Estrace Day 7Still no AF

Okay, AF is really due today - CD28 - I often get AF on CD27 so I'm wondering if the estrace is going to whack-out my cycle. I do notice that my skin is looking a bit sallow, I've lost my usual glow (f*cking estrogen) and that my libido is on the wane.

Lovely.

This is the part about IF treatments that I hate. I guess I should be thankful, though, that I am not using lupron in this cycle. That stuff was responsible for me freaking out and canceling my cycle when I cycled with Dr. Pompy two years ago.

Estrace Day 6Getting Impatient

OK...I started my estace 7 days past my ovulatory surge and here we are on Day 6 of these silly little blue pills.

Let's get this show on the road already. Where's AF when you need her?

Known Sperm Donor Hell

I've been remiss in writing. I've been frazzled with the idea that the new guy and I are likely moving to NYC in April. Freaking out about it is more like it. I've been living day by day not knowing where I am going to be living come April. It's starting to look like we're relocating tho...so it's starting to settle in. I have to take each day one day at a time while this all sorts out.

On the IVF front, it's all going to hell.

As you'll recall: In January I decided to cycle with Dr. Red. They did blood tests, a saline sonogram, got me to do a pap, a mammogram, and an EKG. I've redone every IF test I've ever done. The new guy said in December that he'd donate sperm for my cycle. Everything seemed good.

Until Tuesday. New guy meets with the shrink at the clinic, as he must as he's donating (he's not the intended parent). Unfortunately, he divulges that he's still married to the "ex", whereupon she explains that the rule in said clinic is that he must notify the wife that he is donating sperm to me.

WTF? I nearly fly off the handle.

I don't get it. They're no longer a couple. She has multiple lovers and he has me. We have quite an alternative living arrangement. They've moved on in all ways except legally. What business is it of hers what he does with his DNA? What's more. In divulging that he's donating to "someone", it will be expressly implied that it's for me. So my right to medical privacy is also invaded in the process. The fact that he's doing this for me will be used as a weapon in every argument that they have. I can see it now.

I think this is bullshit and I tried to convey this to the doctor as politely as I could.

The doctor explained that if I were married and wanted to use donor sperm of any kind, known or anonymous, that my husband would need to be notified. It has to do with the fact that they see marriage as a legal bond. The shrink said that it was because the children would have a right to inherit from their father and that this would be somehow jeopardized by my child's existence. Bullshit. I explained to her that it wouldn't matter if they were married or divorced. If I wanted to make a claim for my child, their marriage would no way stop me and neither would it protect the right to inherit of the current children. In essence, whether they are married or divorced makes absolutely no difference to the rights of a child if they decide to flex them. When I said this, she had no ground to really stand on. She just said, "It's our rule."

Well, IMHO, it's a fucking outdated, puritanical rule that doesn't reflect what relationships are really like.

I said to him after his quip that a married woman would have to notify her husband of her intent to use donor sperm:

"So, for instance, if I am a 44 year old woman in a terrible marriage headed for divorce and I want to have another child but my husband doesn't want one and I do NOT want to have one with the man I am married to. Are you going to tell me that I have to wait for a lengthy divorce to happen OR I have to tell him what I am doing?"

Just imagine how this would be viewed in divorce court. Your honor: "My wife wants to use some other man's sperm to have a child..." That would go over really well.

I am sorry, but I think people have rights to privacy, rights to their DNA, whether they are married or not. I don't understand the world that we live in that says that we have to notify people of our intentions to reproduce.

It's just wrong. Terrribly wrong.

CD2: More Fun With Mr. Needle

CD2 is upon me at last. I got a lab slip from Dr. Italian's nurse last night. It has the typical FSH/E2 but all ofthe general STD stuff they test for and since I have the bonus factor of being over 40, they added in a shitload of other blood tests for which I had to fast. Ugh.

They said I should go to LabCorp as that's where my best insurance bet will be. So I went to their site and looked for one in the Santa Cruz area. Score. One was open on Saturdays until 12PM. I headed down about 10:30AM starved from my fast. LabCorp lied. Well, their website lied. They were sold to Stanford and Saturdays were no longer available. Shit. Where to go? I slipped into the Chiro's office next door and begged their advice. They said to go to "Doctors on Duty", "just 'round the corner."

OK. I found that easy enough but they wanted a $60 fee for drawing my blood, PLUS I had to actually SEE their physician for god knows who what. What's more? They couldn't do all the tests I needed. I pleaded them to point me in the direction of yet a 3rd place. They said to head down Soquel to Dominican Hospital and that they definitely were contracted with LabCorp AND had a lab that would see me.

I headed off, following their directions, and never found the hospital. By now my blood sugar was nose diving and I was in near full migraine mode. I saw a Sutter Urgent Care and pulled over immediately. Turns out they did indeed have a lab and were happy to help me. Whew. 20 minutes later, after they'd put in the the huge list of codes for my draw...they finally called me back.

When I was finally out of there I was so relieved to finally have my tests done but then I thought, in a panic, I wonder if fasting, no food or drink for 14 hours, would fuck up my FSH/E2 tests. My thinking was: if my blood is has less volume because of the fast, then won't my levels of FSH be falsely high? So I hemmed and hawed most of the day over whether I should redo my tests tomorrow, on CD3. It would have been nice to have done a 2nd test, but my reason for doing FSH and CD2 rather then CD3 was that I want that number to be lower if possible.

My last FSH was something wretched like 17 or 17.5. If this one that I took today is elevated then I'm going to be screwed. Dr. Italian won't likely let me cycle if I'm above 12 or a bit more. He CAN, however, submit my case to their internal medical review committee to see if they'd consent to let me cycle.

Crap.

So maybe I should have gone to the Hoity Toity College IVF clinic for a consult. There's a doc there who is fine with high FSH levels - but their overall stats, even for younger women, is rather sucky.

Dr. Pompy would make me do a FSH "jump through the hoops" test...so that's out, too, I think.

What to do?

Along another note, I got a call on Thursday that a set of 3 embryos were ready for me if I wanted them. I received the packet on them that same day. There are only 3 embryos, the quality is mid grade, and the biological mother listed both Alzheimers and Parkinsons in her medical history. Her descenents didn't seem to live too long either. One the father's side, he didn't list much in the way of medical history. A red flag. Both were short. So, I'm passing on them. I'd rather go for a larger cluster of embryos. 3 isn't much. The mom was 32 at retrieval...sort of midrange.

Hmmm....lots to think about and things will be moving rather fast from here out.

So I started my BCPs today...and will wait to hear on my FSH values. Should get them by Tuesday at the latest since Monday is a holiday.

Stay tuned for more fun with high FSH.

WTF?

I've been off of my twice daily progesterone supps for 19 hours and AF just arrived?

WTF?

This has never happened before. Usually AF takes an entire week to show after a failed cycle. Or more. THEN she arrives. But nineteen hours?

I'm starting to wonder if I had enough progesterone to sustain anything?

I will never do another cycle without PIO. What were they thinking?

As Alexa so eloquently put it: Fuckity fuckity fuck!

FSH Dip

Last AF,on CD2, I had to swing "up" to my RE clinic for a baseline and E2/FSH test. Oddest thing was that my FSH was at it's all time lowest: 5.6. FSH was somewhere in the 60's if I recall correctly so it could be deemed to be suppressing my E2 to a degree, but 5.6......FIVE POINT SIX. My FSH has never been this low in the last two years.

What on earth could have accounted for this?

I've wracked my brain attempting to draw out some sort of correlation. That's me though. Two senior theses in data analysis, just for the hell of it, mean that I really do have a love affair with data. I love looking for trends. Crunching numbers. Trying to make sense out of nonsense.

So, let's look at what's changed?

• I lost 23 pounds since January. There is some anecdotal evidence that extreme weight loss (such as mine in two months) can lower FSH.
  
• I've started eating meat again. Red, chicken, pork, bacon, you name it. Protein is protein. Protein keeps me thin.
  
• I've cut back on carbs drastically. Very little wheat, rice, or pasta. They're considered luxuries on my plate and they rarely make an appearance these days unless J does the cooking (he's a carb nut).
  
• I avoid carbs that are high on the glycemic index. No corn, carrots, pineapple, bananas, and such. If I want to cheap with carbs, I've got a few bars of dark chocolate in the wine cellar (out of sight) and I eat a bit of that to curb my sugar cravings. Sometimes I eat my mom's sugar free candies that are made with sugar alcohol rather than sugar. Frankencandy, yes, but it keeps my insulin levels steady.
  
• I'm drinking decaf coffee with soymilk (rather than no coffee at all). Previous cycles I only drank organic, water processed decaf and with oat milk rather than soy so that I wouldn't get any phytoestrogens. My acupuncturist would say that I shouldn't drink any coffee at all. Bah I say.
  
• I'm drinking wine again, at max, maybe a 1/2 glass every other night
  
• I'm eating goat and sheep cheese. Not a big deal to you, but I'm allergic to milk protein. Alpha-s1-casein to be exact, which is a protein that cow milk is chock full of...but the major alpha isomer of casein in goat and sheep is alpha-s2-casein, also some beta-casein...but the stereochemistry is a bit different between s1 and s2, and I don't seem to react to it at all. Oddly, when I was in Italy, I gorged myself on cheese, pizza, and all the dairy I could handle and I didn't have a single reaction. Hmm....
  

I started taking 75mg of miconized DHEA to help egg quality. I began taking it either right before or right after this FSH test came in, so I will be damned curious to see what my next FSH test looks like. It might shift yet again since I'm dicking with my chemistry with the DHEA...but I am praying it stays low.

I realize that in premenopausal women (me?) that FSH can tick up & down with a general trend on it's way UP. But my jumps had previously been in the 8 to 10 range. This is huge. A gigantic dip.

I'm just so curious as to what happened and what I can do to ensure that it stays low.

Why Can't Biologists Just Bow Down and Worship IUPAC?

My LH surge came a few days ago and the folks at the clinic have calculated that I'll start my oral estrace on the 11th. So two days until it begins. The financial lady at the clinic called today, no doubt to ask where our money was. We haven't sent it in yet. A bit of procrastination mixed with a lot of hesitation makes for a non-payment of our IVF fees. Back to estrace though, as that's my rant for today.

At first I was happy that I wouldn't be subjected to the birth control pills, aka: ethinylestradiol. But I just went and looked up the chemical formula of estrace and we're looking at micronized 17 beta-estradiol. Hmmm....ethinylestradiol? 17 beta-estradiol?

I dug further. Biologists have come up with a cornucopia of terms to refer to estrace:

1,3,5(10)-Estratriene-3,17b-diol
(17b)-Estra-1,3,5(10)-triene-3,17-diol
cis-estradiol
3,17-epidihydroxyestratriene
dihydrofollicular hormone
dihydrofolliculin
dihydroxyestrin
dihydrotheelin

None of them tell you much about what the hell estrace really is.

All I can say is "leave it to the biologists to f*ck up chemical nomenclature". IUPAC created a sensible process whereby one names a chemical according to how things are "stuck" onto it, or in which order they're stuck on. Biologists, on the other hand, create odd names like toluene that us chemists would call methyl benzene. How much more simple can that be? Methyl benzene: a benzene ring with a methyl group stuck anywhere you wish on it. Remove one H- on each the benzene and the methyl, stick together, and viola! Methyl benzene! Damned easy. But toluene? Unless you have the name memorized, you will have no idea what you're looking at. (Yeah, I've got that one memorized thanks to the biologists). [Note: Biologists might not be responsible for the toluene naming convention, but it's just to illustrate an example, one of MANY, that I found in my pre-med college years].

So why am I all pissy about biologists and their bastardized naming conventions? For instance, the biologists call the substance in birth control pills "ethinyl estradiol".

The chemists? 17-ethynyl-13-methyl- 7,8,9,11,12,13,14,15,16,17- decahydro-6H-cyclopenta[a] phenanthrene-3,17-diol.

Scary? Yes. But this is what it IS. You could build the damned molecule based using the IUPAC name. But what does the name "ethinylestradiol" tell you?

Not a damned thing except that you have an ethinyl stuck onto an estradiol, a diol meaning a "di alcohol" (or two -OH groups on it). But "ethinylestradiol" is shorthand. Who on earth wants to memorize the sequence of carbon and hydrogen atoms in the example above? Not me. So I do see the need for a shorthand version whereby we can all say that "ethinylestradiol" is the same as the huge assed molecule above.

Liken it, if you will, to hieroglyphic versus alphabetized languages. With an alphabet you can break down a word to it's fundamental elements (ie sounds and syllables). With a hieroglyph, there may be nothing that tells you that you are looking at a 3 syllable word that starts with "z". Instead, you have to memorize all 65,000 symbols, or how many the language contains, in order to communicate. With an alphabet, you need only memorize 26 or so, give or take a few depending on which alphabet you're working with. You memorize the sounds to the letter clusters and you're at least phonetically saying something, even if you don't know what the hell you're saying.

So it's twice the work to memorize both the IUPAC version and the biologists' I-want-to-be-a-chemist version. But why the hell do the biologists need to go out and create 8 other names which state the same thing?

That just drives me batty.

Link: Infertility breakthrough with first birth from lab-matured egg

McGill University in Montreal gets the credit for this one. We consulted them about doing a totally natural cycle IVF with them...but since I'm not PCOS, they wouldn't have me.

It's good to see that ART research is moving ahead in other countries, if not our own.

Waiting for the Egg

I've been POAS for a few days now, doing the BBT thing, and ovulation is still not in sight. I started on the sticks a few days early being that my last two AF were separated by less than two weeks' time. Who knows WHEN my ovaries will get around to pumping out an egg?

My menopur should be arriving from Pennsylvania on Wednesday or Thursday...and after that I am 100% ready to go.

Fingers crossed that the old ovaries don't churn out yet another cyst.

Follistim, Oh Lovely Follistim

As soon as I placed an ad on CL looking for Gonal F, Follistim, or Menopur, I spied a fellow IF selling her Follistim on CL at a price and quantity I was grateful to have found. I needed 4 days of the elixer, and four days was what she had.

J and I drove to a Bux over on the East Bay and met T & A to do the exchange. They're a young, friendly professional couple that got totally lucky and, as they said, hit the "baby lottery" on the first try.

T, the husband, gave us a tidbit of information today that was worth investigating. He said that he had heard that for men with male factor, using HGH can boost sperm counts. I'm not sure if it also boosts motility or affects forms, but it's worth looking into.

What I did find today is that HGH is expensive stuff and it needs to be injected twice a day. Okay, so that's what I found from Dr.Google, but I sent off an email to a local doc who runs a "anti aging" institute to see if he could help us in a pinch.

J doesn't have male factor, but his numbers go up and down and since we're not doing ICSI this time, it might behoove us to help his little swimmers as much as we can.

But....on the other hand, $600 for ICSI or $600 for HGH...what difference does it really make for us? Statistics go both ways on whether children born to ICSI have problems so the jury's still out.

Worth investigating at any rate.

My LIT AdventureA Confession

If you've been following my blog for the last 8 or so months, you might remember a post about my rants on LIT* and how the F*D*A has banned it in this country. Well, let me restate that. They've banned it as far as my doctors are concerned. No medical facility, physician, laboratory or the likes in this country may administer this treatment to me. It's banned, pure and simple. But there isn't a ruling about me administering it to myself.

So. Three centrifuge purchases later I am proud to say that I have successfully conducted my first LIT self-treatment.

Yes, I know that this is crazy. Four IVF cycles will make you do crazy things. But it's not that crazy when you think about it. I have a very strong science background. I was premed, applied to 22 medical schools but none would have me. Yeah, I've considered the idea that I'm a frustrated doctor-wanna-be and that I'm a bit resentful about not getting into medical school. There's a bit of truth there I'll admit. But what really pisses me off is that due to the F*D*A ruling on LIT, I am supposed to fly to Tuscon, Arizona, rent a car, drive to Nogales Mexico, where I hand $600USD in cold hard cash to Dr. Q so that he can do this procedure for me.

All in all, a single LIT treatment with airfare, car rental, gas, meals, hotel, and the 600 buckaroos runs about $1500.

Insane, yes?

YES.

This also begs the question: Why do I have to go to a freakin' 3rd world country to get the treatment I need?

So I set out to figure out how to do this for myself.

My first centrifuge came from the East Coast. $140 or $150 with shipping. It came with some slight damage to the hinge and after complaining, FedEx refunded me my costs and shipping. The rotor and buckets were salvageable. Second centrifuge, with a fixed angle rotor, came to me by way of the famous online auction site (need I say more?). A mere $40 or $50 with shipping. A dentist from the central valley mailed it to me and it works like a charm. I can only get it to approach 3000RPM but that's about all I need. My third centrifuge was very much like my first, but it came with an extra rotor and buckets. Let me tell you: swing out rotors are the sweetest thing to a lab-rat who has to do separations.

The centrifuges were about the most expensive part of the lab set-up. The rest of the materials were obtained from various online resources which I won't divulge as I don't want it to be difficult for other do-it-yourselfers to obtain materials in the future. Everything I bought is sterile and is of the highest laboratory quality. The same stuff you'd see in any well run hospital laboratory.

So on June 16th I conducted my first run. I used about 60ml of my partner's whole blood, which is what one would call a "double dose" if you were in Mexico doing the same treatment.

I used 10 sterile separation centrifuge tubes with 3ml of separation media in each. To each tube I added 6ml blood and topped off with sterile saline (2 to 3ml) to aide in separating out the RBCs from the PBMCs. I then spun the tubes at 2500RPM for 15 to 20 minutes. Removed the band of PBMCs (peripheral blood mononuclear cells) with a sterile pipette, placed the bands into two sterile 15ml conical centrifuge tubes, and top off with lactated ringer's solution (ie, a "wash" step). My second spin was at 3000RPM for 20 minutes to pellet out the PBMCs. I resuspended the pellet in more sterile lactated ringers and away we went.

The injections are placed, four in each forearm when doing a "double dose". I did sub-q injections but intradermal also work. Injection sites aren't to be touched, scratched, or otherwise molested for a number of days. No benadryl, steroids, or anything that impedes the immune response. The injection sites itch like hell from the reaction but, as Martha would say, "It's a good thing." My body is creating blocking antibodies that will protect the embryos if, when, they implant.

Today is 11 days after my first LIT and the reaction looks just like what you'd get if you'd go to Mexico and see the good doctor in Nogales. Exactly the same. I'm blown away at how easy this was for me to do. I'll redo my treatment in about 10 days so that the treatments are 3 weeks apart. I'll retest my LADs shortly thereafter. I expect to see my T and B cells (IgG and IgM) go thru the roof. Okay, if they're back at 99 I'll be thrilled. This treatment is also great for reducing NK cells, so I hope that it will reduce the number of IVIg treatments I'll need should I get pregnant.

So, there you have it: DIY LIT. We're joking that we should call my office Linda's LIT Laboratory. But I'd rather turn it into a nursery.

Knocking on wood.

---

*LIT = Leukocyte/Lymphocyte Immunization Therapy/Treatment

CD15 or CD3?

This cycle started off fairly normal. AF started and I went in for a baseline and blooodwork with one of Dr. Generous' associates. This week, on Wednesday, I had another U/S with Dr. Generous herself and that was when she found the 17mm dominant follicle/cyst on my left ovary. If you will remember, she and the other doc put their heads together and figured I'd cease taking my BCPs, go back on Friday for another U/S and then I'd be in for a trigger to release said follicle/cyst.

Well yesterday I met Dr. S. I can't think of any nifty name for him as his last name is just strange. I can't associate it to anything. So, Dr. S he shall remain. He escorted me to an U/S room and I asked him if I could please have a pad to sit on as I was bleeding quite heavily. He seemed a bit surprised at that tidbit of information and left the room. He returned and proceeded with my wanding. The cyst that was at 17mm had now shrunk to 12mm. He measured it a few times just to be sure that it was on the way out, and indeed it was.

Because of this, he said, I would not be needing the HCG at all. He said that it is likely that, even though I "thought" I was on CD14 that I was actually back to CD2 yet again. To be sure, he said that I should POAS daily to test for LH, check my basal temperature, etc. As soon as we get the LH surge we can prepare for me to start my estrace.

I should have been starting my estrace about the end of next week (27th?) but now it looks like it's going to be pushed out about two weeks beyond that.

I feel frustrated at the continual delays that my freakish body keeps causing me, but I am also so happy that this particular group of doctors really seems to be able to respond quickly with changes that seem to make sense. When I had my last cyst with Dr. Pompy, their answer was to keep me on lupron for TWO MONTHS and allowed me to completely lose my mind on the evil drug. I think that I appreciate the approach my current set of physicians are taking much much more. I say that realizing that I might still have my "RE honeymoon eyeglasses" on and that in a year's time I may feel differently about them. But right now the honeymoon is still on.

---

So last night me and my mister stirred up a small pitcher of margaritas. Small, because neither he nor I can drink much without falling asleep on the couch. But during my cocktail I googled a set of the cutest flatware I'd seen in a while.

Yesterday, after my wanding with Dr. S, mom and I went for a bite to eat at this cute Frenchie place that is in, of all places, the "Italian" section of town. Since I'm trying to keep my clinics a secret in this blog, I'm sorry...but despite them having the most luscious pastries (organic I think) I've seen in a while, I won't be able to publicly divulge their location. But they had the cutest plates and flatware by a company called "Comptoir de Famille". It's very simple (the pics don't do it justice), has a neat little silver pin that holds the handle to the metal portion of the implement, and has a perfect weight. The set I bought is in ivory, but they also had a nice red. I adore red but somehow I am not quite certain if it will be something I still love in years. So margarita in hand, I bought myself a set of 10 place settings of the ivory.

I'm telling you: surfing and drinking is dangerous.

Got Meds?

Any of you fellow bloggers have leftover Gonal*F or menopur to sell?

Please ping me off the blog if you do (click the email icon below...that should work).

I'm short 1800iu of the former and 14 vials of the latter. I've found a few sources on FGS but I'm always worried to deal with folks I don't know via the mail. I'm always worried I'll send them my $$ and nothing will appear.

I saw a few ads by ladies there that said they'd do COD...but which mail carriers do COD anymore?

Defiant Ovaries

I had my first face-to-face with Dr. Generous which included an U/S and catheter check. I'm totally thrilled with Dr. Generous so far. I hate to totally fall for my REs as I did for the last two for when the honeymoon was over I felt like the carpet had been pulled out from underneath me.

Before heading in for the U/S I met with Dr. Generous in her office. She went over my latest CD3 FSH/E2 values. My FSH just two weeks ago was a mere 5.6. Sweet Jesus. It has NEVER been than low since I started testing 2 years ago. Never I say. My E2 was a bit elevated at 72 or 73, but hell, it's been as high as 90 when my FSH was 9 point something, so this is something to be excited about.

My mind quickly started to spin. "Is it the weight loss? The DHEA? I started drinking again. Maybe not worrying about the wine and relaxing is working? I've been eating dairy even though I'm allergic. Could that have helped? Hmm, I haven't been eating carbs. Maybe keeping my glucose down is working? Hmmm, it's been five months since my treatment with Dr. Hungarian. He DOES say to wait 4 to 6 months for the full effects of the treatment to show. Is that what explains it?"

You can see how my mind works and churns out idea after idea. It's actually quite exhausting. I wish I could turn it off, but I can't. I just can't.

So back to my meeting with Dr. Generous. There I was, on the U/S table, and Dr. Generous says to me, "Okay...1, 2, 3, 4, 5 follicles on the right ovary. And let's look at the left...oh, wow...that's a big one. Hmm...yes you've got a cyst on the left side."

FUUUUUUUUUUUUUUUUUUUCK!!!!!

After 10 days of birth control pills you would think my ovaries would have the sense to just quiet the hell down.

But no. Not MY ovaries.

Dr. Generous' brain quickly went to work. Paraphrasing...the next words out of her mouth went something like, "Maybe I'll take you off the pill. Have you trigger with HCG and then we'll add in estrace...wait...before I get carried away I'll confer with Dr. S and we'll put our head together and figure out what's best."

All I could do was lay there, my black socks in the fuzzy blue stirrups, thinking, "Shit, is this the same cyst that just won't go away?"

I sauntered back to the waiting room after my vitals were taken and waited with my mom to meet with the clinical coordinator. She called me in and proceeded to go over what the two doctors had concluded.

As it is, I'm to cease my birth control pills right away. I'll be back on Friday for another U/S to see if the cyst is large enough for a trigger. If yes, I'll trigger right away, start estrace 6 days later, and then wait for my AF to arrive. Then I'll go straight to lupron and stims. No BCPs as they're evidently useless as far as my body is concerned. If not, I guess I'll wait a day or two and then trigger. No doubt they'll want me in for another $220 U/S to make sure it's gone. Ugh. It just never ends.

We're not slated for ICSI and they want me to grow my embies to day 5 but ONLY if we have 7 or more. If we have 6 or less, we'll do day 3 transfers with assisted hatching. I'm sort of confident we'll have 7 or more so I'm a bit relieved that we'll save the additional $600 cost that is assessed for ICSI, and the $600 for AH. Every bit helps, you know? I'm also going to buy my meds on FGS unless anyone has anything spare to sell (eg, menopur, gonal-f, vivelle, estrace, etc). Shoot me an email if you have meds to sell. :-)

So, all I can say is that it sure will be interesting to see what happens with this cycle. I'm being primed with estrogen: something that hasn't been done before. Supposedly it's supposed to help with egg quality from what a friend tells me. It's not something I've researched before so I'll be up late tonight with Dr. Google trying to find out if that's true or not.

All in all, I'm feeling quite comfortable with my new slew of doctors. I hope that the honeymoon doesn't end, ever.

Two More Days

Wednesday will be the first day that I get to meet Dr. Generous in person. They've slated a 1/2 hour meeting for the two of us, an U/S, and a mock transfer. It's about an hour and 10 minute drive to their office and I was hoping to catch a ride with a friend that works nearby. Alas, it wasn't possible this trip so I'll be driving up there alone. I couldn't even sway my mother to go along with me for the day. I tried bribing her with thoughts of lunch and shopping, but it didn't work.

What else? Father's day dinner was fine. I made a lemon tart from one of the Moose*wood Cookbooks. It sounded so good: a cookie crust filled with a really tart lemon custard. The custard begins in a pot over the stove and is cooked til it's thick and is then poured into the hot prebaked pie crust. It's baked til it's golden. I think this was a mistake. The filling looked so lovely, creamy, and light right before it went into the oven. Sure it was soft, not truly set, but there's nothing wrong with that. When it came out of the oven it was lightly browned, but the top had cracks in it. It looked so much better before it was baked. Next time I'll not bake it and I'll top it with fresh berries. Yum.

So, ladies how about a brief interlude from this IF BS?

Tart Lemon Tart

Pastry:
1-1/3 C. Unbleached White Flour
7 T. Butter
Pinch Salt
1/2 t. vanilla
1/4 C. Sugar
3-4 T. Ice Water

Filling:
4 Lemons*
5 T. Butter
1/2 C. Sugar
5 Eggs, Well Beaten
1/4 t. Vanilla

1 Lemon, Sliced in Very Thin Rounds

Cut butter into small pieces. Add flour to food processor. Add butter. Pulse til it's incorporated. Mix in salt, vanilla, sugar. Add just enough ice water to bind. Press dough into 9 or 10" drop bottom tart pan. Chill 1 hour or overnight.

Preheat oven to 425.

Line chilled crust with wax paper. Put in beans or pie weights. Bake 15-20 minutes. Remove beans/weights carefully.

Lower oven to 350.

Mix lemon juice, butter, and sugar in a heavy bottomed pan and heat til just warm and butter has melted. If too hot, let cool a bit before proceeding. Pour beaten eggs slowly into hot mixture in a steady stream (note: I use a hand mixer to make sure no clumps of egg form). Whisk or mix continually. Continue to stir on low heat until mixture thickens into a custard. (If your stove can't maintain a low enough temperature, use a diffuser if you have one). Stir in vanilla.

Pour into baked crust and bake for 35 to 40 minutes or until the custard sets and the top becomes golden. (Note: You might want to skip the second bake and just put it in the refrigerator at this point to chill).

Served chilled. Top with sliced lemons (or fresh fruit!)

*4 Lemons? I wish they'd instead say, "4 ounces of freshly squeezed lemon juice" or something similar. How much juice does the average lemon yield anyways? My thoughts here is that you've got 5 eggs to bind all that lemon, quite a bit, so I don't think you can go wrong with using the biggest, baddest lemons you can get your hands on.

Perfect for summer...and guaranteed to get your mind off of your eggs if only for a fleeting moment.

Moving Right Along

I just had my telephone call with the patient care coordinator at Dr. Generous'. All I need are prolactin and varicella tests for my records to be in order. Easy enough.

I've been on the BCPs for four days and the PC Coordinator said "You'll be on the pills for two weeks total." 2 weeks? "Wow", I thought. Dr. French, Dr. Generous' colleague, said it would be three. So we've cut our time down by about 1/4 or thereabouts. Cool. Less is more for me in terms of medications. Let's keep those follicles fresh and happy.

So, next Wednesday is my big let's-wrap-this-shit-up-and-get-this-party-started day.

9:30AM - Phone call with the Clinical Coordinator
2:00PM - Phone call with the Financial Coordinator
3:00PM - 1/2 hour meeting with Dr. Generous and then a mock embryo transfer

I warned them that I might just show up in person for the Financial Coordinator chat at 2PM as I'll likely already be in the area. It feels good to get it all out of the way FAST.

Still no word on the E2 and FSH bloodwork.

I think I forgot to mention that at Sunday's U/S they found no evidence of ovarian cysts (yay!) and the doctor noted 6 follies on the right, and 5 on the left. Dr. French looked at my ovaries really fast, only spending a few seconds counting the follicles on each side, so I am really hoping that there might be one or two more in hiding in there.

But one monkey wrench may have been thrown into the mix: I just got word today that our offer on a fix-and-flip house was accepted. We promised them a two week close of escrow in our offer, so I'm going to be on stims when escrow closes, and beginning to manage a renovation when we're close to retrieval. By the time I'm in my 2WW I'm going to be up to my ears in project management crap. We don't have the signed "acceptance" of our contract in hand so the clock's not ticking just yet, but will be soon. I just hope that I can hire enough qualified people to get things started so that I don't have to stress too much about it all. My work has been quiet or, rather, absent, since December, and now that I'm finally cycling it's all hitting the fan. Why is it always like this?

In the Backseat Where it Belongs

Dr. Generous phoned today. 12:30PM PST on the nose. I love her promptness. Somehow it makes me feel she's on top of everything.

She may be on top of everything, but LabCorp clearly isn't. Although I gave them a vial or two of my blood on Sunday, it's Wednesday and the results are no where in sight. I've never had great results from LabCorp though. Even here in parts south they lose my blood, my results, my records even. Instead, I've found a safe haven in Hunter Labs. I go to the main facility where they have a draw station literally in the laboratory. No way is anyone going to lose my blood walking across the floor to the lab machinery. What's more? I nearly always get same day results. (I'd better quit before I decide to write a haiku in honor of Hunter...heh! Go ahead and laugh, but my haiku to Opera Software actually won me an award at their last anniversary!)

So tomorrow is my phone meeting with the patient care coordinator who will tell me what drugs I need to order, what my protocol will look like, some tentative dates, our fees, etcetera, etcetera. Odd how I stressed so in cycle #1. Everything was such a big deal. Now it's just "Eh!" and I mosey on with whatever it was that I was doing. IVF has finally taken a backseat to my life even though it's actually the biggest thing going on when you think about it. I like it this way.

The Bitch ReturnethA CD1 Rant

I've been gone since April and apologies to everyone for not visiting your blogs. I've had my head buried in the sand for a bit.

We adopted a beautiful siamese girl kitten, named her Gigi (as I adore Collette), and have been ignoring the elephant in the room for the time being.

But I'm back. I guess you can call it a "break" but it wasn't a total conscious decision to take a "break", per se. For anyone who's told me to take time off from the IVF merry-go-round, the last two months off were for you. Please, no matter what you hear or read from me or in my blog, please do not EVER tell me to take time off again. It does NOT help in the slightest. Waiting creates MORE STRESS pure and simple. I'm no better today than I was in January when I was ramping up for IVF #3 with Dr. Pompy. Well that's not entirely true. I'm down 23 pounds since then so I am better in that regard, alone, but I am bitchier, I have lost time when I have so little time, and now I'm on the edge of the precipice. Again: breaks do not help (me).

Speaking of the bitch (not me this time, but my uterus): AF just arrived with a bevy of cramps. Why does it always seem to do this on a Saturday when J is out of town and I can't discuss with him whether we should cycle or not? Which IVF clinic we should see? All the burning questions that are tearing at me. Do I go to Dr. Pompy's where they cycle every other week? They're close to home but God help me if I get stuck on lupron for two months again. Do I cycle with the folks north of here that continually cycle? Their stats are great and I hear such wonderful things about them.

So I made a rash decision. We're not going to see Dr. Pompy for this next cycle. I'm still peeved at him for not taking any responsibility for the 2 months of lupron reducing my follicles from 12 to 7. My confidence is shaken in him. He said my follicles diminishing was due to my age, not the lupron. I don't think I buy it. Every antral count in the last few years shows about 12 follicles. Two out of three IVFs I wound up with more eggs than my antral count predicted. The major difference between my cycle with Dr. Pompy and my first two with Dr. Moustache is that Dr. Moustache had me on lupron for a short time only.

So we're onto IVF clinic #3. What to call them without divulging their identity? My doctor of choice at this new clinic I would refer to as Dr. Generous (that's a good clue but also sounds a lot like Thalia's former doctor, who it isn't) but they work as a team so tomorrow I'll be seeing one of the "on call" doctors. Fine by me. Dr. Generous and I have only had a phone consult so I haven't yet met her in person. She assured me to just telephone her office on the arrival of my next AF to schedule a baseline U/S, which is tomorrow at 11:15AM. I'm seeing of the male doctors, a name I didn't recognize at all for this clinic. But I'm sure he's just fine. I've seen so many IVF docs in the last year and a half that I'm starting to liken them to the Borg.

So is this IVF #3 or IVF#4? I cancelled my last cycle three days before retrieval and wasted a shitload of menopur and GonalF in the process. I guess we'll call it IVF#4 just so I can keep the damned cycles straight. Honestly, I am less prepared for this cycle than any other cycle I've done. I've stopped doing just about every healthy thing I was doing before this. I'm enjoying wine as usual, drinking coffee (albeit decaf), stopped acupuncture, I'm eating meat again, I haven't been good at taking my vitamins or fish oil. The list goes on. The only thing I've been consistent about is getting in good shape and taking my aspirin & synthroid. Everything else has gone to hell in a handbasket.

I know why this is, too.

Deep down I've felt that I led the exemplary life for a year and a half and where did it get me? Not even a single BFP. Sure I had high numbers of beautiful embryos, but not a one implanted in me. So did living without alcohol and meat for all that time do a thing for me? Hundreds of dollars on acupuncture, trips to Mexico for LIT, IVIg up the wazoo. And nothing. I don't know. I guess if we go into this cycle and I wind up with a palsy three embyros, I'll kick myself from here into eternity for screwing up my embryo count. And I WILL torture myself with that. So as of today I guess I'll clean up my act once again. (I know. It takes about 4 months for recruitment of follicles and anything I do TODAY will have very little effect...allow me my madness, ok?)

I just don't know if this is a good time to cycle. But I'm just about out of time. So try I must. Over and over until I just can't stand to cycle again. I had read a study, or an article about a study, that said when women were offered free IVF, that they (on average) gave up after three cycles. Yeah. That feels just about right to me. I've done three (one cancelled days before retreival) and most days I don't know if I can do it again. Those two months of lupron with Dr. Pompy caused something to snap deep down inside me. The first two cycles I didn't have a hard time with the lupron. But this time it was a nightmare. I shudder to think that I might have to revisit that hell once again.

I am told that a friend can hire me to work at his company as his assistant, where they'll pay for IVF up to $10,000 (that might cover two IVFs actually) but the job won't start til January, when I'll have already been 43 for two months. But I know that time flies by, so I view this try as the last one I'll do out of pocket unless a windfall of cash happens between this cycle and January. So I'm going to keep my mood up as best I can and to keep an even keel on the health kick shit this time 'round as I am really wondering how much of it all is utter madness at this point.

Here goes yet another one. Please keep your fingers, and anything else you have, crossed for us.

Peace out.

Phone Consult with Dr. Generous

On Monday I had my phone consult with Dr. Generous from the clinic in the big city north of me. I had basically forgotten that she was going to be calling and was deep in my research at the county records when the call came in. I was immediately anxious that I hadn't charged my cell phone and hoped that it wouldn't cut out on us partway through our conversation.

As you may know, Dr. Generous used to work with Dr. Moustache, and so their protocols are quite similar in that they also do the MD Flare protocol, which worked fine for me the first two cycles. I explained our sordid IF history to her and recounted every offbeat therapy we've tried thus far: heparin, IVIg, lovenox, humira, the laparotomy to remove 5 fibroids/endometriomas/2 fallopian tubes/scar tissue/adhesions, two trips to Mexico for LIT and, of course, the therapy with Dr. Hungarian. She reminded me, "We do not do immune therapy here" to which my reply was "Yes, I realize that" but inside I was thinking, "But of course I'll do what I have to on my own." I think I'd still do lovenox and IVIg as they're not contraindicated in any way, shape, or form in an IVF cycle. That's not exactly true, now that I think of it. I have read many cases of heparin and lovenox causing subchorionic hemmorhages (SCH) in placentas, but that happens once pregnancy is established. So I can always ease off of the lovenox once (knock on wood) pregnancy occurs.

On the topic of my laparotomy last June, she expressed concern that if my ob/gyn (Dr. G) had used excessive cauterization in the removal of my endometriomas that it could cause permanent damage and make it so that follicles weren't able to form. Scary thought. I'll have to call Dr. G to see what she did while she was in there.

I asked her the typical "So what would you do differently question. After a bit of conversation, it was clear that she'd return me to the MD Flare protocol but would add in some femara to help with my endometriosis issues. She explained that femara can help to restore beta-3-integrins in women that are lacking them. Okay. This is good. Something new. Exactly up my alley so to speak.

I told her that I presently have a 30mm cyst on my left ovary and that my right ovary is enlarged with at least one 10mm cyst. (All measured on CD3 when things "should" be nice and quiet). She said that on CD1 I should call her office for an appointment the next day and that they'd do an U/S, and if those pesky cysts were still there that they'd just aspirate them. I do worry that Dr. Pompy said that aspirating cysts doesn't get rid of the problem of the cells that are IN the cyst in that they produce hormone. So I'm not sure that I'm yet on board here. More research is required. (And if any of you readers are up on this sort of thing, I would so appreciate hearing from you!)

One thing that I didn't expect from Dr. Generous was that she nearly immediately brought up the issue of egg donation. I told her that I was open to it, but realizing that if we went that route, it could be done at ANY time in the next 20 years. Dr. Moustache has proven that quite well. For now, I want to focus on trying with my own eggs till they've petered out completely and all hope is essentially gone. After reading the article about the doctors at Harvard that have debunked the the "theory" that us womenfolk are born with a complete set of eggs at birth, I have hope that I'll have a bit longer to try. Actually, I'm just praying that these docs will find a way to get those ovum stem cells out so that I can have a continual supply of eggs from which to try with. Of course they'd have to PGD the hell out of them to make sure that they were usable, but if I never had to go through another bout of Gonal F/menopur and retrieval it would suit me just fine.

So I'm in the typical holding pattern for the time being. I can tell I'm near ovulation, much good that does me, as I've got the typical FCM going on but it's tinged with blood so I'm concerned about infection once again. I'll probably start popping flagyl any day now and I'll add in the zithromax once we're in cycle.

So is this IVF#3 or IVF#4? We canceled ourselves just a couple days before retrieval. I guess I'll call it 4 even though we didn't make it to retrieval just for the sake of keeping cycles clear in my head, and in my blog.

I so can't believe that it's this fucking hard to get pregnant.

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Note: In the comments section a reader graciously left me a link to an article on whether aspirating functional cysts during an IVF cycle has any effect on the outcome of the cycle. Great reading. (Thank you!)