CD29: 10DP3.5DTTequila Anyone?

** Warning: Extensive use of the word "fuck" today.

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First the better news of the day:

CD3 FSH 9.2
E2 72

Both could be better but since I'll be 42 in two months, they're not that bad.

Okay, now for the totally fucked up news of the day:

Beta #1: 2.48
Beta #2: Less than 2.0

I guess they don't bother giving you an exact number when it's this low.

(sob)

I just wish that I knew whether this was residual HCG from my trigger or an embryo that tried to implant but didn't get too far.

We're both devastated, again, and in shock at how much we did for this cycle:

• Two fucking trips to Mexico (treatment: $1200 + airfare/hotel)
  
• Endometrial biopsies (mostly covered by insurance, but painful as hell)
  
• 2 months of Humira ($600+ a shot)
  
• IVIg ($2000+)
  
• Rx: Lexapro, Synthroid, Lovenox, Dexamethazone, Folguard, PIO/Supps, Viagra Supps
  
• And don't forget my June surgery where they took out my fibroids, my endo/adhesions/scar tissue and both of my Fallopian tubes.
  

We thought we covered it all this time.

Apparently not.

What did we miss?

Apparently quite a bit.

Well Dr. Moustache didn't mention to me that it would have been wise to have my uterus tested for beta-3-integrins or Cyclin E/P27.

Some background:
Beta-3-integrins are in a normal uterus at the time that embryos normally implant and act as a "glue" that helps them attach to the endometrial lining. In women that have endo, they are lacking these integrins most of the time (70% or more). Treatment for this? 3 months of lupron and then you have a two month window of opportunity to do IVF and get pregnant before the issue rears its ugly head once again.

He could have also tested me for Cyclin E/P27 in the EFT Biopsy. In a normal uterus, you find Cyclin E from CD1 till about CD18. Then P27 kicks in and Cycln E ceases. In a woman with endo (that's me) Cyclin E just doesn't shut off and P27 just doesn't make it's appearance as it should, if at all. Treatment for this, from what I can tell, is a combination of E2 and progesterone at the right times in the cycle. I'm still waiting to hear from Dr. Kliman on whether that is indeed the treatment protocol.

Both would have predicted quite accurately whether or not my uterus would have been receptive to accepting our last 5 embryos.

Both of these would be been easily treated with medication. In fact, we could have started treatment in June, after my surgery and right about now, rather than putting my last five embryos into my toxic wasteland of a uterus, I would have been giving them a chance at life.

I only found out about these tests from Dr. Feinman down in SoCal via our INCIID chat the other night.

Fuck!

Why is it that shit like this happens? You find out about what could have worked AFTER the cycle has gone bust. Does it always have to be this way?

You know how they say that people go through different stages of grief? Denial, anger, acceptance? I forget the other stages, but I went straight to anger and I am stuck there. I am pissed. Enraged even. If I wasn't on lexapro with most of my feelings and emotions unable to get out because of the drug induced stupor they put me in, I'd probably burst an artery in my head. Seriously.

I've written Dr. Moustache an angry-as-all-hell email and I sat on it all day wondering if I should send it. When I first started to write it I didn't have my beta #2 results in hand.

Now that I have them, I am motivated enough to fire this off and it will be in his inbox by midnight.

$30,000 later and NOW we find out about beta-3-integrins and Cyclin E/P27?

Bastard!!!!

Statia, if you're reading this I only hope that Dr. Pompy will entertain my need to test for this shit because that is where I am heading next. That is unless Dr. Moustache eats crow, gives me one raging discount on my next IVF, AND does every damned test that I want from here on out.

I kind of doubt he'll do that. So Dr. Pompy here I come.

CD28: 9DP3.5DTFRED-less Today

After yesterday's dismal beta I couldn't get myself to POAS today. 2.48 means that nothing is going to show up today: why bother wasting a perfectly good FRED?

So instead of moping about at home, focusing on every cramp that came my way, I made my way to the Palace of the Purple People Eaters and lunched with ModernMillie. It was great to get out and I haven't left the house much since transfer. But more than that, it was nice to be with someone that understands exactly where I am at in my life, and in my head. The time flew by way too fast and before I knew it she was leaving back to her cubeland.

I'll beta again tomorrow at the local hospital, same place that my local lab sends their "stat" bloodwork to, so that my results will be consistent. Millie said 60 hours in between is the ideal time to do a second beta, which puts my time at 8:30PM. Perfect: the lab will be like a morgue. No one in their right mind is there getting a test that late. Save for me. :-)

But I know....I know how unlikely it is that my beta has budged a bit. It's more likely to have gone down from 2.48. That is what happened in IVF cycle #1. I think the first beta was 2.0 and the second was 0.9. A slow slide into nothingness for my embies.

As I surfed for tests that we could have run to try to diagnose what the hell is going on (beta-3-integrin, EFT, CA-125, et al) it dawned on me that what we really should be considering is finding a surrogate. I make loads of follicles, beautiful embryos, but I just can't grow them beyond the petrie dish. It would free up our lives from this never-ending hell called infertility if we could pass the birth baton to someone more qualified than I. Someone who doesn't have a busted uterus, like I.

Until then, I guess J will get his SCSA test done and there's not much I can do with regards to the endo biopsy to test for beta-3-integrin until I'm at CD20-24 in my next cycle. AF hasn't arrived yet, so we're 3 weeks away at minimum of being able to run the test. There's a company called Adeza that seems to have the corner on this test...and lucky for me, they're located right here in the Sillycon Valley. I can drive my test right over if need be.

Last night there was a chat on INCIID about implantation failure that was hosted by Dr. Michael Feinman. I told him our story and he suggested that we do an SCSA test and an EFT test (requires a biopsy). So I may also get a second biopsy done, at the same time as the beta-3-integrin test (OUCH!), to send to Dr. Harvey Kliman at Yale as this EFT (endometrial function test) can also yield some interesting data on why we are not getting implantation.

So tomorrow I'll test progesterone, HCG, and maybe CA-125.

Any other boxes I should check since I've recently added self-diagnosing to my habit of self-medicating?

CD28: 9DP3.5DTFRED-less Today

After yesterday's dismal beta I couldn't get myself to POAS today. 2.48 means that nothing is going to show up today: why bother wasting a perfectly good FRED?

So instead of moping about at home, focusing on every cramp that came my way, I made my way to the Palace of the Purple People Eaters and lunched with ModernMillie. It was great to get out and I haven't left the house much since transfer. But more than that, it was nice to be with someone that understands exactly where I am at in my life, and in my head. The time flew by way too fast and before I knew it she was leaving back to her cubeland.

I'll beta again tomorrow at the local hospital, same place that my local lab sends their "stat" bloodwork to, so that my results will be consistent. Millie said 60 hours in between is the ideal time to do a second beta, which puts my time at 8:30PM. Perfect: the lab will be like a morgue. No one in their right mind is there getting a test that late. Save for me. :-)

But I know....I know how unlikely it is that my beta has budged a bit. It's more likely to have gone down from 2.48. That is what happened in IVF cycle #1. I think the first beta was 2.0 and the second was 0.9. A slow slide into nothingness for my embies.

As I surfed for tests that we could have run to try to diagnose what the hell is going on (beta-3-integrin, EFT, CA-125, et al) it dawned on me that what we really should be considering is finding a surrogate. I make loads of follicles, beautiful embryos, but I just can't grow them beyond the petrie dish. It would free up our lives from this never-ending hell called infertility if we could pass the birth baton to someone more qualified than I. Someone who doesn't have a busted uterus, like I.

Until then, I guess J will get his SCSA test done and there's not much I can do with regards to the endo biopsy to test for beta-3-integrin until I'm at CD20-24 in my next cycle. AF hasn't arrived yet, so we're 3 weeks away at minimum of being able to run the test. There's a company called Adeza that seems to have the corner on this test...and lucky for me, they're located right here in the Sillycon Valley. I can drive my test right over if need be.

Last night there was a chat on INCIID about implantation failure that was hosted by Dr. Michael Feinman. I told him our story and he suggested that we do an SCSA test and an EFT test (requires a biopsy). So I may also get a second biopsy done, at the same time as the beta-3-integrin test (OUCH!), to send to Dr. Harvey Kliman at Yale as this EFT (endometrial function test) can also yield some interesting data on why we are not getting implantation.

So tomorrow I'll test progesterone, HCG, and maybe CA-125.

Any other boxes I should check since I've recently added self-diagnosing to my habit of self-medicating?

It's Worse Than I Thought

The results didn't come in until 6:30PM if you can imagine. Repeated phone calls and finally my fax machine hummed to life and delivered the news.

HCG: 2.48iu

Q: Can a beta be any lower?

A: Yes. My first IVF beta was 2.0.

(sobs)

I will do my second beta on Friday, the day I was schedule for my 1st beta, but impatient me got the better of me. Hell, it might double to 5, but AS IF that would mean anything.

However, I did see on Liana's blog that FETs with a beta of 5 are considered positive.

Truth or fiction?

Millie, I am counting on you for some sage-like advice at this point.

CD27: 8DP3.5DTFRED #6

Bet you're wondering how I went from FRED#4 to FRED#6 without doing the one in between?

Well it's like this. Yesterday when I went to my OB's office to pick up a beta labslip, I chatted up her lab assistant, aked her how sensitive her in office POAS were. She checked. 20iu sensitive. Better than what I've got at home. She asked if I wanted to take one home and give it a whirl. Why not? Worth a try.

I tried it last night about 9PM and there was something that I can only fathom was an evaporation line. It wasn't pink but more gray in color. Nothing to get excited about but I'll be honest: I did kind of get excited looking at the evaporation line wondering, "Hmm, is it? Or, isn't it?" It looks more like a faint line in today's bright light, but still not the magenta pink I've grown to know and love.

This morning's FRED was as dismal as yesterday's FRED.

Nothing.

Nada.

Not even an evaporation line. (Okay, on second look in totally bright sunlight there MIGHT be an evaporation line, but hell, I just can't tell).

I even took apart FRED #4 so I could get a closer look thinking that maybe the shine on the cover was obscuring some tiny fragment of a red line.

Nothing doing.

I don't know if I can trust HPTs anymore though. My girlfriend, LL, who has done SEVEN IVFs, is cycling alongside me. She put in 2 five day old embryos the day before my transfer. (Remember, I put in five 3.5 day old embryos, so she's a day ahead of me and her embryos are a day and a half ahead of my embryos). She's been HPTing as well and for the past four days she has had a very very faint line that gets darker, lighter, and keeps varying. Well yesterday's beta showed that her faint line equalled a beta of 72.5. Jesus christ. You'd think that with a beta that high that you'd see a nice dark pink line that left no question as to the pregnant-ness of LL. What gives?

I guess it gives me the tinest bit of hope that HPTs in general just do not cut the mustard. But the doctor's HPT didn't tell me much different. A bigger evaporation line doesn't really convert me over. I'm not feeling much in the way of cramps (a bit here and there), sore breasts, anything. I can't imagine anything is going on in my uterus at all. I am accepting the fact that the random cramping is the product of PIO, pure and simple.

So in order to get this clown race over with, I went and did a beta today. I wrote "STAT" and "FAX CC TO (my fax number)" on the lab slip and highlighted it all with a marker.

They said that the results should be in some time later today. Thank god that this will be over soon. I still hope, but I am really afraid of the phone call that is to come. I've been thinking about where I would draw the line in terms of doing a second beta. Dr. Moustache's office sees anything over 5 as positive, but all of my IF friends kind of see anything less than 20 as a chemical in the midst of happening. Why is Dr. Moustache so more lenient with this than my IF friends? What is it about him that he isn't as frank as my sistahs?

If I went with Dr. Moustache's ideas, I'd need to be at a minimum of 2.5 today in order to double to a "5" on Friday. That would pass the Moustache test. But if I trust my sistahs, then I'd be looking for something around "10" today, for a 20 on Friday. Neither value would show up on a HPT today, or on Friday, so I am trying to chill as best I can.

So there you have it: 2.5 is our minimum goal to retest. 10 would make me feel better. And anything over 10 will be met with a smidgeon of hope. All will be met with skepticism, of course. I can't help be be skeptical. I'm skeptical about many things. It feels odd to say that when here I am doing IVIg, LITs in Mexico, and ready to take a plane to NYC to see Dr. Hungarian. Oh, yes, and I'm now going to be taking part in the intralipids study that Dr. CC of Chicago is doing. (Intralipids are thought to be as good as IVIg for NK suppression. At maybe 1/25th of the price!)

While we wait for the call, J and I are mentally making plans to see Dr. Hungarian in NYC. Tentative dates are October 13th to the 23rd. We'll be looking for a apartment to rent on the upper east side. 70th & 2nd or 3rd would be ideal according to a fellow IF who's done the NYC routine.

If you know of anything suitable in the area for lodging, or ideas as to what would be nice to do while in the city, please leave me a message.

CD26: 7DP3.5DTFRED #4

And it gets worse.

Today's HPT showed absolutely nothing. Not even the faintest of lines.

I guess this beta party is over. Kaput. Really, there's no need to go to my OB's office for a serum beta today.

If I had a beta of 50 this coming Friday, and let's be honest, an initial beta of 50 is nothing to write home about. But a beta of 50 on Friday would mean that, according to a 48 or 72 hour doubling time, my beta today or tomorrow would be at least 25, and that sistahs, is enough to show a line on a HPT.

No line today means that there's a small chance of a decent beta on Friday.

I just don't fucking understand it. Why won't anything grow in me?

I've done almost everything known to IF medicine save for a few random things like intralipids and visiting Dr. Hungarian in NYC.

J and I are going to get a karyotype done this week and see if that provides any answers. Why we haven't had this done before? Who knows. You would have thought Dr. Moustache would have ordered one by now, but he hasn't.

I don't know where this leaves us. I'll keep HPTing and I'll get the labslips from my OB today just in case I get a bit of a line tomorrow or the next day.

But it just feels dismal.

I think I'm going to go and chew off my arm or something.

CD25: 6DP3.5DTFRED #3

Depression.

Today's HPT was lighter than yesterday's. It's just a tiny bit different. It might just be a variation in the tests themselves...or maybe the oil slick in my urine from the progesterone suppositories didn't make for a good test today. Or maybe the HCG trigger on the way out...and the embryo hasn't made it's presense know yet? Or there is no embryo?

Who knows.

I know. I know. It's early to test. Very early.

I'm torturing myself prematurely.

But if I need an IVIG infusion, I kind of need to know early enough for it to make a difference.

I telephoned my OG/Gyn's office today and left a message for the PA:

"I triggered 11 days ago. My HPTs are still showing faint positive lines. What do you think?"

What did she think? Oh boy. Get this.

She said, "We usually see trigger shots disappear within 2 or 3 days."

Me: "Huh? You've got to be kidding?"

She: "You should come in TOMORROW for a beta. You might be pregnant! We'll do a serial beta, meaning we'll test you tomorrow and again in 72 hours. The lab is already closed today otherwise we could have seen you today."

Damn.

Me: "I'll be there first thing in the morning."

Who am I to argue against taking a serum pregnancy test? But hell if I'm waiting 72 hours for a second one! I'm writing STAT on the top of the lapslips and I'll do the 2nd one in 48 hours.

I don't expect to see anything miraculous given how damned light these HPT lines are, but I'd like to get over the inevitable tears and depression and get back with my life sooner rather than later.

If that is the reality I'm going to be served, hurry up and lay it on me dammit.

In anticipation of a negative beta, and in total self-protective mode, I emailed Dr. Hungarian and asked if J and I could be seen in NYC mid October.

No reply yet, but I'm ready if this beta party is a bust.

And Rip Went My Heart

Found this link on Beth's Blog. All it said on Beth's blog was that it was a multimedia presentation on infertility.

I had tears running down my cheeks before it was over.

My god.

I feel that pain! I live that pain!

What a poignant message to the fertile.

CD24: 5DP3.5DTFRED #2

10:23AM:

After POAS this morning, rather than rush back to the warmth of our bed, I hovered in the bathroom in my furry beige robe to witness whether anything remarkable would materialize on the white background.

After about 5 minutes the very very pale pink line appeared once again. I held it next to yesterday's FRED and it looks pretty much the same. I held them every which way, at every angle, in different light. Yesterday's looks the tiniest bit darker, but undiscernably so. J thought they looked the same, and he IS the arteest in the house.

11:05AM:

We showered to go to the Los Gatos Farmers' Market, I went to the bathroom, and while brushing my teeth, I noticed that I was having cramps that felt much like AF coming on, but AF isn't due to make her appearance for another 4 days. Perhaps it's just the evil PIO. I can't trust what cramps mean, or do not mean, when on PIO. But even if they're meaningless, they give me a bit of comfort where I have none otherwise.

Tag, You're It!!

Tonya over at Great Good Fortune tagged me recently...and wow, she and I share a number of loves. From sushi to x-files, dark chocolate, Anne Rice, and more. I think that she and I are going to have to go out and indulge the sushi thing one day soon!

So, these aren't my "top" picks of all time, but what came to mind right now as I filled out these categories. In other words: they're subject to change. :-)

4 JOBS I'VE HAD (in no particular order)
-Archaeologist (Senior Laboratory Director)
-Research Tech in Immunology R & D Lab
-Product Manager at 2 Search Engines
-Real Estate Broker

4 MOVIES I'D WATCH OVER AND OVER
-Dangerous Beauty
-Orlando
-Anything by Merchant-Ivory
-Monty Python (Holy Grail, Life of Brian)

4 PLACES I'VE LIVED
-LA (Whittier, West Hollywood)
-The OC (Irvine, Huntington Beach, Dana Point, San Clemente)
-The Dreaded Inland Empire (Menifee, Wildomar, Murietta)
-NoCal (Mountain View, San Jose, Los Gatos)

4 TV SHOWS I'D WATCH OVER AND OVER
-Sex and the City
-A Haunting (Discovery)
-X-Files
-South Park

4 WEBSITES I VISIT
-Ebay
-Craigslist
-INCIID
-Immunology Support

4 PLACES I'VE BEEN ON VACATION
-Hawaii
-Canada (Banff, Whistler)
-Morocco
-Europe (France, Spain, Portugal)

4 BOOKS I'D READ AGAIN
-The Mists of Avalon
-Anne Rice's Vampire Series
-Language of the Goddess (Gimbutas)
-Alice in Quantumland

4 PLACES I WOULD RATHER BE RIGHT NOW
-Southern France
-South Pacific
-Italy
-Giving Birth

4 FAVORITE FOODS
-Thai Cuisine
-Seafood: (Sushi/Sashimi/Maine Lobster Drowned in Clarified Butter)
-Cheese (I'm allergic to milk, but still a fav!)
-Gelato

4 FAVORITE BANDS/SINGERS
-U2
-Dave Matthews
-Chaba Zahouania (Rai singer)
-Siouxie Sioux

I'm tagging Statia, Pamplemousse, Coloratura, and ModernMillie!

CD23: 4DP3.5DTFRED #1

My bladder went off before 8:00AM this morning, but I lingered in bed til 8:10AM trying to avoid the inevitable POAS that I was destined for this morning.

8:10AM: I give up and dash to the bathroom.

Bladder wasn't as full as I had thought. Hmmm. Just enough to get the POAS to work with little to spare. Odd.

The single red line shows up almost immediately.

And persists.

Negative. One red line.

What did I expect so early in the game? I guess I should be happy that there's no sign of a trigger to mess with the future HPTs tho.

Back in bed, I give J the news. He's not surprised at all. But I'm bummed nevertheless. A negative FRED is an all too common sighting in our bathroom.

I go back to bed where I pop my bromelain, shoot up my lexapro, and put my cold feet on John.

Sigh.

Update: 9:30AM

Made a second bathroom trip just a few minutes ago and lo and behold, the FRED had the faintest of positive lines. Dr. Beer did say that we should give them much longer than the box directions say to. This I had forgotten but now I see why: it can take a while for minute amounts of HCG to show up.

I did a 10,000iu HCG trigger on 9/14, 9 days ago this evening, so I totally realize that this ever-so-slightly positive test could still be leftover HCG from the trigger shot. Dr. Google says that HCG has a half life of 33 to 36 hours. In other words, you can figure that it takes a day for each 1000 units to dissipate. So a 10,000iu shot would take 10 days to disappear, and a 15,000iu shot would take 15.

This is all, of course, dependant on a woman's individual metabolism though...so variation is to be expected. Your mileage may vary.

I'll be POASing again tomorrow.

Same bat time. Same bat place.

CD22: 3DP3.5DT

Embies were 6.5 days old this morning and edging up on 7 as of this evening. Implantation ought to be underway but I'm not having any overt signs of implantation. Some fullness in the uterine area, more like heaviness, but the evil PIO is known for fooling more than one women into thinking she was pregnant.

I'm optimistic at this point. I don't feel that all is lost, yet. Tomorrow will be CD23 and I'll start the POAS routine in the morning to see if anything is afoot. My HCG trigger was last Thursday night, so theorhetically speaking, it should still show up in my urine. Maybe a dim line, maybe not.

AA the Expat

One of my dearest friends, AA, came over late last night and said that he is most likely moving to Germany. J and I and AA all lived together years ago as roommates in a huge house in the Almaden Valley. We remained great friends after we moved out and have taken a few trips to LA together. AA works at a Sillycon Valley company that has an office near to Stuttgardt and he just received a contract/offer from them. He's nervous as all hell about leaving the US and going to a country where he doesn't speak a lick of the language. I've argued that this could be an excellent career move for him as he's been stuck at in a rut in his current position. He has thought often of quitting, as of recent, and because of that, I told him he should be jumping all over the opporunity to "do something different".

I will miss him terribly, but I will also be going to Germany often to visit him. Hopefully with a tot in tow. :-)

-----------

OK, by the time I finished typing the above I developed a nice uterine cramp. I hope this means something besides MM's progesterone is working wonderfully!!

(BTW: Thank you, MM, for being my PIO knight in shining armor).

-----------

Update @ 8:20PM PST:
Okay. Those cramps that started above? They lingered through my cooking a salmon musaman curry for dinner and became so intense that I had "J" finish the cooking while I sat in my chair and wondered to myself, "What the hell was that!?". I was truly taken aback as this came out of nowhere. After dinner they have pretty much dissipated...but I can still kind of feel where the cramping was. I even had weird cramps down my thighs at the same time. Total strangeness.

Multiple frantic TP checks show no implantation bleeding, but maybe tomorrow?

Cross fingers, knock on wood, throw salt, spit, make sign against evil eye.

CD21: 2DP3.5DT Cramps?

I'm a few days, four precisely, into my PIO, and two days past transfer and I'm already looking at every twinge and cramp with suspicion. Fully aware that the evil PIO often plays tricks on our bodies, I'm hesitant to not believe a damned thing until I see two lines on a POAS or a beta.

But still, I can't help myself. I'm having tiny cramps here and there. Probably the PIO as it's just too early for those little blasts to be doing much of anything. They're a hair past five and a half days old. Implantation tends to happen on day six or seven, not on day 5.5. So what gives? Methinks it's in my head. A product of the evil PIO.

But I can hope. Can't I?

So I ask you...what on earth do implantation cramps feel like?

Are they throbbing cramps? Rhythymic or pulsatile in any sort of fashion? Or would you say it's a single cramp? Dull? Sharp? How long do they last? Minutes? Hours? Days? Do they come and go? How about location? Are they dead center in the uterus? Or off to the side? Does the location change?

Are implantation cramps, if you're lucky enough to get a "sign" such as this, more often than naught accompanied by the mythical implantation spotting?

I had some wicked cramps in my first IVF. They were repetitive, stabbing, right in the middle of my bladder/uterine area. Dr. Beer said that cramps like what I experienced were indicative of my body killing off the embryo at implantation. The cramps were so bad that they woke me in the middle of the night and I sought out a urologist in the morning. I literally thought I had the UTI from hell coming on. Alas, my urine was clean, and my beta negative.

So if you have any information to share on what your implantation cramps felt like, I'd love to hear from you. And if you didn't have any, or any spotting, I'd love to hear that, too.

CD20: 1DP3.5DT (FET)

Yesterday was our transfer day.

We arrived at Dr. Moustache's office before our 8:30AM appointment and waited a little bit for the Dr's assistant to call us in. I checked on proceedings at the Immunology Board and popped my 10mg of piroxicam, an anti-prostaglandin that shows promise as helping embryos to implant. No sooner than I posted a message...they came to fetch us.

When we entered his office, I saw the embryo report. At first glance I only saw two check marks. Two embryos? I panicked. I sat down. J wasn't behind me. Dr. Moustache said, "Isn't J going to join us today?" I felt abandoned for just a second, slightly embarrassed that he might think I came alone today. But J opened the office door and was there by my side.

Dr. Moustache slid the embryo report at me. "You have five beautiful embryos." Ah, I had missed seeing three to the side of the paper. Three that had progressed to morulas. No wonder I didn't see them. The two that I had seen were 7 and 8 celled embryos. The morulas were grade 1, the other two, grade 2. He explained that they weren't quite four days old but that he'd called them "three and a half day embryos". So today is 1DP3.5DT. :-)

There wasn't any question about putting them all back in. Like I really wanted to refreeze any of them and risk losing another embryo? The one that we did lose was our only grade 1 embryo, and now it was gone.

We were dropped off in the waiting room to hover about until a nurse came to escort us to the O/R. I quickly jotted off a note to my RI sistahs about the embryo counts and before I could finish all that I had wanted to say, my fav nurse "A" came to get us. I quickly sent and logged off and we were on our way.

We donned our silly hospital garb, surgical head covers, and walked to the O/R. I crawled up on the table. Nurse "A" asked if I needed to empty my bladder. "Nah, I'm okay." She said she could do an U/S to see if I had more than enough liquid...and upon closer inspection found that I was just about right and shouldn't empty at all. It was nice of her to offer that to me. Very sweet.

About 10:00AM we were in the O/R waiting for Dr. Moustache and the embryologist to return with our 5 embryos. He returned with a copy of the embryo report and a photo of the little guys. Since they were assessed at 8:10AM, the morulas had grown to "early blast" and the other two had progressed to morulas.

Wow! Now that's rapid growth!!

The rest of the protocol was just a standard transfer except that this was likely the most painful speculum experience I think I have even endured. Although I asked for double the valium this time, I didn't feel a darned thing. Not even a bit of lightheadedness. I wonder if it did anything at all to relax my smooth muscles given that it did little for my state of mind.

So we drove the hour long drive home and I stayed in bed like a good girl for 24 hours. Today I've been up and down a bit more than yesterday, but not really doing a whole lot.

There's a lot of controversy about how much one should do after a transfer. Dr. Moustache thinks the first day should be 100 percent bedrest and light activity the next two days, but no shopping, walking much, etc. It's hard to know what I should or should not be doing with such ambiguous instructions, but I'm leaving towards being a bit conservative.

So I've got six FRED POAS's ready for testing and, yes, I do plan on using them DAILY starting on Friday. I want to know if I am having repeated implantation failure and according to Dr Beer it's good to test on CD22, CD24, and CD26 (or CD23, CD25, and CD27). I plan on being a bit more manic than that in my testing as "I've just gotta know". I also feel that testing beforehand will make a potential BFN all the more bearable as it won't be a complete shock to me.

A couple of angels came out an offered me some PIO in ethyl oleate...thank you so much! I am self medicating with PIO in addition to my progesterone suppositories. I confided in my self medicating to Nurse "A" and she didn't seem the least bit concerned about my taking extra progesterone or doxycycline. In fact, my self medicating with parlodel was actually on my chart! So maybe Dr. Moustache isn't such a stick in the mud after all.

CD18: 24 Hours Til Transfer

Transfer is tomorrow and no word on the time we're to arrive yet. My friend LL from Palm Springs is doing her FET way out in LA today. She has 3 frozen embies left. I'm praying for her that they all thawed successfully. She is possibly transferring as I write this.

Her RE said to her, "You can never have enough progesterone". So she's doing PIO and the suppositories. Taking that into consideration, I made my decision to start self-medicating with PIO this morning. 50mg/ml in the hip. J hasn't lost his touch with those needles. He's still a master of the painless shot.

I've only got about a 6 day supply of PIO left, and it's the good stuff packed into ethyl oleate. I called the pharmacy that I use in Arizona and they said I don't have any refills. They're going to fax Dr. Moustache's office and see if they'll refill it for me though. I guess that will tip him off that I'm self-medicating, but what the hell.

I'm already doing 50mg suppositories at night, so another 50mg in the AM can't hurt. At least I don't think it can.

Everything else is status quo except that tomorrow morning, 1 hour before transfer, I'm going to pop 10mg of piroxicam, and with Dr. Moustache's approval, no less. He balked on giving me IV Intralipids even though studies are showing they're cheaper than IVIg and possibly just as effective.

I know that there's no end to the crap I would put into my body if it was to give me the slightest edge on getting pregnant.

CD15: IVIg

I'm exhausted from getting up early to see Dr. Moustache. Drove all the way to his office, 50 miles away (?), and I get there and the nurse says to me, "We don't know why you're here today." I handed her my appointment card with today's date and 9:00AM clearly written on it, to which she says, "Who gave you this?" Me: "The girl at the front desk". They apologized profusely, lots of head shaking, disbelief, and I was on my way back home.

Long drive. And damn was I tired.

Mom and I stopped for a quick breakfast in Los Gatos, cruized the "Happy Dragon" thriftstore where I scored a Ralph Lauren valence for my bedroom for 3 bucks, a pair of black Donna Karan slacks for 6 bucks, and made it to my IVIg appointment with mere seconds to spare.

They pumped 30 grams of IgG into my body today. Ick, ick, ick. It grosses me out when I think of IgG and how it's processed. Pooled human serum ought to say it all. God I hope that insurance covers at least the 60% that they swear they will pay.

Transfer is in 4 more days. It seems SO FAR away. I am nervous about waiting til CD19 to put them in, but I've been amply reassured that all is on schedule.

I'm going to be fit to be tied come Monday.

CD14: Between U/S's

LH surge happened night before last. My calendar said the LH surge should happen sometime starting today. When I saw that I knew they were OFF.

My full bladder at 5AM had me dashing to the bathroom and, while I was there, figured I ought to whip out the old OPK and give it a try. I had done an OPK before going to bed and it looked like my surge was on the way UP, but at 5AM it was on the way down. Could I have missed it? I pulled out a second OPK, different brand. Sure enough, different results. No matter, I called Dr. Moustache's office and left a message that my surge seemed to be happening and that I wanted to come in ASAP. I went to bed, thinking I'd be able to sleep, but I tossed and turned, fretful that the cycle was afoot.

They called at 7:45AM. Impressive. Often they take forever to call. Not this morning. Not when I could really use some sleep. Could I come in at 10AM? I looked at the clock, felt how nice and warm my bed was. "Sure, I'll be there." Threw myself out of bed, upset to leave my warm toasty bed, and I showered and dressed in a hurry. Mom cancelled her Kaiser doctor appointment to go with me. Totally not necessary but she wanted to go. Good thing she did. The freeways were jammed up and having her in the car so that I could use the carpool lane meant we got there in time to grab a bite to eat.

U/S showed that my left ovary had a follicle at 22.7mm. Big! Lining was at 11mm. Nice and thick. Dr. Moustache said the blood test would confirm where I was in my surge: on the way up, or on the way down. They called at about 3PM. LH was at 28, progesterone 1.1, and prolactin was at 26.5. Progesterone, if I recall correctly, starts to rise as the surge is over (maybe I've got that wrong), so I did see my surge finishing up on the OPK. Damned things are so inconsistent. I would highly advise anyone to buy more than one brand and use both. If I hadn't used both I would have likely missed my surge.

I did an NK test on Monday and the results came in yesterday. My NKs spiked from 8.7 to 21 at the 1:50, and to 14 on the 1:25 dilution. DB's assistant said to stop humira immediately (my last shot was Monday) as it was likely causing a flare. We probably didn't see the flare before because of the protective nature of the LIT treatment we did in Mexico. She said that I'd definitely need IVIg before transfer and that she'd call it in with 4 refills. I spent a couple of frustrating hours on the phone with Blue Cross yesterday trying to find 30 grams of gammunex or gammagard. It is still unknown whether they'll cover it or not, but I'm hopeful. 30 grams of either costs about $3000 off of the shelf through my insurance company. Through Columbia pharmacy in Illinois I can get it for about $62 a gram, or $1860. Big savings. I called Columbia and asked them to ship me 30 grams just in case my insurance fell flat on their faces.

To return to the test results: the prolactin at 26.5 seemed high to me being that I'm not on stims. First cycle it was at 19 or so. Second IVF it went to 31 as I had a lot of follicles. Why on earth was it at 26.5 when I'm not on stims? I wondered if that might have flared along with the NKs? I asked the immunology board whether this was possible, and it seems that women with cateogory 2 and 5 immunological issues can have higher than normal prolactin and that it can cause damage to the uterine lining. I immediately cracked open the parlodel last night and put in 1/2 a tab (1.25mg). I emailed Dr. Moustache and asked what he thought. He said he didn't think I needed parlodel. DB, on the other hand, treats any prolactin higher than 20, so I'm going with his treatment plan as it's more aggressive. Here I go self medicating again.

So tonight I do my HCG trigger, although I'm not sure why on earth I'm doing a trigger with a natural cycle. Progesterone suppositories start tonight, of course, with the parlodel french tickler. Tomorrow I've got a second U/S with Dr. Moustache at 9AM, IVIg with two friends from Nogales at 11:30AM.

I'm into the home stretch. Five full days to go and then transfer. I'm nervous as all hell, scared that this won't work (again) and that we'll be faced with decisions about what to do next.

CD7: Self Medicating

There's a lot of talk these days on the immunology board about infections and infertility. Dr. Toth's work in this area is amazing to say the least. Dr. Moustache likes to seem as though he's doing everything on the planet, and that he is immune friendly as well, but he falls short when it comes to "certain tests" such as serotonin, cytokines, thyroid function, LADs, etc. He also doesn't act with much proactiveness with respect to potential infections.

Dr. Moustache's office tested us both for mycoplasma and ureaplasma last December. We both tested negative, but these two microbes often evade detection by standard lab tests. Even the CDC says that current testing is "lacking". We took our doxycycline at that first cycle but that was about it. I recently found a couple of leftover scipts for doxy and went and filled them. I think I have a 15 day supply at this point.

I phoned the office at Dr. Moustache's yesterday and said that I realize they think I don't need to take doxy, but that I'd like to do a course of antibiotics anyways. They phoned back and said I could start them right before transfer. Dr. Toth's research shows that he often has patients do 3 weeks of doxy (100mg, twice a day) as part of a general course of action. So rather than wait to start my doxy, I think that I'll start today, 100mg, twice a day for 10 days. That will put me at CD17, which should be damned close to transfer. I can continue on with Dr. Moustache's doxy protocol at this time and continue on for another couple days.

This seems like the safest option to make sure that an infection is kept at bay. I realize that Dr. Toth uses many other antibiotics like Augmentin, but this is what I have got to work with for now.

I feel a bit nervous self-medicating, but a lot of us infertiles wind up doing this because we don't have as much confidence in our REs as we did in the beginning. Or, we do research on our own and find that there are methods or treatments that our REs are ignoring for one reason or another. I am pessimistic. I think many REs, maybe mine, are partly in this for the $$ and that when we fail an IVF cycle, we then become potential "repeat customers". The REs that say that they don't care about their stats and will treat anyone scare me the most. IMHO, they're more likely to fall victim to the "repeat customer" scenario.

Scarily, that's my RE. He'll treat anyone. He doesn't even bother to test for CD3 FSH. Even DB believed in that and so do many REs. And I think that is why I am self medicating. He's a great RE when it comes down to it, but I worry that because he doesn't have to give a hoot about his stats that he might not pull out all the stops for me.

It is irrational that I continue to see, but I do so because his stats are good despite his not caring about them.

CD5: Feeling Frustrated

I'm really feeling frustrated with things, peevish even. Perhaps it's in part due to the fact that just today I rescheduled my lexapro from AM to PM in an attempt to sleep better and yawn less during the day.

Perhaps that's it.

But I found myself yelling at the imbecile Silicon Valley drivers from behind my wheel and thought for a moment, "My, I am feeling a bit more like myself today! What's with that? Oh yeah, I didn't take my pill today." That would also explain the headache that I fended off most of the day.

Tomorrow I start my dexamethazone in the AM and I'm not sure, but I thought I was supposed to start taking my doxycycline tomorrow, too. Dr. Moustache's nurse, J, actually one of my favorites, said that I don't need to take it, but of course I plan on self medicating. Dr. Hungarian in NYC thinks a course of antibiotics is excellent for dealing with microbes pre-IVF and I couldn't agree more. So doxycycline it is. I've got a script for a 5 day supply (100mg twice a day) and a 10 day supply (same dosage). So I think I'm pretty set on the antiobiotic front. I'll peruse what I was taking in IVF cycle #1 and just repeat the dosage and timing.

Dr. Moustache didn't gripe about my email asking for his opinion on starting my lovenox and dex a number of days early. Here's my thinking: The REs always have you start your meds on CD6. What is the magic of CD6? Some women stop their AF after CD3 or CD4 and then their lining starts to build right away. Tiny clots can form in the endometrium, and that's what lovenox is all about. So if your period stops on CD4, why on earth would you wait two days to start lovenox and risk forming clots? It just doesn't make sense to me at all. So in typical fashion I did what I always do: I self medicated.

I'm totally freaked about taking the dexamethazone though...I know that one of the huge pitfalls of taking it is weight gain. RAPID weight gain. So I've been cutting back on calories the past few days in an attempt to get my body prepped for a bit of a diet. I'm really going to have to watch every bite from here til the dex is ceased so that I don't gain a buttload of weight in the process.

LH testing starts on Sunday. I'm planning on testing twice a day. No way in hell I am going to miss my LH surge and get put off one more month.

Not a chance.

CD4: Pussy Pops and other Wonders

AF came a day late making for a 28 day, picture perfect cycle, but I'm usually a 26 or 27 day person. I emailed Dr. Moustache's office to notify them that AF arrived and they quickly set about putting together my schedule for the upcoming FET. Being that it's been awhile since my last CD3 FSH/E2, I begged for a labslip to test this, and they faxed one on over pronto. They put 256.9 down as the ICD-9 code, and I looked it up here at this tres cool site that converts your ICD-9 codes to something legible. 256.9 is the code for "unspecified ovarian dysfunction", and not anything related to infertility, so BC PPO should pay for this test without question. I'll have to refer back to the huge list of services that Dr. Moustache has done for us thus far and see what sort of ICD-9 codes he's been using. Perhaps we'll be able to get some of the last cycle paid for. That would be sweet, but I realize how unlikely it is. Knowing him, he used a code that explicity states, "IVF Cycle for the Terminally Infertile".

Yesterday nurse J emailed that I should start to use my viagra pussy pops every six hours. My response to her was something in the order of, "Okay....but I have my period. You know, I just don't see how those things are going to stay in there since my innards are basically sliding out." She emailed back, "Just lay down for 30 minutes." Okay, I can do that. But these things are disgusting. They don't even melt like the progesterone ones do. The progesterone ones liquify to a point one could assume that the medication in them really does reach your mucous membranes. These viagra ones slide out in a single waxy mass, and I have to wonder if the medicine in them is really reaching me or not. It's a holiday today so I can't telephone up the pharmacist to gripe about this, so until tomorrow I'll continue on with them and and hope that they are doing their job. It will be an interesting conversation for sure. Dr. Moustache's office is used to us calling or emailing with our questions laden with way TMI ("too much info" for Donna! :-)), but I don't think that the pharmacist is as well equipped for my phone call. I'll try to be gentle and not scare her off too much. It'll be entertaining to listen to her reaction though. They charged me $102 for 32 suppositories (used every six hours) so hopefully they give me a new batch. Dr. Moustache doesn't think that I really need them, but he wrote me the script to appease my worried mind. My friend LL had the same surgery that I had (fibroidectomy) and after her cycle she had the brains to get an U/S to measure her uterine lining. Shockingly, hers was thinner than it had ever been. I didn't have the sense to get an U/S, so using the viagra pussy pops, for me, is a bit of added insurance against a thin lining. Fingers crossed that it works.

My friend ZC is getting her beta call from Dr. Moustache's office today. I'm on pins and needles waiting for her to post her results to the board, or to call me and tell me how she is.

CD27: AF, AF....Where Art Thou AF?

Returned from LA yesterday. I removed my mom's home from the market and gave the listing to another agent to market. I interviewed three agents: the first a novice, the second a fast-talking salesman sort, and the third a flashy "above the boulevard" sort that drove a mercedes and looked out of place in our ghetto neighborhood.

I went with the middle one: the salesman sort of agent. I've seen him a few times at open houses down in my mom's hometown. He talks to everyone that walks into his open houses, maybe a bit too much, but he doesn't let a single person leave without being tapped for whether they might be interested or not. He's also a neighborhood specialist and has another listing two streets over. I figure that having a second listing in the same neighborhood will mean that when buyers don't like the other house he has (ie, too expensive) he'll be sure to send them to our house.

We dropped the price $10,000 to $469,000. This is exactly what the shit hole across the street sold for in April. It makes me ill to see that our house, after $7000 in cleaning up, is now on the market for the same amount as that piece of crap across the street. It's just wrong. So wrong. It took me three trips to LA to get our house in decent shape, and now I question if it was all a waste of time and effort. Should I have just put my mom's house on the market last February while the market was still slightly warm, okay, maybe lukewarm? I wonder. Fucking hindsight.

I'm resentful that my mother couldn't listen to me and sell her house when I told her to. I'm the real estate broker in this household, but she can't hear me or listen to me. She sees me as her daughter, her teenage daughter that did irresponsible things many years ago. She can't fathom that I might know something that she doesn't. And it's costing her, and driving me insane. I am so happy to have wiped my hands clean from this. Let BG deal with her and her insane ideas on real estate. At least I know that he will be able to get through to her in a way that is impossible for me to do.

When I reiterate for the upteenth time how upset I am she retorts, "But I wasn't ready to sell last year!" and my reply to that is, "Was it worth $50,000 to wait? $70,000? It might actually be a $70,000 loss by the time we close this deal!" This is a woman that drives across town to save 2 cents a gallon on gas...but when it comes to market timing and the sale of her house, she pissed $50,000. It's almost as if she put her hand on her hip and snootily said, just to spite me, "I'll sell when I am good and damned ready and I don't care if I lose money." It wasn't as direct as that, but it feels as though it was. My mom might have a bit more than that in the bank, her life's savings. Yet she just pissed away an equal amount of money by not listening.

My closest childhood friend suggested today that my 89 year old mother might be on the verge of senility. My god. That is one scary thought.

Rant over.

Maybe this outburst is PMS? I always claim that I don't get PMS. Really, I don't. I don't get bitchy or cranky. AF just arrives.

And AF was due to arrive today and she's nowhere in sight.

I hear that the humira injections can throw one's cycles off a bit, and maybe that is the case. Great. Right before a FET my cycle is a bit whacked. To say that it makes me a bit nervous is an understatement.