Pre IVF10 Hiatus: Moving Day

I am moving my blog (again). I love that blogger is free (anything owned by Google pretty much rocks), I love its blogroll features that I have never used, and it's a place where you can be sorta anonymous, that is, unless like me you accidentally forget you're sharing your desktop during an online meeting at work and then go off to read your blog. Yes, I did that. I accidentally outed myself, realized it within a few minutes and stopped sharing my screen. I checked my logs and saw a bunch of queries for "my name + blogname". All in one day, which meant that people were looking specifically for me. None of you guys would do that as you already know me.

Yet another reason to start anew.

It took me a bit to get my new blog up and running on WordPress ... I'm a techie by nature and thought it would be a cinch, but it was a pain in the bum. It doesn't have as many features as I thought it would. It's sorta "open source" and you have to add on "widgets" to get it to behave like blogger.

But I waded through it all over the last week or two ... and I think it works for me. I haven't been able to figure out how to get my fertility fish pond in my header so I have static fertility fish for now.

Anyways, let me know what you think?

As Expected

Negative.

HCG < 5 (didn't leave the exact value)
E2: 25
P4: 15.3

Values 3 days post transfer:
E2: 360
P4: 47.6

How did my P4 go from 47.6 all the way down to 15? I was taking at least 800mg/day which is a LOT of P4!!

Also, my estrogen went from 360 to 26!? It looks to me as though my numbers all plummeted.

WTF?

They left the message on my blackberry as the battery had died (I didn't think to look) and left the numbers.

Ideas:
Bad suppository batch (inconsistently made)
I just can't absorb it all vaginally
It leaked out most of the time

Not sure what else explains it all.

Do some women just not absorb it or what?

I would love to retest my numbers. I think I have a "open lab slip" somewhere. I think I'll see if I can find a quest labs to knock one out today while I'm still on my progesterone.

Please...any and all ideas about this?

11DP3DT: Waiting & Strategizing

No news yet. I think they typically start to do calls around 3PM EST. It's high noon. I know it's going to be bad news. A few cells in my body want to believe that, as a few of you have said, I'm one of those that HPTs don't work for. Or that my urine was too dilute.

Hope springs eternal. Many of us have drowned in that damned spring.

I ate my dexamethasone, my aspirin, but I have to walk down the street to refill my levothyroxin. I don't want to take another lovenox shot if I don't have to. My tummy has dark purple bruises that make the BF's kids squeal.

The BF and one of his kids are sick. The little one was screaming in pain from his throat last night. It was heartbreaking. He was in such pain that he vomited. I told his ex-wife that it looked like strep to me, I've had it plenty, and she argued with me that it wasn't. Not sure why she likes to argue with me over stuff like this. I was premed. She went to marketing school. I aced every unknown lab in organic chemistry. I was a protein chemist in an immunology laboratory. I'm not sure she has ever set foot in a lab. I truly believe that I would have made an excellent diagnostician had I gotten into medical school.

It was no surprise that the DH and the littler one just got diagnosed with strep not one hour ago with a rapid-strep test. I knew it. I told him to text the ex and let her know. I hate feeling so smug, but she makes me crazy when she argues anything science with me.

I've already set about cleaning every solid surface with lysol wipes as strep is my kryptonite. When I get strep, my immune system has a horrible time with it. I typically get a horrible psoriasis outbreak from it with patches on my scalp and back (I get a particular form called "Gutate Psoriasis" when I get strep). I'm crossing my fingers that the dark angel of strep passes over my throat and keeps going.

I stayed up til 3AM last night, driven as all hell by those negative HPTs, working on a spreadsheet of suitable gestational surrogates and wrote/posted an ad for myself. I need to start writing to these ladies fast. I found about 15 GS that seem interesting, but I need to shortlist to a reasonable number and start to aggressively work on this. I shudder to think of what this will cost me. I also shudder to think of not having a child if I delay and don't move fast.

I wonder if I need to take a month off after having done a very low stim cycle? That'll be my first call to the clinic when AF arrives. If I do, then I'll do an IVF retrieval that starts late December. I have one last try left with my insurance and it's going to be a full stim cycle, getting as many eggs as possible. These will be frozen or freshly transferred into a GS. There is no fucking way they are going into me, with or without his magic drugs that are supposed to fix my toxic uterus.

After this, I'll consider doing more low stim cycles if Dr. Czech can figure out anything new about my immune condition that would convince me that I should ever transfer something into me again. I know he's hopeful about his "controlled meds", but I'm outta time. I have a lengthy consult with him scheduled for December 6. At that point I'll be moving my immune treatment over to him from Dr. S in California. I'm also talking to Dr. KK's office as I'm interested in her ideas on Resistance Indices for uterine blood flow. I've stuck with Dr. S's office for reproductive immunology for 5 years. It hasn't worked for me. It's time to switch to see if someone else can turn up a new finding that will make a difference.

I sorta doubt it. Yesterday's bloodnurse asked if I'd done some "COX-something" test. I hadn't. But she looked at my list of meds, saw that I was taking lovenox, and said that even if I tested positive for it that I was already doing the prescribed treatment.

All this immune stuff might seem moot if I'm using a GS, but getting the immune issues under full control ensures that I'll get the best eggs out of me.

I don't truly believe that Drs. KK or Czech will find anything new that requires a new treatment but I'm all about contingencies.

10DP3DT: Being Stealthy

Dr. Czech has two offices: one in NJ and one outside Philly. The bulk of the IVF stuff is done in NJ: retrievals, transfers, U/S, bloodwork, etc. The other office does U/S and blood, but they don't do the big stuff like retrievals.

I see the doctor in both offices as I'm one of his "special" patients that he's testing out some "very controlled" meds with - stuff that is supposed to help "detox" the uterus of endo patients like me. Long story short, my file migrates between both offices depending on what I am being seen for.

So this morning as I was preparing to check out of my hotel, I came up with a stealthy idea.

I put in a call to his Philly office and asked, "Would it be ok for me to do my beta there?" Yep, no problem there. I didn't leave my name or anything, lest they start to "do research."

I knew they wouldn't have my file there as it was still in NJ - I was due to be in NJ TOMORROW for my beta, and THERE my file awaits. They also wouldn't think to call to check on my date: most patients are compliant and follow the rules.

Not me. After 9 rounds of this shit, I've learned to work the system a wee bit.

So I showed up a bit after lunch, filled out my paperwork, and got my draw done, no one knowing any the better.

Except for me, who is feeling quite content that I'll have my results tomorrow as planned but without have to drive 160 miles round trip to the Joisey office on a Saturday. The results won't get to me any earlier, but it saved me the long and boring drive.

Well worth the stealth. :-)

9DP3DT IVF9: Screw this cycle

So, I had some rather intense cramps on Sunday night which progressed into Monday. I went to work that day, cramped all day long at my desk, and decided to take the train home that evening, which sucked, as the train broke down, it took 40 minutes to fix, and then I had to walk home 1/2 a mile with my laptop bag. It took me about 1 hour 20 minutes to do my typical 30 minute max commute.

I was exhausted and pissed by the time I got home.

And by the time I got home, the cramps were gone.

I can't help but think that I should have taken a taxi to the ferry and have gone home the more expensive but safer way.

There was just a wee twinge of them the next morning (Tuesday) as I drove to Philadelphia...and then a teeny bit on Wednesday...but really nothing I could notice.

Today there hasn't been a thing. Not even a remote sensation.

And the HPTs are snow white.

So, if progesterone causes cramps, then where have they gone? I've been at work up and to bed at random times and so I've taken a few 200mg P4 capsules to work as I'm sure that some of the P4 has just oozed out before it's had a chance to absorb. So I've probably gotten a bit more than the 800mg/day, which means if the cramps are solely P4 induced, I should be reeling over in continual pain.

But I'm not.

I worry that I screwed this cycle up by exerting myself a bit too much on Monday - then there was the stress of a fight with the other half on Sunday which left me feeling horribly depressed and emotional. I hate all the end of the cycle second guessing that I do. I can't help myself.

My beta is on Saturday and it smells like failure. I am still in Philly on business by myself, in a boring hotel room, alone. I wish I was at home with my cats who let me squeeze them until they're nearly flat before putting out a protest "mrow" in defense.

I think that I'm going to call the clinic in the AM to see if I can do my beta tomorrow and just call this cycle done for. If there's any HCG, and I'm sure there's not, they can do the math to figure out if it's worth retesting.

But my sticks are 20mIU sensitive and they're telling me that this party is over.

6DP3DT: Testing out my HCG

Yesterday's HPT showed the last trace of my bHCG trigger from 9 days ago.

And, today? Today was the first day of a snow white HPT. 6 days after transfer. Now the fun begins.

Two days ago I wrote that I felt nothing. That was until last night. I had some great cramps last night as we drove the boyfriend's children to Toys R Us and, again today, at work and on the way home.

I'm not stressed (yet). Just curious, wondering, wishing.

The cramps might be due to my mixing progesterone types (suppositories and capsules up the hoohaaa) rather than anything. Perhaps they used a different type in the capsule? (Despite the fact that a molecule of progesterone is a molecule of progesterone. Unless it's perhaps synthetic and not exactly the same or mixed with something irritating?)

I try to not obsess about signs. I don't wipe obsessively, looking for traces of pink. I've read oodles on implantation bleeding and I actually think it's more of an urban myth or of a symptom of progesterone irritation to the cervix. This study seems to affirm this.

I can't take huge faith in cramps because progesterone screws with our bodies and our heads. It's comforting to know that something's going on when you get a cramp or two and I hate to say that it makes me hopeful for a bit, but I have had cramps with most cycles. Damned progesterone.

The only thing that will convince me is a red line, no matter how faint.

5DP3DT IVF9: Musings on Progesterone

Progesterone used to make me feel intense uterine cramps, make breasts hurt, and just cause me a lot of physical discomfort. Most of my cycles, I was on 200mg/day and maybe even 100mg/day on one cycle. All these symptoms on 100-200mg/day.

In this cycle I'm on 800mg/day of P4 supplements.

And I feel ... well ... nothing. My breasts are normal, smallish actually. I'm not feeling any cramps from the P4. Nothing to really make me think, "Is that the progesterone or am I maybe getting implantation twinges."

It's just rather quiet. Disturbingly quiet.

My last IVF cycle, I believe I had STABBING cramps at the time of implantation. That was the cycle I saw a very faint BFP that appeared for one day and then disappeared before beta day.

I have to wonder if the pain I was feeling in IVF8 was more a symptom of one hell of an immune reaction happening...or of typical implantation. The more I read of other women's experiences before getting a BFP, the more I think I had a major immune reaction. So many women state that they felt little around implantation, were pessimistic about the cycle, and then went on to a BFP.

One thing that comes to mind is that this is the first cycle I've done since my endo surgery at the end of June. Could it be that the cramping was co-correlated to the presence of endometriosis (stage 4) with progesterone levels? I know that endo can cause the body to produce progesterone at random times in the cycle and can cause the lining to be out of sync. Can progesterone conversely affect endometriosis?

Lastly, I wonder if it's age, and my body's lack of response to the progesterone, or something else. There's nothing special about my progesterone suppositories save that they're 400mg each. I should be recoiling in pain, but I'm not.

I wonder.

Anyone else notice a chance in how you feel with progesterone as you age?

I'm baffled.

4DP 3DT: IVF 9 Spiral Arteries & Progesterone Levels

Made the journey to an out-of-the-way ultrasound clinic to get a quick doppler of my uterine spiral arteries. According to Dr. KK, for IF/immune patients, the resistance index (RI) of the spiral arteries should be below 0.6. If not, then additional lovenox should be added to get the number down. Too much resistance to the blood flow means that it is moving slowly and can clot. Something detrimental to an embryo if it attaches and finds a clot rather than a nice blood source. More about this procedure here.

I'm typically on 40mg/day during a cycle, but if you look at standard dosaging on the lovenox website, one should take 1mg per Kg of body weight. For me that winds up being 79mg/day, or, two 40mg syringes a day.

Dosaging for general purposes *might* be the same as for IF, but I'm not really sure on that, so I increased to 70mg a day since transfer.

So, after 3 days of 70mg/day of lovenox, the U/S technician found that my RI wavered between 0.65 and 0.74. He took multiple data points to be sure, but the number likely means that even at 70mg/day, I'm still not taking quite enough. One thing I am unsure of, is that Dr. KK often does this sort of U/S on certain days of the cycle and I'm not sure if these values apply in the luteal phase when under P4 support. It's a calculated risk to up to 80mg/day, but one that I think isn't too unsafe.

So today I upped to a full 80mg/day, but I am unsure as to whether I should do even more while unsupervised. I've actually seen some of her patients reporting that they're doing 60mg, twice a day. Holy crap. Maybe 80mg isn't enough? I did a PTT test about 10 days ago and I was in range then, but how about now?

I put in a call to Dr. KK two days ago and am going to get on her list of patients. She can treat me remotely, so that's reassuring. (BTW: The U/S technician that did my doppler today was trained by Dr. KK's ultrasonagrapher - so he definitely knows what he's doing.

My other concern, besides getting the right lovenox dosage, is that doing a doppler around this time feels a bit risky. I'm not sure if it is though. Dr. Czech's nurse did a U/S on me yesterday to ensure that my lining had converted post transfer - it had - so is this sort of ultrasound anymore risky than a doppler one? I asked if the "intensity" of the waves used was any different and he said "no". So I think I should be ok. So then the concern of just having yet another wand up my hoo-haa, trolling up in my nether regions. He was actually quite gentle though - no complaints on that department, so I don't think I need to worry about physical jarring of the embryo.

Maybe I worry too much? I just feel that this is one major thing (RI) that's been overlooked in my cycle for the last 5 years and it seems, well....sorta big!?

They also did my blood work yesterday to see how my progesterone levels were - I'm doing 400mg twice a day (supps):

Blood values:
E2: 360
P4: 47.6

I've read that doctors really like to see this number above 30, but I've seen many ladies report values around 10.

They said to change nothing in my protocol. I have to be honest: I don't know if this is a good P4 number considering how much I am taking. I do realize that oral and vaginal suppository P4 yields lower blood P4 levels than, say, PIO. But I'm not sure what the "curves" look like for: method of delivery against amount of P4

Anyone have an idea what a normal range for P4 is after transfer if using the suppositories?

2DPT: IVF 9 - Mo

I just read that Mo and Will lost their baby at just over 7 weeks. I am shocked. Stunned. She had absolutely PERFECT embryos, the best clinic on the blessed planet and still...it happened again.

News like this makes me despair that here I am, approaching 46, with one nearly perfect embryo (visually, not by PGD).

None of us are safe from this fate.

If you're a reader of her blog, or not, please stop by to share your support.