The Chalkboard Project

I started my chalkboard project the other day.  I decided just to label it 0, 1, 2, 3 (hopefully 4, 5, 6...) weeks.  It kind of went with the other idea.    I started out with a brief history of the infertile me (and a little Bean).  I have a much longer list on the timeline page if anyone is interested.

That's it for now.

-Selbe

August 25th, 2012

Today I started out by calling my RE.  I wasn't able to get ahold of the nurse until a few hours later.  Since I'm on a natural cycle, not a medicated one, they are unsure that they can monitor me.  If I was on Clomid, injectable or did IUI, IVF then they would monitor me up to about 12 weeks (early appointments, blood work, ultrasounds).  Then I would get sent to my old OBGYN.  They are still trying to get a hold of my insurance company about monitoring me.

I also called my PCM (primary doctor, military medical center).  They do pregnancy tests without appointments.  Oddly enough Bean had an appointment in the same building at the same time so I had to lie why I was there.  My trip to PCM was LONG:

1. I walked up to the desk and they sent me to the nurse down the hall.  
2. I had to wait about 5 minutes to get in to talk to the nurse.  
3. Talked to the nurse for 10 minutes while she took down all my infomation. 
4. I got sent downstairs to the lab to pee in a cup (I guess they don't do blood betas there?)
5. Back upstairs to spend 15 minutes in the waiting room.
6. Back to the nurse and had to wait 5 minutes to see her.
7. She started talking about the baby and eating right, blah, blah.  My response: "wait is it even positive?"  She kind of skipped over that part.
8. I listened to her talk for about 30 minutes about basic pregnancy facts.  All stuff I already knew.  And then put it all in a folder from me to take home.  
9. I filled out a survey about my medical history.  Ectopic pregnancy, STDs, abnormal paps, genetic history.  
10. I was sent back to the waiting room from 20 minutes for my PCM doctor to review it.
11. Back to the nurse and she explained the referral out to the OB.  Normal referrals take a week or two to process, then however long until the OB feel the first appointment should be.  She explains to me that I'm consider high risk and I'm going to be seen a lot sooner.  
12. Downstairs to the refferals office.  There was already someone in front of me so I went to sit in the waiting room down the hall.  I went to check every so often and then to find out someone cut infront of me.  I just spent over two hours being passed from office to waiting room and my paitence and energy was beginning to wear thin.  
13. Refferals office called the OB for me.  They wanted me to come in tomorrow but I already have to work.

The due date they marked down is August 22nd, 2012.  This is from my LPM (last menstrual period) on November 16th.  If you go by the day I ovulated on, December 3rd then my due date is August 25th instead.  That seems like it would be more accurate.  

I'm 4 weeks, 2 days.

My first OB appointment is Wednesday morning (4wk,4days).  My refferal paperwork states: "LMP 16 Nov 11. EGA (estimated gestation age) 4+5 weeks Infertility pt with HSG Oct' '11 demonstrating "scarring of right tube". Please eval for IUP (intrauterine pregnancy) vs ectopic in this high risk patient."  Since my lap surgery showed a lot of scarring of my right fallopian tube the risk of ectopic is higher than normal, if I ovulated from my right ovary.  They are rushing to get me in sooner rather than waiting a few weeks.  Ectopic would mean I'd have to MC, naturally or with drugs.  And it can cause a lot of problems for me if it is not caught early enough.  I'm pretty sure it's not ectopic, most of the pain I've felt is from the left side, not right.  I knew I'd be high risk for a long time.  My cervix is a mess too. No surprise there.

16dpo @ FMU

16dpo @ FMU

16dpo @ 11PM

-Selbe

4wk, 2day

Post-Op & Planning Appointment 11/3

The Surgery:

It went well.  I recovered quickly and he didn't even look at my stomach at the appointment.  I guess the stitches (?) is suposed to fall off or go away on it own.  I've never actually had stitches before.

RE talked about the same things from the pictures before.  

Right Fallopian Tube:  Eh but he's not too concerned the risk of an ectopic pregnancy.

Uterus:  I have an hyperplastic endometrium.  Not too much of a concern though.  The biopsy of it came back normal.

"a condition of excessive proliferation (cell growth) of the cells of the endometrium (inner lining of the uterus.)...

...result from high levels of estrogens, combined with insufficient levels of the progesterone-like hormones which ordinarily counteract estrogen's proliferative effects on this tissue. This may occur in a number of settings, including obesity, polycystic ovary syndrome, estrogen producing tumours and certain formulations of estrogen replacement therapy." - Wikipedia

Cervix:  I also have cervical stenosis as "very little normal cervix was remaining" and it was a bitch to dilate.  This was already assumed for awhile.  My cervix is scarring over and the opening is very narrow.  This is why cramps are so painful to me and my HSG was a trip from hell.  It's complements of my LEEP in 2005 and 2009, but mainly the second one.  It's a rare risk of having a LEEP done but of course my body loves to be "rare".  I forgot to ask Dr. H about the possibility of having an cervical cerclage put in if I do get PG.  The actual thought of having my cervix stitched closed terrifies me so we will put that thought off for awhile.  FYI a cervical cerclage is used in women that have a incompetence.  The cervix begin to dilate way before it should, maybe times due to the weight of the growing baby.  It results in miscarriage or early labor.  The cervix is stitched closed around 14 weeks and the stitches are removed around 37 weeks.

Ovaries, left fallopian tube and vagina are all good.  Fuck something semi works.  

What's Next?:

I have CD21 Progesterone BW next Monday.  I need to have at least a 3.3 to have ovulated, even if it's a crappy ovulation.  No 1.7!  A 10 is ideal for a non-medicated cycle.  (It was 15 when I was Clomid or if I'm on any other drugs.)

And then I need to decide, ovulation or not.  No ovulation then Provera will be my buddy again.  

Source

Dr. H began talking about doing an IUI (intrauterine insemination).  It's a couple types of shots and then Bean's sperm is poured into my uterus once I've ovulated.  My cervix hates me and I fear having another tube stuck up it, even though the RE assures me it is much smaller than the one for the HSG.  The cost is between $2000-2500 which will not include my meds, an additional $500.  But spending $3000 does not 100% get me a baby, only about a 17% of one.  So odds are I'll need multiple which is $3000 each cycle/month.  

And then there is IVF.  We are not even going to get into that because each cycle costs $12,000.  Again no 100% guarantee.  But if I buy two (results in BFN) then the third if free.  How nice of them!  If I spend $24k I'd better get a lot for free, along with a free crib, stroller and all the other stuff.  We can just pretend like this doesn't exist for now, like the cerclage I'll probably need.

My insurance will NOT cover any of my meds used for an IUI or IVF.  In fact they will even refuse to pay for basic U/S and BW.  They want no part of it.  (Then again my infertile ass is expensive, I don't want to pay for me ether.)  But they will cover my meds for timed intercourse (TI).

So for TI it is the same meds and monitoring as an IUI.  Except when I ovulate I have sex like a normal person, you know penis in the vagina, no tube of sperm in the uterus.  I'd like it to be as normal as possible.  This has a lower success rate but then again it's a lot cheaper.  

The meds I'd use for the TI (or IUI) are:

Gonal-f RFF Pen 450 IU @ 75iu/day - Daily injection used for ovulation induction (OI) with FSH hormone from CD4 for a week or two.  This makes my ovaries produce lot 'o eggs.  This is much like Clomid but for those who don't do so well on it.  I can't wait to stab myself in my stomach!

Ovidrel - Once injection of HCG hormone for my ovaries to drop all the eggs.  I'll be monitored with several U/S to see when my eggs have fully matured with Gonal, then this shot is used.  

I might be on Progesterone also to reduce the risk of MC since my body doesn't produce enough of it on its own.

The injectables come with a higher risk of multiples.  I'm pretty sure it made Bean worry a bit when the nurse said that.  But it's a 10% chance of twin, and much lower for triples and so on.  She let him know there wouldn't be six which I'm sure he was picturing in his head.  To be honest we are both pretty excited for twinkies!

Decision:

I'm going to see what the Progesterone comes back as.  If it's good then I'll hang out on Vitex and hope to be normal for awhile longer.  Or I'll move to TI with the injectables.  If it's too low then I'll definitely be moving to TI.

I'm not ready for IUI.  We have the money but I feel I haven't had enough time having natural sex to have given it a good shot.  I've been having unprotected sex for over a year but very rarely have my ovaries actually released eggs.  And a couple my age only has 20% change each time with perfect timing.  

I'm also waiting to move since our new home (hopefully) has an Army base that does IVF at a discounted rate and includes the drugs.  

Bean is most likely going to be sent back out to sea in the spring.  I can do IUI and IVF while he is gone with his frozen sperm.  I'm going to use the "fresh" stuff now.

If TI works:

I'll have BW for check my betas (PG test) 14dpo after each TI cycle.

I will stay at my RE until 8-14 weeks before being sent to an OBGYN.  My first fetal U/S will be at 6 weeks, then one or two more at a later date before going to the OBGYN.

-Selbe 

CD19, 4dpo