Proceed Follies, Proceed.

First things first, I'm happy to report:  No crazy dreams leading up to the first monitoring appointment. My hoo-hoo wasn't displayed on a Megatron, picture window, or skype for that matter. All good things. As I type this I can only wonder if the whore-bag cyst had anything to do with that. The official report is that she's gone for good! I was super nervous going in that I'd have one giant follie the size of Rachel Zoe, and end up getting cancelled fo' shiz. But Dr. 3 was quite happy with my progress and didn't see that hooker anywhere.

So with all this excitement I have no choice but to whip out my bullet points. (oh my)

• Left Side: 8 follies, all measuring 12 - 13mm
• Right Side: 9-10 follies, all measuring 12 - 13mm
• Lining: 8.3mm
• Estrodial: 587
• Prolactin: 18

Dr. 3 was all smiles this morning, and said that my progress was on the higher side of the median he likes to see. I feel good about that. I think. I go back on Wednesday for another monitoring check, but he thinks I could trigger as early as Wednesday night, possibly Thursday. Which meeeeeans, my ER could be Friday or Saturday!!!

I really, really can't believe our time is finally here. I'm so ridiculously happy right now.  My pants are unbuttoned, and I'm smiling like an idiot - I just can't believe we'll have our very own embryo's this weekend. I love them already - is that weird?

So next up: Meds are the same tonight and tomorrow, except that I'll add in Heparin which brings me to four shots per night, oy. I know that it'll soon be two, once I'm off the stims and start the Progesterone in Oil. Which I've heard is heavenly (she says sarcastically). So again, I ask for your wisdom and experience - what are the best ways to minimize the ouchiness of the POI shots? I've heard horror stories of welts, and sore spots that last for MONTHS. I'd like to avoid that, please and thank you. So, spill it.

Me, On Stims...

Stims are going well so far, I'm happy to report that the Follistim Pen is not nearly as complicated as I imagined. I don't know why, but I was feeling very intimidated by the concept of it alone. Maybe because if you don't pay close enough attention to what you're doing you can destroy $900.00 in meds fairly easily. Thank gawd I can trust Brian not to screw it up.

I'm three days in on stims, and I have to say three shots a day is already getting old. (remember I've been on Lupron since January 16th) AND HOLY CRAP is Menopur a dirty tramp - Why the hell didn't anyone tell me how much that shit stings?!?! If you think I curse a lot here, you should have heard me when the stinging first kicked in. I can handle the shots themselves, it's a little pinch then it's over. And I think I have a pretty decent pain tolerance but good lord... So I did a little research I found that icing helps. I iced for close to ten minutes before injections last night and barely felt a thing. And quick question. How soon into stims did you start to feel anything? I'm not uncomfortable in any way, but I noticed a different type of pressure yesterday. Like, a fullness. Very subtle. Am I nuts? Anyone else notice it this early?

My first monitoring appointment is on Monday, and I'm super excited. I'll go in first thing in the morning and pray that the whorebag cyst hasn't come back to suck up all my meds. I also hope to get a decent preliminary count of follies. This is where it gets tricky because I am constantly reminding myself to not to keep any expectations. SO. HARD. NOT. TO though...

Lastly. I must thank you all for your beautiful enthusiasm when I got the green light. Every one of your comments put a huge smile on my face... Thank you so much for that.

Grow follies, GROW! 
(butnottoofast) 
(HOLY CRAP, I've been saying that for so long, I can't believe it actually applies to ME.)
WOOO!

Waiting It Out

I’m pretty sure I must have been a complete asshole in my past life. I’ve come to that conclusion because there is no other possible explanation as to why this cycle is going the way it is.

It’s taken me three days to write this post because I’m having a hard time breaking down the information enough so that my tiny brain can even process the basic facts, but here's what I've got.

On 1/25: My E2 was 346 (no u/s) which was CD2 for reference

On 1/27: Went back for an u/s which showed a cyst/follicle at 23mm, E2 was 414, Progesterone 2.0

Dr. 3’s Notes: Surprised that you were able to have a period while your E2 was so high.

Melissa’s notes: Fucking figures.

On 2/1: Morning u/s #2 shows an increase in size of cyst/follicle at 24.5 mm

Dr. 3’s Notes: We have to wait this out. Stay on 10 Units of Lupron. Call me when you get your period. Good luck with that.

Melissa’s Notes: Dr. 3 = Cyborg. All hope of having bio children fades. Break down -Open bottle of wine. Shortly after glass of Sauvignon Blanc I get pains similar to Ovulation. Of course.

On 2/2: Find out 2/1’s blood test results: E2 was 391, Progesterone 1.4 DOWN FROM 1/27. Email Dr.3 because the multitude of questions over what the crap is going on with this cycle is keeping me up at night.

The gist of that email went a little something like this:

Me: Am I being stimulated instead of suppressed by the Lupron? Could my lower E2 suggest that the follicle was getting ready to rupture? Is staying on the same dosage of Lupron possibly delaying the ultimate goal of getting this thing to mature and collapse? Will the Lupron shorten my luteal phase? WHY IS THIS HAPPENING???? SOMEBODY HOLD ME.

Dr. 3: You had one rogue follicle that was not suppressed by the Lupron. It will either mature and rupture on its own or the Lupron will suppress it and it will shrink. There is nothing you can do about it. There is nothing I can do about it. We have to let the meds and the follicle take its course. CALL  ME WHEN YOU GET YOUR PERIOD.

So that's it. I'm done. I'm exhausted and so is my Zen. I'm trying not to give myself a hard time for losing my shit over all of this, but I wish I could have processed everything with a little more grace. But graceful, I am not. And that's what makes me, me. So I'll call Dr. 3 when I get my period, and I'll do my best to catch my breath from here.  And I promise if more shit goes wrong with this cycle, I will set new standards for what it is to be considered "mentally unstable".

Namaste.

Ten Units Please!

Lupron shot number one is DOWN! Annnnnd my husband is a total rock star for two reasons: 1) I am still alive and 2) I didn’t feel a thing! I panicked only a little in an excited-giggly-school-girl kind of way, but got over it pretty quickly when I realized he was doing the shot but it didn’t hurt a bit! I am by no means a needle-phob, I’ve just never had anyone who wasn’t professionally trained, jab a needle in my arm. Good times. So as recommended by my in-cycle nurse we are doing the Lupron in the fatty part of the back of my upper arm. (Ironically the place I like to torture the people I love with a surprise pinch when they don’t know I’m behind them.) Because at one point we will be doing three shots per day, she recommended not using all of the “real-estate” on my stomach since it can get sore. Sounds fair to me.

So call me Spotty-Mc–TMI-Spotterson, I’m still spotting but it’s starting to clear up RIGHT IN TIME for me to finish up BCP’s on Thursday and wait for AF to show. Nothing like having your period for two weeks... So the spotting actually got worse starting Friday night, and stayed that way through Sunday. (Like bright red, and requiring more than a liner) I did call in and actually spoke with Dr. 3 since he is on call after hours. My nurse told me to call if it got worse, so I did. I felt a little sheepish bugging him for something that seemed so trivial, but A) I don’t know enough about IVF to gauge if my spotting should even be considered trivial, mostly due to fact that Dr.Google, and all of you seemed to have been treated differently per your respective clinics. And B) I remembered how much we’re paying this chump, he can take a three minute phone call from me don't think he minded that much. Anyhoo, he diplomatically, and promptly explained that it was fine. That they prefer not to ask patients to double up on BCP’s because most people just end up complaining of nausea and go back to taking one per day anyway.

So HOLY CRAP we’re really doing this! I’m feeling really good, and taking a lot of time for myself by thinning out our schedule. It’s been really nice to have the extra alone time with Brian, and not having too much going on socially is a bigger relief than I realized it would be. By the way, thanks so much for all of your thoughtful comments. Even though it’s still early in the cycle you’ve been extremely supportive and super cheerleader-y and I really, truly appreciate it.

GO INJECTABLES!

Meds

This afternoon the Mr. and I will head down to our clinic for injection training. I'm quite certain he's been waiting for a legitimate reason to stab me since about September of 2007.

Saturday I cruised over to the pharmacy to pick up my stash. As the technician handed me the neatly packed bag, I felt surprisingly underwhelmed by the size and weight of it all. The bag containing my burger and fries from In-N-Out that I picked up on the way there weighed more than the $3,800 dollar's worth of medications I now held at my side. Not that I anticipated needing a hand truck to get to my car or anything, but it sure didn't feel like much. It wasn't even all that real until I started taking the pictures of my loot, that it really hit me.

This is for us

For our IVF cycle

It's here. FINALLY.

Hers.

His.

My list of meds to date:

Folgard

Metformin

Pre-natal

Low Dose Asprin

Birth Control

Calcium

Humira

Lupron

Dexamethasone

Cipro - antibiotic

Menopur

Follistim

(Complete with lucky pen)

Novarel - trigger

Brian's meds:

Cipro.

(nice, huh?)

Although to be fair he's been taking a hefty load of supplements since June. Six pills twice a day. Remember the tic tacs? They worked - sort of. Not enough to get us there the old fashioned way. But enough to have made it worth it.

I start Lupron Sunday.

Holy crap.

Crap that Sucks, Part I

Methylenetetrahydrofolate, also known as MTHFR, and affectionately referred to as MoTHerFuckeR.

Methylenetetrahydrofolate reductase is an enzyme that is involved with amino acid metabolism in the body.

A mutation in the gene that produces the enzyme can affect how a person’s body processes homocysteine, which is an amino acid found in blood. (There are several different types of mutations, but this is a blog post not a medical transcript so I’m not going to get into the variances between the different types. But my NP did say that if you have to have a mutation, mine is the one you want to have {two mutations of the A1298C, Homosteine level is 10.5; normal is below 10.4})

An elevated level of homocysteine increases the risk of blood clots, and typically decreases the body’s ability to metabolize Folic Acid and other B vitamins.

Common risks associated with blood clots are Cardio Vascular Disease, Coronary Heart Disease, and Stoke. In pregnancy: Recurrent fetal losses that can occur in any of the three trimesters, Placenta Abruption (when the placenta detaches from the uterine wall before delivery) Small Gestational Age (where the baby is smaller due to clots in the placenta which results in a lower supply of blood delivered to the baby) Preeclampsia (High Blood pressure, proteins in the urine)

It should also be noted that the decreased ability to metabolize Folic Acid and other B vitamins leaves your baby susceptible to Neural Tubal Defects (Spina Bifida, and a whole mess of other scary birth defects), Preeclampsia and Blood Clots.

So part of the reason that not all doctors test for this is because the link between the MTHFR and recurrent Miscarriage has not been conclusively proven, therefore has never been formally introduced as a risk factor that should be routinely tested for.

I wrote this post because doing the research was therapeutic for me. And unlike my ability to properly absorb Folic acid, having to decipher the data and regurgitate it forces me to really absorb the information, and now I might not kill myself. KIDDING. This shit instantly mattered a whole lot less when I got the NK Assay results back. I still have a lot more reading to do there.

Please, please, please, please, please do not hesitate to contact me if you see the slightest bit of misinformation in my statements above. You can also email me for my references.

Annnnd the last of it; Dr. 3’s preferred method of treatment:

• 2.2 mg of Folgard daily, which is a high dosage of Folic Acid, B6 and B12 (starting now, and pretty much for the rest of my life)
• A prescription strength prenatal vitamin (starting now)
• Low dose/ Baby Aspirin (81mg) (starting now)
• Heparin: Likely started just after my transfer, I will need to give myself two shots per day until I’m at least twelve weeks along, possibly longer - pending future blood tests and the actual occurrence of me being pregnant.
• Calcium: 500mg twice per day, because heparin can cause bone loss. (after I begin heparin)

I'd like to thank all of you for your incredibly thougthful comments, success stories, and information. I'm so grateful for all of you, and especially those who are active participants with the LFCA.

Something That Could Have Been Brought To My Attention YESTERDAY

Or two fucking years ago, before we spent six months and thousands of dollars on DIUI's that were NEVER GOING TO FUCKING WORK.

I have Ovulatory Polycystic Ovarian Syndrome. Different than "Classic" PCOS.

(Thank you Meg, for the link.)

Yeah, I've never heard of it either.

Maybe I would have, had I been diagnosed TWO FUCKING YEARS AGO. Because then I would have known that one of the symptoms of OPCOS is an elevated blood sugar level which can hinder implantation - KIND OF A BIG FUCKING FACTOR don'tcha think?!?!

So yesterday I had my CD3 Antra Follicle count. Our new RE (I need to come up with a name for him) wanted to see my ovaries in an "unchallenged state", meaning before there was a dominant follicle present. He quickly counted eight resting follicles on my left, and 12 on my right. FYI, the average for most women is about 10-12 total between the two ovaries. I have 20.

He mentioned something about this on the phone consult Saturday, but honestly I didn't have any idea what he was talking about, because I knew I didn't have any of the "Classic" Polycystic symptoms. But evidently he saw it coming because I have a 30 day cycle, which is a indicative of women with OPCOS. The only good thing about this is that it means I am likely to yield a higher reserve of follicles on a low dose of stims.

He wants me to start on Metformin asap. He says it will essentially make me "more fertile". And thanks to the link Meg sent me, I now know that is because the Metformin will regulate my insulin levels therefore bypass any implantation problems. He also said he will keep me on it until I am 12 weeks along, because it can also decrease the risk of miscarriage for someone like me.

I know I should be happy about the fact that it's finally been diagnosed, and our RE just kept reassuring me that it's actually a good thing because it means I'll be a better than average responder. But just having found out - I'm pretty hung up on the fact that this wasn't caught sooner. It kills me to think about how much time and money was wasted, but most importantly how the failed cycles caused such an epic amount of unnecessary heartache. Really the time and money was one thing, but the depression that followed not only comprimised my marriage but has forever changed who I am as a person.

Oh and now I have to sit with what else could come back from the rest of my blood tests. And all TWENTY-FOUR vials that they took!!!! It was twenty three, but the lab called later yesterday afternoon to tell me they had forgotten one. GAH. And fuck, what if the insurance deception doesn't work?!?!

Commence Meltdown.
(Number One)

Inconsistency

Thank you all for the birthday wishes, my weekend was better than I could have hoped for. We went to dinner Friday night, did a movie marathon Saturday during the day, then finished up by using my spa gift cards (from Christmas) to get both of us massages! Which were fantastic save one thing. My girls. O-M-F-G do my boobs hurt. Laying on my stomach while the masseuse was doing my back was borderline agony. I almost asked her to stop. I've grown accustomed to the typical cast of characters as far as my PMS goes, but it's been all over the place since dealing with meds. Namely the progesterone. Sore boobs have always been a significant symptom, they'd start getting sore the day after I ovulated, and continue that way until I got my period. But once I started the progesterone the soreness was gone... HALLELUJAH!!! I sort of welcomed all the other crappy side effects from the Prometrium because I had been spared from the two weeks of barely being able to sleep on my stomach because my girls hurt so bad... Actually the worst part was taking off my bra at the end of the day.

But now my last two cycles have been fairly strange. The first period I had after my last BFN was nine days early. And I'm fairly certain I didn't ovulate, I'm one of the freaks who can feel it, and I never had any EWCM. And I'm pretty sure I didn't ovulate in February either because again both main indicators were MIA. As was my period, which this time was nine days late. And all the while, my girls stayed silent. Until I got my period, she showed up the day after I finally gave in and tested. (No miracle BFP for us, no way, no how!) So since the day my tardy period showed up my girls have been sore. I finally ovulated on Wednesday last week and from that day on they've gotten even MORE sore - GAH! At one point Brian got so tired of hearing me complain that he barked out: "Jesus, you should go get them checked out!" As if they're sprained ankles or something... I was about to sarcastically thank him for his compassion when he quipped that it would probably suck a lot if his boys were sore for weeks at a time. Indeed, Sir.

Anyone else have anything like that? - Odd cycles and strong PMS symptoms after stopping medicated cycles?

Anyway, where was I ? Right - the weekend. So yes, I had a lovely birthday although I insisted that Brian not call it my "birthday weekend" and just call it my "me-time". I didn't really want to acknowledge it much. Thirty one - oy vey. It's not that I feel old or anything, it's just absorbing the fact that I'm not twenty-two anymore. Which in a way - thank gawd for that. But you know what I mean... Back to my "me-time" I think hands down the best part of my weekend was having Brian all to myself. He's been pretty busy with his company as of late, so it was quite the treat to steal him away. Thanks for spoiling me dear.