Pathetic

I'm really embarrassed to admit this, but since I've written about all sorts of things here, I might as well go the full 9 yards and confess...I POAS when I knew the HCG shot was still in my system just so I could see what a positive stick looked like.

Is that seriously pathetic or what? I just wanted to see if I could really make a stick turn positive and see those two little lines even when I knew that those two little lines were false. I'm seriously losing it, right? This is what IF has turned me into.

I go in for my beta on Thursday and I don't think I'm going to test before then. I'm 99.9% sure it'll be negative. I don't have any symptoms, nothing, nada, not even a twinge of boob soreness, bloating, headaches, or nausea.

Doc and I have talked a bit about our next steps if this doesn't work. I've scheduled consultations with SI.RM, CC.RM, NO.VA (another clinic in our area), and I recently emailed our old RE (Dr. P) who actually thinks that we can get pregnant with my eggs and says not to give up. With all these consultations, I hope we'll get some answers that will help us decide where to go.

Most likely our next cycle will be in early 2011. I'll spend the next 6 months doing acupuncture and herbs (hopefully to improve egg quality), taking metformin and possibly doing one or two IUI cycles. I've also talked with Doc about reducing my hours here at work and taking some time to decompress. Although, my job isn't stressful, I think I might benefit from reducing the workload.

But, in the meantime, I'm still counting the minutes until doomsday...

Throw Me A Bone

I'm back at work and all I've been doing is surfing the web for anything that I can find on improving egg quality. It seems that each doctor and each clinic has their own opinions. Even my mom (who is in Korea right now) has chimed in with her two cents worth.

My mother is trying to convince me that I need to leave Doc for three months, live in Korea, take herbs and then do IVF at a clinic there. My cousin is a big-wig ob/gyn at one of the hospitals in Seoul and so knows some other big-wig RE at Maria IVF (the first clinic in Korea to do IVF), and supposedly, my cousin has guaranteed my mother that I will get pregnant if I do IVF in Korea.

Now, although I'd love to buy into this guarantee I have a hard time swallowing this gigantic, cockamaymie, crap-filled pill. Not only does this does this not make me feel any better right now, but it bugs the living crap out of me. I need reasonable, honest, helpful advice, not more shit-based rhetoric on how advanced Korea is and how things are just better if I do it out there. For god's sakes, what the hell would I do out there for 3 months?! I barely speak the language, I don't have any friends (other than my relatives who will all be in my business), and I'll be away from Doc! I have a hard enough time talking to the doctors here with all the medical jargon, let alone having to do it in Korean...Freakin' a.

On another note, I feel absolutely no symptoms. My nipples o' fire are now only smoldering because the HCG is almost out of my system and other than a few period like cramps, I'm feeling pretty much the same. I don't have very high hopes for next week's beta.

On the Slow Boat To Insane...

That's what I'm riding right now. I feel like I'm one step away from full blown breakdown.

I'm supposed to be relaxing and thinking positive thoughts, but all I can do is think about Dr. Zed and his f***ing donor egg comment. I'm pissed, sad, hopeless, frustrated, and so, so confused. I understand that he was being completely honest with me and not getting my hopes up, but damn, is this really it? Am I at the end of the line? Both times I tested my FSH, it was 6.8 and 7.6. Granted, not super awesome, but not bad either. The same goes for my antral follicle count. So, then what the hell? How can I be expected to throw in the towel with stats like that?

I mean, doesn't the fact that my periods are super light and I have very low estrogen levels change anything? Can't there be something done to adjust for the low hormones? He hasn't even made an attempt to even look at that. No one's tested my testosterone levels or my LH levels. Couldn't those provide some insight as to why my eggs are immature and then maybe we could find some sort of solution?

I've already spent hours upon hours searching the internet for information. I'm almost positive that I have oligomenorrhea, the term used to describe infrequent or very light menstruation in a woman with previously normal periods. It usually occurs in women with PCOS and may be caused by an eating disorder and/or excessive exercise. Could it be that this has been/is my problem? But, if this is why I'm not getting pregnant, why didn't anyone see this before? Have I spent the last 2 years doing useless procedures?

I know some of this is my fault...actually, maybe a lot of it is my fault. See, I've never openly told anyone about my "food/exercise issues." I'm not even sure if that's what it is. How do you get diagnosed with an eating/exercise disorder? When do you know you have one? I always thought that you only had it if you were 105lbs and 5'7" (like the women you see coming out in special Oprah segments).

It seems so hard to discern what is "healthy" living and what is a disorder? I always assumed the more you exercise, the better, right? I mean, that's what the government says: eat lots of vegetables and very little fats and carbs and exercise every day. That's what I did. And, the only people I know that have eating disorders are either stick skinny or throw up after every meal (neither of which I am/do). Is this why the doctors didn't see it either?

I'm sorry this is just a slow ramble. I'm just so confused right now. And the cherry on top: Doc wants this to be the last IVF cycle. So, this will be it. It's all or nothing.

The Dreaded 2WW

I went in for my transfer yesterday and I got some really bad news and a little good news.

The bad news first. Dr. Zed reviewed the results of this cycle and last cycle and the fact that both resulted in a high percentage of immature eggs leads him to believe that there's something inherently wrong with the quality of my eggs. His recommendation was to look into using donor eggs and although I respect his opinion, this is a really hard pill for me to swallow. I'm going to get another opinion at SI.RM in Sacramento and also probably do a phone consult with CC.RM.

There are a few things that I know after doing hours of research over the last few days. 1) I have very low estrogen levels throughout my cycle, hence, my thin lining, very light periods, and low estradiol value of 32 on CD 3, and 2) low estrogen can cause immature eggs. Scouring through the different message boards, I've found a few women in the same situation as me have their doctors prescribe them metformin even though they do not have PCOS.

Actually, I toyed with this idea in the very beginning of my IF journey, but a lot of the literature I read said that you had to be overweight and have cysts (hence, the "C" in PCOS). However, I didn't realize until now that lean PCOS can manifest itself in different ways and can be caused by other things. You don't necessarily need to have cysts or be overweight, the main factor is the hormonal imbalance of excess testosterone and reduced estrogen and possibly some insulin sensitivity.

Way back in 2001, I went on this highly restricted calorie diet and started to exercise excessively. I monitored my calorie intake and made sure it was always between 1100-1300 calories/day plus I exercised anywhere from 2-3 hours/day (once in the morning and once in the evening). I wanted to be skinny, really skinny. And it worked for awhile, but then I noticed that I started to gain weight and around my stomach and my periods started to get really, really light. Since then, my body has changed dramatically. I gain weight around my stomach (which I never did before) and my periods have always been really light (think: pantyliners for 2 days).

Up until I got married, I sort of maintained this diet/lifestyle, albeit a bit less extreme, but still calorie restricted and lots of exercise. I really think that my lifestyle has caused a hormonal imbalance. I haven't had my testosterone tested, so I'm not sure what that is, but I have some of the symptoms that have been listed for lean PCOS including hair loss/thinning, difficulty in losing weight, oily skin/acne, and irregular periods.

Ok, sorry this is getting so long, but what this led me to believe was that maybe the addition of metformin will help. All of the women on that board said that they had better egg quality with metformin. So, if this cycle doesn't work, I've already discussed with Dr. Zed about putting me on metformin.

Alright, so on to the somewhat good news...our 7-cell embryo, the only one that made it, had turned into a morula by the time we had a transfer. So, we had one 3-day morula to transfer. Typically, embryos are morulas by day 4 or 5, so the fact that this little guy had already grown to a morula is a good sign. We're hanging on for dear life to the one hope that our little bean makes it. PLEASE!!!

Again!

FML! I should've posted this yesterday, but it took me awhile to digest and process the news...again.

I got the fert report Saturday morning and we got the exact same results as last time. Ten eggs retrieved of which 3 are mature of which 1 fertilized and 1 possibly fertilized. How the fuck does this happen twice in a row?! Completely different protocol, completely different doctor/clinic, exact same results? Even if we wanted to duplicate the results, there's no way it would've been this close.

I don't know what to do now. We're going in for our 3 day transfer tomorrow morning. At least we have one embryo, although I'm not sure what the quality is and we may have a second one. We get a chance to talk with Dr. Zed tomorrow before the transfer to discuss the results. I guess we'll ask him the WTF happened.

Ugh!

Just wanted to give a quick update on the retrieval now that I'm back up. The good news is that Dr. Zed harvested 10 eggs (7 on the right, 3 on the left). The bad news is that the recovery from the retrieval hasn't gone so well.

I'm finally up and running, but it's been a tough battle back. I had severe nausea and much more cramping than my last retrieval. I threw up several times during the recovery and had to stay at the clinic for an additional 1.5-2 hours for monitoring. After leaving the clinic, Doc and I had lunch and unfortunately, I lost most of it on the drive back home (luckily, we had taken a plastic bag from the office for just that reason!).

Now, we're just waiting for tomorrow's call to hear how many of those eggs matured and fertilized. I'm praying that we have better results than last time.

Countdown to Harvest Time

After waiting at Dr. Zed's for over an hour, I finally had my last ultrasound and E2 draw today. The numbers looked good. I have 4 follicles on my left side and 7 (possibly 8) on my right side. Of those 11 follicles (maybe 12), at least 4 of them are at 18-19mm. My E2 is at 1,747, which they told me matches up nicely with my follicles.

I'm scheduled for the retrieval at 9am on Friday morning and for the time-being I've stopped all meds. After the retrieval, I'll start up again on the heparin, baby aspirin, and progesterone. Interestingly enough, I'm not taking any estrogen after the retrieval or transfer. Last time, Dr. P had me on both the progesterone and 6mg of estradiol.

I've also ramped up my acupuncture sessions to twice a week and per Dr. Zed's orders, we've focused on suppressing the immune system.

I can't help but compare this cycle to my last and overall, things seem to be going a lot smoother (even Doc has mentioned this). Last time around I struggled immediately out of the starting gate with almost no follicle growth and no rise in E2 for the first 4-5 days of stims. Also, my lining was a bit on the low side, maxing out at 7.9-8mm. Let's hope that this is a good sign and everything will be better this cycle.

On a different note, talk about bruises! Holy cow! The heparin is really starting to kick-in and it's not a pretty sight. I guess no bikinis for me this summer. I'll have to post a belly pic for you. Such beautiful shades of blue and purple....

Bloated and Blah

That's how I feel right now. Very, very bloated. Yesterday night, though, was the worst. I seriously felt like I was retaining 10 gallons of water in my stomach and on top of that I had a headache and nausea. The freaking heatwave that we had yesterday definitely didn't help. I made Doc go out and buy me some Gatorade because I read it helps OHSS. I definitely know I don't have OHSS, but last night, I was so unhappy, I was willing to try anything.

Fortunately, something worked, whether it was the cool night temp or the Gatorade, but I went pee three times during the night and felt like a new woman when I woke up. Unfortunately, the bloating is starting up again and although I've drank 6 cups of water already today, I've only gone pee once. This is just miserable. I definitely wasn't this bad last time around. And let's not talk about the weight gain...I'm praying that it's all water.

On the positive side of things, I had another ultrsound with Dr. Zed this morning and all looks good. My lining has increased even further to a whopping 9mm!! I've never made it past 8 before, so I'm ecstatic! Right now, there are 7 follicles on the right and 4 follicles on the left with the largest being 15 and the smallest being 8.

Things are looking pretty good and the retrieval is scheduled for this Friday. I'll also being doing the intralipid transfusion at that time. Wish me luck!!

Oh, and have I mentioned how much I like Dr. Zed and his staff! They've been fantastic so far.

Progress!

Sorry if I've been MIA for the past few days, but there really wasn't much going on. I could've written some tirade about how stupid my boss is (that could've taken up several blogs) or how the government keeps its employees working in sweat-shop conditions (another full-time blog), but those are matters for another time.

Today I had my second ultrasound and E2 blood draw. So far, so good. I'm right on schedule and have 6 follicles on my right side and 4-5 on my left side (about the same count as last time). The biggest is an 10.7 on my left and the rest are ranging anywhere from 9-6mm. But, the best news...my lining is at an all-time high of 8.1 and trilaminar to boot! I don't think I've ever had such a beefy lining this early in my cycle. The estrogen seems to have worked!

So, I'm going back in on Monday for another ultrasound and if all looks well, the retrieval will be set for Thurs or Friday of next week. Med amounts have remained the same with the addition of hepa.rin beginning Monday which means that I'll have to prepare for some major bruising.

I have a bit more faith this cycle mainly because I'm right on track in terms of my progress. Last cycle, I stimmed for 14 days and lining was barely 8 on the very last day. So, we're making progress and I'm keeping my fingers crossed that this is all going to work out!

Just Along For The Ride

The fear is starting to kick in. What if this IVF doesn't work? Do we have it in us to do IVF #3...and #4...and #5? When do we stop? How long do we have to sneak around our families and friends? What do I do next?

I know I should be optomistic and think positive thoughts, but having one failure after another really doesn't allow for those thoughts. I am scared enough this time around that I've actually thought that maybe we should postpone this IVF. If this IVF doesn't work, particularly with Dr. Zed, what hope do I have left?

Last time around, Doc and I had discussed what we would do if IVF #1 didn't work and we both agreed that we would do IVF #2, but this time around we haven't discussed a back-up plan. I think it's a sign that both of us don't really know what to do if IVF #2 doesn't work. This scares the living bejeezus out of me because both Doc and I are super-planners and we hate not having back-up plans. To not have one means that: 1) we can't think of one, or 2) we don't want to think about our inital plan not working. Unfortunately, I think the reason is all of the above.

Since we haven't talked about a contigency plan, I don't know where Doc's head is at. I'm not sure if he's leaning towards another IVF or towards adoption, donor eggs, or living as DINKS, and to top it off, I'm not even sure what I'm leaning towards. I just hope that we're both leaning in the same direction. So far, our marriage has remained strong. Yes, we've had a few hormone-induced spats, but nothing that's done any major damage. But, I'm so scared about what would happen if he was dead-set on living as a DINK and I wanted to do IVF #3. Would we be able to work through that?

Also, our insurance coverage for IVF maxes out at $30K and we'll probably use it all by the end of this IVF, which means we won't have anything left for a possible IVF #3. While we're fortunate enough to have the additional money to be able to fund IVF #3 out-of-pocket, if necessary, I don't know if Doc would agree to this.

There just seems to be so many unknowns that have the potential of affecting our lives on such a significant level and yet, we have absolutely no control over anything. Sometimes I feel we're just along for the ride.

At The Starting Line

Well, I am back from Puerto Rico and overall, it was a good trip. I wouldn't say great, but it was nice to get away from the office and relax.

Flights were on time and we had no real issues (we even got upgraded to first class). The resort was OK. Although it was ranked as a 5-star, I would say it was more of a 3-4 star resort. The lobby and restaurants were all very nice, however the rooms could've used an update.

But, I guess the main reason why the vacation was just OK, was the island itself. There's really not much to do. There aren't a whole lot of nice beaches, no real places to sight-see (other than old San Juan and the rain forest), diving was mediocre at best, and the food was just so-so. I wouldn't say it was a bad vacation, but I probably wouldn't make the effort to go again since it takes close to 10 hours to get to PR from CA. Both Doc and I decided if we want an easy U.S. beach vacation, we'll go to Hawaii.

One really cool thing that we did do was swim in a bioluminescent bay. In Puerto Rico, they have a couple of protected bays where bioluminescent plankton live. The plankton glow when they're disturbed, so as you swim, the water around you starts to glow and if you hold up the water in your hands, you can see the individual plankton glowing and it looks like flecks of glitter. Very, very cool.

Alright, now that I've finished my vacation summary, time to start writing about IVF #2. I had my baseline ultrasound and E2 levels taken yesterday. Everything looks good. No cysts, polyps or any other issues. I'm already starting to develop a trilaminar lining. I think the estrace that I'm taking has helped...thank goodness, since my lining has always been on the thin side). My E2 level was at 152, but they said that's to be expected since I'm doing the estrogen priming protocol.

I started the microdose lupron today and will be starting the stims on Saturday. I'm just hoping that I react better to the stims this time around. According to Dr. Zed, the estrace priming will help my lining and it'll make me more sensitive to the stims so that I should react better and faster.

I'm still taking the fol.gard and also the low-dose aspirin, which is making me bruise like I got into some UFC fight. One little bump and I have the biggest, nastiest looking bruise ever and I haven't even started the hepa.rin yet. Doc says that he's going to make me wear my snowboarding helmet 24-7 when I start injecting the hepa.rin.

The other bad part in all of this is that I feel bloated like a freaking whale. I think the estrace is making me retain boatloads of water and I'm a very unhappy camper. Ah, but it's a small price to pay for the end result, right?

Home Again

Hola! I'm back from Puerto Rico and ready to roll!

We got back in late last night and I'm still catching up on work and settling back into the swing of things. My baseline ultrasound and bloodwork was today and I just received the thumbs-up on starting the micro.dose lu.pron tomorrow and the stims on Saturday.

I'll post more soon and I still need to catch up on all my lovely lady blogs! Glad to be back!