Trigger-treat!

Ok so it's a little late for that title...but I liked it...

I hit the wall this morning.  I'm finally completely uncomfortable.  My nurse patted my belly and said, "Your poor belly, that looks miserable."  I'm done...I feel like my ovaries are about to explode.  I tried on three different pairs of pants this morning before giving up and moving on to a dress.  They would button but it's really uncomfortable for anything to squeeze my abdomen.

I've been an emotional train-wreck today.  I almost came over the table over something a co-worker said.  One of my co-workers was asking around for garlic and wolfsbane to keep me away today.  She loves me, though!  (Yes, Whitney, it was your mother :) ) Lots of people and everything is really pissing me off.  I blame my hormones, and maybe a little anxiety over having to wait 9 hours for a phone call to hear if it was time...

...And lo, it was!

I was instructed by my IVF coordinator, Jan, to inject 10,000 units of HCG into my ass.  So, I did.  It's a simple process...

You start with your basic everyday around the house syringe and 18 guage needle. Oh, and your bottle of HCG that you can order off any crazy diet website even though all the paperwork says it does nothing for weight loss...which if you ask most pregnant women, they'll probably tell you the HCG in their system had the opposite effect...but I digress...

You mix 1ml of the skinny vial into the fat vial...

You hand it to your husband for an inspection.  Actually this is BJ's first time holding a syringe.  I'm really proud of him.  He's very brave...

Insert needle while husband keeps his back turned and your puppy at bay and move on with your life for a whole 36 hours of needle-free bliss.  YAY!  It feels great to be at this point.  I'm going to swell even more as my follicles get to their final maturity level, which means another dress tomorrow, but it's totally worth it!

Tomorrow night BJ and I will head down for the big needle in Chattanooga Thursday morning.  I get to meet Dr. Bird, Donesky's partner, for the first time face to fa...Oh, hell, let's face it...face to beav... Talk about an awkward first date...at least I'll be ruphied...  I've only ever talked to the man while sobbing, so I hope this goes over better...on the bright side, it will be Donesky doing the transfer next Tuesday...

Jan, the coordinator, emphasized the importance of not wearing any perfume or scented lotion.  Eggs and embryos are extraordinarily sensitive to it and not in a good for them kind of way. So BJ and I will show up steam cleaned and Eau de Naturale.

We are that much closer to the moment of truth.  I cannot emphasize enough just how grateful I am to have another chance.  I'm confident in my medical team.  I'm excited to see/hear how my embryo-babies do this time.  I kind of feel like I have to kick my future children out of the nest when they are -38 weeks old. Hopefully, if things go well, they'll use this against me one day. It's hard thinking about them having to fend for themselves outside of my body their first few days.  Susan, my embryologist, will take good care of them, though.  I know she wants things to go better for us this time.

Peace, Love and Praying for Strong Em-babies,
MK

Tra-la-la

So today's results are in, and I'm very happy to tell you that all is well! My ovaries are now closer to softball size and my skinny jeans are a bit uncomfortable to wear. However, I have a huge amount of nearly mature follicles to give another days worth of stimulation medication too.

My labs were great! My estradiol was 3269, progesterone .881, and my LH was 1.46. I don't have any other labs to compare to today, because I didn't get this far last time.

My acupuncturist is thrilled.  So thrilled he let me have my cell phone during my treatment because I was so balanced...but then he took it away because I couldn't behave.

On pins and needles...

I learned a lot at acupuncture today.  My former acupuncturist practiced Traditional Chinese Medicine.  My current practitioner uses 5 elements acupuncture.  I learned that my speech style is groaning (What the hell?), I'm deep and I'm blue which makes my main element Water.  Water types enjoy salty foods, and their main emotion is fear.  We can be soft like a dew drop or violent like a tsunami...I don't really understand, but I do feel better after I go, and my acupuncturist says I am doing better and I'm more balanced.  That's all I need to know...

I'm excited to see what my embryos do this time.  It's a balance of knowing what the worst is, and giving it a go, anyway.  I'm cautiously optimistic that things will go better this time.  So here's to not triggering (the act of injecting yourself with HCG to fully mature the eggs).  I will probably get to trigger tomorrow.

I am ready to be able to make plans for the future, again.  Today, for instance, I went in at 10:00am and was told at 3:00pm that I had an appointment at 9:00am the next morning.  This is not much notice for my boss, but I'm very blessed that he is extremely understanding and supportive of the process.  I wonder how women with less flexibility go through this?  I also can't tell my own mother-in-law when I'll be having surgery.  Today, I could tell her that it won't be Wednesday, but could be Thursday.  Yesterday I told her it wouldn't be Tuesday.  It's hard to plan for dog-sitters, MK-sitters and the like. Eh...minor details.  It will work itself out...

Bottom line is I'm happy.  I'm not scared, yet. I'm not anxious.  I'm just here and very grateful that things have worked out so well this far.

Peace, Love, and Another Day of Growth,
MK

Hip-hip

So yesterday's results are in. I have 13 measurable follicles on my right ovary and several more that weren't worth measuring. I have 7 on my left that are all about 15mm. 18-22 is the goal for maturity.

I'm happy to report that all my anxiety over my hormone levels was for nothing...

Last cycle my numbers on day 10 were:
E2 - 3063
LH- .998
P4- .251

This time they are:
E2 - 2462
LH - 1.47
P4 - .610
And my follicles are growing more evenly.

Now, I'm waiting for today's bloodwork. My follicles are about at that 17 mark which means they would definitely be 18-22 in the next couple of days. Dr. Donesky said things were "looking good" today.

I'm not near as uncomfortable as I was at this point in the last cycle. I am aware of my ovaries, which is strange, but not painful. I'm definitely going for acupuncture tonight! I want to be in a good place mentally. I can't believe we've almost made it to this point, again!

Now I'm just tapping my fingers and waiting for a phone call from Jan. Ahhhh!!!

Peace, love, and a little anticipation,
MK

Crashing, but not burning...

"Hail Damage"

So Friday was a little too adventurous for MK. It was worse for my car, but at least no tow trucks nor tow truck drivers were harmed in the creation of this ugly hood!

I had my third monitoring appointment Friday, and I have no idea if it went well or not. My estrogen level almost tripled instead of doubling.  There's not really a rhyme or reason to E2 levels except that sometimes you get ovarian hyper stimulation syndrome (OHSS), especially when you get over that 4000 mark, and sometimes you don't.  Some studies say it affects implantation, and some says it doesn't.  The internet is evil in times like these...

I'm going to have to believe Pat when she said I was doing "super" when she called with my results. I hope it's not just rose colored glasses.  Dr. D wants me to lower my dose of Follistim to 150 units from 225.

I'm a little anxious for my appointment today (yes, Sunday)...I'm afraid my levels will start to sky-rocket and I'll be in the same boat I was in last time.  So I'm going to do what they tell me to do.  I hope and pray my follicles continue to grow and that they have enough time to fully mature.  I don't want to have to go in for my retrieval before Wednesday.  I want my follicles to have a little more time this time.

On the bright side...they could've told me I had to come in yesterday!

Now just waiting for the day's results and praying they don't ask me to trigger just yet!

Peace, Love and Simmering Down Now,
MK

Slow and Steady

I must say for a "small town", we Knoxvillians are pretty lucky.  As I was having my blood drawn again by the new andrologist, Diane, I noticed she had a Yankee northern accent.  I asked where she was from and she said New York.  She worked at a fertility center in Manhattan that claims to be one of the top clinics in the world.  (It does have some amazing stats, but they are the same as my clinic's, FYI...and if you compare Donesky's 20-40 cycles a month to their 200+ a month, the numbers seem better for Donesky!) She has degrees and credentials after her name to make the alphabet look short.  She was looking for a change of pace and a more personal approach to the chaos that occurs in a "top clinic in the world."

A Google search will tell you that the top clinics are Cornell Reproductive Endcrinology (CRE), Sher Institute of Reproductive Medicine (SIRM) and Colorado Center for Reproductive Medicine (CCRM) [This is where Guiliana and Bill Rancic were going when they found out she had breast cancer if anyone watches E!.].  These clinics thrive on IVF tourist patients but, you never become more than a number.  It's like a cattle call...NEXT!

So anyway, we have an experienced andrologist right here in town who's an expert in her field.  Who knew?

Since Diane is fairly new to the clinic, I asked her what she thought of it.  She said she is impressed with Dr. Donesky's research and that he was very progressive compared to even her former Manhattan clinic.  Again, who knew?  I also found out that Dr. D is a bro to one of the doctors at CRE which many consider the best in the country if not the world.  Furthermore, I found out Dr. Donesky's nickname is "The IVF King" here in the Southeast.

I'm getting in to all of this because I have occasionally thought maybe I need to get out of East Tennessee to get help.  The thought of adding the stress and added cost of traveling to this process has been a huge turn off, but the cattle call idea is even worse.  If I need anything, it's support and opportunities like I had today to ask questions, even hard ones.

I took advantage of Diane's huge clinic in Manhattan experience and told her about my last cycle.  I told her my estrogen levels from last cycle and she said they sounded fine.  I told her about all my eggs being "slow growers" and not making it to the blast stage and she immediately said it sounded like they might have been a little immature.  Immature eggs can be fertilized but they have fragile DNA that tends to fragment...sound familiar?  My LH levels and my estrogen levels were getting high which would overcook my eggs.  Dr. D had to make a call, or I may have ovulated on my own and lost all my eggs, so he decided to trigger then.  Looking back, I knew he must not have been happy with the cycle because he was very eager to tell me that he would change things up if the transfer did not work... Not being an MD myself, my theory is thus far, that the Lo-Loestrin did not suppress me enough and my ovaries did not get in line and follow orders.  This time, Dr. D made damn sure my ovaries were suppressed and subservient.

The unfortunate thing is that this is still far from a guarantee, but it is my pleasure to tell you that things are still going quite well and better than last time.  I still have 10+follicles visible that are just over 1cm on each ovary. This is more than last time, and they are still growing more evenly.  My E2 (estrogen) level is 435, which is exactly what it was on my first monitoring appointment of my last cycle.  This is perfectly good for my number of follicles at this level of development.  My LH is now 1.18 which is less than half of what it was at my 2nd appointment from August and my Progesterone is at .361.  Jan, my IVF coordinator, has gone from saying the numbers, "Look good," to, "Everything looks really good!"  I am more achy in my abdominal area than I was at this point last time because I have a lot more follicles growing away.  They are putting some pressure on my ovaries, and it's not super comfy, but hopefully this is just a taste of the discomfort I'll have in the future.  

Peace, Love and Lookin' Good,

MK

Trick or Treat!

Gaius says, "Trick or Treat!"

Today was my first monitoring appointment of cycle numero dos and the first one where my husband, the super-professional, could not be with me.  It was fine...there isn't much for him to do anyway accept compare my uterus to the DeathStar, which I for one have never found all that amusing.

Any-some-how I bravely had my blood drawn by the new tech since my favorite nurse in the world, Pat, recently broke her wrist a couple of weeks ago while running on a treadmill on her vacation.  (Turns out exercise is bad for you on vacation.)  They put a plate in so she'll be back in business by Wednesday, but I digress.  So in one (YES just 1) stick the tech got my blood.

My ultrasound went well.  My lining is already up to 5.1 (10 is the magic number) so that was right on track.  I have "too many follicles to count" on both ovaries and the biggest one is 9.1mm which is good for only having 3 full days of stims.  The first thing Dr. Donesky said when he started the ultrasound was, "This is a much better stimulation."  I asked him if maybe the Ganirelix protocol (what I used last time) wasn't fit for me. He said, "That's possible. People respond differently to different protocols and last time you had some [follicles] take off and leave the others behind."  I also asked him is we should expect things to go differently, and he said, "Yes.  Remember you've been on Parlodel for cell membrane stabilization and you're stimulating more evenly."  So right now, all my follicles are staying pretty even which is a great thing!  YAY, for something.  I've been dying for Dr. D to say anything like that for 2 months, and FINALLY there is something positive for him to say.  I may not have bad eggs after all!!!!

So my bloodwork came back...

E2 (Estradiol) - 175
P4 (Progesterone) 0.244
LH  0.998

Last cycle...
E2 - 435 which was a little high because some of the follicles got big a little fast...
P4 - 0.266
LH - 1.03

So I'm all excited, again.  Here goes nothing but hope!!!

Oh and belly update...

Boo!  I look kind of diseased...was not near as bad this early last time...but  I'm kinda proud of it!

Peace, Love and a little optimism,
MK

Supression check - Check!

Today was the day, and a day it has been.

Firstly, because I'm not going to sit here and lie on my own blog, I want to tell you how Negative Nancy I've been.  I cried on the phone to my mother last night for a half hour because I just knew this cycle was not going to go well.  I keep having these flashes of my mother stepping off the plane to me, in tears, devastated and unable to compose sentences again.

This morning in the parking lot of the fertility clinic, I told BJ I didn't want to get out of the car.  I said, "Let's not and say we did."  BJ replied, "C'mon, let's go."  So I did...I do listen occasionally, but it's by free will.

Before you yell things like, "It's not going to work if you don't want it," and "Your thoughts are powerful." may I remind you of the fact that positive thinking only got us to round 2 of IVF with nothing but a huge dent in our bank accounts. Would you tell a cancer patient that if they relaxed and thought positively (maybe throw in a macrobiotic diet) they would get better?  That worked so well for Steve Jobs.  (Sorry if that's too soon for my geekier friends, I hate that he's gone too. Damn granolas and their holistic bs...)  Scientifically/philosophically speaking, things are gonna go how they go just like they went how they did in August.

I was ashamed that I felt so negatively last night.  Too ashamed to tell my husband.  But I did this morning, and he told me about the Stockdale Paradox.  This Stockdale guy is pretty amazing and describes my situation perfectly.  I'm not comparing myself to a POW, or a cancer patient, but please realize I do have a disease, and I am a patient. I think that is one of the most difficult things for breeders to understand when a friend suffers with infertility.

Relaxing, head-standing, adopting-to-induce-spontaneous-conception or any other natural method is pretty much giving the macrobiotic diet a whirl in lieu of chemotherapy and radiation.   I'm not sure this IVF cycle will work.  I want to have a baby more than anything in the world.  This is my paradox and if you take the link, you'll see it's not only rational to have these conflicting thoughts, it can save your sanity.  So I read it, and now I feel better.

So much so that I am willing to share my results.

Estrogen Level:  20.0    August Baseline 37.3  Desired results <50
So I'm over-achieving in this area, but I don't think how low necessarily makes a difference so long as it's below 50.  One website says the lower you are the better your response to stims...so YAY!

Progesterone Level:  .333  August Baseline .252   Desired results <1.5
Little higher than last time, but still nowhere close to 1.5, so I think it's all good.  We want this one to stay low until after the retrieval, and then I want it at 40 by 5dpt.


LH level:  2.86  August Baseline 4.16  Desired results <7
Better, it means my ovaries are "quieter" as the specialists like to call it.  They are more easilty taken hostage by stimulation medications.


Baseline Scan:  12-15 follicles on each ovary  August Baseline 5-7 on each  Desired results 10-12
Yeah buddy!  That's potentially a lot of eggs and I just need 1! 


So, yeah, I'm a little bit excited again.  I also know I'm gonna be alright no matter what.

Peace, Love and Last One of These,

Mary Katherine

Quickie-fastie update...

My appointment went well. I have 24+ follicles now that are 10.5 to 13mm. My E2 level is 1052 which, I believe is as high as it ever was with any of my IUI attempts. I'm doing swell, so they are keeping me on the same doses of everything. My head is still splitting, and everyday seems like a marathon, but I feel it's going to be worth it. I'm toeing the cautiously optimistic line to the absolute excitement area. I can't help myself, so I pray things keep going well! 18mm + sized follicles is the next goal. We'll see if we're any closer on Friday!

Off to bed,
MK

OK, this is not for wimps...

Well, I said in my last blog that I couldn't feel my ovaries yet.  Well, that must have been the kiss of death because the next morning, if I walked too fast, jumped, or even just breathed deeply...I sure felt 'em. It's an odd sensation. Like I have two stones in my lower abdomen that feel bruised.

Speaking of bruisies...check this out!

This is my bruised, swollen belly that is taking the brunt of this process.  Ain't it cute?

Yeah, so thanks to the baby aspirin, I bleed all over my shirts if I don't use a bandaid and then I just form sexy little bruises.  Plus the bandaids help me know where I injected myself so I don't use the same place over and over.  You know, the whole blood clot thing...

BJ is just thrilled, as you could probably guess.  Nothing is hotter than a wife with multiple bandaids and bruises all over her body.  I feel like Pig-Pen from Charlie Brown! Yuck! Both injections seem to be leaving bruises at this point, and the Menopur definitely is like stinging myself with a bee.  I thought it wasn't so bad yesterday, and then today it came back and bit me. I guess I'll have time to experiment some more as the week is still young.  I still wind up with a headache every night and am dog tired from 2:00pm on.  However, the laundry situation does not resolve itself, unfortunately so I must trudge on.  (I still think BJ could just go to Wal-Mart if he needs more underwear...)

I had my first monitoring appointment yesterday with Dr. D.  I have 10+ follicles on each side that are close to approaching the 10mm mark which I thought was disappointing since it wasn't much bigger than last Thursday at my baseline.  Dr. D explained that it was just great because in an unmedicated cycle several of the follicles would already have been reabsorbed at this point. Also you would expect some follicles to begin to dominate, which we do not want to happen because I want all 20 eggs next week!  Dr. D also said he'd probably know by Saturday when I would have my retrieval.  Yikes! Can't wait!

They also took more bloodwork.  They hit the vein in two attempts this time. My estradiol (E2, otherwise known as estrogen, but calling it that wouldn't reinforce all the money the doctors spent earning their MD's...) has gone up from 37.5 to 435.  My E2 may get as high as 3000 something if all goes well.  Anything above 4000 indicates I may have ovarian hyperstimulation syndrome which is no fun and we would like to avoid.  My progesterone level is nice and low (I'm still deficient, but that's ok on this side of the cycle), and my luteinizing hormone (LH) dropped from 4 something to 1 and some change which is good because LH is the hormone that surges to cause ovulation.

They had me remain on the same doses of my medication until my next appointment which is tomorrow.  How exciting! Here's to growing follicles and tennis ball-sized ovaries.

Peace, Love and Tylenol,

MK