Top Secret Blog Update

I took the bait.

Email me at: JessicaCHoward@gmail.com if you don't have the password.

Otherwise, nothing new to report today, really.

I did the 4AM trigger which went smoothly even if my husband and I were both a little grumpy at having to interrupt our sleep to get it done.

I woke up at 3:45 to mix the trigger shot solution and we were back in bed by 4:05.

I'm scheduled for a 1PM ultrasound to see if that pocket of fluid is still there and, it so, aspiration of it. James is scheduled for his part in all this at 1PM, too.

Then we return at 4PM for the grand finale.


Go Team May Baby!

About to pop

Another update so soon?

The nurse called me with the blood work results and yes, I'm about to pop some eggs so it's go time.

E2 = 468
LH = 29.3 (At least, I think that's what she said. I wrote down 9.3 but, that can't be right.)
Progesterone = 2.2

The doctor told her that before we do the IUI, she's going to aspirate the fluid (if it's still there). So, that is one problem that will no longer exist.

Who's ready for another May baby?
This girl right here, that's who!

Team May baby!

Time to trigger

Since my E2 was 295 yesterday, I was called in for another ultrasound this morning.

Right side:
R1 - 18
R2 - 16

Left side:
Nothing

I have to do a trigger 4AM tomorrow for a Thursday afternoon (CD 11) IUI.
This feels early to me. My fertility monitor only gave me a high reading this morning and last month when I triggered, my E2 was 549.

One hiccup, though. Yesterday the doctor noticed some fluid on the ultrasound. Today, the nurse mentioned it too and asked if I was still spotting. I'm not, so we don't know what that pocket of fluid is.

She said if this were IVF transfer, it would be cancelled if that fluid was there the day of the transfer. Fluid can cause an embryo to not implant.

Because of that, on Thursday they're going to do another ultrasound before the IUI to see if the fluid is still there. She also said the fluid wouldn't necessarily mean that we have to cancel because by the time implantation occurs, the fluid could be gone. We'll see what the ultrasound shows on Thursday afternoon.

Gut instinct tells me this isn't going to be a successful cycle. Not because of the fluid or even because I'm trying to prepare myself for the worst. I don't know where gut instinct comes from really, but, mine is telling me this isn't working out.

Brianna mentioned in a comment that "low and slow" is the way to do this. And, I realized she's exactly right. And one thing this cycle hasn't been is low or slow.

The thing about IUI is I feel like success is just outside of my grasp. However, a little tweak here and a little adjustment there and I feel like we would have success. We're not dealing with MFI which is a huge impediment for a successful IUI. I have a history of getting pregnant and even bringing forth children from pregnancies.

Granted, my last successful pregnancy (yes, I consider Nathan a successful pregnancy) was over two years ago and I'm 39 now. So, IVF makes sense. Right?

But, I don't exactly have a history of miscarriages from IUI either. Four attempts has netted me one CP. That's not really a bad track record given that a woman my age is expected to get pregnant 1/12 attempts (at best).

Anyway, make it through this cycle first, right?
One thing at a time grasshopper.

I will not give up. I will not give up. I will not give up.

That was not the best appointment I've had.

In fact, it was altogether disappointing. 

No follie growth from Friday to today. WHAT, how can that be?!

More blood work done and I'll get a call back this afternoon with the results but she believes it might be prudent to increase from 112.5 to 125. I couldn't agree more but, this is so frustrating! 

I'm only on CD 8 so I know it's still early days but I expected some growth after 3 more days of shots.  

Back on Wednesday for another ultrasound. I'm feeling like it would be more beneficial to live near my clinic than work these days. 

Alright, that's enough out of you Negative Nelly. 

Everyone have a super day!

Afternoon update:
Doctor called and my estradiol is up to 295. Tonight I'm going to stick with the 112.5 protocol and instead of returning on Wednesday, she wants to see me tomorrow.

As Brianna said in the comments, "low and slow" is best.

Some random thoughts

First
Remember how yesterday I said I was feeling nothing towards this cycle?

Well, that all changed yesterday when, out of curiosity, I looked at the estimated due date of this cycle. Based solely on LMP (assuming CD14 ovulation) it would be 5/17*.

Why does that matter? Ryan was due on 5/15 and he was born via scheduled c-section on 5/5 and my birthday is 5/7.

Because I've had 2 c-sections I'll have to have another c-section with my third. Scheduled c-sections are done no less than 5 days from your due date and not more than 10. My doctor likes to do Saturday c-sections if possible because most doctors don't and it's not very busy at the hospital.

So, that would possibly mean a 5/9 scheduled c-section date.

5/5 - Ryan
5/7 - Jessica
5/9 - Baby #3?

That would be a pretty big coincidence so incredibly unlikely to come to fruition but I am running with it!

* The rate I'm going this cycle, ovulation will happen before CD 14 so that moves the whole timescale up.

Moving on
Speaking of my fast acting cycle...
I was looking more closely at the estrogen number they gave me yesterday: 119.
That was after 3 days of injections. Last month, after 5 days of injections, my number was 81.

Doesn't that seem like a rather larger increase over last month in a shorter time frame? I don't know if this is good or bad. Last month was a fail but now I'm worrying (again) about having to cancel the cycle because of too many follies.

The ultrasound yesterday only showed 5 and only 2 of those were over 10mm so maybe this will work out okay.

When the nurse called she said 119 was a good number and we'd stick with the Gonal-f 112.5 protocol until Monday and we'd reassess then.

I don't know, maybe this is all just looking to be a better cycle!

Lastly
I've been thinking that it would be nice to have a forum type set up for bloggers I have become friendly with. A place that would be all our own where we can talk in a little bit more "real time", exchange experiences or just talk in general.

I have loads of TTC forums I'm on and I hate most of them because you have to dig through 10,000 posts to find anything useful. I would like a place that would be by invitation only so it doesn't get bogged down by the nonsense.

I was thinking a closed yahoo group at first but does anyone still have yahoo accounts anymore?

I love reading all the blogs and this isn't meant to replace that at all. Sometimes I ask a question in the comments and then forget to go back and follow up. So I'm sure others have done that, too. I'm often thinking I wish I could just ask someone questions outside of their blog.

In my mind, I would invite my favorite bloggers, some who are still TTC and some who are finally pregnant. Anyone who chooses to join can also invite their favorite bloggers, too.

I'm going to look into it a bit further but if anyone has any suggestions, I'm wide open. Is this something you'd participate in?

Glamorous? I don't think so!

Ultrasound today

CD 5

3 days of injections: Gonal-F 112.5 (increase from 100 last month)

Right ovary = 3 follies total - 2 x 10mm, 1 less than 10mm

Left ovary = 2 follies total - both less than 10mm

Lining = perfect (I didn't ask for number)

I'll get a call this afternoon with the estradiol results which will tell us if I should continue on 112.5 dose or dial it back to 100 since I appear to be responding a bit quickly. 

I take all the numbers this early with a grain of salt because last month on CD 6 I had 7 follies and ended up with only 1 mature. 

What's interesting this month is that the right side seems to be responding better than the left. That's never happened to me before. 

I have to return Monday morning so they can check again. Since I'm on a rather high dose of Gonal-F (for an IUI cycle, at least) they're going to be checking me a lot more often.

It's weird because now that we've decided to move on to IVF, this cycle feels perfunctory. It's like I'm not really expecting any results from it so just going through the motions so that we can start the process of preparing ourselves for moving on. 

I feel like I have nothing vested in this cycle; I'm not feeling hopeful or hopeless. In my head, we've already moved on.

Probably not a good attitude to have and my dearest friend Felicia will get on me when she reads this. She's always reminding me to "think positive". 

But, maybe it's better this way. Let the course run and what happens, happens. At least I know I'm not likely to get super anxious this time around. 

Notice Olivia Wilde on Glamour magazine in the background. There is nothing glamorous going on in that room, with that machine!

Update: Estradiol 119
Sticking with current 112.5 Gonal-F protocol.

The final IUI

I love my RE clinic, I really do.

As soon as I walk through the door the receptionist always asks "where's my Spider-Man today?" referring to Ryan. 

Every single nurse that walks by me says "hello Jessica, how are you?". I feel like I'm getting individual treatment and that's the benefit of going to a small practice. You never feel like a number or statistic. 

I've heard of clinics turning women down for treatment due to various factors simply because they want to keep their success rate statistics high. That's utter bullshit. My office is not like that and I appreciate it so much.

When the nurse took me back to get the ultrasound she asked if I was going to do another IUI and I said yes. She said something along the lines of "are you sure it's not time to move on to IVF? I hate to think of you spending all this money on IUI's". I know that you might read that and think she was being rude but it really wasn't. 

I told her that insurance pays for both she got excited and said "Do it girl! We want to see your pregnant!". 

I told her that I had come to that same conclusion and had gotten my insurance ducks in a row to proceed on to IVF.

Then Girl Doctor came in. 

Side note: my RE's office has two doctors - who I refer to as Girl Doctor and Boy Doctor.

She was able to see both ovaries without any trouble. No cysts so I'm cleared to proceed with this IUI cycle.

Then I told her that if this doesn't work, I'm moving on to IVF. She said she was 100% in support of that decision.

We spoke about logistics and she told me she thought it would be beneficial if I lost 10 pounds. She only mentioned it because I asked and I'm glad I did. I appreciated the complete honesty, I needed to hear it.

Also, I made the decision then that if we do have to go the IVF route, I want Girl Doctor taking over my cycles. 

Don't get me wrong, I LOVE Boy Doctor. He's fabulous and incredibly kind and attentive. Girl Doctor is a bit more matter of fact. 

However, Boy Doctor has rarely been able to find my right ovary. I don't know why this is but he tries and tries and moves that wand around like he's checking my tonsils. But, my right ovary always seems to elude him. 

Girl Doctor finds it in seconds. So, she is my best bet for egg retrieval purposes in my opinion. 

She explained that I'll come in on the first day of my period just like with IUI cycles and I'll be put on birth control for 2-3 weeks. Then we'll start injections and go from there.

I didn't talk to James about it last night at all, I guess I wanted to mull it all over before I spoke to him.

This morning as we're getting ready for work I told him about the appointment. He agrees also that it's time for IVF. We both agreed that waiting until October/November would be a good idea, too.

This gives me time to lose that ten pounds, save up more vacation days and save money. Even though all these treatments are paid for, it's not without some costs to us. Affordable costs for sure, but costs none the less. 

So there we have it. This is it, our fifth and final IUI. 

Come on sperm, hook up with my egg - you know you want to!

7 to 3 to 1 (or, Fukity, fuk, fuk!) Now with afternoon update!

Today's appointment did NOT go as planned!

To recap, last Saturday I had 7 potential follies. All under 10 and I was hoping for no more than 3.

Blood work:

Estrogen 81

LH 4.7

On Tuesday I returned and there were 3 growing pretty nicely at 12mm, 11mm, 11mm.

Blood work:

Estrogen 233

LH 5.2

Yesterday morning I got a "high" reading on my fertility monitor and OPK. Things are looking good, then!

That brings us to today.

OPK = Peak

FM = High

Hmm... 

Ultrasound this morning now shows 16mm, 11mm & 12mm.

So, one barely grew the other didn't grow at all and the last is on it's way to being mature. 

That would indicate the fertility monitor was the more accurate and that's good to know.

(Blood work pending)

I told my RE about the OPK this morning so she said we'll see what the blood work shows but I am scheduled for an IUI tomorrow late morning unless blood work suggests it's too early.

My frustration is with the two follicles that didn't grow much/at all. WTF?! I got the same result on Clomid at 1/2 the cost and no needles!

I voiced my frustration to the doctor and she said injectibles are a numbers game the first time. You don't want to go too high and run a risk of ten mature follicles and having to cancel the IUI. Now we know how I respond to 100iu and if we don't have success this month, we'll up it a tiny bit next month.

Okay, fair enough. But, I feel like last month was my "next month" moment. I don't know if that makes sense but I'm sick of saying "next month". Next month is the one where we'll change this and this and then it will work! Eureka, the secret formula!

I'm whining, I know. I'm paying way less for Gonal-f that most women and for that I'm grateful. I'm not paying for the IUI at all and I have to remember to thank my lucky stars for James' new job that is providing us with all this. 

So, please ladies, be aware that I understand how my whining might sound to many of you who are struggling and have the financial burden as well.

But hey, the bright side... no risk of multiples this month!

PS - Please don't forget to comment on my previous post to win the four leaf clover!

UPDATE:
Doctor called close to 3PM
Estrogen 549
LH 31.8

So yeah, I'm surging.
I'm at work and my very brave co-worker (and friend) watched the video with me and then gave me the trigger shot. Seriously, I owe her because she did a great job.

That Estrogen number would indicate that only one follie will release an egg. Still a little disappointed about that so let's hope it's a good one!

IUI at 11:30AM tomorrow. Here we go!

7 little eggs - Oh, hello right ovary!

So my early appointment went well, if not even a tiny bit scary.

First, my right ovary was visible (hoorah!) and held 3 follies and my left ovary showed 4. So, I respond really well to Gonal-F.

They were all under 10mm which is expected since I've only been doing injections for five days. I started to panic because the nurse told me if I had more than 2 mature follicles we'd have to cancel.
Today my doctor said since I'm 39 he'd proceed with 4.

I was relieved and yet petrified. Hold on... 4?!?! But, but... wouldn't we run a risk of twins?
He said "Yes, but we did tell you that's the risk with injectibles."

Okay, very true. And that's why we tried 4 cycles with Clomid before going down this path.
Anyone who knows me is aware that twins is my second biggest fear with fertility treatments.

I know.

I know!

Two babies will be better than no babies (first biggest fear). But, I did ask James to have a chat with his "fellas" on IUI day. You know, just to say "Hey guys, if one of you gets to an egg first, the rest of you should just back off. Deal?"

Now my other fear is having to cancel the cycle. 7 follicles under 10 doesn't mean all will mature by trigger time; my hope is no more than 3.

Tuesday morning I return for another ultrasound and we should know from there what day to trigger and IUI.

I'm feeling pretty excited about this cycle because things seem to be progressing so well.

Maybe, just maybe, this will be it!