I don't know why, but reaching the 6 week mark feels like a milestone.
The second beta was 224, and estrogen and progesterone levels looked good. I was able to cut back from daily progesterone to weekly, and stop taking estrace.
My parents and immediate family are thrilled. I haven't told many other people yet - just a few who knew we were doing IVF. I plan on waiting until the end of 1st tri before going public with the news.
Symptoms so far: insomnia, fatigue, sore abs, sore breasts, bloat, constipation. I really haven't had much to complain about yet, except the insomnia which is so frustrating.
Looking forward to our first u/s next Monday!
Tuesday, December 22, 2009
Wednesday, December 9, 2009
Beta #1
My first beta was yesterday. The pain of being stuck four (yes, four!) times (my veins suck) was completely made up for when the doctor called later that afternoon. Beta is 84 - I am pregnant!
It is just starting to sink in - I keep having to remind myself that it's true. J said something to me early this morning and the last part of the sentence was "..now that you're pregnant," and it just sounded so strange!
I have almost no symptoms - slight sore breasts, which is probably as much from the progesterone injections as anything, and my abs are a little sore. A few cramps and twinges here and there, but nothing noticably different from early menstrual cramps.
Of course, we are both feeling somewhat cautious - I have the second beta tomorrow, and I'm not sure I will really relax until the first ultrasound three weeks from now. But for today, I am pregnant.
It is just starting to sink in - I keep having to remind myself that it's true. J said something to me early this morning and the last part of the sentence was "..now that you're pregnant," and it just sounded so strange!
I have almost no symptoms - slight sore breasts, which is probably as much from the progesterone injections as anything, and my abs are a little sore. A few cramps and twinges here and there, but nothing noticably different from early menstrual cramps.
Of course, we are both feeling somewhat cautious - I have the second beta tomorrow, and I'm not sure I will really relax until the first ultrasound three weeks from now. But for today, I am pregnant.
Monday, December 7, 2009
Fert Report, ET, 2WW
I have been negligent in keeping up this blog - sorry!
The ER went well on Nov. 24. They retrieved 10 eggs, 9 of which were mature, and 7 of which fertilized normally. The RE was very happy with this outcome. I recovered well from the procedure with no complications.
At 3dpER we got an update. The RE said our embryos looked "spectacular." We had 4 at 8-9 cells, grade 1-2. The others were developing more slowly. But things were looking good and we were on for ET on day 5.
I went for acupuncture the morning of ET. While I was waiting for the acupuncturist to arrive, the RE called and gave me an update. The embryos had slowed in growth and weren't as far along as they would have liked. We had one early-blast, one morula, and some stragglers. At that time she wasn't sure if we would do the ET that day or wait until day 6. Ugh! Talk about nerve racking. The ET was scheduled for 11 and we needed to leave by 10, so the RE said she would call back at 10.
At 10:15 we got the call. The embryos had progressed enough in that 2 hour span such that the embryologist and RE both felt the ET should be that day. So we hustled into the car and I started drinking water with a purpose.
We didn't wait long before they took us back. The nurse checked my bladder and said it wasn't full enough. I explained that I had just finished drinking my water, that I had started late since we weren't sure it was going to happen. But she forced me to drink another 12 oz on top of the 30 oz I had just finished. I was not happy.
By the time the RE arrived to check me, my bladder was TOO full and I had to let some out. This happened twice, and I blame the nurse. I was so not happy and couldn't concentrate well on anything the RE was trying to tell us about our embryos.
In the end, although I had hoped to transfer just one excellent embryo, we ended up transferring two that were "ok." One was a blast and one was just between morula and early blast. It made me nervous because I'm not trying for multiples. But it seemed like the best thing to do and was recommended by the RE. J was fine with it. I think I was the only one with hesitation.
The next day I got a call from my regular RE (it's a group practice so he didn't do my ET). First, he reassured me that he agreed with the decision to transfer two embryos. Then he gave me the bad news that none of the remaining embryos had made it to freeze. I was crushed. I had fully expected we would have at least a couple to freeze. FET was our backup plan if this doesn't work. But it wasn't meant to be.
It's been a rough several days for me since the ET. I was was really focused on not freezing any embryos for the first few days, and I was pretty down. But then life got a bit busier and I got more distance, and now I've mostly accepted it. I've been trying to focus on the two embryos we DID transfer. As J said the day after ET, "We are farther along than we've ever been before. We know there are two embryos in your uterus right now." And he's right. For now.
Tomorrow is my beta. I have managed to hold out and not POAS. I decided it would make me crazier no matter what the outcome. Besides, my clinic does betas at 14 dp ER, so it's really not that long of a wait. Fingers and toes crossed!
The ER went well on Nov. 24. They retrieved 10 eggs, 9 of which were mature, and 7 of which fertilized normally. The RE was very happy with this outcome. I recovered well from the procedure with no complications.
At 3dpER we got an update. The RE said our embryos looked "spectacular." We had 4 at 8-9 cells, grade 1-2. The others were developing more slowly. But things were looking good and we were on for ET on day 5.
I went for acupuncture the morning of ET. While I was waiting for the acupuncturist to arrive, the RE called and gave me an update. The embryos had slowed in growth and weren't as far along as they would have liked. We had one early-blast, one morula, and some stragglers. At that time she wasn't sure if we would do the ET that day or wait until day 6. Ugh! Talk about nerve racking. The ET was scheduled for 11 and we needed to leave by 10, so the RE said she would call back at 10.
At 10:15 we got the call. The embryos had progressed enough in that 2 hour span such that the embryologist and RE both felt the ET should be that day. So we hustled into the car and I started drinking water with a purpose.
We didn't wait long before they took us back. The nurse checked my bladder and said it wasn't full enough. I explained that I had just finished drinking my water, that I had started late since we weren't sure it was going to happen. But she forced me to drink another 12 oz on top of the 30 oz I had just finished. I was not happy.
By the time the RE arrived to check me, my bladder was TOO full and I had to let some out. This happened twice, and I blame the nurse. I was so not happy and couldn't concentrate well on anything the RE was trying to tell us about our embryos.
In the end, although I had hoped to transfer just one excellent embryo, we ended up transferring two that were "ok." One was a blast and one was just between morula and early blast. It made me nervous because I'm not trying for multiples. But it seemed like the best thing to do and was recommended by the RE. J was fine with it. I think I was the only one with hesitation.
The next day I got a call from my regular RE (it's a group practice so he didn't do my ET). First, he reassured me that he agreed with the decision to transfer two embryos. Then he gave me the bad news that none of the remaining embryos had made it to freeze. I was crushed. I had fully expected we would have at least a couple to freeze. FET was our backup plan if this doesn't work. But it wasn't meant to be.
It's been a rough several days for me since the ET. I was was really focused on not freezing any embryos for the first few days, and I was pretty down. But then life got a bit busier and I got more distance, and now I've mostly accepted it. I've been trying to focus on the two embryos we DID transfer. As J said the day after ET, "We are farther along than we've ever been before. We know there are two embryos in your uterus right now." And he's right. For now.
Tomorrow is my beta. I have managed to hold out and not POAS. I decided it would make me crazier no matter what the outcome. Besides, my clinic does betas at 14 dp ER, so it's really not that long of a wait. Fingers and toes crossed!
Monday, November 23, 2009
ER is on!
At my appointment yesterday, the tech told me I needed to have at least 5 follies over 18mm to be ready to trigger. She found 6!
I triggered last night at 7pm. We have to be at the office at 6:15am - and it's 45 minutes away. Good thing J is a morning person.
I triggered last night at 7pm. We have to be at the office at 6:15am - and it's 45 minutes away. Good thing J is a morning person.
Friday, November 20, 2009
Movin' right along
Yesterday I had my second monitoring appointment since starting the stims. I am on day 8 of stims and so far the side effects have been pretty minimal - minor headaches (though they may have been unrelated), feeling crampy/achy, moodiness. No significant bloating yet, but I'm expecting it. Things are progressing well - 17 follicles, 10 large enough to potentially have mature eggs. I started the Ganerelix last night, in addition to the Gonal-F and Menapur.
It looks like my retrieval will be pushed up by a day or even two, so I will trigger either Saturday or Sunday night. I go in tomorrow for another monitoring appointment.
It really feels like this is whooshing by so quickly!
It looks like my retrieval will be pushed up by a day or even two, so I will trigger either Saturday or Sunday night. I go in tomorrow for another monitoring appointment.
It really feels like this is whooshing by so quickly!
Tuesday, November 10, 2009
Oodles and oodles of drugs, oh my!
I woke up with a sore throat and a fever this morning, so I stayed home from work. Unfortunately I still had to drive nearly there and back anyway to pick up the shipment of IVF drugs from the FedEx location I'd had them shipped to - ironically, to be convenient to pick up from work.
After downing two cups of lemon tea with honey and two bowls of soup, the pooch and I took a drive. She was such good company. I swear, there is almost nothing as comforting as my dog by my side.
So, this is what I picked up:
I am doing an antagonist protocol. I start with Gonal-F, Menopur, and Femara for the first five days. After that I continue with the Gonal-F and Menopur, adjusting the dose as needed based on my monitoring visits.
My last BCP was Sunday night. Monday morning I had my baseline ultrasound and bloodwork. My nurse called in the afternoon to tell me that everything looked ok and that I can start the stims on Friday as scheduled.
I am excited and nervous. Especially nervous about the PIO injections that J will have to give me. But that is several days down the road. For now, I just need to focus on the first injection, which shouldn't be too bad. One thing at a time.
After downing two cups of lemon tea with honey and two bowls of soup, the pooch and I took a drive. She was such good company. I swear, there is almost nothing as comforting as my dog by my side.
So, this is what I picked up:
I am doing an antagonist protocol. I start with Gonal-F, Menopur, and Femara for the first five days. After that I continue with the Gonal-F and Menopur, adjusting the dose as needed based on my monitoring visits.
My last BCP was Sunday night. Monday morning I had my baseline ultrasound and bloodwork. My nurse called in the afternoon to tell me that everything looked ok and that I can start the stims on Friday as scheduled.
I am excited and nervous. Especially nervous about the PIO injections that J will have to give me. But that is several days down the road. For now, I just need to focus on the first injection, which shouldn't be too bad. One thing at a time.
Monday, October 26, 2009
And the winner is...
We’ve decided on IVF.
It really wasn’t a hard decision. J’s 4th SA results came back with no new issues preventing us from doing IUI (good count & motility, morph at 8.5 but at a less strict lab, good survival and motility after 24 hr incubation). But after considering all the factors, IVF felt like the right choice.
It’s been a bit of a whirlwind ever since I told the nurse our decision. I went in today for more blood work and a mock transfer, which really wasn’t bad at all. I have a tentative schedule for the beginning of the cycle:
Nov. 4 – Class for J and me – drug injections, etc, more b/w for J
Nov. 8 – last BCP
Nov. 12 – baseline u/s
Nov. 13 – Start FSH
From what I can tell we’re doing an antagonist protocol. I am set up with the pharmacy – they called and read off the list of medications. Wow. Just wow. I knew it would be a lot but I really didn’t expect such a long list. As soon as we are ready to start meds I will call and they will ship them overnight. I should be getting a more formal calendar from the nurse later this week. And kicking it all off is our trip to CT & NYC – J is already in CT, and I fly out on a red-eye on Wednesday night. Yippee!
It really wasn’t a hard decision. J’s 4th SA results came back with no new issues preventing us from doing IUI (good count & motility, morph at 8.5 but at a less strict lab, good survival and motility after 24 hr incubation). But after considering all the factors, IVF felt like the right choice.
It’s been a bit of a whirlwind ever since I told the nurse our decision. I went in today for more blood work and a mock transfer, which really wasn’t bad at all. I have a tentative schedule for the beginning of the cycle:
Nov. 4 – Class for J and me – drug injections, etc, more b/w for J
Nov. 8 – last BCP
Nov. 12 – baseline u/s
Nov. 13 – Start FSH
From what I can tell we’re doing an antagonist protocol. I am set up with the pharmacy – they called and read off the list of medications. Wow. Just wow. I knew it would be a lot but I really didn’t expect such a long list. As soon as we are ready to start meds I will call and they will ship them overnight. I should be getting a more formal calendar from the nurse later this week. And kicking it all off is our trip to CT & NYC – J is already in CT, and I fly out on a red-eye on Wednesday night. Yippee!
Friday, October 16, 2009
The New RE
The appointment got switched from Tuesday to Wednesday, and J was able to come after all (yay!). We spent about an hour talking with Dr. S. These are the stats he gave us:
Approximate chances of conceiving in a given cycle:
Normal healthy couple - 20%
Clomid/IUI – 10%
Injectables/IUI – 15%
IVF (2 embryos transferred) – 40-50%
IVF (1 embryo transferred) - 35%
FET – 40%
Us, naturally – 2-5%
It’s not hard to see why one would choose IVF, all else being equal. But, you have to consider the cost and the medications and invasiveness of that procedure as well. We are extremely lucky in having significant insurance coverage for infertility. Which means it’s a lot easier to think about going straight to IVF.
It might seem like I’ve jumped from considering trying naturally to IUI to IVF very quickly. But I’ve known that IVF might be in my future since my first laparoscopy in 2007. And since there is a medical motivation to get pregnant as quickly as possible (to minimize the recurrence of my endometriosis), IVF is becoming more and more appealing.
We haven’t made a final decision. J is having one more SA done, this time with testing of motility and survival after 24hr incubation. Dr. S says this will tell us if IUI is even worth considering. In the meantime, I’m staying on BCP. He also gave us some literature about the risks of multiples. I was happy about that, because I haven’t been able to convince J on my own that twins really aren’t the goal. Given my age (relatively young, for IVF), we may decide to transfer just 1 instead of 2 embryos. But we’ll cross that bridge when we come to it.
The second part of the appointment was an internal ultrasound. Dr. S said things looked pretty quiet around my ovaries, which is good, and not unexpected because of the BCP.
So now, I go on my work trip, and a few days after that I fly to the east coast and meet up with J. We’ll visit his family and then spend a few days of R&R in NYC.
Approximate chances of conceiving in a given cycle:
Normal healthy couple - 20%
Clomid/IUI – 10%
Injectables/IUI – 15%
IVF (2 embryos transferred) – 40-50%
IVF (1 embryo transferred) - 35%
FET – 40%
Us, naturally – 2-5%
It’s not hard to see why one would choose IVF, all else being equal. But, you have to consider the cost and the medications and invasiveness of that procedure as well. We are extremely lucky in having significant insurance coverage for infertility. Which means it’s a lot easier to think about going straight to IVF.
It might seem like I’ve jumped from considering trying naturally to IUI to IVF very quickly. But I’ve known that IVF might be in my future since my first laparoscopy in 2007. And since there is a medical motivation to get pregnant as quickly as possible (to minimize the recurrence of my endometriosis), IVF is becoming more and more appealing.
We haven’t made a final decision. J is having one more SA done, this time with testing of motility and survival after 24hr incubation. Dr. S says this will tell us if IUI is even worth considering. In the meantime, I’m staying on BCP. He also gave us some literature about the risks of multiples. I was happy about that, because I haven’t been able to convince J on my own that twins really aren’t the goal. Given my age (relatively young, for IVF), we may decide to transfer just 1 instead of 2 embryos. But we’ll cross that bridge when we come to it.
The second part of the appointment was an internal ultrasound. Dr. S said things looked pretty quiet around my ovaries, which is good, and not unexpected because of the BCP.
So now, I go on my work trip, and a few days after that I fly to the east coast and meet up with J. We’ll visit his family and then spend a few days of R&R in NYC.
Thursday, October 8, 2009
No easy road
IUI.
That's what my RE is recommending. We could try naturally, but she feels IUI offers better odds. IVF is an option but is much more expensive and invasive. Given that I have *maybe* a 6 month window before the endometriosis is back at unpleasant and unhelpful levels, it makes sense for us to up our chances, even though it means giving up the dream of conceiving naturally.
Don't get me wrong, I am not opposed to IUI or IVF. I will do what I have to in order to have a child. But both J and I would love to get pregnant without additional intervention. We like the idea of not having to schedule more appointments, take medications, undergo procedures. We like the "easy" road. Who wouldn't?
But of course, life can't always be easy. So, I've scheduled a consultation at another clinic with another RE. Since J's insurance covers at a higher level if we go to clinics designated as "Centers of Excellence," and since my current RE happens to not be at one of these locations, I'm doing my due dilgence and exploring our options. I love my RE, but if we go through several IUI or IVF rounds, every penny will count, since the insurance coverage does have a limit.
So, more paperwork, more phone calls, more time missed from work. I couldn't convince J to go to this appointment with me (well, really, I scheduled it before checking with him and it was incompatible with his schedule. But I offered to reschedule and he woudn't hear of it). He trusts me completely and doesn't feel the need to be there. Truth be told, I wish he wanted to come. But I know he wants a baby and I know he loves me, so really, why push it?
That's what my RE is recommending. We could try naturally, but she feels IUI offers better odds. IVF is an option but is much more expensive and invasive. Given that I have *maybe* a 6 month window before the endometriosis is back at unpleasant and unhelpful levels, it makes sense for us to up our chances, even though it means giving up the dream of conceiving naturally.
Don't get me wrong, I am not opposed to IUI or IVF. I will do what I have to in order to have a child. But both J and I would love to get pregnant without additional intervention. We like the idea of not having to schedule more appointments, take medications, undergo procedures. We like the "easy" road. Who wouldn't?
But of course, life can't always be easy. So, I've scheduled a consultation at another clinic with another RE. Since J's insurance covers at a higher level if we go to clinics designated as "Centers of Excellence," and since my current RE happens to not be at one of these locations, I'm doing my due dilgence and exploring our options. I love my RE, but if we go through several IUI or IVF rounds, every penny will count, since the insurance coverage does have a limit.
So, more paperwork, more phone calls, more time missed from work. I couldn't convince J to go to this appointment with me (well, really, I scheduled it before checking with him and it was incompatible with his schedule. But I offered to reschedule and he woudn't hear of it). He trusts me completely and doesn't feel the need to be there. Truth be told, I wish he wanted to come. But I know he wants a baby and I know he loves me, so really, why push it?
Thursday, October 1, 2009
Post-surgery recap
It was a very long week. It started on Weds, Sep. 23 with bowel prep. I’ll leave out the gory details, but the short story is that I had to drink a gallon (literally!) of Go-lytely solution, and it is quite possibly one of the nastiest things I’ve ever had to consume. I followed the instructions of the pharmacist (8 oz every 10 min.) and finished in about 3 hours or so. Not fun, not fun at all. But as it turns out, it was good that I was able to do it.
For the rest of the day I was on a liquid diet, and of course, no food or water after midnight. I was very jealous of J’s yummy-looking dinner. I had my last glass of sports drink around 10 pm.
My mom arrived around 9:30 on Thursday, and we visited for a bit before leaving for the surgecenter. All the prep went smoothly – I answered the same questions over and over about the surgery and my history to the very nice male nurse, my RE, and the anesthesiologist. I think they wheeled me in around 1 pm. I was already hooked up to the IV, and within minutes they had me on the table, arms out, stockings on my legs. I was feeling lightheaded right away, and the anesthesiologist told me he’d started my meds. My RE was with me, I told her my mouth felt tingly and she confirmed with the anesthesiologist that it was a normal effect from the drugs. That’s really the last thing I remember before waking up in recovery. I woke up feeling nauseated, in pain, and very cold. The nurses gave me something to help with the nausea and pain, and plenty of warm blankets.
My RE spoke with J and my mom about the surgery. It apparently went well, as these things go. They removed what endo they could, drained the ovarian cyst, and resected the left tube. I *think* they may have drained the tube, but I don’t remember for sure. They did a D & C – I’m not sure if there was a problem with the uterine lining to cause this. Part of my bowel is adhered to the back of my uterus. My mom thinks this was observed during the first lap, and she may be right, but I didn’t remember it. The key point there was that it shouldn’t have any negative effect on pregnancy. But my bowel was also apparently up around my left ovary and tube, and neither my RE nor her assistant surgeon (another RE from the same practice) felt comfortable messing with it. Fortunately there was a general surgeon who happened to be available and was able to step in and work on it. To be honest, I’m not sure exactly what he did. I suppose I’ll get the details at the post-op appointment.
The best news is that the right tube and ovary all looked normal. We may actually have a shot at trying naturally for a few cycles if we decide to.
Recovery was a bit rough. I had a lot of pain, both cramping and gas pains, the first 2-3 days. I also had taken my last birth control pill the day before surgery, so I had a period but was still on the vicodin, so the cramps were mostly bearable. I started the BCP again on Monday. By then I felt better but was still very tired and napping a lot. I was off work for a week, and needed every day of it. This is my first day back and I’m glad I have no meetings, so I can sit at my desk all day.
My post-op appointment is next Tuesday, so I should be able to clarify some of the details (and hopefully be cleared for sex!).
For the rest of the day I was on a liquid diet, and of course, no food or water after midnight. I was very jealous of J’s yummy-looking dinner. I had my last glass of sports drink around 10 pm.
My mom arrived around 9:30 on Thursday, and we visited for a bit before leaving for the surgecenter. All the prep went smoothly – I answered the same questions over and over about the surgery and my history to the very nice male nurse, my RE, and the anesthesiologist. I think they wheeled me in around 1 pm. I was already hooked up to the IV, and within minutes they had me on the table, arms out, stockings on my legs. I was feeling lightheaded right away, and the anesthesiologist told me he’d started my meds. My RE was with me, I told her my mouth felt tingly and she confirmed with the anesthesiologist that it was a normal effect from the drugs. That’s really the last thing I remember before waking up in recovery. I woke up feeling nauseated, in pain, and very cold. The nurses gave me something to help with the nausea and pain, and plenty of warm blankets.
My RE spoke with J and my mom about the surgery. It apparently went well, as these things go. They removed what endo they could, drained the ovarian cyst, and resected the left tube. I *think* they may have drained the tube, but I don’t remember for sure. They did a D & C – I’m not sure if there was a problem with the uterine lining to cause this. Part of my bowel is adhered to the back of my uterus. My mom thinks this was observed during the first lap, and she may be right, but I didn’t remember it. The key point there was that it shouldn’t have any negative effect on pregnancy. But my bowel was also apparently up around my left ovary and tube, and neither my RE nor her assistant surgeon (another RE from the same practice) felt comfortable messing with it. Fortunately there was a general surgeon who happened to be available and was able to step in and work on it. To be honest, I’m not sure exactly what he did. I suppose I’ll get the details at the post-op appointment.
The best news is that the right tube and ovary all looked normal. We may actually have a shot at trying naturally for a few cycles if we decide to.
Recovery was a bit rough. I had a lot of pain, both cramping and gas pains, the first 2-3 days. I also had taken my last birth control pill the day before surgery, so I had a period but was still on the vicodin, so the cramps were mostly bearable. I started the BCP again on Monday. By then I felt better but was still very tired and napping a lot. I was off work for a week, and needed every day of it. This is my first day back and I’m glad I have no meetings, so I can sit at my desk all day.
My post-op appointment is next Tuesday, so I should be able to clarify some of the details (and hopefully be cleared for sex!).
Monday, September 21, 2009
A quiet week in Lake Wobegon...
I haven’t posted in a while. Not much happening on the ttc front. I had a long business trip to Europe this month which, while a bit of a drag, did help to take my mind off of babies.
Last week I had my pre-op appointment with my RE. She spent at least 80 minutes with me – I was quite impressed. She described her plans for the surgery, answered all of my questions, and did an internal u/s to check on things. (Yep – cyst and blocked left tube – present!) The good news is that the right side is still looking normal, so there is a chance that after all is said and done we will still have the option of trying naturally. My mom will visit the day of surgery, and probably come back a few days later when J leaves on a trip to Yosemite. J had a 3rd SA done earlier this month, but has still not picked up the results.
I have been on the bump boards less and less lately. I think I needed a mental break, and I find myself popping in more on nest boards that aren’t baby related. It’s refreshing to not feel obsessed for a change!
Last week I had my pre-op appointment with my RE. She spent at least 80 minutes with me – I was quite impressed. She described her plans for the surgery, answered all of my questions, and did an internal u/s to check on things. (Yep – cyst and blocked left tube – present!) The good news is that the right side is still looking normal, so there is a chance that after all is said and done we will still have the option of trying naturally. My mom will visit the day of surgery, and probably come back a few days later when J leaves on a trip to Yosemite. J had a 3rd SA done earlier this month, but has still not picked up the results.
I have been on the bump boards less and less lately. I think I needed a mental break, and I find myself popping in more on nest boards that aren’t baby related. It’s refreshing to not feel obsessed for a change!
Tuesday, August 25, 2009
Pins and needles
J and I went to see Julie, my acupuncturist, on Sunday. While I don't love the process (the needles don't bother me so much as feeling like I can't move), I'm a fan of Julie and the results she has achieved for other clients.
Since we are pushing up the timeline of pursuing treatment, I am going to start seeing Julie again on a weekly basis. I convinced J to come along as well to see if she could help with his morphology numbers.
Julie's take on J's results was that he should have a 3rd SA done to confirm them. She found the good count and high motility a strange contrast with the zero morphology. And while she didn't say she couldn't help the morph at all, she thinks it would take a very long time (longer than the time between now and whatever treatment we pursue this fall). She has had good results with improving count and motility over a few months, but not so much with morphology.
So, it's up to J to schedule yet another SA. Meanwhile I started my treatments in an attempt to achieve "balance" in my body. Back on the table, needles in every limb and on my belly and head, I actually did start to relax for a change.
Wednesday, August 19, 2009
Good fortune
We are in a holding pattern until my surgery in late September. At first I was excited to have a TTC break. I was getting so stressed out by everything and it was nice to not feel the pressure of trying to make everything work. But now, just a few weeks later, I’m feeling impatient and wanting things to move more quickly.
So, I’m trying to take a step back, take a deep breath, and enjoy the moment. Just because I don’t have a baby in my life yet doesn’t mean I can’t enjoy what I do have to the fullest. And so, here is my short list of things I am thankful for:
1) My general health. Aside from my reproductive issues, I am very healthy.
2) My SO. I am so very lucky to have him as a partner.
3) My dog. She makes me smile every day.
4) My family and friends.
5) My job. It may not be perfect, but I am employed and it’s a pretty good gig.
6) Where I live. Northern California is one of the best places on earth.
7) Good food.
8) Yoga and dance.
9) My house and yard.
10) Good literature and movies.
I am very, very fortunate, indeed. If we are lucky, J and I will add a child to our family sometime in the next few years. And we will have been lucky to have this time together, just us and the dog. Once we have a child, life will never be the same. And life, as it is now, is excellent. So instead of focusing so much on what I want, I am going to do my best to cherish this time and appreciate all that I do have.
So, I’m trying to take a step back, take a deep breath, and enjoy the moment. Just because I don’t have a baby in my life yet doesn’t mean I can’t enjoy what I do have to the fullest. And so, here is my short list of things I am thankful for:
1) My general health. Aside from my reproductive issues, I am very healthy.
2) My SO. I am so very lucky to have him as a partner.
3) My dog. She makes me smile every day.
4) My family and friends.
5) My job. It may not be perfect, but I am employed and it’s a pretty good gig.
6) Where I live. Northern California is one of the best places on earth.
7) Good food.
8) Yoga and dance.
9) My house and yard.
10) Good literature and movies.
I am very, very fortunate, indeed. If we are lucky, J and I will add a child to our family sometime in the next few years. And we will have been lucky to have this time together, just us and the dog. Once we have a child, life will never be the same. And life, as it is now, is excellent. So instead of focusing so much on what I want, I am going to do my best to cherish this time and appreciate all that I do have.
Monday, August 10, 2009
No fancy title
After playing phone tag with the RE for a bit over a week, I finally got to speak with her by phone.
We talked about our options with the repeat SA results and now that J has added me to his insurance plan that will cover IUI/IVF (up to a limit). Basically, I have two choices.
1) Go back off the pill and try IUI
2) Have a laparoscopy to assess/treat my left tube, remove as much endo as possible, and determine best course of action. Follow with IUI or IVF.
J and I agree that going through more periods without any additional treatment is not an option for me. It's just too painful. So now I wait for the scheduler to call - the RE said I will need one week off work and can't travel for two weeks, which may be tricky with my work travel this fall. And I hate to give up five more days of my time off for surgery (as opposed to real vacation), but truly, for the chance to have a baby, it is more than worth it.
We talked about our options with the repeat SA results and now that J has added me to his insurance plan that will cover IUI/IVF (up to a limit). Basically, I have two choices.
1) Go back off the pill and try IUI
2) Have a laparoscopy to assess/treat my left tube, remove as much endo as possible, and determine best course of action. Follow with IUI or IVF.
J and I agree that going through more periods without any additional treatment is not an option for me. It's just too painful. So now I wait for the scheduler to call - the RE said I will need one week off work and can't travel for two weeks, which may be tricky with my work travel this fall. And I hate to give up five more days of my time off for surgery (as opposed to real vacation), but truly, for the chance to have a baby, it is more than worth it.
Friday, July 31, 2009
Plan, Shman.
I joined J for his urologist appointment yesterday. This was a follow-up after having his first consultation and additional testing.
First, the blood work was perfectly normal, and there are no hormonal issues to worry about. Good news!
Second, the ultrasound showed a minor vericocele (a varicose vein) on the left side. It’s not severe enough to warrant surgery based on the other results. Ok news.
Third (the other results), the repeat SA showed a count of 23 million and motility of 85%! Normal count and motility - light years away from the previous results. Excellent news! (The first SA was, I found out several days after the results came in, incomplete. Meaning J missed the target a bit, and the entire sample didn’t make it into the cup.)
The not-so excellent part of the results was the morphology. It was done using Kruger’s criteria, a stricter, more conservative, method. Out of 200 sperm analyzed, 0 were normal.
But the urologist emphasized that morphology is not clearly associated with fertility. As currently performed, it’s a subjective measure, and it hasn’t been demonstrated to correlate with function (i.e. fertilization). So while it’s measured, and could potentially impact fertility, it’s an unreliable test at best.
The urologist said that if I was perfectly healthy with no fertility issues, he would see no reason not to recommend continuing to try naturally. But since I have the endometriosis and the tubal issue to deal with, I need to consult my RE again with this new information. I just went back on the pill (b/c we thought J had sperm issues to overcome, and because my cramps have become unbearable). I am going to discuss surgery for the hydrosalpinx and the endo with my RE. We may not be able to make a decision about trying naturally vs. IVF until she gets a better picture (literally) during the surgery.
The other good news is that J was able to add me as a domestic partner with his company for the purposes of health benefits, and it is effective immediately. This means that I can take advantage of the limited IVF coverage available through his plan. We just hope that it remains covered next year, as well, since we may not do IVF until then. (if at all!).
First, the blood work was perfectly normal, and there are no hormonal issues to worry about. Good news!
Second, the ultrasound showed a minor vericocele (a varicose vein) on the left side. It’s not severe enough to warrant surgery based on the other results. Ok news.
Third (the other results), the repeat SA showed a count of 23 million and motility of 85%! Normal count and motility - light years away from the previous results. Excellent news! (The first SA was, I found out several days after the results came in, incomplete. Meaning J missed the target a bit, and the entire sample didn’t make it into the cup.)
The not-so excellent part of the results was the morphology. It was done using Kruger’s criteria, a stricter, more conservative, method. Out of 200 sperm analyzed, 0 were normal.
But the urologist emphasized that morphology is not clearly associated with fertility. As currently performed, it’s a subjective measure, and it hasn’t been demonstrated to correlate with function (i.e. fertilization). So while it’s measured, and could potentially impact fertility, it’s an unreliable test at best.
The urologist said that if I was perfectly healthy with no fertility issues, he would see no reason not to recommend continuing to try naturally. But since I have the endometriosis and the tubal issue to deal with, I need to consult my RE again with this new information. I just went back on the pill (b/c we thought J had sperm issues to overcome, and because my cramps have become unbearable). I am going to discuss surgery for the hydrosalpinx and the endo with my RE. We may not be able to make a decision about trying naturally vs. IVF until she gets a better picture (literally) during the surgery.
The other good news is that J was able to add me as a domestic partner with his company for the purposes of health benefits, and it is effective immediately. This means that I can take advantage of the limited IVF coverage available through his plan. We just hope that it remains covered next year, as well, since we may not do IVF until then. (if at all!).
Thursday, July 9, 2009
I like a good plan
I am not a very spontaneous person by nature. I like the occasional pleasant surprise (flowers from my sweetie! work is letting us go home early!), but generally I like to have a plan.
So walking out of my RE appointment today with some sort of plan was such a relief.
First we talked about J. He wasn't at the appointment but we discussed his first SA results and next steps:
1) Repeat SA, but at a different lab that measures morphology by Kruger's rather than WHO method.
2) If results are similar, follow up with bloodwork to test FSH, LH, testosterone, prolactin, TSH. May also want to do the following genetic tests: chromosomes, y-microdeletion, cystic fibrosis screen.
3) See a urologist who specializes in male infertility. She gave me two references in our area.
Then we talked about me. My periods have become increasingly more and more painful since going off the birth control pill last December. I've had lots of mid-cycle spotting, but otherwise regular periods, and am confident that I'm ovulating. She did an ultrasound. My right ovary and tube look ok. I have an endometrioma (about 2cm) on my left ovary. This seems to be recurrent as one was removed during my lap in 2007, which returned within six months. As of last December, it wasn't visible, but here it is again. The worst news is that my left tube, which is twisted around my ovary, is hydrosalpinx (filled with fluid). According to the RE, this could cause problems with implantation when we do IVF.
So the plan for me is:
1) Have CD3 bloodwork done. If the 2nd SA results are similar to the first, go back on continuous birth control to try and keep the endometriosis from getting worse and avoid having painful periods.
2) Go back for a follow-up visit in September to see how the cyst and left tube look.
3) Possibly have a second laparoscopy to a) drain the tube, b) pinch off the tube, or c) remove the tube about 2-3 months before IVF. Also remove as much of the endo as possible.
4) Start on Lupron about 2 months before IVF to get the endo as quiet as possible and because it has been shown to improve IVF results .
Then we would do IVF after the first of the year, when we hopefully have some insurance coverage for it.
If the 2nd SA results are significantly improved, we will reassess, but I'm not counting on that.
I feel like a huge weight is off my shoulders. If we follow this plan, we will have about 5 months of not TTC, which will mean:
1) No stress about trying to have sex on particular days.
2) No temping/charting (not a big deal but nice to not have to worry about waking up around the same time every day and stressing if I have to get up to use the bathroom in the early morning)
3) No avoiding the bathroom for hours in order to use the ovulation predictor kits.
4) No ups and downs hoping for a pregnancy and being disappointed.
5) Regular coffee! I had given this up at the beginning of the year.
6) A break from acupuncture (most people find it relaxing, I do not).
7) No herbs from my acupuncturist (blech!).
It wasn't great news today, but I'm feeling more positive about everything than I have in months. It's a good feeling.
So walking out of my RE appointment today with some sort of plan was such a relief.
First we talked about J. He wasn't at the appointment but we discussed his first SA results and next steps:
1) Repeat SA, but at a different lab that measures morphology by Kruger's rather than WHO method.
2) If results are similar, follow up with bloodwork to test FSH, LH, testosterone, prolactin, TSH. May also want to do the following genetic tests: chromosomes, y-microdeletion, cystic fibrosis screen.
3) See a urologist who specializes in male infertility. She gave me two references in our area.
Then we talked about me. My periods have become increasingly more and more painful since going off the birth control pill last December. I've had lots of mid-cycle spotting, but otherwise regular periods, and am confident that I'm ovulating. She did an ultrasound. My right ovary and tube look ok. I have an endometrioma (about 2cm) on my left ovary. This seems to be recurrent as one was removed during my lap in 2007, which returned within six months. As of last December, it wasn't visible, but here it is again. The worst news is that my left tube, which is twisted around my ovary, is hydrosalpinx (filled with fluid). According to the RE, this could cause problems with implantation when we do IVF.
So the plan for me is:
1) Have CD3 bloodwork done. If the 2nd SA results are similar to the first, go back on continuous birth control to try and keep the endometriosis from getting worse and avoid having painful periods.
2) Go back for a follow-up visit in September to see how the cyst and left tube look.
3) Possibly have a second laparoscopy to a) drain the tube, b) pinch off the tube, or c) remove the tube about 2-3 months before IVF. Also remove as much of the endo as possible.
4) Start on Lupron about 2 months before IVF to get the endo as quiet as possible and because it has been shown to improve IVF results .
Then we would do IVF after the first of the year, when we hopefully have some insurance coverage for it.
If the 2nd SA results are significantly improved, we will reassess, but I'm not counting on that.
I feel like a huge weight is off my shoulders. If we follow this plan, we will have about 5 months of not TTC, which will mean:
1) No stress about trying to have sex on particular days.
2) No temping/charting (not a big deal but nice to not have to worry about waking up around the same time every day and stressing if I have to get up to use the bathroom in the early morning)
3) No avoiding the bathroom for hours in order to use the ovulation predictor kits.
4) No ups and downs hoping for a pregnancy and being disappointed.
5) Regular coffee! I had given this up at the beginning of the year.
6) A break from acupuncture (most people find it relaxing, I do not).
7) No herbs from my acupuncturist (blech!).
It wasn't great news today, but I'm feeling more positive about everything than I have in months. It's a good feeling.
Wednesday, July 8, 2009
I am such a nag.
I couldn’t help myself. After asking J twice last week to call his doctor with no results, I asked him Monday night and then sent an email reminder yesterday morning. And…he called! He now has a referral for a repeat SA and a follow-up appointment with his GP on July 30. I was really hoping he would schedule an appointment with a urologist, but I guess he wants to see his regular doctor and get a referral from him, even though he has a PPO and could pick a urologist himself. I am trying to be satisfied with the progress such as it is and not be critical.
I am such a control freak! But at least I recognize it, and knowing is half the battle, right? :)
Now I am looking forward to my RE appointment tomorrow. It just feels good to be talking to doctors about our issues and hopefully moving forward, even if it is by teeny tiny baby steps (no pun intended).
I am such a control freak! But at least I recognize it, and knowing is half the battle, right? :)
Now I am looking forward to my RE appointment tomorrow. It just feels good to be talking to doctors about our issues and hopefully moving forward, even if it is by teeny tiny baby steps (no pun intended).
Wednesday, July 1, 2009
The results are in...
After a week away for work, and a hectic weekend, life finally seems to be settling back to a more normal pace. J and I are enjoying our new living arrangements (read: living together!). The dog seems thrilled with her new digs as well, despite fighting a bronchial infection brought on by an enthusiastic drink from an industrial sprinkler (who knew?).
Over the weekend we received J's results from the testing of his swimmers. The good news? Several factors are normal. The bad news? Some critical numbers, motility and count, were low. Too low, in fact, to do morphology. J was, understandably, disappointed, but didn't seem too shaken up by it. I think it helps that he has a friend who has similar challenges.
I'm left wondering, though, what this means about our combined fertility (or infertility, as it may be). How much of it is due to my endometriosis? Are we destined for IVF? Or do we still have a chance to conceive naturally?
And none of this is easy for me, planner that I am. Because J has responsibilities to follow up on his side, and although I know he wants a baby as much as I do, he seems less driven to make the necessary phone calls immediately, as I would do. There's nothing wrong with that, except that it makes me crazy. And I don't want to be a nag. So I sit and twiddle my thumbs, and try to think about other things.
And it only sort of works.
Over the weekend we received J's results from the testing of his swimmers. The good news? Several factors are normal. The bad news? Some critical numbers, motility and count, were low. Too low, in fact, to do morphology. J was, understandably, disappointed, but didn't seem too shaken up by it. I think it helps that he has a friend who has similar challenges.
I'm left wondering, though, what this means about our combined fertility (or infertility, as it may be). How much of it is due to my endometriosis? Are we destined for IVF? Or do we still have a chance to conceive naturally?
And none of this is easy for me, planner that I am. Because J has responsibilities to follow up on his side, and although I know he wants a baby as much as I do, he seems less driven to make the necessary phone calls immediately, as I would do. There's nothing wrong with that, except that it makes me crazy. And I don't want to be a nag. So I sit and twiddle my thumbs, and try to think about other things.
And it only sort of works.
Monday, June 22, 2009
Round and round
And we're on to cycle 8.
What makes the demise of cycle 7 even more painful? The ridiculously painful cramps I'm enduring thanks to endometriosis. And I am travelling for work, and without my heating pad. I wish I could fast forward a few days.
I miss J and wish I was home with him.
That's all I have the strength for tonight.
What makes the demise of cycle 7 even more painful? The ridiculously painful cramps I'm enduring thanks to endometriosis. And I am travelling for work, and without my heating pad. I wish I could fast forward a few days.
I miss J and wish I was home with him.
That's all I have the strength for tonight.
Thursday, June 18, 2009
where we're at
J and I decided last December that we were ready to add a baby to our family. After six disappointing cycles, we're ready to take the next step.We know that healthy couples can take up to a year to conceive. However, given our respective ages and my known issues (stage IV endometriosis), we feel comfortable pursuing testing and exploring our options now rather than waiting for the full year.
I saw my ob/gyn this week. We reviewed my charts, discussed the potential problems I may be facing given the endo, and she ordered bloodwork to be done near the start of my next cycle. She's also going to refer me to a reproductive endocrinologist.
J is doing his part by making a donation in a clinic tomorrow. Despite all I have been through with surgery and other procedures, I don't envy him his task one bit!
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