Monday, October 27, 2008

Today's scan

I'm not feeling like typing much, so I'm just posting the results.

No mature follicles.
No improvement in the lining.

The nurse said to just skip the trigger shot. There is no point since I'm not producing an egg this cycle. We meet again with Dr. Dunn on November 7 - ironically one day short of being exactly one year post op.

I had to return to work after the scan, and that was pretty tough. Thankfully Lisa was comforting as usual. I don't know if there is much more the doctor can do for us. I don't know if increasing the estrogen and trying injectibles will be an option or not.

Sunday, October 26, 2008

I am an idiot

I have been SO SICK over this that I haven't even managed to log on and type it out.

I screwed up my medication. I was supposed to be taking 2 Femara pills from cycle days 3-7. Instead I am a huge screw up and only took one. I didn't realize it until it was too late. As a result, I am not expecting to see multiple follicles at my scan tomorrow.

The Viagra has made me really sick for the past 10 days. Within 30 minutes of taking it, I can feel the blood rushing to all parts of my body, and it's an intense and painful feeling. It's making my gums bleed a lot when I brush my teeth, to the point where I can still taste blood for about an hour after I brush. I've been up all night for the majority of the nights since I began taking it. Oddly enough, since I started the estrogen, I have been sleeping through the night again. I don't know what the deal is, but I am thankful for some relief. I'm really disgusted that I am going through all of this, and it could be for nothing thanks to my Femara mishap.

I called the nurse as soon as I realized I had messed up, and she talked me down from the ledge. She told me that this happens, and we need to just move on and not worry about it. She wanted me to continue all the other meds as planned, and she told me that we'll just see how I respond to a half dose of Femara.

I go for my ultrasound tomorrow, and I'm terrified. If they tell me the lining is not improved, I don't even know where to go from here. Maybe a higher dose of estrogen? Or maybe there is nothing more we can do? My stomach is in knots.

I've beat myself up over and over for messing up. This should be THE most important thing in my life right now. Yet, I am so over-extended with work and other responsibilities that I was careless. I decided that my life is way too disorganized, and as a result, I've spent the entire weekend decluttering my house. I'm hoping this will help me also declutter my mind. How could I do something so stupid? After all that we've been through.

Saturday, October 18, 2008

Some information on Viagra

A good synopsis can be found in an article written by a brilliant infertility specialist, Dr. Geoffrey Sher. (Thanks for pointing me in this direction, Amanda!). The article can be read here.

The cyst is gone

I had another scan done with the start of a new cycle on Thursday. It was all clear, so I am back on a medicated cycle. The plan this time:
  • Femara - cycle day 3-7
  • Viagra - cycle day 3-12
  • Estradiol cycle day 10-12
  • Ovidrel (shot to trigger ovulation) - cycle day 13

The Ovidrel may move around a bit depending on what my mid-cycle scan shows. I am going on October 27th (cycle day 13) to have that scan performed. If all looks good with mature follicles, I will trigger that evening. I've been reading more information on Viagra for lining issues. It was briefly addressed on an infertility blog that I will now link over on the right side of the page. There is a lot of good information there.

I suppose I should be more enthusiastic about this cycle, trying new medication, etc. The truth is that I've really lost the wind from my sails lately. It seems like there have been more tears than usual, and the beginnings of acceptance are creeping in. I'm talking about the acceptance that this just might not happen for us. We've been trying for a long time now, and I'm still in the game for now. But I need to establish some type of ending point to this, because I feel like my life is on hold. Not in the literal sense, but in my head. I realize now more than ever how important it is to treasure every single moment and every stage of Elise's childhood. This journey with infertility is taking a small piece of that joy away from me, and I don't like that. I need to start living my life to the fullest, and right now I feel like I can't do that because I am constantly waiting for this huge, life changing event to happen. Every month when it doesn't happen, it breaks my heart a little bit. There definitely has to be an end - whether it involves a pregnancy and new baby or an acceptance that it wasn't meant to be. I need one or the other to happen sometime in the relatively near future. Jamie and I talked about it tonight. He agrees, but neither of us are sure when it will be. We talked about the summer, because that would be the 2-year mark since this all began. But nothing is set in stone other than the beginnging of that realization.

Friday, September 26, 2008

First Femara Cycle Failed

And now I have a cyst on my right ovary that is currently preventing us from trying again. Hopefully it will be gone by the start of my next cycle, and we can give it another shot.

Next time we will be doing:

Femara from cycle day 3-7
Viagra from cycle day 3-12
Estrace from cycle day 10-12
Trigger shot on cycle day 13

The Estrace and Viagra are for my lining and the Femara will stimulate the ovaries to produce multiple eggs again (hopefully). The trigger shot will be needed to tell my body to ovulate, because when we add the estrogen, it will confuse my brain into thinking that I am further along in the cycle than I actually am.

We don't know when we'll get to try again now that we have the cyst. I will get a baseline ultrasound at the beginning of each cycle until it's gone. When we get the all-clear, we'll start the protocol above.

This is getting REALLY old.

Sunday, September 7, 2008

Mid-cycle scan

Our mid-cycle scan was on September 3rd.

Good news: 2 mature follicles, one on the right measuring 21 and one on the left measuring 20.

Bad news: Lining is only measuring 5mm.

The nurse said she's not happy to see the lining measurement, but it's not impossible to become pregnant. We know this will not work in our favor. I think it's good to at least be able to focus on what is most likely causing the problem. I've been reading a lot about the use of viagra suppositories to treat lining issues. A friend of mine who has done IVF told me that they took her lining from 8mm to 14mm in only 3 days!

I'm guessing that this cycle will probably be a bust, so I am making a list of things for us to ask Dr. Dunn when we go back on the 19th. I'm definitely going to see what he thinks of using viagra. I feel confident that if we can get my lining above 8mm, I can get pregnant. I think.

Sunday, August 24, 2008

Baseline Scan

I had my baseline ultrasound on Friday. The nurse said all looked good. I didn't have any "left over follicles" from last cycle, and my lining measured 4mm. She said that was right on track.

I began the Femara this evening, and I will take it through Thursday. I go back for another ultrasound on September 3rd. We are hoping to see several mature follicles and a lining measuring 8-10mm.

I'm praying that Femara will do its job. I asked Jamie if he thought it would work on the first cycle. He said, "Knowing our luck, probably not." I'm glad he said it, because I was thinking it. Still, I am trying to have a positive attitude, because as Jamie loves to remind me - the mind controls the body.

I could use a lot of prayers, because at this point, being positive is not something that comes naturally for me.

Will update on the 3rd after the ultrasound.

Sunday, August 10, 2008

Jamie's Test Results and The Plan

We met with Dr. Dunn (again) on Friday to go over Jamie's semen analysis results. His numbers were all really good.

Normal Volume is 1.0 - 6.5 mL per ejaculation.
Normal Count is 20.0 - 150.0 million per mL.
Normal Motility is 60% or higher.
Normal Morphology is 70% or lower.

Jamie's Results:
Volume 1.5mL
Count 216.1 million per mL
Motility 62%
Morphology 76%

The morphology is a little high, but that is more than offset by the count. The dr. was very pleased with the results, and we are now satisfied that my issues are the only obstacles we have to face. That is an enormous relief, because we are hoping my issues can be fixed with minimal interventions and drugs.

Dr. Dunn mentioned endometriosis again at this appointment. He said I had Stage I when he did my surgery, and it was just a few points away from being Stage II. This does statistically decrease the odds of pregnancy in each cycle.

So here's the plan:

Since I face a statistically lower possiblity of pregnancy, we are going to start doing things to increase my odds from another standpoint. I do ovulate on my own with no issues, but our first step is going to be medication that stimulates the ovaries to ovulate, sometimes producing multiple eggs. More possible targets = higher odds of pregnancy. Clomid is one of the more popular medications of this kind, but it is not what I will be taking. One of the side effects of Clomid is a decreasing of the cervical mucus (which is what creates a hospitable environment for sperm) and a slight thinning of the uteran lining. Thinning of the lining is the LAST thing I need, obviously. This is what makes Clomid an unattractive choice for me. I will be trying a cycle on Femara instead. This drug operates a bit differently from Clomid, but gives the same end result.

Clomid aids ovulation by binding to estrogen receptors in cells and tricking the brain into thinking that estrogen levels are low. When this happens, the brain tells the ovaries to work harder, thus creating more eggs and/or stronger ovulation.

Femara aids ovulation by interfering with the conversion of testosterone into estrogen in the body. So, rather than tricking the body into thinking estrogen is low, this drug actually does cause lower estrogen levels. In doing so, the ovaries are stimulated.

I'm a big student of Google University, but I had never read about the differences between Clomid and Femara. I learned something new!

We are instructed to wait out the remainder of this cycle. When the next cycle begins, I am supposed to call the nurse and come in for a baseline scan. I assume they will be checking the lining at that appointment. Then I begin Femara on cycle day 3 and continue to take it through cycle day 7. I will go for another mid-cycle scan around cycle day 13 or 14. At this ultrasound, they will be able to measure the follicles that my ovaries have produced and tell how many eggs I will most likely release. We are supposed to use an ovulation predictor kit and have timed intercourse (oh how romantic). Then we will see what happens. We'll meet with Dr. Dunn again at the end of the cycle to assess how things went, how my body responded to the Femara, etc. What we hope to learn is that my body does just what it should on the Femara - or better yet...that we are pregnant.

In the event that I do not get multiple eggs on the Femara, we may need to try something different. Dr. Dunn said we might even end up trying a Clomid cycle if the Femara is unsuccessful in producing the kind of results we want to see. If both the more "minor" fertility drugs fail, then we may have to resort to injectibles. This is when our odds of multiple births really begin to increase substantially. I have some major worries about multiples, which is a topic for a different post. Needless to say, I really am praying that the Femara will do the trick. Our odds of twins are only 5-10% on that drug.

So we should be off and running in about 2 weeks.

Saturday, July 26, 2008

I am not an outwardly religious person.

This blog has been very quiet for a long time. Jamie and I decided a few months ago that after my lining check, we were going to give my body some time to rebuild and take a much needed break from trying to conceive. The baseball team went deep into playoffs and we had 2 big vacations this summer. We really didn't have time to even think about it, so it has been placed deep into the back of our minds for a few blissful months. I loved our break. I loved not waking up to a thermometer in my mouth. I loved having a sex life that was spontaneous and not dictated by ovulation tests. I felt free of all the stress, disappointment, and sadness that I had been feeling for the better part of a year.

Dr. Dunn told us back at our last visit that he wanted us to try on our own for 3 cycles, and then he wanted to test Jamie. He was due to get a semen analysis back in May, but since we were breaking anyway we put it off. We didn't really discuss it much, because it led to a heated exchange each time the subject would come up, but I am sure both of us were hoping to get pregnant during our break and not have to deal with it. Of course that didn't happen. I'm really having a hard time coming back out of denial yet again and facing more testing. It has been a really rude awakening for me.

Jamie went in for his semen analysis on Friday, which was what he described as a totally humiliating experience. I can relate to a degree, because sitting with your legs spread in stirrups while a man who is not your husband sticks his head and face down in your vagina is a little humiliating too. The stress level in our house is high, and I hate it.

I am supposed to go in for more bloodwork, because they like to have current tests in your file at all times, and my original ones are now over a year old. The semen analysis results will come in on Thursday. Once I go in for my tests and all results are in, Dr. Dunn will sit down with us again to come up with yet another plan.

I think I have cried every day this week, and I'm so tired of this. I've reached some sort of breaking point. I am not an outwardly religious person, but I do have a personal relationship with God. For the most part, it is something private that I keep to myself. I have prayed about this a lot. In the beginning I felt led to seek treatment, but the more time that goes by, the more I feel like there is a lesson that God is trying to teach me. He keeps telling me that He is in charge. I am not in control. Things will happen according to His plan. And He is telling me to wait - to be patient.

Unfortunately, He is not telling Jamie to wait. Jamie is still very driven to seek medical intervention - any intervention, whatever it takes. I am just not in the same place, and it's causing a lot of friction and hurt feelings.

So, that is where we stand right now.

Monday, May 5, 2008

Digital Pregnancy Tests

These things are pretty cool. I don't think they were around when I was pregnant with Elise (or if they were, they weren't very popular and I didn't know about them at the time). The only problem with them is that they are brutally honest and leave no room for interpretation. All you get is a big fat

Not Pregnant

Well, shit. Thanks a lot.

So now the ball is in Jamie's court. I've been poked, cut into, prodded, and violated. It's his turn, and at the moment he has a lot of excuses as to why he should wait. The current excuse is that he needs to wait until baseball playoffs and school are over.

Monday, April 28, 2008

One Year

I've been dreading this, and I've put it out of my mind for quite some time now. In a few days when May arrives, we will have been trying to get pregnant for one year. It's just a number, and it doesn't even mean anything. God will bless us with children when the time is right. When our baby is finally conceived and born, we will be so glad for the timing, because that will be what gave us the exact child we are meant to have. So then why does it hurt so badly?

I think I've been in denial for a while now, trying to convince myself that I was fine with having an only child even if it came to that. I've been focusing on all the things I can do since I'm not pregnant - enjoy my wine, exercise, drink my morning coffee, not watch what I eat. In fact, I think I've been over indulging a bit.

Along with the whole one year anniversary thing, I've come to the realization that we are looking at - best case scenario - a 4.5 year age gap between children. And it could easily be more. I'm so afraid that my kids won't be close enough in age to play together, keep one another company, and be friends to one another. That is very upsetting, because the desire to give Elise a confidante is one of the reasons I want to add to the family. It's certainly not the only reason, but I'm in a panic all of a sudden. I feel like I'm running out of time.

I'm going to be 30 this year. While I'm mostly really excited about that and embracing it, I have to acknowledge that my fertility is not being enhanced by the extra year. Statistically speaking, I don't have a whole lot of child bearing years ahead of me.

With all these concerns running through my head, I almost feel like the walls are slowly closing in around me. Time is becoming of the essence to me, and everything is totally out of my control. And at some point, I'm going to have to deal with that.

Friday, February 29, 2008

Update: Today's RE Appointment

I seem to be getting a lot of good news from Dr. Dunn lately!

Much to my surprise, my lining measures 7mm. That is quite an increase from the 3mm that it was measuring only 4 months ago pre-surgery. Dr. Dunn told me that if we were in the middle of an IVF cycle, this would be sufficient and he would not cancel the cycle. He said something about being able to see 3 layers (which is good). I didn't catch all of that, but it is a good thing!

I also have one mature follicle on the right side, which is great since that is the best tube. It was measuring 19. We were instructed to continue using the ovulation predictor kit (OPK) and have intercourse on the day of my LH surge and the day after. My test yesterday was negative, but today's is coming up positive, so we have to get down to business! I can't believe my mom is going to read this...sorry mom!

Dr. Dunn wants us to continue to try on our own with the OPKs and charting for 3 cycles. At that point, if we are not pregnant yet he wants Jamie to do a semen analysis. He sent us home with the "kit" and instructions just in case. I think Jamie is really hoping it does not come down to that! So am I.