even though Saturday's weather was less than perfect. We boarded/skied in a light snowstorm, but we still managed to get in a full four hours. It was definitely worth it, considering this may be the only time we get to go up for the season (eyes begin to tear...).

Alright, now that my complaining is out to the way, I want to tell you all about my morning. We went to our IVF training also known as the Injection training. The nurse, who is also my case manager and will henceforth be known as Nurse Sweetie (cuz she's so sweet and nice) was our instructor for the day.

We spent the morning learning how to use the folli.stim pen and how to give an IM shot. It was really funny to see the faces of the husbands in the room when Nurse Sweetie explained all the details on the IM shot. They looked very concerned and a bit worried -- poor guys, but at least they're not on the receiving end.

I also got my baseline blood work and ultrasound done. Ovaries look good, no cysts and the blood work shows that my estradiol is nice and low. So, I'm all set to start stims on Friday. Tomorrow will be my last day on BCPs and today I'll start my low dose aspirin.

One thing that Nurse Sweetie said that really stuck in my head was that she told us to ask questions. Be proactive and ask questions during our ultrasound. Ask specifics, don't just accept a broad statement from the doctor. Her statement really made me realize that we are our own best advocate. Yes, the doctor is there to make sure that everything goes well and he'll do his best, but it's also our responsibility to make sure that he's doing all he can for us.

I'm excited, but at the same time so, so scared. What if this doesn't work? I guess I shouldn't think about it, but how can you not? Arghhhh...

Happy ICLW!

Welcome to all you ICLWers! This is my second ICLW and I'm excited to see a few new folks visiting my blog.

Just to give you a bit of introduction...I'm 34 years old and my husband, Doc, and we have been TTC for 13 months. Not too long in the whole scheme of things, but considering my age, we don't feel like taking any chances and waiting.

We've been diagnosed with unexplained infertility and have gone through 1 round of clo.mid, and two rounds of fe.mara/let.rozole with IUI. With my last BFN in early February, we decided to take things to the next level and go the IVF route.

Right now, I'm on BCPs and will be starting the stims (men.opur and foll.istim) on Friday. My doctor has me on the antagonist protocol due to my age and my low-average antral follicle count. My retrieval and transfer are scheduled for early/mid-March. We're keeping our fingers crossed and hoping for the best!

Snow!

We're going to Tahoe this weekend and I plan to snowboard until the cows come home!

We haven't been able to go up to the mountains all season and I've been going through bouts of mental and psychological anguish over this. Along with all the other things that I'm not able to do while TTC (drinking alcohol, hot tubs, eating sushi), I also am not supposed to impact sports which includes my favorite sport in the whole wide world...snowboarding! However, I'm on BCPs right now and so, I have one more weekend before I start stimming and I'm back to my restrictive regimen.

Typically, Doc and I go up to Tahoe almost every other weekend during the winter season beginning at the end of December. So, you can imagine how excited I am since I haven't hit the slopes in almost one year!

After watching hours of Olympic snowboarding, I am so ready to ride! I really don't think there's much that compares to carving the mountain in fresh powder or landing that single jump. Anyone else have a sport that they love?

$100 here, $1,000 there...

Ah, it's just money, right? Not! I can't believe how expensive these stinkin' meds are. What a rip?! Seriously, how much does it cost to make foll.istim and how much are you selling it for? I'm not sure which is worse -- the health insurance industry or the pharma industry?

As you can probably tell, I just paid for my meds for this cycle. I didn't even purchase everything the clinic ordered and it came out to 2,900 buckaroos! What gets me is that I took some of these same meds for my IUI cycles and they were covered under my Kai.ser insurance, but because this is IVF, I'm SOL.

But, hey, what can you do? We're at the mercy of the man and right now, I'm not in the position nor the mood to fight.

I got my foll.istim coming and my men.opur. I'll be taking 225 of the foll.istim in the AM and 150 of the men.opur in the PM. Luckily, I won't have to do any of my own injections. That's where having Doc comes in handy (that and asking questions while watching House).

Package comes tomorrow! I'll take a pic of all my goodies.

I Won and I am Beautiful!

This is my first award and I'd like to thank all the people who helped me get here and...Ahem, sorry, wrong acceptance speech. I did win an award, though, and I'm officially a Beautiful Blogger. I really want to thank Venting Vagina for the award! Not only is her blog awesome, but she's also getting ready for a FET which will be around the same time as my IVF!

So, the instructions that go along with this award are as follows:

* Thank the person who nominated you for this award.
* Copy the award and place it in your blog
* Link the person who nominated you for this award.
* Tell us 7 interesting things about you
* Nominate 7 bloggers
* Post the links to the 7 bloggers you nominate.

And now for my seven interesting things:

1) I knew my Doc for many years before we started dating. He was a bible study teacher at the church I went to while I was in high school. Obviously, at the time I was not interested in him at all and we went our separate ways for 15 years before meeting up again.

2) I love zombie movies. It's a guilty pleasure. The cheesier and gorier, the better. Doc hates zombie movies and I tell him that one day, when the world is overtaken by zombies, I'll be the sole survivor because I'll know how to defeat the zombies.

3) I hate humidity with a passion. I grew up in Northern California and went to college in New York. Right after college, I lived in NYC for a year. Everyone assumes I moved back to Northern California because of the cold, but little do they know that it was the humidity that drove me out. I can't understand why it has to rain during the summer...Umbrellas are only for winter!

4) My celebrity crush is Brad Pitt (hubba-hubba). I've been crushing since he was in Thelma and Louise. He just seems to get better with age.

5) I am a book snob. I scoff at Oprah's Book Club books. I delight at going to independent book store readings. But, I have a secret...I loved the Twilight books. I read those books non-stop and finished the whole set in less than two weeks. I refused to read them in public, so only behind closed doors and covered windows. Oh, but were they good!

6) Doc and I were married in a museum. We wanted something different, but yet very elegant. It worked out well because it poured on our wedding day, so any outside pics that we wanted to take had to be switched to indoors. The museum paintings and interior provided great backdrops for all of our pics.

7) And lastly, I am a karaoke addict. I'm a terrible, horrible singer, but man, do I love me some karaoke. I think it has to do with my inner need for attention or maybe I was a singer in a past life. Whatever it is, I have absolutely no qualms about going up in front of strangers and howling out the lyrics to "Livin' On a Prayer" or some other 80s hair band (that's my specialty -- 80s hair bands).

And the lucky bloggers who get this award passed to them (sorry, I'm still new and only know 4 bloggers who haven't received this award yet):

1. Misconceptions About Conception

2. Chasing a Miracle

3. Confessions of a Fallopian Tube

4. Lily in the Valley

Ready, Set, Go!

Our plans our set and our calendar has been sent to us with the dosages and dates. I'm a bit nervous and excited at the same time!

As I mentioned in a previous post, Dr. P put me on an antagonist protocol. I'm already half-way done with the birth control pills and I'll be starting the stims on Friday, February 26th. He's also recommended baby aspirin to take along side the stims.

The dosage for the stims are: Menopur 150 and Follistim 225. I've been trying to search on the internet to see if this is the standard dosage, but it seems that everyone is recommended something different and the dosage can change depending on how you react to the stims.

My retrieval is tentatively scheduled for March 9 and then I'll either have a three-day transfer or a five-day transfer depending on how the embryos do. I'm keeping my fingers crossed that everything goes ok.

I'm still going to acupuncture, but I've upped it to 2 days per week based on the acupuncturist's recommendations. And, last but not least, I've added royal jelly and CoQ10 to the daily regimen. Randine Lewis of the Infertility Cure recommends both supplements and they don't seem to have any major side effects, so doesn't hurt to try.

The only thing I haven't really been able to work is my stress level. I'm a bit worried about that (ha! stressed about being stressed). I haven't been able to sleep well and the sleep that I do get is punctuated by fitful dreams of doctors and needles and unsuccessful IVFs. Anyone have any good recs for relieving stress?

Counting Chickens Before They're Hatched

That's basically what we did on Friday and I was sadly disappointed...Looks like my antral follicle count was 4 on the right and 4 on the left with a low total of 8. There's always a chance that the count will go up with the meds and that I'll have good quality eggs, but then again, I've read about so many people that have 15+ eggs retrieved and only 2 or 3 making it to transfer.

On the bright side, the saline sonogram showed no abnormalities in my uterus. No fibroids, polyps, or cysts. The opening to my cervix is a bit tight, but Dr. P didn't seem to have any big issue with getting the catheter through.

The rest of my appointment on Friday was working out the logistics of the cycle. Ordering the meds, getting the dosage and the schedule finalized. Everything seems so overwhelming...

Around the World

Maybe not around the world, but I wish that we could travel that much. I thought I'd write a non-IF related post just about me or should I say us.

Doc and I love to travel. Doc's been globetrotting a lot more than I have, but since we've been together we've gone to quite a few different places. We like the more remote destinations. Places that are off the beaten path and require long plane rides.

Some of the places that we've gone to: Mongolia, China, India, Mozambique, South Africa, Reunion, Mauritius, Tanzania, Croatia, Hungary, Slovenia, and the latest place, Russia.

I have to say that the most interesting place I've gone to is Mongolia. We lived in gers (aka yurts) for 2 weeks while we ventured across the country. The most difficult part of the trip was the food...All lamb, all the time. You know those Mongolian BBQ houses you see in the U.S., those are all lies. Trust me, there's no Mongolian BBQ in Mongolia.

We also enjoyed our trip to Russia! It's nothing like what I expected. No KGB on the prowl. No Russian spies lurking in dark corners and definitely, no Soviet workers toiling in fields.

In May, we're headed to Puerto Rico, probably one of our more tame trips, but we're hoping that they'll be a reason to stay close to home!

Confirmed!

Yes, the dates have been confirmed and all systems are a go! The IVF Case Manager at Dr. P's office called and sent me the tentative schedule for my March IVF. It's such a relief after all the ups and downs that we've been through.

I go in on Friday for my first sonogram and an antral follicle count and then they'll be able to confirm what protocol I'll be using. Right now, Dr. P thinks I should be doing the Antagonist Protocol, but we'll know for sure in a few days.

Tonight I start BCPs...Funny that I should be starting BCPs to get knocked up, but hey, that's the way it works. But, since we're not actively TTC this month and Dr. P said it was ok, I'm going snowboarding!!

We're going to Vegas this weekend, but next weekend, I'm in Tahoe, baby! Enjoying the fresh powder and riding those mountains. Just the thought of this has made my day! I'm a much happier camper right now.

It's Been a Busy Weekend

Well, what can I say...I guess I knew it was going to come and this IUI cycle #2 was going to end in a bust. I woke up on Saturday with a bit of spotting, but I didn't think much of it because I've never spotted while on progesterone. When the spotting became heavier on Sunday, I knew there was no denying it. I did the test, which came out stark white, and then stopped the progesterone.

On a happier note, though, Doc told me that I should email Dr. P and see if there was anyway that he could fit us in to the March schedule. Since they both work for the same HMO, Doc was hoping that Dr. P would be a little bit more accommodating. Well, it worked! Dr. P said he could squeeze us in to do the stimulation the first week in March and then do the transfer the second week in March. This means I have to reschedule a business trip that I have, but that's a minor inconvenience.

As for the phone consultation with the Dr. Hollywood...He's very good, really informed and very thorough. But, I think we're going to go with Dr. P. We really liked him and in the end both clinics have the two highest IVF success rates in Northern CA. We decided if the cycle or cycles with Dr. P aren't successful, we'll probably try with Dr. Hollywood. I'm praying it doesn't come to that, though.

And lastly (it's been a pretty busy weekend), we've been dealing with whether or not to tell our families about this IVF business. I know that I do not feel comfortable telling Doc's family. His parents are very conservative and have a tendency to say things that are flat out rude. Not necessarily because they mean to be rude, but because they don't filter their thoughts. Also, I don't feel comfortable having my sister-in-laws (Doc has two brothers who both have children) know all about our business. Not that they aren't nice people, I just don't know them well enough and it's just none of their business.

Unfortunately, Doc's family has decided to have a family weekend in Tahoe from March 12-14 to celebrate Doc's birthday and my MIL's birthday. This coincides with the transfer week, which means I probably won't be able to make it up. We haven't come up with a good excuse yet, so we'll see how it all plays out, but even if the transfer is completed before this weekend, the last thing I need is stress from hanging out with the in-laws.

Uphill Battle

That's what it feels like, an uphill battle.

I got a call from the Dr. P's IVF nurse who told me that Dr. P was fully booked for March's cycle and could not take us on. The news came as a total shock to me because although I wasn't 100% sure I'd be going with Dr. P, I was 90% sure and Doc and I had started to make plans regarding when we'd do this and that.

We had made appointments for my initial ultrasound, the IVF training and Doc's sperm analysis. I had talked to the IVF coordinator on Monday to confirm our spot and I had envisioned in my mind that Dr. P was my doc. I'd even received an email from him justifying the protocol that he'd chosen to go with. And now this!

It just seems that the course of the world is against us in trying to have a child. How is this possible? I just don't understand...Between this and the injectables fiasco, I feel like I'm fighting a war on two fronts. One dealing with my actual infertility and the other dealing with doctors, protocols, insurance and all the BS associated with TTC. Why is this so difficult?

8DPIUI

Ok, I'm 8DPiui. I told myself this time I'd chill out. Not analyze every little symptom and just try to focus on other things. Yeah, right...not happening.

So, for others on this same journey, here are my symptoms so far:

- HOT! I am freakin' hot. Not hot as in, I'm too sexy for this blog, but hot as in, get me a fan and turn down the heat! Usually, I'm the exact opposite, but these past few days, my internal thermostat seems to be acting a bit haywire.
- Holy Pimples, Batman! I feel like I'm 13 again.
- Constipation...this, I tell you, has to be the worst. As Doc likes to say to his patients, "Nothing more underrated than a good bowel movement." And, I haven't had one of those in awhile.
- I feel like I'm retaining the Pacific Ocean. I think this might go hand-in-hand with the symptom above. It's pretty miserable.
- And lastly, nipples on fire.

There they are. Same as last month, but yet, I can't help but think...maybe, just maybe.

Answers to Questions - He Wrote Back!

Ah, what a relief! Dr. P wrote back and gave me his two cents on why he was recommending the antagonist protocol.

Back when I was doing my first cycle of clo.mid, I did the CCT (clo.mid challenge test). They measured my FSH at CD 3 and then again at CD 10. On CD 3, my FSH level was 6.8, but on CD 10 it had gone up to 9.6. Now, during the meeting with us, he did mention that the CD 10 was a little bit of a concern because it was so close to 10, but he also said that my numbers on CD 3 were very good and that my estrodial numbers during the clo.mid cycle were also very good. So, he wasn't overly concerned. But, I guess he was concerned enough that he decided to do the antagonist protocol versus the normal long lupron protocol.

Next up, Dr. Z's consult!

Doctors, Protocols and a Whole Lot of $$

After much research on IVF clinics around the Bay Area, I narrowed my choices down to two clinics. The "Big Clinic" with Dr. P and "Hollywood" with Dr. Z.

Doc and I met with Dr. P on Friday and he was very nice. A straight shooter with a very friendly demeanor with lots of experience. We talked for about an hour and he explained that my upcoming cycle (if this current IUI didn't work) would fit in perfectly with his March retrievals and transfers. The estimated cost of the meds would be about $3K and the IVF itself would be $9,500. A whole lot of dough...

Unfortunately, the clinic will be closed for cleaning in April, so if for some reason we didn't do the transfer and retrieval in March, we'd have to wait until May and May would be very bad for us because we have a vacation planned to go to Puerto Rico. So, I'm a little hesitant about the timing of all of this. It's a bit more complicated than I realized.

Anyway, I called yesterday to follow up with the Big Clinic's IVF coordinator and didn't get a call back until 4:30. That concerned me a bit, because if I'm going to pay $10+K, I'm expecting not to have to wait all day for call backs. I don't want the logistics to add more stress to the process. Anyway, the IVF coordinator told me that Dr. P had recommended the antagonist protocol for me (he hadn't mentioned this during our meeting on Friday). After doing a bit of homework on the internet, it looks like this type of protocol is typically used for low responders, older women, and sometimes women with PCOS. Statistics show lower pregnancy rates with this protocol. This sort of concerned me, so I sent Dr. P an email...we'll see if he responds. Anyone know anything about the antagonist protocol?

As for Dr. Z at "Hollywood" (Hollywood because it's pretty glitzy and nice), we have a phone call with him on Friday. We'll see what he has to say about all this.