ODWU

I tossed and turned all night Thursday, barely sleeping at all.  Not sure if this was due to the bed at the hotel or anxiety about my CCCRM ODWU (One Day Work-up).  Thankfully, my energy stayed with me all day.

I tweeted updates all day, since there was down time between appointments.  And as my Twitter friends can attest, I even tweeted half the evening, having dinner at the bar of a restaurant by myself (excellent people watching).

7:30am  New Patient Orientation
The day started with a New Patient Orientation.  This was basically a review of the coveted Binder each couple is given at the start of the day (I know I'm single, but for ease of communication I'm going to use the word couple to reference the others going through their ODWU).  There were 5 couples having their ODWU on Friday.  They generally take 5 couples a day through the ODWU, Monday through Friday.  WOW!

8:30am  Fertility Labs of CO (FLC) Consent Review
FLC is a separate entity from CCRM although they are co-mingled as an operation. I spent about 10 minutes going over embryology related consent forms with the representative (I should have captured all of the names).  

It was a quick review for two reasons  1)  I've been through IVF before - so I understand the consents  2) I didn't have to debate disposition of embryo options with a partner, specifically the options that have to be specified for the event of a divorce.


10am  CCRM Business Office
This was a financial review of cycle related costs.  This also took about 10 minutes.  When you have been through IVF before you already understand the costs/breakdown, so it was just going over the specifics.

10:30  New Patient Consult (with your doctor)
First the nurse took my vitals then took me to a small consult room.  This was my first Face-to-Face with Dr. Surry.  He was running about 20 minutes late.

He's very nice, quite personable and, of course, SMART.  The consult seemed to be pretty quick and to-the-point (although we talked 20 - 30 minutes).  He said that he knows what protocol he wants to use for me, barring any changes based on the results from the testing we're doing, along with my ultrasound results.  I'll share more on all of this once things move along a little further.

Since Dr. Surry was late, I missed my 30 minute lunch break that was scheduled on my calendar.

11:30am  Psychologist - Donor Sperm Consult
CCRM requires a consult for anyone using donor sperm.  This meeting lasted about 35 minutes, as the psychologist realized that I understand what I'm getting into with Donor Sperm given I've been at this so long.

Thankfully, since my psychologist appointment was brief I had 20 minutes to grab lunch at their kiosk in the back lobby.  They have fresh salads, sandwiches, soda, water, juice, coffee, etc.  Of course, I'd been eying the cold Diet Coke all day but couldn't have it yet... not until after my ultrasound.

12:30pm  Baseline Ultrasound & Doppler
This was the coolest vaggie ultrasound I've ever experienced (and I've had a LOT of them).  This is probably a post in and of itself.

Overall, my uterus looks healthy.  She measured the length, width of both my uterus & ovaries.  They have a flat screen on the wall specifically for the patient to watch during the Wandy session.  She measured the lining (triple stripe) and all sorts of other things.  Then she turned on the doppler to measure the blood flow on the left & right side of the uterus.  I heard the "heartbeat"... of my uterus (bittersweet).  I did text my acupuncturist afterwards because the bloodflow in my uterus is perfect (if it's not, they require patients do acupuncture).  The ultrasound tech said that she's never had a patient who regularly does acupuncture have poor uterine bloodflow.  The only thing is... I have to keep it up (which I was planning to do) to make sure the bloodflow stays perfect!

She then went to count my follicles.  I had 3 on the right and 2 on the left.  A small number overall... that was the most disappointing part of the report.

You are asked to refrain from caffeine/chocolate for three days leading up to your ODWU because caffeine can skew the results of the uterine bloodflow measurement taken during the u/s.  So after my u/s, I went straight to the kiosk for my Diet Coke fix!

1pm  Primary IVF Nurse Consult
At this appointment I met my primary nurse, Tonie.   She's cute as a button and sweet as can be (and very sharp too).  We covered the remaining IVF consent forms and other administrative details, along with an overview of their CCS (Comprehensive Chromosomal Screening of embryos).  I don't mean to gloss over this, because this took an hour, but it was a lot of small details (i.e. next steps, instructions about local testing, etc).

2:15pm  Labs
They took 4 vials of blood for all sorts of testing.  Hint:  Drink LOTS of water leading up to your ODWU and through the day (altitude can dehydrate).  I had a ton of water for a few days leading up to this so my 4 vials were quick!

Another Hint:  Don't go to the bathroom right before your Labs, because they want a urine sample too.  Although I had been drinking a TON of water, I couldn't give a sufficient sample so I had to down more water and try again after my hysteroscopy.

3pm  Hysteroscopy with Dr. Surry
My last appointment of the day was a hysteroscopy.  The purpose of this was for a more thorough look at the uterus, different than the ultrasound provides.  The nurse had given me ibuprofen during our earlier meeting to prepare for the discomfort.

It starts with the speculum.  Then comes oxygen.  It stings a bit, but it's an overall, general sting, not terrible.  And it's quick.  Everything looked great.

Dr. Surry mentioned that based on my low follicle count, he would lean to probably doing a CCS-Polar Body Biopsy (PBB - this is when they test the egg after retrieval, before fertilization) and a Day 3 freeze, rather than trying to go to Day 5 for CCS- Blast.  This will show me if my eggs are chromosomal normal (rather than the embryos overall).

I'm comfortable with this approach because one of my biggest questions is whether I have 'normal' eggs.  This will help give me answers.

CCRM Lobby

Next Steps...
This cycle, 9 -11 days after a +LH surge (OPK) I'll have an endo biopsy which will be sent out to be tested for the presence of a Beta 3 Integin.  The lack of this protein in the uterine lining leads to implantation problems.  My local Resolve friend who is now 20 weeks along with twins was missing this protein.  She was treated prior to FET (with Lupron and I'm not sure what else) and had great success!


When my next cycle begins, I'll have Day 3 labs drawn and shipped to FLC (the CCRM lab) for testing there.

I also have to have some additional bloodwork testing run, probably by my primary care physician.  So I'll be managing my cycle and making appointments.

I did email with my local RE nurse today and asked her if I could have the endo biopsy and D3 bloodwork done there.  She said it was fine as long as I had written orders for the tests, which I do.  It was a little awkward to ask my local nurse/RE to help me with my CCRM orders, but I'm trying to stay open about this... since this will either lead to success or answers for me.

Tentative schedule... I would start estrogen priming after ovulation from my September cycle (expected cycle start 9/17).  The following cycle would start my stims.  After local monitoring, I'd go to Denver somewhere around CD6 for a week - 10 days for monitoring/retrieval.  A transfer would be, at best 8 - 10 weeks later. It's not a fast process, and I've accepted that.  It's a long process but it's my best shot!

Long post, I know... even though I really only gave the high level overview.  I really liked Dr. Surry.  The whole staff was really great, nice, friendly.  I REALLY liked the nurses I met!

As I mentioned, I tweeted most of the day on Friday.  It was a bitter sweet day in the Twitter IF community.  Cassie gave birth to her beautiful son Gabe.  Like Ellen2 heard her baby's heartbeat for the first time.  And Dipitie learned that her baby lost its heartbeat at 9 weeks.

Infertility is so unfair!

Colorado

Just a quick update because I've been up since 4:30am ET and I'm going to try to get to bed by 9pm Mountain Time.

I'm in Colorado!

I got in this morning and after a quick check in at the hotel, along with a shoe change, I headed out to explore.  My exploration started with finding the CCRM office.  I found it!

CCRM - Lone Tree office

My appointment is tomorrow from 7:30am until around 4pm.  LONG appointment.  I will write about it once I get home this weekend.

After I found the office, I was starving...  it was now about 2pm ET, I had breakfast at 6:30am.  I drove around the area trying to figure out where I wanted to have lunch and found a nice shopping center with a Sweet Tomato's (yum).  There was a nail salon next door (one that I read about on a CCRM patient message board) and I was hoping to get a pedi today - so I did!  And then right next to that was a movie theatre.  I caught the 1:25 showing of One Day.  

I came back to my room after a quick stop at the grocery (there is a mini kitchen w/ a full fridge in the room).  I was going to do a yoga DVD but I couldn't figure out how to get the player to work with the TV.  Maintenance was supposed to come up but after 30 minutes, I decided I just wanted to get a shower and rest.  So that's what I'm doing.  

I've been reading and trying to comment a bit, but the break has been good for me.  I don't think the break is fully over, but I'll update everyone on how my visit goes and what comes next.  

I'd like to do personal call-outs to many of you, but I'd be up another hour putting it together... so I'll just do one.  Shannon, I've been following your updates on Finn closely and you have been constantly in my thoughts and prayers.  I'm glad you got to head home today and that the Bone Marrow results were negative!  You are so strong!  And Finn is such a trooper!  

The Other Side of IVF

I didn't want to miss an opportunity to share this article (and the video of the interview is good too) which appeared in the WSJ on Saturday.  Holly Finn, author of "The Baby Chase" (and a 42 year old SMC wannabe) talks about being on the other side of the IVF statistics, when IVF does not work.

Detox Cycle

So the long-shot, hail Mary IUI (83 injections worth) was a bust.  While my beta date was not scheduled until next Tuesday, July 26 (why 16dpiui, I don't know), I started spotting Wednesday afternoon and AF arrived today (CD30).  Yes, I was supplementing with progesterone.  Actually, for whatever reason, it was prometrium  this cycle, rather than progesterone.

So this cycle is to be a detox from the super-hormones.  I estimate my next cycle will start around August 18... and I'll head to CC.RM between CD 5 - 11 of that cycle for their ODWU (one day work up, aka - a full day of testing).  At BEST, I would start stimming for my next IVF mid-September.  And since the PGD requires freezing my embryos and uterus preparation, I'll be lucky to have a FET by the end of the year.

Sadly, I'll turn 40 childless, not pregnant, single and overweight.  Not exactly how I envisioned hitting 40... but I can take control of the things I can control.

Since I have, in a sense, a break for the rest of the year (although I'm not getting any younger)... I'm formulating a plan to work on my health (fitness) and maybe get some resemblance of my life back.  The life I've put on hold for far too long.  I'm working on the plan and starting to take action.  I'll share more once I'm farther along.

You may not hear much from my blog for a little while.  I'm not gone, but I am on a break.  I appreciate all of your ongoing support.  I expect I'll continue reading but forgive me if I'm not commenting much.  I'm going to try to extract myself from the SMC, TTC, IF world as much as I can during this time.  My goal is to exchange my TTC/IF OCD for Health & Fitness OCD...  Until next time, I wish each of you the best!!!

Girls Weekend

My two oldest friends came to town on Thursday for our girls weekend, the one to celebrate our turning 40 this year.  It's the weekend we originally wanted to go somewhere tropical and luxurious but my infertility got in the way...  but they didn't make me feel like spending the weekend with me in Char.lotte was any less spectacular than it would have been in the Caribbean or Mexico.

The Backstory
These friends, you must understand, go back to in-utero.

RL was born 2 months before me.  When we were born our parents lived in the same neighborhood, our houses were just 1 house apart (her mom and my parents, to this day, still live in the same homes!).    We went to Montessori together but then went to different schools for elementary and high school.

UD moved in 1 house down on the other side of me when we were all 4 years old (she's an October baby). We all became the best of friends.  UD and I went to the same middle & high school.  We walked to/from the bus stop together every day.  RL's boyfriend used to drive us/pick us up for high school our Sophomore year (because he went to our school).

Funny story that both RL and UD had parrots at their house... my  house being in the middle heard the squawking from both sides!

UD & RL were roommates at the same college!  Today they still live in my hometown (they are definitely a driving reason for me to consider moving home).

We played barbies together. We went to RL's for MTV's debut (I wasn't allowed to have MTV).  We played tons of Atari tennis at RL's (my parents wouldn't buy me video games).  UD's family had HBO (are you kidding, we absolutely NEVER had HBO)!!!

Growing up in FL we were very clever about how to crack coconuts, although we realized how clever our parents were to send us outside to find a coconut with a screwdriver and a hammer... we were out of their hair all day.  We choreographed a dance to Prince's "When Doves Cry", which we reenacted this weekend, surprisingly (or sadly) accurately.

We founded the Huffy Kid Club, for the kids in the neighborhood who had Huffy bikes (that would just be RL and UD) and I was an exception even though I had a Schwinn.

Recent History
RL and UD don't see each other very often although they live a mile apart... busy lives, although they do see each other occasionally (RL actually lives around the corner from my sister). Whenever I make it to my hometown (maybe twice a year) we are sure to get together!

Three years ago we went to NYC together, finally, after talking about doing a trip together for years.  We saw a broadway show (Legally Blonde), shopped, got our palms read and took in the experience of the city together.

We've been talking about doing something to mark our 40th year together for years.  We talk about retiring in the same community (although since they have kids ranging from college age to elementary school age, I am trailing behind in being able to retire, after kids).

They are super supportive and sincerely sympathetic of what I'm going through trying to become a SMC overcoming infertility.  My heart was happy because there was no judgment or 'why don't you just...' statements.  They even understand my current weight gain is much due to the year of super-hormones.  


The Weekend

Courtesy of Google Images

Shortly after they landed we headed to a Zumba class, which was a riot!  We then went to the grocery store where they continued to showcase their new zumba moves up and down the aisles trying to embarrass me, they have always lived to embarrass me.

Friday, we had massages and facials scheduled at the spa.  We were welcome to go early, which we did, to use their gym and pool.  We even had lunch catered poolside.  The entire day was such a treat!

We went to see Bridesmaids later that evening.  If you have not seen it, you must!  It was absolutely hysterical!  I actually laughed until I screamed!!!

We tried to get our palms read but didn't have luck finding a 'reputable' astrologer in Char.lotte.  We took it as a sign that we were not meant to have our palms read at this time (I'm not sure that's anything but a bad sign).

We shopped on Saturday and went out to dinner and then a local pub.

Each of us are experiencing significant, life-changing shit in our lives; each shit is different than the other.  Yet we talked and supported each other.  We talked and laughed and cried.

While spending the weekend with RL and UD makes me remember how blessed I am to have such amazing friends, when I left them at the airport, I choked back tears.
 

Hope & Fear

I was in the waiting room at the RE today, waiting to be called back for my IUI and I realized I had (all too common) conflicting emotions... I felt hopeful.  I even wore my #hope t-shirt I bought during NIAW this year.

Feeling hopeful brought on an overwhelming sense of fear.  Fear of disappointment from another failure. All I know from all of my IUI's and IVF's is failure, disappointment and heartbreak.

Dr. K was on duty today, I've seen him a lot this cycle.  He basically said this is a perfect cycle, as long as at least one egg is a good egg.  I have my 5 or 6 eggs ovulating, 22 million sperm making their way to the eggs and a healthy triple stripe lining in my uterus.

When this cycle was converted to an IUI, I basically gave up hope for the cycle at that time.  I even went back on Diet Coke and have indulged in a few glasses of wine since IVF3 was cancelled, even though I continued to stim for IUI... because IUI's have failed me for 6 cycles already.

I do question whether stimming for so long (due to my lack of response coming off the BCPs) impacted the quality of my eggs for this attempt.  Time will tell.

But today, I felt it... I felt the hope... and the fear.


*Gwinne, you asked in your comments about the clinic allowing me to do an IUI based on the number of follies I had... with my history, it's not an issue; the more follies the better, hoping that ONE might be good enough.

83

No, that's not a beta number.  It's the NUMBER OF INJECTIONS that I've completed over 15 days of Stims for this (now) IUI cycle.

Oh, how times have changed... I was recently reminiscing with my RN friend, the same friend who insisted on staying with me after IVF2.0 transfer - along with her family, about my first IUI when I drove 30 minutes to her house for my first EVER trigger shot.  And then how proud I was of myself when I was able to do my first EVER self-injection.  Who knew???

Somebody check with Guinness... I think this must be a world record number of injections for an IUI.

PS... trigger was tonight.  I've got 5 or 6 follies between 17 - 21 at this time.  IUI on Sunday.

BUMP (aka Cancelled)

Courtesy of Google Images

So there is yet another bump in the road on the way to my baby bump.  My ovaries are not responding and my follicles are not growing and estrogen is not rising... they are all 5mm or less, one is 6mm and one is 10mm.  I am cursing the damn Birth Control Pills... which I didn't want to take in the first place as a lead in to this cycle.  I'm f*&ing OVERSURPRESSED.  Not that my doctor used those words, but I have NEVER had issues with follicle response and this protocol worked beautifully during IVF2 (without the BCP lead-in).  Yes, I am a bit pissed.

I was given the option to continue meds and convert to an IUI (which is what I was thinking would be the best option) or stop the meds and start a estrogen/progesterone to stimulate the receptors on my ovaries in order to lead in to a new cycle.

I am electing to convert to an IUI because this was to be my last IVF locally.

I'm in the midst of a quick cry due to disappointment and hormones... but I've already contacted CCRM to get the ball rolling.  By my estimation I'll head out there for initial testing at the end of July.

Happy 4th everyone!!

Annoying Reminders

Courtesy of Google Images

One of the things that annoys me the most about IVF is having to set an alarm as a reminder to take all of my various pills/injectables/insertables.  But, alas, I need the alarms in order to take the drugs at the required time... otherwise I get distracted with life, work.

It's not the actual setting of the alarm that annoys me, it's when the alarm goes off.  Like I need multiple reminders a day that I'm infertile and am now working on my THIRD IVF... but that's really what the sound of that alarm represents...  hey you, yeah, the Infertile one... it's time to stop life and set up your sterile area for your injections, pull the vials out of the refrigerator and let them warm up to room temperature so you can stick yourself (and bruise your belly) because, while there is no guarantee you'll have a baby by doing this day-in and day-out, there IS A GUARANTEE that you WILL NOT HAVE A BABY if you don't!

But the message the alarm sends is not the point of this post... it's just the alarm itself that's caused some annoying and uncomfortable moments.  I've had two recent incidents of bad timing with the alarm.

Acupuncture
The first incident was a few weeks ago... it was the reminder to take my BCP/Letrozol at 6pm daily.  I was at acupuncture...  you see where I'm going with this...  I had just replaced my iPhone a couple of days before (I'm so happy to be back on Verizon!) and I flipped the switch to Silent on my way to acupuncture.  Yet at 6pm.... RING... (old fashioned telephone sound)... RING... RING... RING... RING... RING... RING... RING... RING... RING... RING... RING... RING...  (warning:  with the iPhone 4, the alarm rings audibly even when the phone is set to Silent)   RING... RING... RING... RING... RING... RING... RING... RING... RING...

You get the idea, right?  Phone alarms don't take a break unless you hit snooze... so it just continues... RING... RING... RING... RING... RING... RING... RING...

Well, while I'm getting used to needles (and I used to be a needle-phobe) I am NOT getting off the table with needles sticking out of my head, abdomen, hands, legs and feet.  Moving around the room to get to my phone and shut the alarm... it's just not an option.  I yell out to my acupuncturist...  'A'...  I keep yelling out her name every few rings... I'm getting louder and louder... but she doesn't hear me.  I'm not kidding when I say 10 minutes passed before she finally came in and fished my phone out of my purse for me.  I didn't realize the walls were soundproof!

Yes, the benefits of that acupuncture session was a #fail.

Monitoring
Oh yes, I'm going there...  Yesterday, I was in for morning monitoring at 7am.  I had my bloodwork done, waited to be called back to an exam room, finally went back, got undressed from the waist down... you know the drill...  I sat back with my feet in the stirrups and my paper sheet covering my lower half and read my Kind.le waiting on the doctor to check my follies and lining.

In comes the doctor (not my doctor).  Over the last 14 months I've seen each doctor in the practice numerous times but they still tend to walk in and introduce themselves, like it's the first time we've met.  I know they see a ton of patients... but really...  you've seen me a dozen times or more over the last year+.  And this doctor starts asking me what I think about stimming so far... like it's my first time at bat.  Again, I don't expect him to know my case history off the top of his head... but at the same time... this is my third time in for IVF (not to mention all of the IUI's)... given the amount of business I've given them... anyway, not the point of this post!

So the Doc is in position and Wandy is doing its thing, the nurse is writing down the sizes of all of my follies and.... TRILL... TRILL... TRILL... TRILL... TRILL... TRILL.... TRILL... TRILL... TRILL... TRILL... TRILL... (I changed my alarm tone after the BCP/acupuncture incident because I couldn't stand to hear the RING... RING... RING... any longer).  Kind of ironic to be in the stirrups for monitoring when my alarm reminder for my morning injections goes off.

Of course, my purse (where my phone is) is across the room next to my pants.  I asked the nurse to grab it and I finally turned it off... all the while, the doctor barely pauses and continues to call out follicle sizes.


The good news is I have so many follies (the news I find disappointing is that they were all only 3 and 4mm in size).  The doctor was encouraging because I didn't have any outliers... they are all consistent in size.


Today I'm thankful for having 11 follies... more than I've ever had during this stage of IVF.  And, while I don't like the alarm itself, I am thankful to be in the age of technology that makes it so easy to set multiple alarms (labeled) and carry it with you... as much as I can't stand that damn alarm.

And now I need to pick another new alarm sound... any recommendations?  I find them all annoying.

In My Dreams

Courtesy of Google Images

It's been a very long time since I've had dreams about my child. And even through this long TTC path, I've not had many dreams about my baby (not while sleeping, that is).  

But this week I've dreamed of my baby twice that I can recall.  First was a dream I barely remembered having the next day, but it was my baby as a newborn.  Last night I had a blonde little boy, probably around 2 years old.

I see these dreams as the hope that does remain in my subconscious...  so today, I'm thankful for dreams of my future child!

Moving on to IVF3.0

I'm amazed that I have to write those words...  I never imagined that I would be the kind of person who would do IVF after IVF (but then again, I wasn't planning to be infertile).  Now, I'm going into IVF3.0 with a plan for IVF4.0...

I had bloodwork last week that confirmed that my CA125 dropped to 27.7 (from 34.3) after nearly 2 full cycles of BCP & Letrozol (my last day for the second full cycle of BCP is tomorrow).  As I've mentioned before, while it's controversial as to the use of the CA125 test to 'diagnose' Endometriosis, since I made the decision to go with Dr. T for IVF3.0, I'm going with it.  Dr. T wanted the level to drop under 30, which it has... this means I do not have to do the dreaded 3rd cycle of BCP/Letrozol and can begin stimming for IVF3.0 next week.

So assuming this is the first time in my 14 months TTC that I have a possible diagnosis, the treatment used is deemed effective (the level dropped), hence possibly giving me my first really good chance at conceiving.

However I do not expect that I'm going to be excited and optimistic, I just don't feel like I have it in me.  I don't have the heart to listen to my meditations.  It's all I can do just to give up the wine, caffeine and artificial sweeteners (diet coke) without some kind of guarantee.  But I know all too well, there are no guarantees.


I do appreciate knowing that you all will carry hope for me, when I am not able to do so for myself.

Courtesy of Google Images

For now, the meds are ordered.  The schedule is set, but always tentative, of course (and it's quite tight in order to finish just BEFORE my friends visit in mid-July).    My July 4th plans are cancelled to be home for monitoring.

So for IVF3.0... I'm going to try to list (at least) one thing that I'm thankful for during each blog post.  Today, I am thankful that my last BCP will be tomorrow (and that I do not have to do a 3rd cycle of BCP).  Good riddance birth control pills!

A Decision... for now

My apologies for not writing about my appointment with Dr. T any sooner.  The appointment went well, work has just been busy and I have not felt like blogging since then.

Test Results
CA125... while it is not diagnostic of endo (actually it is diagnostic of ovarian cancer), levels above 20 can indicate an increased risk of endo.  My level was 34.3, not very high but elevated.

I didn't get into the validity of the test because seriously, different doctors have different opinions... I'm not going to try to change her mind about her belief in the test.

Also, I asked if I should be concerned about Ovarian Cancer and she said the levels for that are much, much, much higher, plus we've been looking at my ovaries frequently throughout TTC, Ovarian Cancer is not an issue.


Endo Function Test (from my Endo Biopsy)... this test showed low grade inflammation that could be indicative of endometriosis.

You put the CA125 and EFT results together, along with my mom's history of endometriosis and there is a probability that I have mild endometriosis.  

Protocol/Treatment
BCP + Letrizol - this is the current method of treatment that she and the other doctors at the clinic believe is most effective in calming the uterus prior to an IVF cycle.  They do not use lupron due to the overly suppressing effects which take longer to wear off (given my age suppression is not the right method for me).


Decision
I will continue with this protocol with Dr. T for this cycle.  If this cycle is not successful, I will go to CCRM or another reputable clinic (this gives me time to line up additional consults).

Dr. T also agreed that she will test my CA125 at the end of my second cycle of BCP's (approx. June 20) and if the number goes down, I will not have to do a full third cycle of BCP's and we'll move into my IVF cycle.

And thank you for all of your feedback on your thoughts and experiences with CCRM, other clinics.  I appreciate all of the information you shared in your comments on my last post!

Timing
Since I have no idea within about an 8 week period when my IVF3.0 Stims/ER/Transfer will take place, rather than booking a trip with my oldest friends to celebrate our 40th birthdays this summer... they booked flights to come here in July!  All I have to do is make sure my ER/Transfer is not going to be over that weekend (which I can be sure to manipulate since I'm on BCP's anyway).  We're going to do a spa day, maybe a day at the USNWC rafting, etc along with some boutique shopping.

A Positive Post

I told the nurse to go ahead and book the appointment with Dr. T, fully expecting it would be late June.  She comes back and asks if I can make it at 3:15pm today?

Are you kidding?  Yes, I'll be there!  I'm even thankful it's AFTER the meeting I HAVE to facilitate at 2pm...  although I would have figured something out (like getting someone else to run the meeting).


I was going to wait until after the appointment to write a post, but then I thought, it might be a negative tone... depending on how the appointment goes.

So here's my positive post!

Do I or Don't I?

First of all, thank you for your wonderful comments of support from my last post.  Secondly, I really want to change the tone of my blog from whiney (about IF) to something more positive... but then something happens again and I have to work through it on the blog... feel free to skip over if you can't take more on my IF woe's.

Today is the day to start my second pack of 'active' BCP's.  I had to call the nurse because the pharmacy said it was too soon to refill the Rx.  She got that worked out but I asked her if she had my EFT (endo biopsy) results back yet.  After fumbling around she found them and started to read things to me... she might as well have been speaking a foreign language.  She said the bottom line was something showed slightly abnormal  and it might be the endometriosis that the CA125 test had indicated was a possibility.

So the doctor wants me to have another CA125 test after this second round of BCP's and then go into yet a THIRD cycle of BCP's leading into my next IVF cycle.  I was crushed.  A third cycle of BCP's, that's 63 days... which would put me into late July before I could possibly start stimming for IVF3.0?  For treating POSSIBLE endometriosis??  This puts me at 5 months in-between IVF's... what happened to No Cycle Shall Be Without A Purpose?

So do I have endo or don't I??  I have no idea.

I asked if I could talk to Dr. T about the test results and the possible diagnosis, even if by phone.  I was informed that Dr. T doesn't "do" phone consults but I could make an appointment.  Of course, I know that means at LEAST 4 weeks before I can talk to her, I'll be in my 3rd cycle of BCP's by then.

I was blinking back tears at the pharmacy this afternoon picking up the BCP's I need because I can't get pregnant... it sucks and it doesn't make sense.

Second Opinion

I had my phone consult with Dr. Su.rr.y at CCRM last week while at the beach.  He does suspect that with my 2 chemical pregnancies (he agreed that's what they were) it's likely an embryo quality issue.  He recommends PGS (Preimplantation Genetic Screening) with my next IVF cycle to get a better idea of my embryo quality.  He also talked about how different labs impact the quality of the embryo.

He also doesn't believe in using the CA125 test to diagnose endometriosis (it is a test commonly used for cervical cancer) and it could mean MANY things, especially given it was barely above the normal threshhold.  Apparently the use of the CA125 test as an indicator for endo started at Wake Forest so he suspected it was picked up by my clinic due to the local connection.  He doesn't believe in using BCP's for endometriosis control, he would use Lupron priming.  He doesn't believe in the EFT (endo biopsy) as it's not validated outside of the Yale research facility.

If I work with CCRM, I would need to travel to Colorado 3 times... 1) Initial evaluation/workup; 2) Egg Retrieval; 3) FET (after PGS results)

There was a lot more to the consult but I'm trying to keep this post condensed.

Do I stop taking the BCP and go to CCRM for my next cycle or don't I?  I have a pro/con list in my head.

Pros

• New lab 
• New doctor
• More info on the embryos
• Moving forward within next 2 weeks
• Local monitoring (via my current clinic, is that a pro or con?

Cons

• New doctor not as familiar with my history
• I'm 1/3 through the BCP protocol (should I need to start it again one day, I'll have to start over)
• Travel/time away from work
• What happens if my CCRM IVF doesn't work?

In the meantime, I'm at a loss for whether I can schedule a trip with 2 of my oldest girlfriends to celebrate our 40th birthday's... we were thinking late July.  If I stay with Dr. T, I'll be stimming in late July. If I go to CCRM, I'm not sure (depends on when I stop the BCP's) but my ER could be mid-July so we might be able to do our trip (depending on how I swing things with work).

Decisions... I wish someone could just tell me what to do for a change, because I have NO IDEA.

I'm Sorry, Life is So Unfair

I'm so sorry this is happening to you, life is so unfair.

These are the best words of support you can offer to a friend who is struggling with infertility.  Especially if...

• you don't know what to say or how to support your infertile friend
• you have a child of your own
• you have never struggled with infertility
• you have been drinking heavily ALL day!

WHAT NOT TO SAY under any of these circumstances (and many, many unnamed circumstances as well)...

• she needs to take a break for a while and get back to the person you remember her to be (because somehow the months in-between March 2011's IVF2.0 and hopefully July's IVF3.0 is not actually a break?)
• she should take a break and lose weight
• tell her she doesn't have any idea how hard pregnancy is and how crazy pregnancy makes a woman (even though she's been swallowing, injecting and inserting thousands upon thousands of dollars worth of hormones over the last year)
• you didn't know how to respond to the information she was sharing about the second opinion consult she had that morning (the appointment she waited 6 weeks to have, even though she had to take the call from the beach trip) so you kept asking questions about using Facebook during her debrief with the other girls who actually wanted to know what the doctor had just said
• she shouldn't refer to the spare room in her house as the "one-day nursery" because SHE DOESN'T HAVE A BABY or a NURSERY, it's just a ROOM
• she should stop trying and it will happen (hello, you know I'm single - plus this happens in 5% of the cases of infertile women... that means 95% of the time, an infertile doesn't get pregnant when you 'stop trying'.)

While you may INTEND for this conversation to be supportive and well-meaning out of concern for your infertile friend, it's not.  Instead, what you have done is...

• broken your infertile friend's heart
• made your infertile friend feel more alone than she's ever felt before 
• made your infertile friend decide she will no longer talk about her infertility with you and other close friends, she will now elect to suffer in silence (other than her online & IRL infertility support groups)
• made your infertile friend not want to spend time with you (which is difficult since you are currently sharing a room on vacation)
• made your infertile friend need a second Xana.x in the middle of the night in order to sleep
• made your infertile friend debate whether she can even write about this on her blog since you have access to the link, although she doesn't think you actually read it (this blog is my safe place and how I process things, especially for support of those who may understand)
• made your infertile friend have doubts about being able to continue with our annual beach trip tradition
• made your infertile friend FEEL GUILTY for her hurt feelings because she knows that your intention behind your comments was well-meaning even though the comments hurt her to the core

The struggle of infertility is a tremendous hardship financially, physically and emotionally.  If you have not been through this type of struggle, please keep your "well-meaning" comments to yourself.  

The best way I can describe a fleeting moment of how an infertile feels to a fertile person...

1. Think about your children
2. Now think about a time before you had your children
3. Now imagine someone has told you that you will never have your children, they will not exist
4. Think about that fleeting moment of fear and your stomach sinking... wouldn't you go to the ends of the earth to get to your children?

An infertile knows their child is meant to be... and she is doing whatever it takes to get to her child!

I'm so sorry this is happening to you, life is so unfair.

Beach Week - Chicken & Grape Salad

I'm seriously unhappy with Blogger right now.  This post was almost done and I accidentally deleted part of it... and there is NO WAY TO GO BACK!


So... the short story...  I'm going to the beach with my girls this week, annual trip.  I'm behind on blogging, reading & commenting because work has been busy.  Hope to catch up soon!


The other part of the story is that my CA125 test (for endo) came back slightly elevated) so I've been told that the standard protocol is 2 cycles (42 days straight) of BCP + Letrozol... I'm about 14 days in.  Based on this, the earliest I will stim for IVF3.0 is late June.  I'm still waiting on the EFT/Endo Biopsy results... which should be in any day.  Once those results come in, I'll talk to Dr. T and learn more about what's going on.


In the meantime, I have a phone consult with CCRM while I'm on vacation.


I'm making my summer chicken salad - the chicken & grape salad - by request again for our beach trip.  I HATE mayo & mustard... will not eat it, will not cook with it.  This chicken salad is inspired by Dean & Deluca...  I've been perfecting it for years and it is, if I do say so  myself, much better than D&D.


I do tweak things every time I make it, especially at the start of each season when I begin making it again.  I must say, I've outdone myself today!


Here's my best attempt at measuring. Play with it and make it your own. Let me know if you add a twist/spice/etc. 
3 chicken breasts (more for a bigger batch)
1 cup OJ
Chopped Pecans or Walnuts
Red Seedless Grapes
1 Orange for zest
1 Sweet Onion (preferably Vidalia)
Celery (4 - 5 stalks)
Brown sugar
Salt
Lite House Salad Seasonings (optional, but makes a flavorable difference)

Cut up the chicken, cook in slow cooker with some OJ & Brown Sugar (enough to marinate). Chop celery & onion, half grapes, zest the orange, add nuts. Squeeze the juice from the orange into mixture. Add OJ, brown sugar, salt & salad seasonings (to taste). Note, you don't want it soggy, just moist, so don't over-saturate with OJ. 

Blogger Faux Paus

So I had a miscommunication with Blogger on when my 100th blog post was coming up.  Now mind you, I've been watching the post numbers grow for a while... 96, 97, 98, 99...  knowing I should mark some kind of tribute for my 100th post.

What I didn't realize that Blogger was including 'Drafts' in that count.  So my 100th post was actually my 92nd post, the remaining 8 were long-forgotten drafts.

I still stand by my 100th Episode post, even it was slightly premature.

100th Episode

You may recall that Seinfeld, one of the top sitcoms of all time, put together summaries of their episode milestones.

Courtesy of Google Images

This is my 100th blog post, my 100th episode.  In the spirit of Seinfeld, here is the first 100 posts in review.

Never would I have imagined when I started this blog that 21 months later I wouldn't have my baby in my arms.  I envisioned wacky tales of figuring out how to buy donor sperm, getting inseminated at the doctors office (rather than by candlelight) and the experience of being pregnant, preparing for baby.  I thought that perhaps like Julie & Julia, my unique (I thought it would be unique when I started) blog would get picked up for movie rights, blazing the way for other SMC's (this was before The Backup Plan, The Switch, and The Kids are Alright - we've come a long way, baby).  As I broke into the blog world, I realized that there was a wide-world of SMC's... and later learned more than I ever wanted to know about the in's & out's of infertility.

The Pilot: The pilot episode aired in August of 2009, but it didn't get picked up for the season. It was a good learning opportunity as I connected with my first SMC-wanna-be's and created my Twitter persona to align with the blog.  I had some housekeeping to be done, in the terms to getting back to a steady-corporate income, before things could move forward.

Syndicated:  It took approximately 8 months for me to get things into place and under way.  My blog picked back up in May of 2010, just in time for a hysteroscopy and my first IUI.  I was going to be a mom, a SMC, in 9 months!!  ....only things didn't work out that way...

I didn't get pregnant right away.  I continued IUI's while new SMC friends I had connected with got their BFPs.  I began to deal with the idea that it might take me longer than I imagined to begin my life as an SMC.  And it hurt.

After several failed IUI's I finally went back to work for my former employer, the one that laid me off after 12 years of service, the one with great benefits.  Getting laid off in early 2009 was a big hit to my ego, very much defined by my career at that time and much of the reason my SMC TTC got to such a slow start.  Going back was a lesson of swallowing my pride, in the interest of what is best for me and my future family.  This employer has not only good maternity benefits, it has good infertility coverage as well.

Advancing from IUI to IVF:  My 6th IUI gave me a glimpse of hope, as I had implantation bleeding and a BFP a few days before my beta, but as fast as it appeared, it went away.  I started my period an hour before trick-or-treaters came on Halloween night.  I was actually happy because I had never gotten to this level of success previously, even though it ended in failure.

My 6th IUI also allowed me to hit a milestone I wish I never met, an official diagnosis of "Unexplained Infertility".

IVF1.0:  November/December 2010 was my first IVF.  Surely moving to IVF would get me to my dream of being a mom!    Three days before Christmas my BFN is confirmed.  I was devastated and trying to figure out how to make it through the snowbound family holiday.

Bringing in the New Year was tough, especially when I learned a high school friend announced her third pregnancy the day after her 3 year wedding anniversary.

IVF2.0:  By the end of January I was preparing to start my second IVF.  My response to the protocol was much improved and I had one (of many) HPT that turned positive... that was an afternoon of hope, elation and joy I've not felt in so long, even knowing it was early  

Regrouping:  Sadly, there has been more negativity and sadness in my blog than I would ever have imagined.  As I ventured out of the world of hopeful SMC to the world of a single Infertile woman, things got really difficult.  I wish this were the blog I planned, about a single woman happily becoming a mom, and I pray one day that it can be 'that blog'.

My Bloggies:  The best part about this, my 100th post, is recognizing the amazing women I have met along the way!  We may not be neighbors, but I know I am not alone.  We may not be in the same place on our paths, but your support never waivers.  At times, this blog, and your comments are a lifeline.  And I am happy that at times, I can support you.

Thank you for being with me, during the good and the bad.  It's time for more GOOD.

Mothers Day, Different Meanings for Different Experiences

First, Happy Mothers Day to those of you who are mothers and expectant mothers!  I hope you enjoy this day for everything that it is worth!!!

Second, my heart goes out to everyone who has lost their mother or may be estranged from their mother.  My own mother is such a blessing and support, I can't fathom not having my dear mother in my life so I know this day must be such a difficult reminder for you.

Third, I wish for peace to all of the mothers who have lost a child during or post pregnancy.  I have no words to express how unnatural and unfair this is for any mother to endure.

Next, I pray for blessings for those of us who desire with all of our hearts to be mothers but struggle with the pain of infertility.  Today, we must suffer through, endure and survive... (as I did last year) I have HOPE that by next Mother's Day, we'll all be able to celebrate BEING a mom!

Lastly, I leave you with a link to a touching post by Keiko to remember the childless, not by choice.  Her words hold so much truth in how I feel:

We may not have stayed up late when the kids wouldn't go to bed.  But we've stayed up late worrying about our transfers he next morning.  We've stayed up late wondering why the agency hasn't called.  Stayed up late wondering "how on earth are we going to pay for this?"

We may not have endured 20 hours of labor and a natural birth. But we've endured countless hours in stirrups, endless rounds of needles and herbal treatments and painful surgeries. And years of silence and shame.

We may not have brought our child to work but we've sacrificed careers to stay in jobs we hate just to maintain specific health insurance coverage, however crappy that coverage might be - but it's better than paying 100% out of pocket. 

My Resolve

I went to my first Resolve meeting this week (for those lucky enough not to know, Resolve is an Infertility support/advocacy organization).  I was supposed to go to my first one in December, but my IVF1.0 Retrieval happened the same day.   There was no January meeting and I never actually got added to the local group's mailing list so February/March passed.  I reconnected with the leader but I was traveling in April so here it is May... and I finally went to my first meeting.

Back when I was seeing my Infertility therapist, Dr. G, she was a little skeptical about me joining up with the local Resolve group.  She was concerned meeting other women suffering from infertility may not be healthy for me.  Really?

As one woman in the group put it, no one who isn't or has not been through IF truly understands what we feel.  That she wants to talk about IF, with someone who understands, and she wants to talk about it all the time.  She's sad and she's pissed off and she believes she was put on this earth to be a mom.  She said everything I felt, and everyone else in the room.

There were at least 15 women at the meeting.  While it's "scheduled" to be 90 minutes, we were there for 3 hours... and apparently that's pretty standard.  It starts with some informal announcements, then it's an open opportunity for each woman to share what's going on (since the last meeting).   

There were women just starting to seek medical assistance after TTC on their own and there were women who had been trying for many, many years... and many women somewhere inbetween.  One woman was headed to Colorado the next day for her FET, several were in their 2ww, one is just about to embark on her first IVF.  A few of us have begun considering, or down the path of donor egg.  One woman had just... finally (after multiple years)... had a diagnosis that uterus is shredded (after multiple losses, D&C's) and she'll never sustain a pregnancy.

For those who know me, you know I've come to a certain acceptance, even comfort level, of being a single mom.  And as I listened and shared, I was reminded again of the advantages & disadvantages of going at this on my own.

There were stories of supportive husbands who attended appointments, gave shots and offered support unconditionally.  And there were stories of husbands who dragged their feet with every decision, who were ready to give up and felt their wives didn't think that they (the husband) were enough which is why the wives had this unrelenting drive to overcome infertility.  Women were reading the book What He Can Expect When She's Not Expecting to see if their husbands actually did read the book.

A couple of the husbands, not necessarily religious, required that they consult their priest/rabbi, before making decisions about IVF, Donor Egg, Adoption.

While I would love someone to mix my vials and tell me which syringe goes with which drug, even someone who would inject me and hold me when I cry, I am thankful that I, alone, am responsible for my decisions.  I can ponder or move forward as I come to terms with things in my own time, however little or much time as it takes.

I found it enlightening when several of them mentioned how their husbands just don't want them to be in pain anymore and that they are not the same women that they married.  I can relate to that.  I'm not the same person.  Infertility changes you.  You become very much single minded, as you are your own best advocate.  You do everything you can to remain in control of an uncontrollable situation (creating charts, calendars, schedules, etc).

I know I've turned down the opportunity to be introduced to men, because I don't recognize myself... I don't have the energy to focus on someone else, especially someone who wont really know me.  I know I'm still in here somewhere... but this life of ongoing limbo, desperately wanting to move into the next phase without success, this limbo-stranger will not leave until I know my child is safely on its way.  Until I'm able to experience real JOY again.

Other Updates

Endo Biopsy:  One year ago today, Cinco de Mayo, I had my Hysteroscopy to remove my uterine polyp.  Today, I had my Endometrial Biopsy for my Endometrial Function Test (EFT).

My Mom Had Endo: When I sent my mom the video explaining the EFT, she emailed me later and said, I just realized I should tell you, I had Endometriosis.  My mom had a hysterectomy when I was quite young but I was to little to understand what was happening; I just knew that my sister and I had to stay at my Grandmothers house for several days.  How did I NOT know my mom had Endo?  How, in all of these years did I not ask her about it?

But I have no signs of Endo myself.

IVF3.0:  When AF arrives, that will be the start of my pre-IVF cycle.  I'll start Estrogen priming after ovulation.  I had thought I was going straight into Stimulation thinking I'd have the ER/ET the week before Memorial Day.  The good news is, that would have been the same week as my annual beach trip with sorority sisters.  I'm disappointed it's going to be 2 more cycles until IVF3.0, I'm happy I'll get to enjoy my beach trip.

Mothers Day:  I'm not gonna lie, it's gonna hurt.