Holy Crap, I Just Canceled Myself!

We had our 8:45am appointment with Dr. Pompy today. An U/S appt to see how the follicles were doing. On the way to the appointment J protested that he didn't want to do another IVF cycle after this one. That he was tired of "throwing good money at bad". Yes, his words. I protested that I wasn't ready to throw in the towel just yet but he voiced that if I wanted to keep trying that it would be on my own. Fine. And shall I look for donor sperm, too, while I'm at it? "No, I didn't say that". Me, paraphrasing, "Okay. So you want the privilege of being a parent but you don't want to write your 50% of the check to help us be parents?" OMG. It was a terrible and hurtful argument. Infertility hurts couples in so many ways: emotionally, financially, and then there are the physical considerations. The shots, the hormones swings, possibility of overstimulating, etc. It's endless. But arguments like this are poison. Toxic.

So today is something like day 8 or 9 of stims. I tender in the ovary region and seriously bruised from the lovenox.

A bit of history: recall that we started off with 12 follicles...but they found a cyst...so they put me on stronger lupron in order to make the cyst go away. Dr. Russian said that antrals vary. They come and go. This was in response to his finding 7 on our last U/S about a week or so ago. I panicked but he seemed to imply that the others would likely be coming back.

But they didn't come back.

Today they only found 7 follicles. One at 7mm, a few at 11 and 12mm, and one at 14.4mm. I expressed concern over the 7mm follicle that it might not be able to "catch up" to the others. Dr. Pompy said "it might" catch up. So in reality we only had 6 follicles to work with.

I was devastated. This was my worst cycle ever. I always wind up with more follicles than they think I'll have. Heck, Dr. Moustache would always find extra follicles in the OR when he was poking around with the retrieval needle.

Withdrawing the wand, Dr. Pompy said that he wanted to test my estrogen to see if it was high enough to proceed. He didn't seem enthusiastic about it given how many follicles had disappeared.

I asked a multitude of questions as to how they might have disappeared:

"I worked out quite a bit the last two months. Might this have caused this?"

"No."

"I was on lupron since February 8t. Could it have put my follicles to sleep."

"No." (I have my doubts about this. Honestly, I think this was the culprit.)

"Okay. I've never done a cycle with menopur before. Do you think the LH did something to suppress my follicles to the point of disappearing?"

"No." (There are docs that would argue in my favor)

What he did say is that he felt that I'd done quite well for my age up til now and that it was possible that in the last year that it's caught up with me.

"But what about the 12 follicles? 12 is more like what I normally produce." I protested. There was really no answer for this.

Dr. Pompy said that they'd call with E2 results and would let me know what dosage to take for my evening shot. He said that if my E2 was lower than 250 that I'd be canceled and we'd try again next month. If this were the case I'd trigger with my hCG to induce ovulation so that I could get the "ball on the road" as soon as possible, rather than waiting up to six weeks for AF to arrive.

So we left and we argued all the way home as to what to do. It just doesn't sit right with me that 5 of my follicles disappeared. This has never happened to me before. With our first two IVF cycles I had 12 and 15 (or was it 16?) follicles. We had fantastic retrieval & fertilization rates.

About 4:30pm they called with my E2 results. 445. I asked what sort of number this represented in the spectrum of typical results. "Average". Okay. So I have less than normal follicles for me, and my E2 is average.

Evening came and I took my shots as planned save for the menopur and lovenox. It wouldn't matter if we proceeded or not: I'd still have to take them in order to trigger tomorrow. No reason to take the latter two shots as I'd made up my mind.

8:30pm came and I made the call. I telephoned our sweetie pie nurse and confided in her that J didn't want to do another IVF cycle after this one and that I didn't feel that we were truly giving it our best shot. I'd been thru the ringer with the cysts, the 2 months of lupron, and now I'd lost a huge percentage of my follicles. I explained that I didn't think that this was an optimal cycle for me and that I felt it was best that we cancel and start again with the next AF. I think I probably told her a bit too much about our reasons for canceling. Hopefully I didn't burden her with undue information.

I'm not sure why I felt the need to apologize to her, and to Dr. Pompy, but I did. I feel that I kind of let them down in a way, but as La Coloratura said, I paid them for each visit, ultrasound, and blood draw. I had a right to do whatever I wanted with this cycle. I fought back tears of disappointment during our conversation. But it's done. We're canceled. I'm kind of shocked we canceled ourselves, but hopefully next month will be better.

It's a hell of a let down after all we just went through.

[Millie if you're reading...I'd love to hear what you think of all of this.]

Stims Day 8The Beginning of Panic

Tomorrow is our first U/S since commencing "stims" to see how the follicles are shaping up. The nurse who made my appointment today said for me to administer my shot of lupron, but not the FSH, as they might change the dosage during the appointment. I'm already doing 225iu of Gonal-F in the AM & PM, and 150 of Menopur (50:50 mixture of FSH and LH) so I'm getting a total of 525iu of FSH a day. This is more than I've ever taken. One would think that perhaps this would lead to overstimulation...at least I would, however, I'm feeling a bit tender in the ovary region but it's nothing outrageously terrible. I'm still working out without issue and going about my daily business without much thought to what's going on down there. Once in a while it feels crampy down there.

Clearly if they are planning on changing my meds, I would think they'd adjust them downwards as the risk of overstimulating me looms.

The hCG will change my tone of complacency. It always does.

After the shot of hCG that 36 hour clock starts ticking rather loudly, nerves set in, I start to panic, and who wouldn't? My ovaries will start to feel like they have lead weights attached to them and I'll fret that they'll explode before I can reach the clinic in time. I am already worrying if their custom blended lupron is adequate to suppress me. I'm 5'10" and weigh more than many of the waifs that I see in the clinic. Is 5iu twice a day enough for me? Such is the way in which I panic. This is the 3rd time. It's my routine and I do not anticipate wavering far from it.

Stims Day 5Black and Blue

Yesterday my stomach had a few bruises from the injections thus far. Post endermologie session, not only was I left with petechiae all over my upper back, leaving me to look like a victim of domestic abuse, but the purplish marks on my midsection are starting to coalesce into large purple bruises. Honestly, this is so icky that I've asked my BFF, JS, so swing by with her camera to capture the moment. If my child ever asks if s/he was "wanted" all I will have to do is whip out said photograph and it'll be clear that I walked through hell bring him or her forth.

Tomorrow morning I go in for my first IVIg infusion of the cycle and a routine blood draw to test my NK levels (Natural Killer cells). If elevated, I'll be doing yet another infusion of IVIg two days prior to the embryo transfer (knock on wood that we get some!). It's disconcerting to be doing an IVIg before we even know how many embryos we might be getting (one report said 12 follicles, one said 7, the latter report came from Dr. Russian who clarified that antral follicle counts can fluctuate within a cycle) but at least we'll know for sure by the time of the next treatment. I am worried about the idea of 7 follicles. We're used to much more. At my age (42) it's reported that 1 in 5 eggs is "normal" (which aneuploidies they're referring to is up for grabs) so I am quite uneasy about having so few. I'd like to put back 10, yes TEN, embryos as that would give me a chance at two normals, and hopefully one will implant. Both implanting would be ideal, actually, but given my score card, I think one will do nicely.

Stims Day 4Human Pincushion

Seven shots a day is excessive. There is little uncharted territory on my stomach for this to go on much longer. The Lovenox isn't creating huge bruises, as the heparin did, but I see telltale black marks where the needles entered.

What is most surprising in this cycle is how f*cking much the Menopur shots hurt. IF women will complain about the heparin. How it burns and the intensive bruising that it causes. They plead with their physicians for scripts for Lovenox, and that eases the pain a bit and lessens the bruising. But Menopur is something created in hell.

Tonight, for the first time in 4 cycles, the pain was so much I took the needle out and had to start over. Never before has that happened. Well, it might have happened with the Humira, but that memory is buried safely away.

I noticed this evening, while preparing my quartet of injections, that I have a veritable menagerie of infertility drugs in my refrigerator. Gonal F from Z, from JP, and even one box of Gonal F with a woman's name of it that I have never met, nor do I recall how it came into my possession. A few follistim pens without instructions, lot numbers, or expiration dates, a multidose Gonal F vial, a couple of 450iu multi dose vials, three boxes of 900iu pens, and so much more. Five boxes of menopur that were gathered from at least three sources, not one a pharmacy. There's even a box of vivelle patches in the lettuce drawer. I'll probably never use a few of these things and when this cycle is over, I'll pass them onto the next IF woman who is in need of such things.

One day she, or perhaps yet another woman, will find my name on a box in her lettuce drawer and wonder who I am, and what my story was.

Stims Day 2 Scale Success!

Tried to work out at the gym yesterday and I found myself exhausted much earlier than normal. I think eating a carbohydrate laden fruit/nut bar (a chocolate/coconut Larabar) before a workout was a total mistake. Rather than burning fat, my body was focused on digesting and after burning 300 calories I was winded and I quit. I can't blame my lack of performance on the single dose of Gonal F I shot up right before heading there as it is just too early for it to have had any effect on my ability to do cardio. I truly wish that someone would make a whey protein bar that is otherwise dairy free (no casein, caseinates, or the like) that didn't have a shitload of sugar in it, natural or otherwise. I just don't see them out there. It's so repulsive, to me, to eat a protein bar, in essence a meal replacement, only to have it coated with chocolate, or have 18g of sugar (or more!). I totally adore some of the nut bars that have come onto the market lately, but honestly, they really don't have much in the way of protein and they still have way too much sugar in them. J says I should go into business and make my own. Not sure where he thinks I'll find the time between IVF, classes, buying and rehabbing foreclosures, and everything else on my plate.

My digital scale says I've lost another 1.5 pounds today! Down 15.5 pounds total. Do I dare to trust it? Yeah, why not. I've finally figured out I have to place it in exactly the same position each morning, and then recalibrate it a few times before stepping on. I am totally wow'ed by my efforts. 15.5 pounds is a smidge over 3 of those 5 pound bags of flour you get at the market. That's a frigging lot of weight that I gained Put three of those in your hand basket at the market and walk around for a while. No wonder my lower back pain has been so bad in the last year. I got the "wake up call" to lose weight in late December when I hopped on the scale at the doc's office. My BMI was "right" at 25 and just about every IF knows what that signifies. Today my BMI is at 22.7. Just about right in the middle. I always wonder if when we're all looking at those BMI charts that the RE gives us if we're supposed to be in the middle? Or towards the lower end? I don't think I could ever have a BMI of 21, or 20. But if someone told me it would double my chances at conceiving I'd lose the weight in a heartbeat.

We do tend to eat really healthy food, mostly organic, here at home, so it wasn't the sorts of foods I was eating but, rather, the lack of movement. J is also a carb nut. He loves pasta, bread, tortilla chips. Dr. G was right on the money. The last month or so I've stopped making anything with starches or laden with carbs in the evening. If mom and J want rice, they'll have to make it themselves.

This tactic has worked wonders, so far. The entire pantheon of gods, if they're up there, will probably knock me up this cycle just because I lost weight and it would be oh so entertaining to watch me gain it all back with a big belly to boot.

I've tried to keep my weight loss to around 2 pounds or a bit less per week. Apparently this is a "safe" rate at which to lose. I wonder what they mean when they say "safe". Hopefully my pre-antral follicles have slept quietly through the cardio and the high protein diet and won't be affected by any of this. I've also been wondering if all of the hour long cardio sessions in the gym might help to get extra blood to my ovaries? I do femoral massage but it just doesn't seem like it can do much for long periods of time.

I'm also going in for an endermologie session on Sunday. Girls, if you have never done endermologie you have GOT to try it. It's a fancy machine assisted lymphatic massage that was developed by a doctor for breaking up scar tissue on burn victims (I think he created this for himself, I could be wrong) but it was found that it has all sorts of other great side effects: lymphatic circulation, toxin release, skin becomes moister, more elastic, increased collagen growth, reduction in cellulite, it helps with the pain from fibromyalgia & arthritis, and so much more. You slip into a sheer white stocking, for privacy and so that the machine stays clean, and they rub vacuum assisted rollers over your body in various directions. I've done massage here and there for years and let me tell you that this is by far more intense than any massage I have had.

I did acupuncture in the last 3 cycles and this time I'm just going to do endermologie instead. It's guaranteed to stimulate the hell out of any meridian point on your body and it is so much more relaxing that having someone jam needles into your body.

Stims at Last - Day 1

Well, after three postponements....we've finally been given the green light to start stims today. I had Dr. Russian again, instead of Dr. Pompy...not sure why we were given him twice in a row, especially as Dr. Pompy was there today. But there you have it.

Dr. Russian did an abdominal u/s rather than the usual wand (don't ask)...and so he wasn't able to "see" my ovaries as normal. He spent quite a bit of time pressing and looking and finally said, "I can't see your ovaries, and I can't see any cysts." He said they're run my estrogen to make sure it was still low, and if so, that I'd start stims this morning.

Bloodwork showed estrogen had dipped from 16 or 17 two weeks ago to 14 today...so nothing should be going on down there.

But actually things have been going on down there. Last Friday I started spotting and by Monday it was looking like AF had come. But how could that be? I'm on full strength lupron. Today the spotting had dwindled to a mere smear, at least I could be happy for that. But that was short lived as it just returned to Monday's levels. Dr. Russian said it should disappear altogether by day 3 of stims.

I'm quite pessimistic going into this cycle. What with two IVF losses and one FET loss all with a span of 14 months, who wouldn't be? What's more? J was totally freaked out over having to write a check for his share of the IVF w/ICSI fee. He argued, "I didn't know we had agreed to do ICSI!" even though the doctor said we should basically keep most things the same as we know they've worked for us in the past. When we get to the actual ICSI bridge I think we'll have to revisit. We each wrote our check for $5100 US. Ouch. That hurt. Oh yeah. I need to get to the bank today and deposit the moolah before they realize that there's nothing there.

And with check in hand I depart...

What's next?

I started spotting three days ago. Lightly, but bright red, but it persists and even got a little bit heavier this morning. The 21st will be six weeks that I've been on lupron, the latter two weeks on full strength lupron. I shouldn't have ANY lining TO shed at this point. What gives?

Nearly two weeks ago I had some rather intense ovary pain on the right side, fertile CM (nice and clear). One would think I was ovulating. On. Lupron. Nearly two weeks later I'm spotting. I honestly think that this is when I'd normally have AF. So why isn't the lupron shutting me down? I don't understand. Millie? Help?

I anticipate being canceled this Thursday when we go to see Dr. Pompy & Dr. Russian. Everything has been so abnormal this cycle.

Maybe it's for the best at this point.

Rambunctious Ovaries

So I'm five days into my new bottle of lupron, the stronger stuff, and someone forgot to tell my ovaries that they are supposed to be behavin'. I've been been having loads of twinges in the ovary region that feel like mittleschmerzes as well as copious amounts of fertile CM.

And my libido should be absent. Right? I'm supposed to be in chemical menopause, aren't I?

At this point, I believe we'll be canceled when we got back to see Drs. Pompy and Russian. Something's just not right.

What gives?

Good News, Bad News

Good News:

I have lost 13 pounds since the end of January. Nearly 1 stone for you UK folks (thanks for the correction Pamplemousse!). It took daily torture sessions on the elliptical trainer and a diet that was as lacking in carbs as I could stand, but at long last I have made it back to the weight I was at last summer.

Bad News:

At our last ultrasound (Thursday) Dr. Russian found a cyst on my RIGHT ovary that measured 17mm. Okay. We knew we had a cyst on my LEFT ovary the previous week: it had gone from 17mm two weeks ago to 11mm a week ago. Progesterone was down to 0.6 and so we anticipated getting the green light to start stims on Friday.

He gave us two options: (1) Test for estrogen and if it was low enough, start stims, watch me like a hawk, and if the cyst started to take over we would cancel the cycle. (2) Put me on full strength lupron (after having been on a microdose Rx for an entire month) for two weeks to see if we could get it to suppress. If not, the cycle would be cancelled.

Being that the first option would waste up the bulk of my GonalF, which will not be replaced by insurance (we are all maxed out) I opted for the second option. I also figured that my uterus, formerly chock full of endo, might actually benefit from the lupron, and I did not want to give that cyst a chance to grow. Either we suppress it or screw it.

So we are in a holding pattern of sorts, and I am descending further into the hell that is lupron. I am certain, at this point, that J is close to killing me and burying me in the backyard. Lupron is evil stuff and let me tell you: doctors do not warn patients enough of how bad it will mess with your psyche.