And our RE's say our uteri are sticky like a peanut butter sandwich?

I've been doing a lot of reading while I heal from my surgery a week ago Wednesday. I feel a bit better each day but had a setback on Friday when it seemed I had a mild case of food poisoning. I ran a bit of a low fever, slept for about 36 hours, and today I'm feeling perky again. I am still experiencing some cramping on the right side, where I am told the bulk of my adhesions were at (and this is what Dr. Persian explains why I've had ongoing pain on the right side). Add in the appendectomy that they did and it's no wonder my right side is aching.

In my off time, I am trying to find a surrogate (no small feat), prepare for my meeting with Dr. Check at Cooper (which is in NJ, a state that hasn't completely banned surrogacy), and I'm trying to find out if there's anything concrete to the link between adenomyosis and infertility.

From, "Adenomyosis: New Knowledge Is Generating New Treatment Strategies: Adenomyosis and Fertility":

"The first experimental evidence that adenomyosis may cause infertility comes from Barrier et al. [50] In 2004, they published a case–control study in a population of captive baboons and found that adenomyosis was associated with the presence of lifelong infertility (odds ratio: 20.6). Their conclusion was that the condition is strongly associated with primary infertility in baboons, even in the absence of coexisting endometriosis."

I wonder if lupron depot therapy offers any relief for adenomyosis as it does for endometriosis? Something I'll be researching. In one of my many adenomyosis articles I came across a mention to JZ contractions, which seem to be correlated to failed transfers.

On this particular subject, I found in subsequent reading that our uteri actually elicit these contractions, called JZ (junction zone) contractions, which seem to kick off when something foreign (ie, a catheter) is put into our uterus by way of the cervix or when a tenaculum is affixed to our cervixes. Ladies, if your RE has ever assured you that your embryos aren't going to slide down your leg after a transfer ... please point him (or her) at this article.

Junctional zone contractions and embryo transfer: is it safe to use a tenaculum?
http://humrep.oxfordjournals.org/cgi/reprint/14/9/2367.

This is an older article, from 1999. But it starts off with,

"Embryo transfer is one of the most critical steps affecting the success rate of in-vitro fertilization (IVF) and has changed little since IVF was first described.

Unless something has changed in embryo transfer research in the last 11 years this article may very well still be current.

Then, go to the 2nd page and locate the paragraph on the right that begins with, "The ability of fundo-cervical contractions to move the mock embryo towards the cervix...".

Read and be stunned.

All I know is that my paranoid fears of losing my embryos with transfer aren't all that unjustified. They do say that a surgical transfer that bypasses the cervix is more successful. Interesting indeed, but where on earth does one get a surgical transfer. This article is 1999 though, and perhaps it's something that died off in the late 1990's?

Anyways, back to reading more and trying to figure out this mystery called adenomyosis.

CD2: Pre-Op Appointment

I met with one of Dr. Persian's "fellows" for my pre-op today. A really nice Indian lady. Lots of instructions were doled out. I'm on a liquid diet tonight .... only clear liquids, nothing red or blue (as in gatorade). I also need to drink down this wretched magnesium-citrate crap to clean out my intestines, which is to be followed by the even more humiliating pre-bedtime enema. I was also instructed that I won't be able to eat solid food until I ... pass gas? Gosh, is there no dignity in this surgical procedure? Usually before surgery, I've always been told to not eat after midnight the night before. But during this surgery, they're throwing in the added bonus lower GI, bladder scan, and hysteroscopy. It sounds like they're not going to leave any stone unturned.

So one thing that the nice Indian lady doctor did for me was to do a very thorough U/S scan. I have a special dislike for U/S during the first few days of my cycle for obvious reasons. Ick, ick, ick. She did the routine check of my uterus and ovaries. Verified that I do have fibroids and then said, "You have a very normal looking right ovary but do you see these dark spots? These are small cysts like what you would expect of someone with PCOS."

Hot damn.

So a possible key to my problems might be adding in metformin? Hmm...

I hope that she is really skilled with that wand. I would hate to get all in an uproar over my gaggle of RE's not being able to find something that this doctor found in, 5 minutes?

So she pulls out the wand. Starts to go over the details of the operation tomorrow. She mentions that they'll be doing an endometrial biopsy. I asked her if they would be able to look for adenomyosis while they are in there. She replies that she can check for it with the doppler ultrasound right now. Back on the table I go, wand back in. She quickly locates my uterus.

I see a few "reddish" areas on the screen.

"Do you see those red marks?" she asks. I tell her I do and that's when she says that they are indicative of adenomyosis.

My uterus isn't chock full of the stuff, but it's there on the sides of the uterus. She seemed to think that having it didn't mean that I couldn't get an embryo to implant and pointed out that the embryo implants into the lining and not the uterine muscle itself.

So then why did Dr. Indian at CU tell me that adenomyosis was a known problem for implantation success?

I'm so confused.

I hope that he can confirm or deny the presence of adenomyosis and PCOS tomorrow so I will know what to do next.

Beta Burn

Less than 1.

Negative was pretty much what I reckoned it would be.

I had a (very?) faint positive 9 days past my 3 day transfer (embryo 12 days old on this date). It still shows up on the damned HPT to this day - so it's real enough - but I still wonder if the negative HPTs the day or two before were in fact negative (dilute urine?).

I knew it was going to be negative and had my good cry over the last few days. Today I just feel numb. When the call came in I felt bad for the nurse who called me as she was trying to be so sensitive towards how I felt and I just felt nothing. I was very matter of fact. I'm sure she has her share emotional, tear filled calls.

Anyways.

In typical fashion, and wasting no time, I moved directly into contingency plan "A": an MRI of my pelvis with contrast is scheduled for next Monday evening. It'll show where all the fibroids and endometriomas are located, as well as determine whether I actually have adenomyosis as has been only slightly suspected as a reason that I've never had implantation (since I was 16, that is). If I do have the dreaded adenomyosis, then I'm left to surrogacy if I still want to have a biological child. They are doing it with contrast at my request as I'd like for them to determine if I am getting adequate blood flow to the uterus and especially the right ovary that seems to have shut down entirely.

I also stopped by Willner Chemists (lovely vitamin/homeopathy shop in NYC) on my way home and loaded up on the supplements that CCRM is using on their patients these days:

Myo Inositol (4g/day, divided into 2 doses)
CoQ10 (800mg/day, divided into 2 doses)
3mg Melatonin (at night)

I wound up with Jarrow brand Inositol in a powered form - the helper at Willner said to just mix it into whatever it is that I'm drinking (water, juice, smoothie, etc). Sounds easy enough. Powdered is also a lot more economical.

I also read a bit that most people are deficient in magnesium (functions in fertility in some fashion) and that we should be taking calcium & magnesium in a 2:1 ratio (2 parts calcium: 1 part magnesium). So I found a nice pill form that met this need.

Another thing I've read about is that D3 is another supplement that is hard to overdose on. I've been on 2000iu, but Dr. Mercola (who I read with one eyebrow raised) suggests that we can do 4000-5000iu a day easily. In fact, the human body produces about 10,000iu of natural D in about 30 minutes of sun exposure. So, for people like me that are locked in an office all day (with pasty white skin), a healthy 4000iu of D3 a day won't hurt in the slightest, and will probably do some good.

The last thing I walked away with was two bottles of False Unicorn extract. The helper at the Chemists said that it's helped a lot of female customers conceive and carry. OK. I'm a sucker for a potion in a bottle: I bought two. He recommended a single dropper full, three times a day.

So, tonight dinner will be accompanied by a bottle of red, a bubble bath, and an early turn (a la melatonin) in as I've not been sleeping well with the progesterone turning my body temperature up so high that I wake up in a sweat every night. Tomorrow it's back to the grind of handfuls of supplements and fish oils as usual.

Peace out.

Big Apple BluesCD3

"D" and I moved to Jersey City about 4 weeks ago. He got transferred here...so we're holed up in corporate housing for another month while we search frantically to find our own place. But...that's another story.

I went to my new Manhattan clinic yesterday for the first time. I adore my new doctor. We'll call him Dr. East since this clinic, and he, are both eastern.

I wasn't able to find my last FSH test result showing that my FSH came in at 10 or so, and I didn't realize until it was too late that I'd handed them the one showing my FSH at nearly 16 (which is their cut off). Of course they wanted to update this figure so they did a blood test for FSH, E2, and MIS (Mullerian Inhibiting Substance, which is supposed to be a much better test of ovarian reserve than is FSH/E2). Fingers crossed that I pass the blood work. I just came out of a bout with strep and was weak, dehydrated, and felt a bit like crap. I tend to test poorly on days like this, I think, due to low blood volume.

Anyways. It wasn't all good. On the table, Dr. East did his wanding, found the dreaded endometriomas on my left ovary (now 2cm large - 3cm and they'd do surgery to remove them), a good number of follicles (he didn't do a count), and then asked me if I'd ever heard of "Adenomyosis", which is a proliferation of endometrium in the uterine layer. Apparently my ultrasound appeared to have found this, and it might explain why I've never gotten pregnant in any of my previous cycles.

Moving right along, he said that he'd like to do a full blown hysteroscopy on me, send a little camera in to make sure that there aren't other functional reasons why I'm not getting preggers, so I'm going in on Monday morning for the procedure.

All I know is that these guys move FAST and I like that. No messing around at all at this clinic. My hat's off to them. I hope they figure out for me once and for all if I should try to cycle again. It would be good for my mind to know where it's all at.

I telephoned the ex today to tell him about the results, but he got off the phone in a hurry. The new GF doesn't care for my calling him, but too bad. I think he has a bit of a right to know why we spent nearly $50,000 and never had a child to show for it.

As I settle into this new life living on the edge of NYC, I wonder if I still have it within me to bear and raise a child. I'm not 100% clear on this. It's just one day at a time. I guess I'll know on Monday if I have any say in this or not.

Ya know?

They have a 16% success rate in women over 40. One of the best I've seen. I've got 5 tries left if they give me the green light.

More on Monday.

Update:
Lab results came in later on today.

FSH 8.15
E2 54.3

It's a go! MIS test results will come in a few weeks from now.