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Surrogacy Blogs:
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Waiting for Baby Orange
Jenny From the Infertility Block
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Other Good Reads:
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Mc Gill Reproductive Centre - Montreal
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Jinemed Hospital - Turkey

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Zouves Fertility Center"
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IVF Meds - UK
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Blastocyst Grading Criteria
How much hCG is Left After Trigger?
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More POAS Ratings
The Beta Base

Friday, October 30, 2009

Day After Surgery: Ranting About The East Coast

The doc wasn't able to do the sclerotherapy procedure on my right ovary as they weren't able to get the medication that they use in time. Apparently, the compounding pharmacy in St. Louis that packages the medication that I needed failed to renew their NY state licensing in time and so they're out of commission for another week to week and a half. Ugh.

All it is is pure tetracycline in a sterile vial - my doc would reconstitute it with sterile saline and use this to flush out my ovary once the blood had been aspirated away.

Amazing that there seems to only be ONE pharmacy in the entire blessed country that can do this. Ya know? I bet there are other pharmacies that can do this. Really. It's got to be an east coast madness thing. More on this later.

So they weren't able to do this procedure.

Upon waking up, the doctor said that they also didn't aspirate the cyst on my left ovary as it had already popped.

So, the last RE clinic (Columbia) had essentially postponed my cycle for NOTHING. NOTHING! I could have easily cycled right away. Damn!!! I have loved the doctors there and they have a top notch embryology lab, but it's just frustrating that they have a cookie cutter approach to IVF. Even my cycle was cookie cutter, using ganirelex on me when I am nearly 45. Ugh.

So he did the hysteroscopy, the only thing he COULD do considering the circumstances. He found some flimsy sorts of adhesions in my uterus, which he removed. I had some good cramping afterward and have bee spotting since then.

Bummer that I have to do another procedure the week of November 9th because of the pharmacy. That just bites.

So I am going to be doing cycle #5 in December unless I am able to get them to cycle me out of the December cohort. I am going to beg for that. Hopefully they'll relent and let me proceed earlier, but they do close for holidays so they wouldn't be able to monitor me during Thanksgiving as no one would be there. Maybe I could at least start my stims then and monitor right after the holiday?

We'll see.

It's so hard to be patient when I have so many damned setbacks like this.

Along the surrogate route, I placed an online ad for a gestational surrogate. Three gals have written so far. Wow. I'm a bit scared to go this route, but I am seriously considering this if I wind up getting the job that I am currently interviewing for. I can't afford a surrogate without a job that pays really well as it'll cost me at least $18K for her fees and, at most, another $6K for the attorney's fees to draw up a contract. Add in her travel fees and any other expenses and it's easy to imagine that a surrogate would cost me $30K. At least.

I would love to find a local surrogate to cut down on fees but also that I would simply want to be close by while she is pregnant - but chances of that are slim as you can't pay a surrogate in the state of New York. It's illegal here. Can you f*cking believe that? I simply don't understand why it's illegal for me to literally "rent" a woman's uterus in order to have a child. Also, why shouldn't she be able to provide this service for others? It's her body for cryin' out loud. Some women love to be pregnant and are thrilled to provide this service for others. It's their right to be able to do this! I don't understand our country's laws. We're so behind. We're in such a dark age when it comes to how we deal with fertility, the LGBT community, etc.

It's not illegal in the state of NY to have a compassionate surrogate (unpaid) so I have a few family members that I will ask to see if they might help. I am not hugely close to either side of my family, so asking one of them to help is very uncomfortable for me. Also, because I have immune issues that might be hereditary in nature, a family member might also have the same issues that would cause her to have repeated implantation failure as well.

Why can't the law realize that there are very good reasons for our need for paid gestational surrogates? We need access to women who are willing to do this for us who have had children of their own, or have been surrogates before - women with a proven ability to bear children. At least California doesn't have such silly laws. Paid surrogates are fine. Having the intended parents' names on the birth certificate is fine too. Sheesh.

I am so frustrated with all things east coast today. No offense to anyone who reads this on the east coast. But even the act of buying a bottle of wine in this blessed state (NJ) means that I have to hit up a "liquor store" in addition to a grocery store when I am out shopping. Same for NY, CT, and other surrounding states. The east coast is so puritanical. Anti anything that is outside of the box. State lobbyists say that allowing liquor sales inside stores will cause mom and pop stores, and wineries(!), to go out of business. Really? I don't think so. Opening up your market to new customers would increase sales. Multi level marketing. It's marketing 101 folks.

I've stopped being mad about this one - well almost. I just order my wine from California now and have it shipped here to NJ. Screw this stupid state and the horse it road in on. My dollars are going back to California where it is SANE.

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Wednesday, October 28, 2009

Day Before Surgery

So surgery is scheduled for tomorrow morning at 11am. I'm due to arrive half an hour early, empty stomach, sans contact lenses, jewelry, etc. The BF will pick me up in the car at some point to be determined.

They're going to aspirate the cyst on the left ovary, asprirate the endometrioma (chocolate cyst) and flush it with a tetracycline wash to assist it in healing, and then they are going to do an HSG to see if the fibroid that we partly dealt with in late July is in fact still behaving.

I'm still sorta stunned that it all came together as fast as it did.

I guess the fibroid is the limiting step. If it's still there, I'll continue with the cycle but I'll freeze everything and then head to SF in November to do the full blown surgery. I'll return and do another course of IVF or two, banking embryos as I go.

When I have enough, I'll do CGH testing to determine which are good and then I'll transfer those.

As a side note, I'm currently interviewing for a dream job in NYC right now and I am thinking that if I get it, it might make sense to go the gestational surrogate route rather than fight my immune system AND the stress of a new job.

I posted an add on one of the surrogate websites to see what I could get. If I could find a gal outside of an agency, willing to carry my embryos for $20K, I think I'd do it in a heartbeat. But NYC has rather inhospitable rules/laws with respect to surrogacy. Surrogate contracts that include compensation are not valid in the state. It seems that you need to look to the state in which the surrogate lives in order to determine which laws come into play. Here in the tri state area it gets confusing as there are many states in distance of each other. I live in NJ, but I will likely be working (and cycling) and delivering in NY. PA and CT are within two hours of me. They have their own rules and regulations. It gets confusing. I'm just now starting to seriously consider this route and it's daunting. Agencies and lawyers all want a cut of the action (ie, money) and that's just so incredibly frustrating when I've already spent a small fortune when I didn't have IVF coverage.

So, I am starting to feel that I might be at a crossroads...I will likely have to decide in the space of a week or so if I am going to get serious about a gestational surrogate.

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Monday, October 26, 2009

Busy Day of Busy Work

Got up at the crack of dawn to see Dr. Indian in the Big Apple. Two trains to get there and about a mile of walking. The place was pretty empty, luckily. They took my blood and put me into an exam room. Two of the docs that did my retrieval came in to do the U/S. I told them that I was having pain on the left side and suspected a cyst. They checked, and as I suspected from the nagging pain on my left side, I've got a good sized cyst on my good (left) ovary about 17.8mm large. Endometrioma on the right side.


Canceled again.

Just when I THOUGHT that I had things all planned out.

I decided to spend some time in the city and just wander and think. I treated myself to breakfast at Penelope over in Murray Hill and then spent some time browsing Kalyustan's (the mother of all spice shops) before heading home. My head must have been in the clouds over the U/S findings because I wound up taking the train to Hoboken rather than Jersey City. It was only a delay of 10 minutes or so, but I haven't done that in a long time.

Back at home, I quickly got on the phone and made a bunch of calls.

I followed up with my reproductive immunologist to see which drugs I should continue and which ones I should cease and to beg them to prescribe some hGH for my next cycle. I called the pharmacy and ordered 2 months of lovenox, to arrive on Wednesday. I made an appointment with the current RE to discuss what happened. I called the Persian doc in Palo Alto to see if there were any cancellations this week. (There weren't but my December 2nd surgery might get moved up to November 23rd). And lastly, I fired off an email to Dr. Italian in NYC to see if he would simply drain my cyst and let me cycle.

He replied right away.


He instructed me to get myself on BCPs ASAP and to call his office in the AM to schedule the procedure.

Thank you universe.

Finally something is going to happen that includes my trying again as soon as possible. I envision that this means my surgery with Dr. Persian will get postponed or, better yet, canceled due to pregnancy. Fingers crossed.

And...while I was out...Dr. Las Vegas telephoned me to tell me her hGH protocol and tell me that she's working on getting a letter to Dr. Persian.

Things are falling into place.

I hope.

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Saturday, October 24, 2009

AKA CD1, Well Sorta

I woke up this morning to the sound of the BF's kids screaming, about 9 or so, and went to the bathroom and lo and behold saw a flash of brown/red on the TP. So soon? Gosh I didn't take progesterone last night...and here comes AF already. Panic about logistics set in.

If today, Saturday, becomes CD1, then Monday would be CD3...and I need to see the IVF clinic on CD2, not CD3 in order to start another IVF cycle right away. Fuck! I'm way out in Philadelphia with the BF and his kids...and we're not due to come home til late tomorrow night (on CD2). So I'd be back at the clinic on the morning of CD3 (about 7am). I want to cycle again, but I also don't want to go to NY tomorrow AM at the crack of dawn.

What to do?

Should I just go on the morning of CD3 and lie to them and tell them it's CD2 and hope that my blood tests don't give anything away...then, rather than take my meds that night, I could take them around noon (or earlier?) so that it's closer to what it should be for where I am in my cycle? I could take subsequent injections an hour later each day until my injections were at 7pm on the 7th day. Would it matter? I don't think so. I think it's worth the risk actually. I'm going to try for it. I just really don't want to drive nearly 100 miles to NY tonight, and then back tomorrow AM, and then back again tomorrow night. It's just too much. Or I guess I could take a train home tonight...and just stay there. I'll have to think on it. I might make a split last second decision but that's how things sometimes go.

So, back to the cycle at hand. I called the nursing like at 11:30AM as directed and they weren't there. Arrgh. They said they'd call back as soon as they could find the nurse.

We took my BF's boys to breakfast and after an hour I was antsy to find out for sure. My AF had picked up steam by noon and it's pretty clear that AF is here. I picked up the phone and dialed the nursing line again and just as the phone started to ring, the call came in. The call center patched me over to the nurse.

Beta was less than zero. Definitely not pregnant. But the writing was on the wall.

Back to square zero.

Walking back from breakfast I thought it might be a nice night for a drink. I stopped in a wine shop and perused the wares but at the last second realized that drinking right as I'm going into a cycle is probably not a great idea. So I walked out empty handed. The BF looked at me oddly - he was probably looking forward to a glass of wine tonight, but I'm just not in the mood.

When we got home I promptly telephoned the doctor in Nevada to see if she'd fax over a letter to Dr. Persian in the Bay Area so that he could do my endo surgery and also asked if she would share the HGH protocol that the SoCal doc uses so that I could give it a try next week. I just don't know where the hell I'll get my hands on some HGH unless I get an Rx for it.

It's always something, isn't it?

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Friday, October 23, 2009

Beta Day

I got up at the crack of dawn and went to the clinic to do my beta. I did a urine test before leaving and it was negative...so I wasn't expecting much out of it. They make you pay for your visit before you do blood work or see a doctor. I went to the cashier window and she said, "You have a balance due of $500.". I figured it was for my cycle, the part not paid for by the insurance company, but...no...it was a $500 fee for the 2nd tube of sperm that they didn't use.

I said, "Really? You're charging me $500 to store a $200 vial of sperm? That's crazy. Just toss it! I'll buy more when I need it." She: "Well it's for handling your sperm and for freezing it for an entire year." Me: "You guys told me to buy two vials, I only wanted to buy one, and then you only use one and you don't tell me so I don't have a chance to say "toss it"?" This doesn't make sense."

She: "Well your sperm arrived on October 6th and it's nearly November"...then she stopped herself and realized it's only been two and a half weeks. But she didn't say anything more. Only that I'd have to argue the point with someone in accounting. Fine. Sure. I'll do that.

I spent the rest of the day in the city and didn't get home til nearly 3pm. I checked my phone periodically to see if any calls had come in. Nothing.

By 5:30pm we were on the road to see the kids in Philly and I noticed that a call had come in. It was the clinic and they said something like:

"Hi this is the clinic calling about your pregnancy test. Please give us a call back before 4pm to discuss your results. If you can't call by then please call back after 7am on Monday".


No, "Please continue your meds". Nothing. So, I'm nearly 100% sure that I'm not preggers, but talk about a nagging question hanging there in the air. Hellllllo?

What really sucks is that I drove to Philly without my progesterone, lovenox, or anything with the assumption that the cycle had failed and that they would have left a message for me to confirm the obvious.

I just chatted with the on call nurse who said that they will leave messages about everything except pregnancy results and that it was something that was covered in the IVF class (that I didn't take).

Oy. You would think that this "caveat" would be on the forms that I signed that said "It's okay to leave messages on my cell phone."

What the hell?

Why is this such a cluster fuck?

I'm to call the clinic back at about 11am in the AM to get the results. In the really offchance that I'm knocked up, I'll have to drive 80 something miles home to get my meds. Sheesh.

Stay tuned.

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Thursday, October 22, 2009


This morning I switched from the nasty POAS that say "pregnant" or "not pregnant" to the ones that just have one or two pink lines.

Only one line.

Tomorrow's the official beta day. I don't expect anything miraculous to happen obviously.

Ordered a case of wine from Cameron Hughes in preparation for the news. I don't think it'll arrive by tomorrow, but just knowing that I have a case of wine coming from California is a mood altering fact in and of itself.

Endo surgery is tentatively scheduled for Wednesday, December 2nd, with Dr. Persian in Palo Alto. I've got to get my records and doctor's notes (ultrasounds, prior surgical reports, etc) to his office ASAP. My calendar show that I've got time to do a cycle in between now and then, so if the Big Apple docs will let me go right into another cycle, I will.

More tomorrow.

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Wednesday, October 21, 2009


I've been POAS every single day and it's just BFN after BFN. I've been continuing to do my baby aspirin, lovenox, dexamethazone, and synthroid...but I'm back to 200mg progesterone. I'll keep up my high dose vitamins, pycnogenol, resveratrol and I might even stay caffeine, dairy, and alcohol free.

My official beta is Friday morning, less than two days away. It's not exactly 14 days after transfer, more like 12. But any viable embryo would be able to churn out at least 25miu of HCG by now and make themselves known. Seriously. Just check the Beta Base. I'm not being reactionary. If I get a positive on Friday that is 5 or 10miu of HCG it won't be a strongly viable fetus.

I'm trying to keep my chin up. I knew going into this that my chances were really low and that it was a needle in a haystack chance that I'd get pregnant. But it's still hard to look at those BFN morning after morning. They're all taped up on the mirror in sequence so that I can see if there are changes. There aren't. I was in Shop Rite yesterday and Phil Collins was crooning, "There must be some misunderstanding, there must be some kind of mistake", and all I could think of was, "Yes, there must be some kind of mistake. I am supposed to be a mother dammit!! What the fuck!?" I lost it. Tears streaming down my face in bloody Shop Rite of all places. The littlest things seem to be setting me off and I'm sure that a lot of it can be attributed to the hormone fluctuations I've gone through in the last few weeks, so I try to not dwell in my sadness too much. It'll get easier.

So I am gearing up to either go straight into another cycle (and yes I will be doing HGH with or without the support of my physician - but where am I going to get my hands on HGH without a Rx?)...OR...to get my beta integrins tested (and take a month off to also do surgery on my fibroids, endometriosis, and endometriomas)...OR...to just do surgery and skip the beta integrins. The beta integrin issue seems to be highly correlated to the presence of endometriosis, so if Dr. Persian can get rid of my endometriosis, shouldn't the beta integrin issue resolve itself if it does in fact exist?

So many questions I have...lots of calls to make tomorrow to see if I can get my surgery squeezed in next week.

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Saturday, October 17, 2009

Progesterone, Bloating, and Pinopodes

6 days past transfer. This morning's POAS looks lighter than yesterday's. The ones I am using are the ones that most doctor's offices use - they're thin strips of paper rather than the huge plastic things with windows. So to keep track of them in an orderly fashion, since the kids are here this weekend, I taped them all in sequence and stuck them on the bathroom mirror. I can only imagine with the BF thinks of this but I didn't ask.

It's been a bit of a day - my abdomen is all bloated and distended. A quick check with Dr. Google says that bloating is normal for progesterone. Lovely. I don't recall having this effect so much before, but perhaps it's mostly due to my increasing myself from 200 to 400mg a day of the stuff.

I wish I could say I've had huge twinges indicating something's going on down there, but I know just about anything I'm feeling is due to the progesterone at this point.

I found a rather interesting article tonight on how endometrial pinopodes (little structures that blasts adhere to) show up earlier in stimulated cycles (1 to 2 days earlier) than they do in natural cycles and might be the reason for repeated implantation failure in some patients. So put into laymans terms, if you put in blasts that are ready to attach but your pinopodes are on the way out or area already gone, you're screwed. There's nothing for them to attach to. I haven't figured out if there is a way to delay pinopode formation...but surely someone's studied this. I wonder (bet?) that this is part of my problem. It feels intuitively right. I suspect that perhaps delaying progesterone a bit could help my lining "catch the wave", to use Dr. Harvey Kliman's term (however out of context - apologies to Dr. Kliman for the liberty).

Anyways, I've got enough progesterone to last me through Tuesday but I just don't know how I'm going to stand this bloating. I seriously look 3 or 4 months pregnant, easily. Don't I wish?

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Friday, October 16, 2009


Spent about 7 hours in the car today driving from our place near NYC to Philadeliphia to pick up the BF's two boys while he was returning from a business trip on the West Coast. I didn't think I'd be in the car THAT much but the weather was really bad and it took forever to get there and another forever to get back.

The oldest of the two kids near demanded that we stop at Target on the way back to our place so that he could buy a Batman toy that his dad had promised him. As if they need more toys in our 1000SF apartment? Maybe if we ever get furniture and shelves for them to store their things, but as it is, the 2nd bedroom is a veritable disaster zone of toys, bedding, clothes, computer gear, and clear totes with things that will never ever be unpacked. I don't understand why children today have SO MANY freaking toys. I really don't. What is it with society today that parents feel the need to buy toys up the wazoo? I swear to god if I ever get knocked up that I will NOT be like that. I won't. Never. I am a bit of a neat freak and it would just make me crazier than I already am to have crap laying everywhere all the time.

Am I stressed from the drive? I'm not sure. I don't think so. Driving's sorta zen to me. I don't even play the radio at all. Not once in the 7 hours. I just drive and think. Drive and have my internal dialogue going on. Drive and plot. I think I'm unusual in that I do that.

So on the cycle front I'm now doing 200mg of progesterone every 12 hours...hoping that if there's anything in there with half a chance of growing that this will give it a little extra incentive. This morning's POAS looked a hair fainter than yesterday's.

My girlfriend "J" said that you can't feel implantation. True? Really? I always thought that many women say they have cramping, spotting, or something heralding the blessed event. My mother had no symptoms at all with me...and didn't know she was knocked up til the 4th month. I find that hard to believe. Maybe she just wasn't paying attention? I sorta think that many women in the 1950's and 1960's were a bit out of tune with their bodies, ya know?

I do have a wee bit of cramping but I reckon that's just from the progesterone, especially since I've kicked it up 100%. I'm going to run out end of day Tuesday at this rate so I'll have to find myself a compounding pharmacy rather fast and get a refill.


Thursday, October 15, 2009

Taxes Due Today

What timing...I'm in the middle of my 2WW and it's the last possible day to do my taxes. Oy. Usually this would be a recipe for stress and disaster, but it wasn't as bad as I thought it would be. That, or I really screwed them up royally! I cut my checks, wrote out my envelopes, and was done by 4:15PM EST. Whew. Relief. Glad that is over...until next year.

Embryos should be 7 days old today (you're still in there, yes?)...so definitely blasts, hopefully hatched, and hopefully trying to burrow in somewhere. I've been taking it easy hanging out at home save for a quick trip to the post office and Target. It's cold, rainy, and windy outside. I so do not have the wardrobe to be living in this part of the world. Really I don't. I feel I'm inferiorly dressed even for Target as most of the women there either have stylish rainboots or heeled leather boots with their jeans tucked in.

Me? I look like I just floated in from California with my jeans and YouTube sweatshirt. I am the epitome of casual.

So, here's my nether region report:

Slight cramping today...probably mostly due to the progesterone (which I am doubling up on and am at 400mg now). My daily POAS show that the HCG trigger is pretty much gone from my system - the line was barely visible this morning. So if anything shows up in the days to come I'll be quite thrilled. I bought a box of very sensitive POAS's from a biomedical supply company a few years ago and although they are expired by at least a year, I'm sure they're just fine to use. I think they came 30 to a box for about $35 + S/H and the sensitivity is about 15iu of HCG (which is better than just about anything over the counter).

The boyfriend is on the other coast til tomorrow night on a business meeting and I'll drive out to Philly to fetch the kids tomorrow night so that they'll be here when he returns late tomorrow night...and then we'll have them for the entire weekend. They say that it's good for your fertility to be around babies when you're doing IVF, but do three year olds count? :-)


Wednesday, October 14, 2009

Panicking Over Temperature (TMI Alert)

Last night I went beyond the call of hydration duty and drank quite a bit of water...reading how important good hydration is for an IVF cycle. Makes sense that they're in a nice, cozy moist environment. I put in my progesterone capsule and went to bed only to be awoken three times during the night to pee. After one rather forceful pee, I felt that I'd pushed out my progesterone capsule so I put another in. Then I laid in bed panicking that maybe that was the wrong thing to do. Maybe a huge surge in progesterone would screw up the lining I reasoned? Ugh. Why isn't it ever easy. Third pee, I removed as much as I could, worried that I'd overdone it and might have compromised my lining. I doubt it though...Dr. S said that 200mg is the MINIMUM and I'm sure that some women do loads more.

I awoke about 7am to take the BF to NYC to catch the LIRR and get to JFK, and my task being done, I then checked out an Indian Spice Shop over in Murray Hill. (I've found the mecca of all spice shops by the way). All the while I could feel cramping going on down under, progesterone or otherwise. It's silly but the cramping, from whatever source, is oddly comforting. It's as though you know something is going on down there.

I headed home, exhausted, and surfed a bit then decided to nap for an hour or so and get up to do my taxes. (This is ONE THING I procrastinate on). I should have undressed first as I woke up a few hours later and I was hot and clammy. I remembered what the clinic said about not letting your core body temperature get elevated and I just panicked. I took my oral temperature. 98.7. But I felt so hot. What to do? I stripped off my clothes and hopped into a fairly cold shower...trying with desperation to get my body temperature down. Of course, that being done, I envisioned my acupuncturist freaking out that I'd immersed myself in the cold water...telling me how bad it would be for my Qi, my yin/yang balance, whatever.

I took my oral temp again: 98.7. But not trusting the number as my mouth felt fine, it was my body that was the problem, I dared to take my nether region temperature...much like one would do with a toddler...and it was 99.9 or so. Now sheer panic set in. I sulked that I'd again killed off my embryos by cooking them to death. But reason set in, thank god, and I went and consulted Dr. Google on the matter. Apparently we're rather efficient creatures at thermoregulation and our nether region temperatures are 0.5 to 1.0 degrees F higher than our oral temps are. Likewise, axillary or armpit temperatures are about 0.5 degrees F lower than are oral temperatures. So unless you have a nether region temperature of 100.4 or above, you most certainly don't have a fever or anything to worry about. 99.9 is just fine.

While I feel that this means that I shouldn't have anything to worry about, my panic was pretty intense all the same. This isn't the first cycle that this has happened to me. I tend to get really cold at night and want loads of covers on top of me when I go to sleep but I routinely wake in the middle of the night sweating and hot. I know a bit of this is due to the progesterone that I'm taking (and perhaps the steroids as well) but it's just a total mind fuck during an IVF cycle.

What is really eating at me right now though, is that ever since I woke up I've had nary a cramp. It's as though I went to bed all crampy and hopeful, and awoke with an empty uterus. I know I'm probably over-reacting but I can't help but think I've fucked up my cycle by not being much more cautious. I was just so tired, and that bed looked so warm and cozy considering that it was in the low 50s when I'd returned home.

But I keep trying to calm myself down by realizing that our cores are very hard to heat up above that 99.9F as our hypothalamus ensures that we're at a constant 98.6 or so. Otherwise we'd be baking our eggs, our sperm, and no one would ever be conceived under a toasty warm down blanket. Just to be certain, I took the nether region temp one more time about 10 hours later. 99.9F again. So it's been consistent since my inferno embryo-cooking episode earlier today.

Sigh of relief. And wasn't that a small cramp that I just felt?

The embryos should be hatching today...fingers, toes, and everything I have crossed.

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Tuesday, October 13, 2009

Fun with Resveratrol & IVF

I'm in the 2WW...not really feeling anxious except for one thing.

I was reading online today, trying to figure out if taking Resveratrol during early pregnancy was OK to do. Dr. Italian at the other clinic said to take it before a cycle but didn't say when to cease.

So this morning I popped my dex, my synthroid, and a 250mg pill of micronized Resveratrol. Then I pondered that I should ask Dr. Italian when I should stop taking the Resveratrol. I fired off an email to him and then continued to look online. Meanwhile, I found and read this research from The Chinese University of Hong Kong.

The abstract reads as such:

Estrogen is crucial in preparing of pregnancy, and its role in the maintenance of pregnancy has yet to be elucidated. During the course of pregnancy, the placenta is responsible for the provision of estrogen. The hormone biosynthesis is catalyzed by cytochrome P450 (CYP) 19 or aromatase. In the present study, we screened several common dietary components and identified the grape polyphenol resveratrol to be a potential inhibitor in the hormone synthesis. In a recombinant protein system resveratrol inhibited the aromatase activity with an IC50 value of not, vert, similar40 μM. Subsequent analysis was performed in the human placental JEG-3 cells, and 25 μM resveratrol significantly reduced the mRNA abundance in these cells. Since the transcriptional control of CYP19 gene is tissue-specific and the proximal promoter region of exon Ia has previously been shown to be crucial in CYP19 expression in placental cells, we also evaluated the promoter activity of this gene. Reporter gene assays revealed that resveratrol repressed the transcriptional control of promoter Ia. The present study illustrated the possibility that dietary supplementation of resveratrol interfered with the normal functioning of placental cells.

While I was reading the article above, Dr. Italian's first reply came back that I should just continue on until pregnant. I replied back immediately with the article link asking if I should be concerned. He didn't write back as fast as he replied the first time so I dashed off to the bathroom and yakked up my mornings meds just to be safe.

It wasn't until well after my breakfast and meds were flushed away that I realized that the article was about "placental" cells, not endometrial cells or embryos that haven't yet hatched. My 5 day old embryos are still encapsulated by the outer shell and won't hatch til tomorrow or the next day and even then I don't think they will have anything which one would refer to as placental cells. Wish this was something that we'd covered more deeply in college Anatomy/Physiology class. As I don't know the half-life of Resveratrol, I felt that yakking up my last pill was the safest thing I could do, just in case.

Stomach in a better mood, I retook my dex and synthroid - if the first dose was absorbed, I'm sure a double dose will do just fine. Nice way to start the day. I am going to hold off on taking anymore Resveratrol until Dr. Italian has had a chance to reply to my email. If he doesn't I will play it safe and abstain.

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Sunday, October 11, 2009

CD15: Transfer Day

The crux:

3 embryos for transfer out of 4. I think 2 were "fair" and 1 "good", or it was that all 3 were "fair". Their reporting is "good, fair, or bad". So not bad for someone pushing 45.

The other embryo was fragmented but still alive and will be watched for two days. If it pulls through it'll be frozen as a day 5 blast and we'll use it another time.

The transfer went well...no weirdness with my uterus, no spotting, etc. I did my 10 minutes or so of bed rest then flew on angels' wings to the bathroom to unload my bursting bladder.

Beta HCG scheduled for Friday, October 23rd.

"D" and the kids fetched me outside about 20 minutes later and we darted off for breakfast.

I was told to just "rest" today and that (had I a job) I could return to work tomorrow. Just take it easy the next few days and not do activities that really raise my core body temperature (ie, excessive exercise and heavy lifting). I have a hard time not getting too warm as I'm always wearing layers of sweaters and a coat. I hate being cold. At night, I have a really thick down comforter on the bed. I crawl into bed freezing cold but in the middle of the night I routinely find myself really warm with the covers tossed off. I wonder if this sort of overheating is also bad?

They also asked me to abstain from caffeine, alcohol, unpasturized dairy products, and things of that nature. Pretty normal stuff.

All I know is that if I don't get pregnant, I can still say that this was by far the best IVF experience that I've ever had. Everyone in this clinic was wonderful, compassionate, friendly, and the skill of the lady doctor that did my retrieval was top notch.

OK, back to the couch to watch Scooby Doo and the Reluctant Werewolf with my guy's kids.

Let the 2WW begin.


Saturday, October 10, 2009

CD14: IVIG Day

Long day.

The kids are now on their morning "school schedule" and woke us up at the crack of dawn. Arrgh. It was 7:30 by the time I dared ask what time it was. The alarm was set for 8:00 so there was really little hope of catching any more sleep.

Got up and made the kids breakfast, dressed, and ran out the door to catch the light rail to the infusion center. My infusion appointment was at 9:30 or 9:45 but I was really early and showed up at 9:15. I don't know how I was SO early but I was kicking myself for the lost sleep.

I waited for TWO whole hours for them to finally hook me up to the IV and then it took another THREE hours to drip the 30g of IgG into my arm. By 3:00 I was back home, ravenous, on edge. Also contributing to my edginess was the fact that I started taking steroids again a day or two ago. I hate these things. I react so terribly to them. I've already caught myself snapping and second guessing myself for having moved to the east coast.

Breathe in. Breathe out.

Blue in. Red out.

Had a leisurely lunch and then headed to the pharmacy to pick up some low dose steroids and thyroxine, courtest of the reproductive immunologist. I said I'd never do steroids again, but I think I'm losing my senses at this point.

I'm really sorta edgy to find out how many embryos survived these last few days. If I have all four left I'll be totally shocked. But wouldn't that be great?

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Friday, October 09, 2009

CD13: Fertilization Report

Woke up this morning and postponed my IVIG until tomorrow morning. I didn't want to waste good IgG if the report came back that nothing fertilized. 30g of gammagard is worth about $3K and the infusion is worth another $425 to $550. So it's a huge waste of $$ if I do the infusion for naught. I have insurance that covers this nearly 100%, but my sensibilities said it would be a waste.

But the call just came in about 5 minutes ago.

4 follicles
4 eggs

and ... drum roll ...

4 fertilized!

100% rates across the board. I've had 100% retrieval rates or 100% fertilization rates, but never BOTH simultaneously.

I'm elated. Relieved. I can actually see a shred of hope again when I had essentially lost all hope.

Thank you Julia, Amanda, Brandy P, and anyone who reads my silly blog for sending my eggs prayers and good thoughts.

Grow little embies ... grow!!!


Thursday, October 08, 2009

CD12: Retrieval Day

Took the subway into NYC bright and early. So early it was actually dark. Retrieval was at 7:30AM, but they were a bit late as they had to haggle a bit over some information in my consent forms. That taken care of, we proceeded to the OR room.

They did a quick ultrasound to make sure that I hadn't lost the rest of my follicles, and luckily all four (on the left) were still there. So they gave me the lovely syringe of sleep and off we went. I just love that feeling of a chemically induced sleep.

They woke me up what seemed like seconds later to see how I was. One of the doctors stopped by a few minutes later with a grin to tell me that they'd retrieved 4 eggs. So a 100% retrieval rate. I was happy, but still a bit bummed that I didn't have more to start with.

Beggers can't be choosers.


"D" met me downstairs in a cab shortly thereafter as they required an "escort" to meet me and deliver me safely somewhere, a somewhere not specified. I dropped him off at work and then took the ferry home. Blew about $50 in cab fares today, but I won't gripe too much about it.

My box of IgG showed up today, courtesy of overnight FedEx. The guys at the Illinois-based pharmacy snuck in a baggie full of bite sized Hershey chocolates and microwave popcorn. It's sorta important to get some sort of sugar and fluids when infusing to ward off headaches. Cute and thoughtful touch. That's why I love to give them my business. I also met with the hematologist today (Dr. Russian) so that I can get started with my infusions before transfer. He didn't really know much about why I needed an IVIG infusion but he was open minded. I plan on photocopying loads of information for him so that he'll be up on things should he ever meet up with another infertile immune patient.

I get the fertilization report tomorrow about 1pm, so I'm going to postpone my infusion until Saturday. No sense wasting expensive IgG if the embryos don't make it through the night.

So here I sit, having just had a dinner of shrimp & lobster claw panang curry. (Did they say to take it easy today? I forget. Oh yes, and the part about the bland diet? I decided to purposefully ignore that one). So I sit here, tummy full of curry and cats crawling on our laps, imagining my little cells sitting in a warm cozy incubator filled with some sort of nutrient fluid...doing their best to survive.

I wish they knew how much I want them to make it through the night.


Wednesday, October 07, 2009

CD11: Night before retrieval

I triggered last night - the clinic insisted on my doing the HCG shot in my hip rather than my stomach (ugh). I hate hip shots. I had the other half do the shot for me with help of an inked circle courtesy of my new cycle nurse. (The old nurse seems to have quit me which is a good thing as we had serious language/communication barriers).

So, I'm up at 5:30 and taking the subway into NYC for retrieval, which is scheduled at 7:30am. So early. And it's cold and windy outside. I'm sure my acupuncturist would give me all sorts of shit about how I'm supposed to stay warm and cozy during this time and the next two or so weeks.

I did have one bright spot today - my insurance company is paying 100% of my IgG for my IVIG procedure and the actual infusion will only cost me my $25 copay. It's just wonderful that they're doing so much. The IgG normally runs about $3K for the 30g I use, and a typical infusion is $425-$550. So this is a huge savings for me.

Anyways, off to bed early so that I'm perky for Mr. Needle in the morning!


Tuesday, October 06, 2009

CD10 - Triggering Tonight

So here we are at my 4th attempt on IVF cycle #4. And it looks like it's all systems go.

It's been a white knuckle ride and, as I've been out of town for most of it (let's hear it for remote monitoring in Las Vegas!), I haven't had a chance to write about it at all.

So here's what we're injecting this time 'round:

CD1: AF showed up on 9/27. Two AFs in one month? Holy crap.
CD2 thru CD5: 450iu Gonal-F & 2 vials Menopur in evening
CD6: U/S in Vegas shows six follicles: 2 on right, 4 on left. Add in Lovenox per DS
CD7: Add in Ganirelix, 1 shot at night. We're up to 4 needles a night now folks.
CD9: 2nd U/S in Vegas shows that the two follicles on the right have disappeared since we added in the Ganirelex to my protocol. Same thing happened when I cycled with the clinic back on the west coast (IVF #3). Grrrr!
CD10: Here we are today.

Took my last cocktail of Gonal-F/Medrol/Ganirelex this morning and will trigger tonight at 8:30PM EST. Retrieval of my four measley follicles (worst cycle ever) is 7:00AM EST at the clinic in the Big Apple. The doctors feel that egg quality on this protocol should be good, but I'm not hugely hopeful.

The Las Vegas RE doctor that did my remote monitoring while we were on vacation said that I have massive endometriomas on my ovaries that, she feels, are keeping me from doing a great cycle and the remaining endometriosis might be causing beta integrin issues that can only be resolved with surgery and/or 3 months of lupron depot. Ugh. I hate lupron. It makes me evil beyond all measure.

But I love this doctor. She supports the use of HGH in older patients and uses Dr. M's (Los Angeles) protocol of making a solution of 5mg/ml HGH and taking 0.5ml a day starting on CD6. I missed being able to do this by 2 days as I was pretty much ready to retrieve on her table yesterday. NEXT TIME DAMMIT! Even I have to fly to Mexico to buy the stuff. Actually, now that I'm established with her I'm sure I could get a script so no worries.

My beta will be on 10/24 or 10/25 and, as I am pessimistic about my 4 follicles, I am already anticipating a BFN and am booking endo surgery with the famous Dr. N in Palo Alto for the end of this month.

I am wasting no time.

I turn 45 next month.


My Diagnosis

My Infertility History

My Usual Protocol for Diet, Herbs, & Supplements

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