Carb City

It was a good day and a good retrieval. I only took today off so I’m just napping and resting and filling up on all the carbs I missed out on these past few weeks.

I’ll write more in the morning but everything went well and the pain is minimal. I’m just battling a violent headache. 

They retrieved 20 eggs!  I’m extremely surprised and elated. I know most of them won’t be mature but that’s a great number. I was worried that with that many eggs I would be in a bunch of pain but I’m really doing well. Right now anyway. 

One day at a time. And today was a win. 

Thank you very much everyone for keeping us in your thoughts. Thank you so very much. 

Now, if you’ll excuse me, I have to dive into a grilled cheese sandich… Maybe two. 

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A Long Overdue Update

HI!

It’s been a minute. My absence was purely due to either being insanely busy at work again or spending all my free time on the couch and I don’t think a running commentary of either was blog worthy.

But finally, movement on our side again which is great. IVF really is like sitting in traffic. You’re either completely at a standstill or you’re speeding through a cycle. There’s no happy medium. But I digress.

We had two appointments these past two weeks. One with the third urologist. Touted the best urologist this is side of the Miss’ipi (always wanted to use that line, not sure if I’m using it correctly). And the second with a new reproductive endocrinologist to get a second opinion.

When last I left off, I said that our previous RE had pretty much run out of ideas and was unwilling, at that stage, to move forward with another cycle until we got more answers and a possible second opinion. Our last cycle was a horrendous failure so we all agreed this was for the best.

Urologist:

This day was a mess. For some reason everyone in Boston was on the road and no one could get anywhere. N left the house at 5am to be at their clinic to do an SA at 7 and he was about 15 minutes late due to traffic. Our follow up would be 10:30 to discuss results. Thankfully, after the SA the nurse told him a lot of people hadn’t shown up and they’ll push our appointment to 9. So I rushed out of work at 8 (a mere 30min drive to Boston from my office) and only got to the clinic around 10!! And the doctor STILL only saw us at 10:30. geez!

Anyway, he seemed nice enough but I can’t say that I liked him very much. I won’t deny that he knows his shit though. I went into appointment with high hopes. I spoke to someone a few days prior whose husband had azoospermia and they did a TESE and got 6 vials! I was excited. I thought we’d won the world cup. Of course this wasn’t the case. The doctor was long winded in his explanations and he lost me a few times so some of this information might not be 100% accurate but this is what I got from that appointment.

  1. All the vitamins and supplements we’re taking aren’t doing anything, we’re wasting our time
  2. The Anastrozole N is taking for his count isn’t going to work. It affects a hormone that won’t increase count if that hormone is at the level it’s supposed to be (if that makes sense).
  3. TESE is not a viable option for us because there is sperm in the ejaculate. TESE is reserved for men with azoospermia or a blockage, so no sperm in the ejaculate.
  4. The sperm you have to work with is what it is. Good luck. Try a donor maybe because I see here your eggs are crap too.
  5. GTFO with your shitty sperm and eggs.

Okay so he wasn’t that harsh but it was hard to hear all my hopes get shot down one by one in an hour long conversation. The good news is that at our last retrieval they couldn’t really find anything to work with in N’s fresh sample, that’s why they used the backup sample and that day at the appointment his count was up to what it usually is. We suspect that it was the fact that he has strep throat about a month before we started the cycle but the doctor didn’t think so. I guess sperm just fluctuates and that retrieval day was a bad day. Another good thing is that N has to do another back up sample at our clinic so Dr O said he wants to get the notes of that sample and see if it’s worth using or if he should do another one. That way we’ll know that the backup sample is good if it’s ever needed again.

So that appointment sucked. It sucked a lot. I almost gave up. I didn’t speak to N much when we left and I feel bad about that but I didn’t know how to react at the time. I told all my friends and family that it’s not looking good for us. We’re not at the point where we want to consider donors yet and to have 2 doctors suggest donors was so hard. I cried a whole lot. I also felt like I was being a spoiled brat. I admire women who have gone the donor route. I think it takes courage and selflessness and I also felt like they deserved to be mom’s more because they wanted it more than anything. And here I am crying over the fact that I may never see what my husband and my children will look like. If they’ll have his light brown eyes or my curly hair. If they’ll have his laugh. If they’ll be loyal friends. Will I have to start them early in group activities to help with the shyness both of us struggle with. It was the first time I was really faced with the possibility of this dream not coming true and it scared and angered me. Having that dream slip through my fingers.

I cried most of that day during work and when I got home. I spoke to my husband and he said he didn’t think Dr O would have all the answers. He basically said that a urologist wasn’t the end all and be all. We’ve made embryos before, we can do it again. We just have to keep trying and we’re not out yet let’s see what the new RE says.

Over the next few days I was torn between putting all my hope in this new RE and thinking of what life will be like as a childless couple. When the appointment rolled around I was a mess with nerves. When we sat down he said that he wanted to go over our history and discuss some options and just the way he said it my heart sink. I thought this is it. I’ll never get to meet our biological children.

Reproductive Endocrinologist Second Opinion:

The appointment was at our regular clinic just with a new doctor. I kept seeing pictures of our previous RE and had to laugh at my misplaced guilt. I couldn’t look the pictures in the eye.

Dr P… I couldn’t get a read on him. He barely cracked a smile during the entire consult and I prefer that people at least smile when I deliver my funniest one liners. But nothing. He was soft spoken and spoke kindly and explained everything perfectly. So while he was very serious, he was everything you would need in a doctor. I often say that I don’t need a doctor to have good bedside manner as long as he got the job done I was a little bummed that her never smiled. I know this is crazy but I kept thinking that he was judging us for jumping ship with our old RE. Of course this isn’t the case based on what he was saying. Let me get right into it. There’s a lot of information and I forgot to write everything down.

  1. He is on board with vitamins and supplements and even wants us to increase Ubiquinol as it could help with embryo quality. This is huge to me and N. I know these things maybe probably don’t affect quality/quantity but I really don’t like when doctors dismiss them completely. It just bothers me.
  2. The fact that we’ve had 2 normal embryos in 4 cycles is pretty awesome considering our diagnosis. And we’ve made embryos before, we could likely do it again (note hubby’s words above)
  3. The fact that 2 normal PGD tested embryos (that have a 70% chance of attaching) had no implantation is a little baffling to him and it could be one of 3 things. 1. The labs effed up. 2. Something wasn’t picked up in the genetic screening. 3. something is up with my uterus.
  4. points 1 and 2 are unlikely since it happened twice. At least one of those embryos should have attached. So he’s interested in my uterus. I’ve had 2 HSG’s and 1 endo biopsy and everything is normal. So his next likely suspect is Progesterone. Dr G used vaginal progesterone which he thinks isn’t sufficient so he wants to try the PIO shots (Yay!). He also wants to know if maybe the amount of days I’m taking the progesterone is enough. Typically, you’re given about 15 days of progesterone and sometimes for some women that’s either too much or too little. To find out the answer to this question we’re going to do and ERA test (double yay!)
  5. You can find out about an ERA test here. But just a quick rundown. After our next retrieval cycle we’ll do a mock FET cycle with meds and then instead of a transfer we’ll do an endometrial biopsy (yuck!) and send the sample off to the lab in Spain. If it comes back “normal” then perhaps that means the PIO shots are working. If it comes back pre-receptive then we’ll add a day of Progesterone when we do the next transfer. Now from what I’ve read it sounds like you have to keep doing this test until you get a “normal” result. Dr P said we would only do it once and go from there. It makes sense and I really don’t want to keep paying for a test if we don’t have to because it’s not covered by insurance and will run us around $800-$1000. But yes we are on board and ready to go!
  6. I can’t remember if I have this right but I think he said that if the test comes back pre-receptive then we’ll add another day of PIO but if it comes back normal and we have 2 embryos to transfer, he will consider transferring 2. They typically do not transfer more than one PGD normal embryo but he thinks this could be an option.
  7. He doesn’t want me to do a lap to rule out endo. All these doctors seem to think that I am endo free. I was going to fight him on it but he said that there aren’t enough studies out there that say that removing endo will get you better quality eggs. I guess it depends who you ask but I won’t push the issue. He also said that since I’ve had 2 surgeries in that area (appendectomy and ovarian cystectomy), the doctors would have said something if they’d seen something. Granted there’s a chanced they didn’t see anything if they weren’t looking, but my cystectomy was a full laparotomy so I was completely opened up, it’s unlikely that surgeon missed any endo. I could of course go and search for those surgery reports to find out but I’m not sure it’s worth it and the surgeon who did my cystectomy has since passed away and those records are in South Africa somewhere. That would be a mission. So we’ll put a pin in this one for now.
  8. I did ask (and I’m so proud of me for asking everything) if whether he thought that foregoing PGD testing was a good idea. My reasoning being that we have so few embryos and I read one lonely article that said that some embryos self-correct and it made sense to just transfer what you have and pray for the best. He said that since we have a balanced translocation that most affected embryos would end in miscarriage and he wouldn’t want me to go through a miscarriage and also some miscarriages are more dangerous than others. So fine, that makes sense. I just thought I’d ask.
  9. If we get insurance consent in the next two weeks (fingers crossed) we can start our next cycle. We’re going to go back on the antagonist protocol with 300 Gonal-f and 150 Menopur. He said I respond well with this mix. And I think on this cycle we got 11 eggs and all of them fertilized. I’ll have to check my notes.
  10. His nurse is great I love her already but I’m so very sad to be leaving my nurse. Like really extremely sad. I never realized how important these people become.
  11. I have to come to terms with the fact that we are not ever going to have more than 3 embryos to test. He sounds like that’s the nature of the game with our diagnosis. It’s not great but it is what it is. I have been distraught because we start with double digits in egg counts and then have 3 or less measly embryos. I think if I just focus on a goal of 3 and make sure that I stay healthy to try and get the best 3 that there ever were, then we’ll be okay. Actually 3 to test isn’t a goal to focus on. I need to focus on 1 healthy normal embryo. I’m going to work hard for 1 healthy normal baby. That I can do.

Final thoughts:

A really good IVF friend recommended Dr P. She actually pushed me so hard despite my best efforts to resist change. I will forever be grateful to her for pushing. We both liked him a lot and I’m back to dreaming about who our children will look and be like. I’m beyond excited to start again. I just did the math and if everything goes swimmingly we will only be transferring around April (yikes!) which feels like forever away but at least things will be happening and balls will be rolling. I’m also scared. Knowing that our embryo yield isn’t going to be fantastic scares me. We only have 3 rounds left on insurance so we’re getting to do or die time. That thought is scary. But for now, excitement is winning.

This post was really long but I had a lot to cover. Thanks for reading if you made it this far. I hope to not go into radio silence again until we actually do start again. Maybe I’ll do something exciting this weekend.

Until we meet again,

XX

IVF Season 4: Episode 12-13

Date: 8.1 – 8.3

Starring: 10 units microdose lupron twice a day, 0.5mg tablet dexamethasone, 200iu Gonal-F twice a day, 5000iu HCG Trigger.

Produced by: 14 follicles (12 on left, 2 on right): Left – 20, 18, 16, 15.5 x2, 15 x5 ,13.5 ,12.5 and a few <11; Right – 14, 13 and a few <11. Estrogen at 3912 on day 13 and 4552 on day 14 (Yikes!).

Directed by: Oh so much nausea and crazy period cramps.

Synopsis: So things have been rough since I last updated. Rough but good, if that’s even possible. It all started when I woke up rudely yesterday morning at 5:45am! I missed my alarm!! My appointment was at 6:30 an hour’s drive away! I was in stupor trying to gather my thoughts and scramble to get dressed and come to terms with being late for everything. I had to lay my head down for a second because I extremely frazzled and just had to wrap my mind around having overslept. I looked at my phone again and blinked a few times and then realized that I was looking at the South African time, 6 hours ahead. The mixture of anger and relief I felt messed me up for the rest of the day. I even gave myself some serious heartburn and couldn’t fall back to sleep for at least an hour. (Side note: This is not the first time that this has happened btw. I should probably change that clock)

Thankfully, I made the appointment with time to spare. I got the funny chatty super quick tech. She went really quickly, as usual, and I couldn’t keep up with her measurements. She lost me at 8 on the left so I really thought that I’d lost follicles so I was pretty down all day. I’m still in shock that she managed to measure those 12 on the left at that lightning speed. She’s the best.

I got the call in the evening that I was to not do any Gonal-F and just the 10units of microdose lupron that night. Then this morning I had to take the 10 units of microdose lupron, 200iu of Gonal-F and 1 Dexamethasone tablet before my blood draw. My estrogen was at 3912 which is the highest it’s ever been. The dizziness and nausea are still ever present and I’ve also been having bad period cramps but according to Instagram it’s all normal.

Aside from being very sick my spirits have been better since my last post. Not even bleeding all over myself after this morning’s blood draw could get me down (I guess she missed the mark with the gauze). That was a lot of blood.

So today I was prescribed another tablet, Cabergoline. This is supposed to help prevent OHSS. I’m supposed to take it tonight at bed time. My estrogen today is at 4552 so I have to take all the necessary precautions. I also bought all the electrolyte drinks and protein bars and shakes.

We did the trigger shot at 7pm and retrieval is set for 8am on Friday. Whenever I’m at the end of a cycle I think that it’s really flown by but I know that just a day or 2 ago I was crying for it to be over.

I’m not going to lie, I’m nervous as hell. I want a good number of eggs but I want to be realistic too. I keep repeating “quality over quantity” to myself just to center myself and be realistic.

It’s been a good cycle, I think, but the best part was having N do the trigger shot and the moment we shared at the end of it. I love him so much. I wouldn’t want to do this with anyone else.

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Please don’t fuck me over

 

IVF Season 4: Episode 9-11

Date: 7.29 – 7.31

Starring: 10 units microdose lupron twice a day, 0.5mg tablet dexamethasone, 225iu Gonal-F twice a day

Produced by: 12 follicles (10 on L, 2 on R) ranging from 11 – 15 mm. Estrogen at 2100 on day 11.

Directed by: Oh so much nausea.

Synopsis: I can’t tell if these counts are good or not. My retrieval is supposedly set for Thursday which means only 2 more days of stimming and I don’t think that’s enough time to get more follicles to grow. And he wants me to drop the Gonal-F to 200 now as well. Don’t know if that’s good or not. I’ve definitely hit the mid-cycle bump. Not feeling very confident right now as I’m writing this. It’s because I’m comparing cycles (comparison truly is the thief of joy).

I go back on Tuesday. There’s really nothing else I can do except wait and chat to my eggs. Especially my right ovary. She’s making it so hard. *sigh*

At least birthday month starts tomorrow! I have plans for almost every weekend which is fantastic and I have 2 vaca days that I have to use before the end of the month. Groupon Getaways here I come! Just have to get through this week.

I’ll leave you with a pic of my left ovary. I think it’s cute that it looks like a fist. I can’t almost hear is shouting “follicle power!”. I’m proud of you lefty, thanks for carrying the team.

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Best enjoyed with: Bacon, egg, avocado and a mushroom for breakfast and we’ll be having salmon and

Outtakes:
PSA

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IVF Season 4: Prologue

So here we go again. My parents left yesterday. Thankfully I have a busy cycle ahead of me to keep me busy. The house is really quiet. I can’t stand it. I have to write down what’s going to happen this cycle before I forget and mess it all up.
July 11 – 18: Took 1 active birth control pill daily
July 19: Supression check. All clear. Estradiol < 5. Progesterone = 0.251.
July 19: Meds arrived – 1 Vial Microdose Lupron, to be refridgerated. 3 x 900iu Gonal-F pens, to be refridgerated, 20 dexamethasone tablets, 1 vial of HCG trigger, syringes, sharps container, alcohol pads.
July 20: Spend the day Googling Micro-dose Lupron protocol. Get excited about prospects. Get anxiety attacks about possible outcomes. Slowly start to fall apart. Try like hell to pull self together. Breathe.
July 21 – 23: Begin Stimulation – 10 units Microdose lupron AM and PM, 2.5mg tablet dexamethasone
July 24 – 28: 10 units Microdose lupron AM and PM, 2.5mg tablet dexamethasone, 225iu Gonal-F AM and PM.
July 28: First monitoring appointment, await further instructions.
August 4: Tentative egg retrieval!!
So, from what I’ve been Googling, it sounds like this protocol is given to women with diminished ovarian reserve or who don’t respond well to stims and while I’m seeing better results, I’m not seeing huge yields of eggs. But again women are going from 2-3 eggs to 5-7, which is slightly better. My RE said he wants a lot of eggs from me and I’m averaging 12 eggs per cycle and, honestly, if I get 15 I’ll be happy.
My biggest concern is quality. I read that dexamethasone can help with quality so that is making me feel better but I’m doing what I can for the most part. I am currently suffering through separators between my teeth in preparation for the braces on Friday. They are torture and I can only eat soft food. The other night I had custard and a protein shake for dinner and tonight I had egg salad and jello. So my diet isn’t the best but I’m not drinking so I’ll take that as a win.
I was also having trouble deciding what time to take shots. They said to space it out 12hrs. I decided on 6am and pm because I have to take the morning shot before monitoring  appointments which I do at 6:30. It’s good because then I don’t have to take shots in the bathroom at work but bad because if we ever go out I’ll be taking shots in public places again. It’s just 2 weekends of shots, I can do this.
I’m excited to start tomorrow. But I’m more excited to get these damned separators out of my mouth.
Ready, set, go!

Refreshed! Relaxed! Ready!

Another round of IVF is upon us! But first, a big congrats to all the BFP’s I’ve missed, big hugs to everyone else still struggling and a big hello to everyone who’s reading this :). I felt some guilt for disappearing and not being able to be supportive. But I have to remember that these breaks are important and you can’t give your all to anyone when you don’t have anything to give. So I switched off and put my feet up and prepared for a relaxing month and a half off… or so I thought.

The first 3 weeks were a nightmare. A nightmare. I had a huge work deadline this last term that became suddenly life or death in the last three weeks. I was had to teach myself how to finish the project in new software and we ended up having to restart a few times, abandoning all our best laid plans. I hardly slept stressing about the project and the last week, I worked 16 hour days for 7 days straight. A  nightmare. Now, my poor husband works 14 to 16 hour days for 6 days a week so in actuality it was an eye opening experience for me. I’m definitely going to be less “complainy” with him. I don’t know how he does it. I was a whiny little b*tch those last couple of days.

Thankfully the nightmare ended with a long weekend. We planned a quick Groupon weekend getaway about an hour out of town. We did some hiking and eating and drinking. It was much needed because when we got back my parents landed in the country. They’re here for the month. It’s really good having them here and I was able to take all of last week off to do some touristy stuff. We did Newport, Boston and a few others here and there. This weekend we’re going to New Hampshire and their last weekend we’re going to Martha’s vineyard and then they leave :(. They’ll have been here for a month but it feels like it’s flying by.

And amidst all of this, my best friend gave birth to her second son. He’s so cute! I love his fat cheeks! And Game of Thrones wrapped up their most incredible season to date. I get goosebumps just thinking about it. I’m in a GoT discussion group (don’t judge!) on whatsapp and we’ve all decided to start from season 1 to keep us going until season 7.

And so… here we are… IVF Season 4. I just got the call to start birth control this evening. We still have 2 weeks before stims start but here’s my tentative timeline for this cycle.

July 17th: Stop birth control pill
July 18th: Suppression Check/Baseline appointment
July 20th: Begin Lupron
July 26th: Begin Gonal F 225 iu
August 5th: Retrieval with PICSI

Phew, just writing that is making me excited. August is my birthday month and so far has consistently been the best month of every year for as long as I can remember. I’m putting it into the universe that this trend will continue. When I turn 35 I will be celebrating our awesome results. It’s going to be a great cycle, my friends!

It’s good to be back.

 

Today Was a Good Day

I’m having a good day today. In case the title of the post wasn’t clear.

First, food. The school’s culinary department has a healthy eating program. For $50 you get 3 meals a day and a snack for 5 days. So I ordered 2 for both of us and the order came in today. This may seem like nothing but food makes me excited. Especially when I didn’t cook it. I love cooking but I love eating more and I was really excited about this week’s menu. scallops Mozambique with cauliflower rice. vegetarian lo mein with asian bbq chicken and caprese stuffed chicken breasts with roasted broccoli for the dinners. Even writing this is making me excited.

Second, PICSI. The RE called this morning to tell me that he had a meeting with the embryology department and they’re going to do everything they can for us to do PICSI our next round. He said that he can’t guarantee that things will be ready in time but I told him that we decided to start in July so he sounded more positive. I guess they need specialized equipment and a specialist to come in and help them. I’m so excited! I know that PICSI isn’t going to be the missing puzzle piece but I’m just happy that Dr G is going the extra mile.

Third, and most importantly, insurance. You guessed it. After 5 months of fighting to get my claim reimbursed, these punks finally approved my claim and I should get my money in a few weeks. Granted I had to throw a tantrum on the phone because the guy told me the claim was denied. But damn it, they approved! I really hate raising my voice and I was very shaken up after the phone call but I’m glad I did and I’m glad it’s sorted out. I just sent in my second claim yesterday but hopefully this won’t be as big of a nightmare since I know exactly what to send in now.

Bonus fourth. It’s pay day tomorrow!!!

This upcoming weekend is going to be hard. Saturday, my father-in-law’s memorial service and Sunday, Mimi’s baby shower (I deleted the post I wrote about her but maybe some of you will remember). I hear there’s going to be a bar at the shower so that’ll help. I know I am not obligated to go but I’ve been in a good head space wrt pregnancies and stuff and I’ll get to see some other friends who I miss so I don’t think it will be bad.

I’m glad to be able to share some good news from my camp with you guys. I know it hasn’t been sunshine and roses over here but that’s how this journey goes right?

I’m about to go dig into one my dinners. No, I think I’m going to make grilled cheese and a glass of wine wile Ice Cube breaks it down for me.

xxx