Friday, February 22, 2008

17 DPIUI#3

I thought about posting a picture of my actual temperature chart again, but I came across this graphic in today's LA Times, and this is a pretty good estimate of how my chart looks now! Today's temperature took a big dive from 98.6 to 98.1 F. Hopefully this means that the end is finally near. Once I get a negative test, I'm always eager to move on to the next cycle.

Cycle #15, here I come!

Thursday, February 21, 2008

16 DPIUI#3

The ironic thing is, my AM temp is still sky high today -- (98.6F again). However, I woke up with a migraine headache, so that's probably a sign that the end is near. I swear, having a 15-17 day luteal phase is torture sometimes.

I'm glad I tested last night, because otherwise I would have seen that high temp this AM and I would have started to truly believe that I must be pregnant. Yesterday, I was really hopeful, but not convinced. I think a negative test would have been even more upsetting today.

I don't cry over my negative tests. I did a few times last year, but not any longer. I'm not saying that I'm proud of that, just stating a fact. I think that deep down, I know that we are going to need IVF with ICSI to get pregnant.

If that doesn't work, though, I think I'll be absolutely devastated. :(

Wednesday, February 20, 2008

No Embarazada

I'll cut to the chase: No, I'm not pregnant... "no embarazada"... one line... BFN.

My high temps this morning apparently messed with my mind, because I started feeling like maybe my breasts were doing something and I was having occasional mild twinges in my uterus area all day. Kinda similar to 2 months ago, I felt a sense of inner calm and kept thinking, "Ah, so maybe this is what it feels like to be pregnant. Now I finally know."

I debated all day, but decided to test this evening. I needed to buy a test first, though. My initial plan was to drive to Dollar Tree, but it is significantly out of the way from my evening commute, so I decided to "splurge" on a "real" HPT instead.

I stopped at Long's Drugstore and perused the selections. I wanted something sensitive, but not expensive. I randomly chose "Answer Early Result" based on the fact that it is a pink, two line test (rather than a blue or plus/minus test), and that the "Early Result" in the name kinda implied that it's a sensitive test.

Anyway, I then had to do a full grocery shopping trip. Finally, I came home... and then forced myself to bring in multiple loads of groceries AND take out the recycling AND put the garbage out for tomorrow AM, all before testing. Well, I finally cracked at that point and rushed upstairs to do the test, leaving about 6 bags full of groceries out on the kitchen counter. S wasn't home yet, and I was just hoping that tonight would be the night that I got to say, "Honey...guess what?" when he walked through the door.

But, no such luck. This Answer test had nothing but bad news for me. After I could clearly see that it was negative, I pried open the case for a better look... still negative. And then I looked up the test on ... unfortunately, it's a very sensitive (25 mIU/mL) test. So, I tend to believe it.

The ironic thing PM temp was very very high (99.7F). You're not supposed to follow those, but I do it sometimes anyway. I know that they usually run lower than that, especially at this point in the cycle.

Oh, blah. On to Cycle 15, our last chance before IVF.

15 DPIUI#3

My temps are still up (98.5 F at 5:06 AM, which is equivalent to 98.6 F after the computer adjusts for the fact that I woke up 40 minutes before my alarm.) I wonder if increasing anxiety alone can increase my temps???

I have had decent temps at 14DPO in the past, but I've never had a particular cycle's peak temp at 14DPO. (Does that make sense?) This is such a tease if it means nothing!

I need to get ready for work now. Afterwards, I'll have to decide about whether to buy some tests. I'm pretty much paralyzed with anticipation and fear. I am SO afraid of disappointment at this point. This is Cycle #14 for me; I've had 13 cycles of disappointment.

P.S.: Lately, I've had a few commenters (s.e., Alisa) who seem to have blogs, but I can't read them as I don't have access to their profiles. I'd love to check out your blogs if you'd like to share them)!

Tuesday, February 19, 2008

14 DPIUI#3

Argh! A temp spike to 98.5 F this AM (after decreasing to 98.2 F over the weekend) ruined my plans for quiet acceptance of another negative cycle. I've now spent the past 15 hours or so poking at my breasts and wondering... But I'm trying not to read much into it.

1) I may be 14 DPIUI, but I may only be 13DPO... at least that's what the Ovusoft computer program tells me.
2) I have had many episodes of high temps at 13DPO. It's really not that unusual for me.
3) Any sensations in my breasts (which are very very faint, if even there) and pelvis have occurred before. From what I understand, early pregnancy breasts are quite noticeable. This isn't something I would notice if I wasn't obsessing.

I am trying to keep my anxiety at a low profile because I don't want to set up S for disappointment. I'm thinking that I'll wait to see what the next day or two of temps bring before I decide whether to trek over to the Dollar Tree store. Yes, I have a box of 2 digital HPTs in my closet, but I told myself that I am saving those for a special occasion... like the day when I get a strip with two lines on it. Luckily, I have lots of other work to keep me busy, but it is hard not to get distracted.

Monday, February 18, 2008

13DPIUI#3 & Desert Trip

Unfortunately, I have zero symptoms and my temperatures are doing the slow dance downward, so I'm not going to bother testing this month. I'm really surprised how good that has felt last month and again now. I hate seeing stark white HPTs, and I'd like to never see one again if I can help it!

The desert camping trip was a success. We camped in an area called the A.rroyo Seco del D.iablo, in the Ca.rrizo Badlands of Anza-Borr.ego State Park. It was an area with less cholla (those are the evil cacti that have spikes that "jump" off and HURT you) than many of our previous campsites, so those 2AM stumblings out of the tent to pee were a lot less treacherous than before!

Instead of cholla we were treated to a landscape dotted with the purple blooms of desert verben.a and a few early desert lil.ies and primroses. The ocotillo were just starting to develop their red tips. S is saying that we may need to take another daytrip out there in 2-3 weeks to see the blooms at their peak, and I'm tending to agree. This was a pretty good year in terms of rain, so it should be nice. We also found some petrified wood (I was the one who found it, actually), and saw fossilized castings of cougar prints (a local pointed those out to us).

I wish I could show you some pictures, but my camera's rechargable batteries finally died for good, and S forgot his camera at home. Well, perhaps I will share a few pic from a previous trip (in 11/2005) to give you an idea:

dirt road with ocotillo (the tall, spindly looking plants)

this is what cholla looks like. You don't want to get very close. I cut out the amusing right side of this amusing picture...S was puckering up as if preparing to kiss it!!

These furry guys are out there, but it's pretty rare to actually see one. This is the only time that any of us has seen one out there. He was cruising along in the middle of a dirt road. In any case, I always shake out my shoes/slippers before putting my foot in! On the other hand, I have seen rattlesnakes many, many times here in San Diego (on hiking trails) and in the local mountains, but I have never actually seen one in the desert.

Saturday, February 16, 2008

11 DPIUI #3

I wish I could report some sort of symptoms, but quite honestly, I feel nothing. I'm guessing that this cycle is another bust. My temps look decent enough, but they're flat rather than rising so I'm not excited by them. I'm not planning on testing until next week, and only if my temps were to stay up, which seems unlikely!

We're going camping in the desert this weekend for two nights. We're going with three friends (one couple, and the male half of another couple). I really wish that we were going for only one night, as I'd rather have at least one full day here at home to get stuff done, ya know? Camping in the desert is an odd experience. First of all, there are no campgrounds. You need some sort of 4 wheel drive (or at least a high-clearance vehicle so that you bottom out onto large boulders), and then you drive on these dirt roads for several miles until you see a spot that appeals to you. Then, you set up camp. No campground required. This also means no bathroom facilities, no other people nearby except for your group, and no running water. At the same time, there is no natural water source either, as this is the desert. It is a beautiful landscape, and there are some interesting plants and animals, but at the same time you have to watch out for the "jumping" cholla and I usually end up with quite a few scratches all over.

This is maybe our fifth time going camping in the desert. We usually go out there, set up our stuff, make a nice campfire (in a portable ring so as not to scar the landscape), and then eat, hang out, and have good conversation. Then we camp out one night, and go on one "big" hike. On the other hand, I'm pretty sure that these friends are not very used to hiking, so I'll be interested to see how far we actually get! I wish we were coming home on Sunday night, but apparently we are staying until Monday morning.

The thing that stresses me out a bit is that last time, the other parties involved occasionally brought along a stash of pot. I don't smoke at all and it doesn't appeal to me, but S is tempted by it as it reminds him of old times and having fun with these friends. However, given our TTC difficulties, I would rather him not smoke it at all. I also get testy when he drinks more than a couple drinks. Last time we went camping (Thanksgiving), these issues led to some tension between S and I. I was taking my first round of Clomid, we had our first IUI coming up, and I was stressed out by that entire process. It seemed really unfair that S didn't want to do "everything possible" to optimize our chances, and that I had to be the nagging wife. He didn't smoke, but he kinda resented being reined in, I think. Anyway, to try to avoid a repeat, when S and I had our IVF consult, I did ask Dr G about both smoking pot and drinking (for the male). I gave Dr G all of the same disclaimers that I'm giving you guys (it's very rare, etc). Dr G agreed that it is best to avoid all of this, but he was kinda vague in the way he said it and S probably thinks that he said it's OK to smoke pot as long as it's very rarely.

Just to clarify, S normally drinks 1-2 drinks, 2-3 times per week, so he is not a heavy drinker. But have you ever googled "sperm count alcohol"? It is terrifying. S has not smoked pot during the almost 3 years that we have been together, but he did it in his younger days and I know he'd like to feel connected with his friends again in that way. I really hope that he understood Dr G's advice and that he doesn't want to. Otherwise I feel like the controlling, straight-laced wife and I don't like feeling that way. :/
Edited to add: Never mind! I just talked to S and he did understand Dr G's point of view, and he is not planning to smoke! As I just told him, I doubt that it would be harmful, but you never know. Likewise, I doubt that my prior 2-3 caffeinated sodas per day would be harmful, but I've decreased it to one on Dr G's advice. I am so happy that S is 100% committed to doing everything possible to help this process along! I guess I already knew that, but I'm glad that I got Dr G to back me up on this one.

Tuesday, February 12, 2008

7 DPIUI #3 and not obsessing...YET!

I'm 7DPIUI, but maybe only 6 DPO based on my temp rise. Hmmmm. Wow, this 2 week wait is flying by! No symptoms whatsoever to report... but I wouldn't expect them yet. My temps look nice, but they always do at this point in the 2ww. And I'm not using progesterone, so I'm not dealing with the vaginal irritation that plagued me for the last 2 months.

Today was a huge day for me, career-wise. I did an all-day interview at my current workplace. I will be completing Hematology/Oncology fellowship at the end of June, and I'd like to join the breast oncology program as a junior faculty member.

I know that not everyone is familiar with the terms hematology and oncology, so here's a brief explanation:

Hematology is the study of blood disorders. This may include benign conditions like anemia (iron deficiency, sickle cell, thalassemia, etc), bleeding disorders (hemophilia, von Willebrand disease, etc), clotting disorders; as well as malignant conditions such as leukemias, lymphomas, Hodgkin's disease, myelodysplastic syndrome, aplastic anemia, etc.

Medical oncology is the treatment of cancer using chemotherapy, and when appropriate things like hormonal agents and biologic therapies. The surgical oncologists do surgery, the radiation oncologists administer radiation, and the medical oncologists administer the chemotherapy and/or hormonal/biologic therapies. We also tend to do a lot of the long term followup of cancer survivors.

My training includes a lot of time in both hematology and oncology, but I would like to focus on one specific field (breast oncology) and develop an expertise in that area. The opportunity for focus on one subtype or group of cancer is one of the advantages of staying in an academic center.

For this one position, I had one interview on Friday, and seven more interviews today (what a whirlwind!), followed by dinner. I was a little nervous about it. I personally knew most of the people who were going to be interviewing me, but I don't know all of them well, and I wasn't sure how it would go. I was expecting difficult, pointed questions with themes like, "why should we hire you as opposed to so-and-so who has twenty years of experience?" and "how are you going to benefit our institution?", etc, but really everyone just chatted with me. In some of the conversations, it felt like they were already kinda assuming that I will be joining them in July, so it was a great feeling. Wow!

I don't know when I will find out "for sure" about whether I will be working with them, but hopefully it will be soon. If everything goes well, I may need to choose between an exclusive position at the university (breast cancer only, or possibly breast/GI or breast/lung), and a position in which I would split my time between there and our affiliated VA facility (where I would need to be a jack-of-all-trades hematologist/oncologist). Each scenario has certain advantages and disadvantages.

No one asked me about any plans for babies, etc. I'm sure that they can guess given my age, relative newlywed status, etc, but they really can't ask those questions during an interview anyway. Besides, most of them are women.

I was talking with our fellowship program director yesterday (pre-interview) and she made me close her office door so that no one would hear, and she whispered, "I know you're planning to have a baby pretty soon..." I had hinted to her about this a few months back. Luckily I do trust her not to use this information against me in the hiring process. She brought it up yesterday in the context of wanting to "protect me" from being stretched too thin when my "real job" starts.

Now that this big interview is over with, I guess I'll be able to start obsessing about symptoms (or lack thereof) now!

Tuesday, February 5, 2008

Super Fat Tuesday

Yes, it is Super Tuesday, Fat Tuesday (Mardi Gras), and maybe Conception Tuesday all rolled into one! I am happy to report that my OPK turned bright positive by this AM, so hopefully my surge peaked sometime last night and hopefully I'll ovulate today.

I worked overnight at the hospital (this is the "moonlighting position" that pays a lot and helps us afford all of this assisted reproductive technology.) 5 more shifts to go, and then I'm DONE forever!!! Last night was busy, but not as bad as in some recent weeks, so I was happy to get a 1 - 1.5 hours of uninterrupted sleep on several occasions. The difference between only 10-15 minutes of sleep and over an hour of sleep at a time is amazing. I actually feel like a human being today! Which is good when you're trying to get pregnant, I think.

S's sample yielded 11.8 million total motile swimmers, this time. It's really amazing how consistent it has been (11 -> 11.4 -> 11.8 million) but I'm not complaining. I do wonder how the count is "only" 11 million, given that his total count was 180+ million both times recently. I know that some are immotile and some are lost in the washing, but jeeesh! They do seem to lose a lot.

My long-time readers (for all of 2 months) may recall that both Dr A and Dr W had significant difficulty doing my IUI on my previous 2 cycles. Something about my cervix was tilted, or the inner os was tight, or something like that. Last time, Dr W even had them transfer the sperm to a different catheter which was supposed to be "less flexible." So, today I called the RE's office right after S's collection appointment, and reminded that they should put the sperm in the less flexible catheter. I was pleased to find out that Dr W had remembered, and it was already taken care of!

I decided that I really like Dr W. The other day, when I was having my CD12 ultrasound with Dr A, she saw me and waved and said, "Hi Sarah!!" Today, I was mentioning that this was my last Clomid/IUI and that I would be doing one more unmedicated IUI and then IVF. She looked up and said, "IF you don't get pregnant before that." I appreciate that she still has faith that this might work!

Anyway, I think because of the previous problems, they used an ultrasound to look at my uterus and guide the IUI catheter. They had a student (or new nurse?) training on the ultrasound part, so Dr W was pointing out the anatomy (bladder, uterus, cervix, and then the speculum). I did have a brief sharp pain deep inside when she inserted the catheter. My uterus is tilted in the normal direction (antegrade), but it is a very sharp 90 degree angle from the cervix, so I think it makes it tricky. Anyway, it was really cool because when she pushed the sperm in, you could actually see the turbulence of the liquid coming out of the catheter. Yay!! It was nice to see with my own eyes that they got into the right place.

Afterwards, I waited the requisite 10 minutes (I stretched it out to 12), popped my doxycycline, snuck a peek at the catheter in the trash can (on the package, it was called an "embryo transfer catheter; I believe the previous was called an "insemination catheter"), paid my bill, and headed home to vote.

I have a work meeting from 5-7 tonight, but I wanted to go home first so that I could vote. I forgot that the polls were open until 8PM, so it was a wasted trip, but oh well. I am a voting nerd, in that I have voted in almost every primary and every general election since I turned 18. Anyway, I am registered non-partisan, so I wasn't allowed to even consider the possibility of a Republican candidate due to their closed primary. I voted somewhat reluctantly for Hillary and also on several state propositions. I was disappointed to find out that voting as a non-partisan in the Democratic primary means that my ballot is "provisional" and my vote had to go in an envelope and my signature, address, etc will need to be verified. GRRR!! I always like watching the election results come in and knowing that my vote is among the millions. That's part of the reason that I don't like voting absentee... I always feel like it will be counted after-the-fact. Oh well!

See, I can get agitated about just about anything. (Not just TTC stuff!) I hope everyone who has their primary today gets out there to vote!

Monday, February 4, 2008

Almost positive...

Oh no! I think I may have pulled the IUI trigger too early. This morning (6:30 AM), I dipped my OPK and saw a faint line, and then got out of the shower 10 minutes later to see that the OPK had developed to what I generally call "near-positive." In the past, this has signified that it will be positive in a few hours. So, I told S that we're on for tomorrow, and later called and scheduled S's collection and my IUI for tomorrow AM.

Well, I checked my OPK at 5PM, and it actually looks a bit fainter than this morning's OPK. Oh no! I have been fretting now. I think the possibilities are:

1) I had a false surge this AM, and I really won't ovulate for a few more days. (I hope not!!)
2) My urine this afternoon was more dilute, messing with the results. (It definitely was lighter than my AM urine, but wasn't super-clear or anything).
3) I did have a surge today, and my OPK would have been blaringly positive if I had checked it at, say, noon. (the problem with this theory is that my previous surges have lasted longer than this).
4) My actual surge was sometime last night, and I am catching the tail end of it. (I doubt it, because Sunday AM I had almost NO line on the OPK).

Well, with those possibilities in mind, and knowing that ovulation is supposed to occur 12-36 hrs after the positive OPK, I still feel that I have no choice but to proceed with the IUI as scheduled for tomorrow.

If I really wanted to, I'm sure that I could schedule a second IUI sometime on Wednesday. However, it's another $260.00. Which is a bargain compared to the $15,000 that we'll be otherwise paying in March, but which I don't want to spend if I can help it. ARGH! Why does my Blue Cross insurance SUCK so badly??

I just pray that my OPK tomorrow AM will be bright positive. If so, I'm going to just go ahead with the IUI tomorrow and then go with a couple of "natural" attempts thereafter. (fingers, toes, arms, and legs all crossed!) I'm going with the theory that ideally, the sperm should be in there waiting on the egg and that they can survive for a while. Hope so!!

I was also going to mention something that happened last Friday night. S and I went to dinner with a couple, G & H. G is in his mid/late 40s, and H is in her early/mid 40s (not sure of the exact ages). They have been married since early 2005, and neither has children. In early 2007, we told them that we were starting to TTC, and they basically told us that they were "seeing what happens" which made me feel like they were probably trying, but perhaps without charting and OPKing, etc. (OPKing -- a new verb??) I didn't get a good sense of whether they truly want a baby, or want a baby only if it happens easily and 'naturally.' Anyway, H said something like, "My doctor told me that everything is just fine and to relax." Well, I was kinda horrified to hear this (told to an early-40-something), as I felt that at least OPKs would be helpful. However, I do not know H very well, so I hesitated to give too much unsolicited advice. I told her that I was charting and left it at that, hoping that maybe she would explore more on her own.

Fast forward to last Friday night. S had told me beforehand that he was going to bring up our IF struggles with them, along with the fact that we might be going ahead with IVF. I was OK with that. However, once he started talking about it, I became fearful that G & H know way more about the subject than they are letting on. G said, "Do the doctor have those 'buy 3 for the price of 2' deals that I've heard about?" And, "what doctor are you using?", and "it's about $9000, right?"

Anyway, I don't think that any of those are typical questions for a late-40-something guy unless he has been there, done that (at least for a consult). Then, to my chagrin, S started telling them that "our RE told us that we have great odds due to Sarah's age..." etc etc. He was trying to make them not feel bad for us, I think, as well as kinda reassuring himself about it.

However, I kept trying to nudge S to signal for him to cool it down. I was thinking about poor H, and imagining that they might have had to go for an IVF consult, and been told that donor eggs were their only option. Oh, I hope not!! Poor H! What a horrible conversation, if that was the case. I hope for her sake that my imagination just ran away with me and that she knows nothing about REs or IVF. Ugh! I told S afterwards and he feels bad about it. But we can't quite apologize to them since they have not opened up to us about their own situation. The conversation would have been painful only if they are struggling, too. I just hate for anyone to be in this kind of IF pain. :(

Sunday, February 3, 2008

CD14 Ramblings about IVF

I now have egg white CF, so hopefully I'll be getting a positive OPK in the next few days. Yay!

Anyway, I never did write about our IVF consult last Monday, so here it goes.

We met with Dr G. He's the one I see the least often, but the one who did our original consult. Therefore, S trusts him quite a bit. Actually, I don't think that S has ever actually met Dr A or Dr W, but they're the ones who usually do my ultrasounds or IUIs.

So, Dr G told us that he thought that it was good that we had tried the IUIs, because there is no way to know up-front whether sperm with poor morphology will be able to fertilize eggs or not, and it was worth a try. He still hopes that maybe this month (Clomid/IUI) will get me pregnant. But he agrees that IVF with ICSI is a reasonable next step.

I had a whole list of questions, and he answered pretty much all of them. In brief:

- No, he hasn't heard of metformin and/or Clomid raising people's basal body temperature. (Mine has jumped by about 0.3F since the very first day I started Clomid).

- He is satisfied with my 1-2 eggs per cycle and lining with Clomid.

- Yes, I should still take vaginal progesterone after this upcoming IUI. If I want, I can take a different formulation. In the end, he agreed that I can decrease the dose to 2 per day. (But I'm not going to use it at all; see my post dated Friday 2/1/08).

- He told S that "less is better" in terms of alcohol consumption. S is not a heavy drinker by any means, but he does often have a 2 drinks on 2-3 days of the weekend. If you google "sperm count and alcohol" or anything like that, it is really scary. But I wanted S to hear it from Dr G, not me, so I put it on the list of questions.

- He thinks our chances are about 60% for success with IVF/ICSI. This is high enough that he would not recommend the financing plan in which you pay for 3 fresh cycles + 3 frozens, and get a partial refund if you don't get pregnant by the end of all of that. In our situation, he instead would recommend paying for one cycle at a time. At this practice, you also get a "free" 3rd cycle if you are not successful with 2 fresh cycles and transfer of all frozen embryos. The catch is, this does not include meds, and you have to do everything within 18 months.

- If we get good embryos with IVF, he would recommend transferring only one. Otherwise, there is a 40% risk of twins. I emphasized that we would prefer twins to no baby at all, but we'd prefer a singleton to twins. I think we're concerned about the the prospect of dealing with two babies at once and giving them the TLC and attention that they need, but even more importantly, we're worried about the risks of a twin pregnancy (prematurity etc etc). Still, I'd take twins any day over this current situation.

- I asked about S's pre-wash counts during our IUIs. At first, Dr G said, "32 million and 33 million." I was thinking that was a total count, which made sense as S's previous counts were 100 million in June, and 25 million in October. But, it turns out that those were actually the concentrations (32-33 million per mL)! To boot, S had mega volumes of over 6 mL each time. So, his actual count was more than 180 million each time! Good job!! However, then I got to thinking...jeez, with 180 million sperm, how come our post-wash count was only 11 million?? That doesn't seem very efficient...

Afterwards, S had to run back to the office, and I met with the nurse, followed by the financial counselor. I do not particularly like the financial counselor, but I suppose I can work with her. She said that the cycle costs about $17,000. Well, it is actually less than that because she is not accounting for the fact that we have already done mosts of the preliminary testing (FSH, estradiol, semen analysis, HSG, sonohystogram, infectious disease screen, etc). Also, the meds can range from $3000 to $5000, depending on the doses required. The IVF is $8100, plus $1750 for the ICSI and $550 for anesthesia. I'm going to think of it as $15,000 including all meds, freezing embryos, etc. Still, yikes!!!

As for IVF,
The informed consent paperwork assumes that you will have embryos to freeze. Then, it makes you think about all sorts of unpleasant scenarios, such as:

"What would you want to happen to any frozen embryos in the event of:
- death of one partner?
- death of both partners?
- separation / divorce?

Our answers were:
- made available to the other partner if he/she wishes.
- donated to another person or couple.
- made available to the partner if he/she wishes.

But ugh, it was painful to even think about or discuss those scenarios. It made me tear up just to talk about it.

We also need a few more tests before we can proceed. Namely:

- One of us has to be tested to see if we're a carrier for cystic fibrosis. If not, we can proceed. If so, the other one of us will also need to be tested. I can only assume that in the unlikely event that we are both carriers, they will require preimplantion genetic diagnosis (PGD) on any IVF embryos. Cost = $147.50. I think my insurance might cover this, but that would mean that I need to talk to my dumb gynecologist again. Ugh.

- S needs to submit a semen sample for culture. If this is important, I don't know why we haven't already done it. If not, why do it now? Cost = $35.00.

- Sometime before or early in the IVF cycle, I'll need to undergo a trial transfer. This helps them decide which catheter to use for the embryo transfer, how far in it needs to go, etc. Cost = $125.00.

So, it looks like we'll finish up this current cycle, and if not pregnant, we'll probably do one more unmedicated IUI cycle while I have a stressful work on an inpatient team during the month of March. I found out that the IVF will start with 10-21 days of birth control pills, so that the cycle can be adjusted a bit to fit the clinic's schedule as well as my own. So, we'd probably be looking at starting the pills in mid-March, and starting injectable IVF meds sometime in early April.

All I can say is that I can't believe that this is really happening to me. Last summer, when we found out about the morphology problem, it seemed surreal. Now it's becoming a reality. I wish it weren't, but at the same time I am thankful that this is 2008, not 1975, and that the technology is available to at least keep trying.

I still have more to say about other matters, but I've blabbed on long enough... Maybe later!

Friday, February 1, 2008

CD12 Ultrasound Report

Thanks to all of you for your support about the conversation with my aunt. I have a feeling that she won't bring up the topic again anytime soon.

The CD12 ultrasound showed one 16 mm follicle on my right ovary, with a uterine lining of 8.5mm. Dr. A checked my left ovary, too, and measured one semi-decent looking follicle, but he decided that it was too small to count, and he didn't give me the exact measurement on that one.

Anyway, I am kinda disappointed. I mean, really, I ovulate every month without Clomid, so what is the point of this medication and its required 2 ultrasounds if I'm not even going to make more than one egg?? To summarize, I have taken Clomid 50 mg on CD3-CD7 during each of the past 3 cycles. With Clomid #1 I had two follicles measuring 15/16 mm on CD12, and I ovulated on CD16 or 17. With Clomid #2, I had the giganto-follicle (28mm) on CD13, along with two 15 mm follicles. I was having my LH surge at the time and ovulated on CD14, so I assumed that the two 15 mm follicles didn't have a chance to develop further. And now 16 mm follicle. It's annoying because I always ask them if I should take a higher dose of Clomid, and they keep saying, "No." I do think I am happier with this little egg than with giganto-follicle, however. That one was so large that I kinda worried that there was something wrong with it.

Anyway, I expressed my frustration to Dr. A, and in his usual hurried way, he tried to put a good spin on it by saying, "But Clomid will help make your ovulation 'stronger'." Unfortunately, that is a too much of a hand-waving, nebulous of an explanation for my taste, but I'll try to go with it.

I am trying to overcome my regret about the Clomid dose by thinking that if had taken more Clomid, maybe my lining would be thinner right now, and that would make me really sad. On the other hand, I don't think I'll ovulate for 4 more days or so (based on my IUI cycle #1 and my utter lack of egg-white cervical fluid today), so the lining still has plenty of time to thicken up. Dr. A said that 8.5 mm was fine, by the way.

The good news is, right after the, "Clomid makes a stronger ovulation" comment, I asked Dr A about whether I need to take vaginal progesterone. He said, "Probably not, why?" I told him that it causes irritation and that my luteal phases are really long anyway, and he said, "OK, don't do it then. Clomid should give you a good luteal phase." So, I'm not going to. Hopefully S won't be upset with me, because I asked the same question of Dr G a few days ago (in front of S at our IVF discussion appointment) and he said to keep using the progesterone. Oh well!

For now, I am going to try to relax and hope that this 16 mm follicle is making a nice healthy egg!