IVF Wait List?

Source

I've mentioned in the past about how I'm on a waiting list to do IVF.  If you don't know why then read some of my posts from the past.  But the short answer is because it's cheap.

In May at my first appointment at the RE I asked to be put on the IVF wait list even before I did the IUI's.  I knew the wait list was a year long.  If an IUI worked then I'd take myself off the list and give someone else my spot.  If it didn't work then I wouldn't be waiting so long for IVF.  I was given April as my tentative date and was told I'd be added to the list.

Another time in June I was asking about my spot on the list.  They couldn't locate me because the nurse said there was no "find" option in the program.  Which I'm sure wasn't true.  But she swore I was on there and if she couldn't find me she'd add be right away and mark it that I wanted to move up if I spot become available.  Not everyone is interested in moving up.

I called a month ago and asked if April was still my date, no one ever returned my call.

So I've still been assuming April is my IVF date.  I'm going to be pretty pissed if March comes around and I find out I'm not even on the list.  

I'm part of a forum online for this doctor's office.  One women mentioned tonight that she got moved from June to March, skipping two month in-between.  That's weird because shouldn't someone with an IVF date of April or May move up to March, not someone in June?  They never called me about the opportunity.

I asked her what month she was added to the list, thinking maybe it was before me.  October, as in a month ago!  Not May like me.

Someone who was added less than a month ago gets March, but I was added six months before I have April.  

I have nothing against this person.  But Madigan RE does have some explaining to do.  They ether never put me on the list, or they are taking people out of order.  Both seem unfair to me.  Waiting an extra month isn't that bad.  But if I'm re-added to the list now my IVF date will be fall or winter of 2013.  That just doesn't seem fair.  I will voice my concerns at my appointment next week.  If it doesn't get figured out then I'll spend the extra money and switch to another RE for IVF.  I can't take much more of Madigan's bullshit and misinformation.  

-Selbe

Extra Sperm

Source

I paid about $150 to freeze Bean's sperm last summer, and then $40 a month to keep it frozen.  I've been debating what to do with it after the news.

1.  Keep it frozen for IVF.  It's horrible quality but IVF doesn't care the count or if they are swimming.  Only thing is my IVF date is at least 6 months off and I have to pay each month until then.  But if my IVF date come up and my husband is on a business trip, well I have to put IVF on hold.  

2.  Give IUI another try, even though it's far for ideal quality.

3. Discarded it, just medical waste.  Then use fresh for IVF and IUI.

I called SRM up and asked about destroying it.  Come to find out it's a lot of paperwork and Bean needs to be here in person.  So #1 and #2 seems like easier options.  Maybe I'll just do another IUI.

-Selbe

What About Me?

As I was standing in the check out line at the grocery store the other night the cashier noticed the couple in front of me with the newborn baby.  Of course the cashier began adoring the baby.  My mind was filled with all the bitter things that one infertile could think of.  Along with the "I fucking hate babies" thought.  But the second though that came into my head: "what about me?"  

You can't really tell how long a couple has been TTC by just looking at them.  They could have been TTC for a whole two months, or did IVF after five years.  I admit I automatically go with the first of those two options.  Odds are they couldn't tell you much about most fertility treatments.  The "what about me" question pops into my head when, even though I have no proof, I believe I have been waiting longer for my baby while someone else is getting attention for their newborn.  I think of not just the months we have been TTC for, but years.  I have "done my time" with fertility treatment and think of my past loss.  To be absolutely honest I'm envious.  I wish some cashier (or anyone) was looking at my baby and tell me how beautiful s/he was.  But they are not.  I fall off the radar.  I am non-existent because I'm not a mommy.

I deserve some good attention.  Not some depressing crap when people ask how my fertility treatment is going.  It's going just as crappy as the last time they asked.  But I'd love for someone to look at my big belly, or my newborn or child, and compliment it.  

One of the things that upsets me the most and I was never given a chance at being a mother.  We can think for great mothers out there.  But we can also all think of horrible ones ether from the news or those we actually know.  The women that doesn't deserve to be mothers, or can't take care of the children she already has.  I'm not saying I'm going to be the absolute best mum on the face of the planet, no one it that.  But I have to be better than some of those other examples.  Why is it when the stork comes around to give their baby handouts for the month I am always passed up?  And every other infertile women.  Honestly, we can't be that bad of a future mother.  We are never even given a chance at parenthood.  Not even one tiny bit of chance.  Or worst yet, we are given a chance the baby is taken away from us.  

We have a great home here.  The baby will have his or her own room with painted walls to match the gender.  There will be a new crib and everything else will be brand new.  The best products for 2012, and everything checked for safety.  The SUV we bought last year is awesome.  The yard is a decent size and fenced in.  The baby will have a college fund before even being born.  We are financially stable enough that I can stay home and take care of the child for the first five years of their life.  Fuck I think I almost described a yuppie.  But whatever, none of that seems to be good enough.

The feelings that go with infertility is so complex.  I honestly don't believe one could even understand the emotions unless they have been in the shoes.  There is no "fairness" or waiting your turn.  Sometimes it so hard to justify what is happening.  The only thing we can hold onto is the quote: "everything happens for a reason".  But after a couple years honestly, what is the fucking reason?

The Future

Many days I just want give up on fertility treatment.  Even if money was unlimited, I don't want to do another IUI, I don't want to do IVF, I don't ever want to see Clomid or any of it's fucking friends again, and I hate OPKs.  No more!  I just want to be left alone.  I don't want a newborn, I don't want a child, I like my sleep and freedom.  I want to spend all my money on myself, I want to take off without needing a babysitter.  I want to keep my current body with my non-sagging breasts, and kinda flat stomach.  

And there is my husband with his one fucking million sperm he left me.  I am still angry at that.  It seems like his count keeps getting lower and lower over time.  I asked him to take the CountBoost or FertilAid but he told me those had the some vitamins and such as his regular multivitamin that he already takes.  I never looked into whether that was true or not, nor do I know if he even takes those multivitamins on a daily basis like he should.  What about the occasional alcoholic drink he has?  Or his stressful job?  The last two IUIs were great on my end, one and two eggs.  My cervix isn't a problem since they bypass it with the IUI.  My right fallopian tube isn't a problem since I know at least one egg went down my left tube.  I am left feeling like I should be pointing fingers and you can take a good guess who at.  

Some days I say it's OK I don't have children, or at least anytime soon.  I told Bean years ago if we never have kids I'm getting my boobs picked back up once they begin to sag.  I think the surgery cost less than IVF.  I might even be able to get it done for free if I can convince my health insurance my real boobs cause me emotional pain.  Because it's not like infertility cause anyone emotional issues, ever.  No one gives a fuck about that.  But new plastic boobs, well can't have me crying and being self-conscious about the pair I have now, can we?

I fucking hate life.  

Source

And I don't think there is a God anymore, not that I was 100% sure to begin with.  There I said it, and offended a few people.  I didn't grow up with too much religion in my life.  But somewhere I got in my mind that if I pray enough everything things would be alright and whatever I needed would be given to me.  I did pray, many times.  I'm also done blowing out birthday candles, wishing on stars and throwing pennies into a fountain for the same wish.  I'm sick of answering the same thing each year when Bean asks me what I want as a gifts for holidays.  It's been years since I've asked for a gift other than "baby".  And yes, I equated blowing out candles to prayer.  If there is a God I'm pretty sure he despise me or something, and my feelings seems to be heading that way too.  It's going on three years, God hasn't answered my prayers yet.  Unless you want to count the time I did get PG and it was taken away soon after.  I'd honestly rather of never been pregnant to begin with than be pregnant for a month and lose the baby.  I loved my baby boy but there is pain even today.  I still don't make it a whole week without crying about it.  For Christmas this year I want a really expensive piece of electronics, not even sure what.  And for the birthday, just let me eat the cake.  Fuck you candles.  If I'm stuck on this miserable earth I might as well have fun.  God, we are done.  

Next up on the list of spontaneous and random ideas I have:  skydiving.

Sometimes I look at the last ultrasound photo I have of my baby and think of how beautiful he was.  You can't see his face, or arms or much of anything.  But for some strange reason I find that blob to be beautiful.  

-Selbe

Physical Pain is Nothing

Looking at the last couple years of my fertility journey I've learned that the physical pain from everything is nothing compared to the emotional pain I've felt.

The side effects from the drugs (Clomid mostly) are there and blah.  The blood work is just needles in the arm.  I don't even take a deep breath like they tell me anymore.  It only affect me if they take a large number of vials (6+) on an empty stomach.  Bring a snack to eat after in that case.  The most painful thing about blood work is that sticky tape some offices use to patch you up after.  The internal ultrasounds are nothing.  The wand is the size of your standard dildo.  The HSG was hell, but I'd do it again (with a lot of complaining) if I had to.  Lap surgery left two incisions in my stomach.  It was sore but I didn't take any pain meds and was back at work 3 days later lifting heavy items.  The gas bubbles hurt the most.  The Hysteroscopies and D&E I was fine with.  Up walking around soon after and back to work the next day.  Both IUIs there was cramping, but nothing too terrible.  Injections the in stomach seem to creep more people out than the pain they cause me.  It takes a little force to push the needle to break the skin, but once it's in I am fine.  

Source

Many women would get queasy about the thought of simple the blood work or dildo cam.  None of that is pain to me.  I don't even look at the most painful thing in the world, labor, with fear anymore.  All that stuff is just temporary physical pain.

The emotional pain is what will get you.  Sometimes you go through a cycle with so much hope.  You had sex at the right time, or the IUI/IVF went perfect.  You wait two weeks with all these early pregnancy or implantation symptoms.  You think to yourself that you must be pregnant.  Maybe even take a early pregnancy test and swear you see a faint line.  Come to find out your cycle didn't work.  All the hope you had is now crushed.  The only thing you can do is pick up the piece and try again next cycle.  

Maybe your cycle does work, and then you lose your baby.

After my second ultrasound with my first pregnancy I had to start prepping for the great possibility I would need a D&E.  My emotions were a mess at first.  Why did I have to wait two years for this to only have it taken away?  Why does everyone else get pregnant with the snap of their fingers and they take a healthy baby home from the hospital?  Two weeks later at my fourth ultrasound they confirmed our fear.  They told me my body did everything right for the baby, it was still trying to feed it.  The sac was perfect size for a 10 week old.  But the baby wasn't perfect size.  It was no longer moving and the heart had stopped.  The following day was my 27th birthday, the day after I was in surgery for my D&E.  By the time my D&E came I was fine, I had already disconnected from my baby.  But never the same person I was before.

I went back to work before my D&E.  Most days I was so dizzy but my RE told me as long as I wasn't bleeding excessively then there was no need to go to the ER.  I had my insurance card in my pocket along with a brief note about what was wrong with me and my emergency contact.  Just in case because some days I was so sure I'd pass out with the building moving so much.  The dizziness went on for months, later diagnosed as Vertigo, but the worst of it ended after the D&E.

The thing that upset me the most were my boobs.  As soon as I hit 5 or 6 weeks pregnant my areolas began getting larger, along with the standard soreness.  Weeks after my D&E I remember standing naked in front of the bathroom mirror.  My areolas were still large and my boobs sore.  My body was still hormonally pregnant.  It made me angry and I just wanted everything to return to normal.  Those sore breasts where for pregnancy, and I was no longer pregnant.  One day I even wore a bathing suit top in the shower because I didn't want to feel the water hitting them and reminding me.

Emotional pain like this story hurts me way more than any physical pain of fertility treatment.  

-Selbe

Game Over

IUI #1.5... failed.

After five days of spotting and calling up the RE with the WTF question it finally came.  I would count Friday as CD1 but my flow didn't pick up 'til really late at night, so today it is.  I can't start my new cycle of meds 'til Monday anyways.  

My husband got deployed last week.  In the last couple months he had frozen sperm incase IUI #1 #1.5 didn't work.  Which is great now because I can use it and be the talk of every bored military wife if it does work.  The bad thing is that frozen sperm doesn't always hold up as well as the fresh stuff.  Many die in the freeze and thaw.  We also have low count to begin with.  Plus we can't get extra sexy time in before and following the IUI like last time.  The odds are not in our favor.

My Choices:

1. Pay $10k at least and have IVF done at a doctor outside of the military, going ahead of the military wait list.
2. Do IUI #2 with frozen sperm.
3. Do nothing.

I'm going with the second one.  We have two vials in storage, enough for two IUIs well he's gone.  Tentatively mid-September for #2 and mid-October for #3.  I'll put TTC on hold after October.  If the thaw for IUI #2 is really bad then I'll just stop there.  

For IUI #2 I'll start Femara Monday, U/S around the 7th and IUI around the 11th.

I did cry when I knew this didn't work (which has been several days now).  It was more of a combined cry with my upcoming due date (another post).  Which is now CD1!  It's hard for me to understand 1 egg to 13 million sperm in such a small place.  Where does it go wrong?  Not one of those fucking 13 million could find the egg?  

IUI Success Rate - Source

I'm getting rid of baby aspirin also.  Not sure if it helped my follicle grow or if it was all Femara.  I had 10mm follicle with 6mm lining on Clomid.  Compared to 17.5mm follicle with 8 mm lining on Femara.  But if I do crappy on my next follicle scan they'll just move me to injectables like I've been asking for anyways.  All I will waste is time.  That is fine because my race to get pregnant by the end of 2011   have an apocalypse baby   to give birth in 2012    to get pregnant before my due date to beat the deployment is over. 

Normally an RE will tell you your best chance of success from IUI will be in the first three cycles.  Not saying it won't happen, just less likely.  Depending on why you think the IUI failed, how hopeful you are and the price difference between IUI vs IVF, this can move up or delay IVF.  Or in my case a really long wait list, cheap IUI and nothing but time to kill.  I will probably make it to 5 or 6 IUI (if unsuccessful) before IVF.

Deployment

As for my husband's business trip I don't know where he went or when he'll be back.  We have very limited contact.  No Skype, Facetime, Internet, phone call, text messages, snail mail or emails.  I can send him 10 messages the whole deployment and each has to be under 50 words.  Good ol' family grams.  Each one is read by someone before it is sent off, and then read aloud in front of a bunch of people before it is given to him.  Not much privacy there.  I can't say anything too depressing or it won't get sent, or too much "code" text.  And he won't respond to any of them, ever.  There is nothing I can do to get him to come home early, except for maybe dying.  I'm on my own.  I also have a lot of free time.

Etsy

I re-listed a bunch of my old stuff I made on Etsy.  Only thing that really sell is my small animal bedding sets, which goes for about $30 a set.  I'm paid by PayPal for everything, which I then use to buy other things online.  I feel like I get things for free that way.  Problem is I don't put much effort into it.  If I made new bedding all the time and advertised I'm make a lot more.  Right now I get about five orders a week.  

-Selbe

7dpo

Trigger Shot 2dpt - 8dpt

I'm half way through my two week wait.  It's too early to tell if it worked or not.

Hormonally, I am pregnant.  Thanks to the trigger shot, which contains hCG hormone, same found in pregnancy.  I have been testing out my shot and right about now (8dpt) it should leave my system.  But my HPT do still have a faint line.  If I'm PG then: A. the line goes away and then comes back or B. the line never goes away but keeps getting darker.  I'm sure some of my symptoms are coming from the hCG injection.

Some things have been happening with my family that have been keeping me busy.  Nothing bad, just stuff that I can't post here for a little bit.  

Do I think I'm pregnant?

Yes - It's IUI, the sperm and egg are perfectly timed.  How could one not be PG?  I know a few people that got PG with their first IUI.  My boobs are not sore.  Nibbles a little perky, but boobs as a whole, nothing.  My boobs are always sore within a couple days of O.  Except the month I got my BFP, sore boobs didn't start 'til 11 or 12dpo.  This happened to my friend too.  Sore banger every month, except the month she got PG.  I was dizzy at the store tonight, really dizzy.  Maybe it happened a few other times too, but not as bad.  And lots of cramping down there.  It's feels like AF is coming and I even went running to the bathroom on the ferry the other day because I was so wet down there.  Today there is cramping too but it feels a little different, and more towards the right side.  I had a luteal phase dip in my BBT this morning.  I am pretty tired also.

No - You know I'm really not a lucky person.  The timing is too right in our life.  Sometimes people have to do IUI after IUI.  My acne is bad too.

-Selbe

First IUI

Bean had his appointment first yesterday morning.  They need to wash the sperm before inserting it for the IUI.  Washing it means removing any dead ones and separating the actual swimmers from the seminal fluid.  If you insert the fluid part into the uterus it can cause cramping and even for it to collapse.  Normally the cervix filters everything out but they bypass that with an IUI.

The SA came out alright, I think.  I'm really bad about reading SA numbers because "good" or "bad" doesn't depend on just one number, many things go into it.  I don't think these numbers are amazing.  But each one is above what the RE likes to see it at.  If it is too low then they'll cancel my IUI.

	Pre-Wash	Inseminated
Volume	5.0 ml	0.5 ml
Concentration	13 millon	30 millon
Motility	46%	83%
Rapid & Linear	12%	58%
Total	29.9 millon	12.5 million

While the crew was getting their bath Bean and I wasted time by having lunch and checking out the local mall with the Apple store.  I needed to scope out where I'm standing in line for the new iPhone 5.
The rooms at this RE are nice, and the office is huge.  I don't normal go to Tacoma, usually we are at Seattle or the Army hospital.  Everything went pretty quick.  They brought me back in the room and had me undress.  The nurse double checked Bean's info and my bracelet to make sure I got my husband's sperm.  You know, because that it kind of a big deal if I get someone else's.   

Source

The RE put the spectrum inside me without any lube because that kills the sperm.  It didn't hurt since there is cervical mucus in there right now.  It took a few minutes to get the catheter up past my cervix.  It was really crampy.  She kept asking if I was cramping and wanted adjust the catheter or spectrum if it was.  At first I told her it was, but then realized the whole procedure would last longer with her trying to fix it.  I'd rather tolerate some pain for a minute or two then have you keep adjusting everything and drawing it out.  I didn't feel the sperm being injected and it was quick only took about 30 seconds.  After that everything was removed.  I laided on the bed for five minutes with the cramping continuing before I got up.  I was surprised nothing came out like after sex.  Bean went to pay and then drove me home.  I spent the rest of the afternoon sleeping since I got such little sleep the night before with the excitement.  
I had my IUI 28 hours after my trigger and about 38 hours after my +OPK.  Ovulation usually occurs 24-48 hours after ether of those.  I'm not sure when I actually ovulated since I didn't feel the pain, but I'm pretty sure it was the day of my IUI.  We came home and got a little extra action in, just in case.
They told me I can start testing on August 24th (15dpo, 2 weeks & 1 day) which I highly doubt I'll be waiting that long.  I'm just not a patient person.  But then again maybe I will because my due date for my last miscarriage is the 25th.  I'll ether be super happy or crying all day.  I am testing out my trigger though.  I think it is normal in ones body for 7-9 days.

-Selbe

Trigger Shot

I did my first injection yesterday.  It was into my stomach but really wasn't as bad as it sounds.

I took Ovidrel and it already comes in a prefilled syringe.  I think the cost is between $50-100 without insurance, mine was covered though.  It has to be refrigerated.  The shot is an injection of hCG hormone, same type found in pregnancy.  So you turn pregnancy tests positive for a week or so after. 

1. I woke up at 8am to get the meds out of my fridge and put on my counter.  It's good to have them at room temperature when it is injected.  Fell back asleep.
2. At 9am I woke back up to do the injection.  Since Ovidrel is prefilled there is no mixing or measuring like other fertility medication.  You just take it out of the package and the needle is already full of medication.  Take the cap off.
3. You know when on those doctor shows the actor flicks the needle a few times and they a tiny bit of fluid comes out the top?  It's to get the air to come out of the syringe.  Injecting someone with air can be fatal.  This is common sense to me but I know it is not to everyone.  Plus I've spent years filling syringes for my sick ferrets.  Even though everything is oral for them it is sometimes easier to get a better reading of how much medication is in the syringe without it part filled with air.   Hold the syringe with the needle pointing up so the air bubbles float to the top.  Flick it a few times so any lingering bubbles make it to the top also.  Then press on the plunger 'til all the air gets out and a little bit of liquid meds come out.  You want to make sure all the air is out but not lose much of the meds.  I probably went overboard but I'm more afraid of dying from air embolism than anything else.
4. Find a spot where you want to do the injection.  I was told on the belly about an inch or two below or to the side of my belly button.  I think you can also do your thigh or butt also.  But my legs are really muscular and I can't reach my own ass.  My stomach is good enough for me.  Wipe the spot with an alcohol swab.  Also wash your hands before you do this, and don't ever touch the needle.  You don't need to be injecting germs too.
5. I grabbed a fat roll or some skin (easy for some of us) and inserted the needle as far as it would go.  The length of the needle isn't too bad, only an inch or 2cm.  Then let go of the skin and slowly pushed on the plunger 'til everything was out.  Slowly pull the needle back out once it is empty.  
6. My directions told me to put gauze over the site but I didn't have any so I just put a Hello Kitty band-aid over it.  Not needed though.
7. Put the used syringe in a sharps container.  My RE told me they don't give out the actual container but (depending on where you live) I could put all my needles in a plastic soda bottle and then drop them off at a designated location.

I had no pain from this.  Even took a photo after the meds were injected and needle was still in me.  I've probably been through more medical procedures, surgery and testing than most women my age.  Not much is painful to me, or even worries me anymore.  One thing I learned a long time ago before infertility treatment and when I was dealing with cervical dysplasia is to believe that whatever you are going through is "normal".  And everyone else is a bunch of wimps.  This works better for me than seating around feeling sorry for myself.

My IUI is scheduled for today.  Bean has his appointment at 10:30 to make a deposit.  This will be our last fresh cycle for awhile.  And then I'm scheduled at 1:15 for the IUI.  

Packaging  

Filled Syringe

Tummy after

-Selbe

Ultrasound 8/6

I went to my CD15 ultrasound today.  The RE had a trainee with him today so he spent extra long with the U/S.  At first they couldn't find my uterus.  A shadow or something was in there.  I assured the RE it was still there.  (Gosh I'm going to turn into one of those.)  After five minutes or so and a lot of wand action he found it.  My lining was 8mm this time! Perfect for implantation.  Left ovary is doing nothing.  But the follicle on the right ovary is now 17.5mm!  

The plan:  I'll do OPKs all today, then tomorrow, then one Wednesday morning.  They are waiting for the natural LH surge.  If none come up positive then I'll trigger.  Which looks like a great possibly since my OPKs are still really light.  They showed me how and where to inject it, along with needle disposal.   Then I went to wait in a 45 minute line at the pharmacy to pick up the Ovidrel.

The only thing that seems odd is they told me to trigger on Wednesday morning or afternoon, but I've only ever heard of people triggering at night.  I'm going to call up the place doing my IUI tomorrow just to double check.

One of our first photos at a Navy Ball in 2007

• +OPK on Tuesday = IUI on Wednesday
• +OPK on Wednesday = IUI on Thursday
• Trigger on Wednesday = IUI on Thursday

I was told to BD tonight.  Check!  

Out three year wedding anniversary and five years together is on Wednesday.  

-Selbe

Plan for the Future

The Plan

There are some thing in life that I'm adamant about having a plan for.  Like the time in Greece where Bean and I took a bus three hours to a tourist spot only to find they were closed for the day.  I ended up crying on the side of the road because we didn't have a hotel room and I didn't want to take the bus back.  That trip should of had a plan.  And there are some things in my life that I'm "whatever" about.  Like my college degrees, none which I use and I still have no idea what I'm doing with my life.  

So what's the plan if Femara doesn't work?  Femara is shown to have better success in PCOS, especially after Clomid has failed.  But it is not 100%.  I have a little knowledge about my insurance, cost of meds, IUI and pills vs. injectables.

In NH:

• I was seen by an outside provider (base didn't have someone to deal with infertility)
• Since I did so horrible on Clomid I was getting switched to injectables - Gonal-f, which would cost me about $500 since I would be on a low dose at first
• Trigger shot - $50
• IUI, with all the blood work and ultrasounds - $2-2.5k
• Total Out-of-Pocket - $3,000

In WA:

• I was sent out to a local Army Hospital, where they do have fertility doctors
• I can do Clomid+injectables, or Femara+injectable (but not straight injectables) - The meds for this piggy back cycle would be free
• Trigger - free
• IUI - $200
• Total Out-of-Pocket - $200

My insurance will not cover straight injectables.  But they will cover a cycle mixed with pill form fertility drugs.  This is stupid and I don't really get it.  Something about funding.  So even it I do get injectables I'll still be taking Clomid or Femara, even if it does nothing for me.  This is just to make them happy.  Or I could pay the full price of the injectable.  This is at least until I make it to my IVF date, then it will be all injectables.  

They also talked about possible doing ovary drilling.  

Met

My Patriot Nails

I haven't had any bad side effects from Metformin 1000mg ether.  The worst of it is during the morning when I first wake up I am nauseous.  Usually if I eat like half a granola bar and fall back asleep I am fine.

Fourth of July

Happy 4th of July America!  Bean and I are going to eat some unhealthy non-organic, non-glute free fast food, drink Mike's Hard Lemonade and be one of those crazies that sets fireworks off.  Hopefully we will not hurt ourselves or set anything on fire in the process.  It will be some stupid fun, which I think we all need right now.

-Selbe

Fertility Treatment is Elective

Edward wants some new
tits too!

I am so fucking sick of women that have the same insurance company as myself asking if they cover cosmetic, plastic surgery, boob jobs or whatever the fuck else.  There is a rumor that they will cover one cosmetic surgery per life.  An exception I can think of is if you are in a car accident in need facial reconstruction.  Or you have large breast that cause back pain and other health problems.  

If you have A or B boobs and want them bigger, pay for them yourself.  Or lipo or a butt lift or whatever else you may hate about yourself.

And don't even use the "I feel negatively about myself and I'm depressed" excuse.  I have fat thighs, stretch marks, acne scars and my right boob is smaller than my left.  I'm not depressed and crying over those things.  Maybe I just have more depressing things to actually waste my time blowing snot about.

If my insurance company pays for someone to have D cups so they can feel better about themselves, well then they also need to pay for my whole IUI/IVF cycle.  Just saying.  

I'm so sick of fertility treatment getting put in the same group as plastic surgery, elective.  I didn't choose this, I didn't want to be infertile.  

-Selbe

IUI Canceled

Source

IUI 1.0 got canceled today.  My lining grew, I was at 6.5 this morning.  But my 10mm follicle from the Tuesday was still 10mm this morning.  They don't except it to grow anymore, or for my ovaries to even release it.  

When CD30 hits I'll start Provera.  Or maybe a few days early because I have leftovers here.  I'm CD15 now so that will be July 14th.  Then the three weeks for AF to show up.  It puts me at mid-August for IUI 1.5.   

Originally they were going to bump me up to Clomid 150mg.  I thought, "Great, so I'm not doing anything next cycle."  (I was unresponsive last August on 150mg.)  Then they gave me the option of Femara so I took that instead.  It has less side effects, seems to have a better response for PCOSers and isn't Clomid.  

Since Femara is brand new to me I am excited for it.  My three cycles post-Clomid (and before I got pregnant) all resulted in ovulation.  Not sure if it was Clomid left in my system or Vitex.  Maybe I'll have the same luck next post-Clomid cycle.  RE also said my Metformin might help by then and lower my insulin levels.  Not that they are high to begin with (low 90's) but will make them low-normal or something like that.  Maybe normal levels are not good enough for these ovaries.  

Overall I'm fine.  I didn't cry or anything today.  I had I feeling from the beginning that this IUI wouldn't result in PG (although I though I'd make it to the actual IUI part).  I'm looking forward to enjoying my July 4th week like a normal person and not someone going though fertility treatment.  I'll also be enjoying my break since as much as back-to-back treatment cycles sound like a good idea, it is also very emotion draining.  

Thank you everyone for your prayers, thoughts, or whatever you do.  Please save them for August.  

(PS My due date for baby boy is coming up on August 25th and I'm currently looking around for ideas to celebrate him.  Feel free to post a comment if you have any good ones.  Or maybe it is time to give him an actual name.)

-Selbe

Blood Work 6/26

Blood work showed no ovulation.  That's OK.  It's early (CD13) so I didn't think I did anyways.

Friday I have another ultrasound appointment.  Let's hope there is a close to mature follicle.  I'd really like my IUI not to get canceled.  

-Selbe

Bare Minimum Kind of Girl

	Ideal for Trigger	My CD12
Follicle Size  (Dominant)	18-22mm	10mm (1)
Follicle Size (Non Dominant)	<16mm	5mm (1)
Number of  Dominant  Follicles for IUI	1-3	1
Number of Non Dominant  Follicles for IUI	No Limit	1
Lining	8-10mm	5.8mm
Estradiol	200+ pg/mL (per dominant follicle)	175 pg/mL

Ultrasound
I was so nervous going in for this ultrasound for the fear of hearing bad news.  I always try to expect the worst and when something better is heard I am excited.  That works out better for me since with TTC I often feel like I hear more bad news than good.  If I think the opposite way it ends with a lot of crushed hope.
Anyways for CD12 I'm not doing so well.  My right ovary has a 10mm and 5mm follicle, and my lining is only 5mm.  These numbers are about half of what is ideal for ovulation.  My left ovary has no follicles.  They still have time to grow, follicles grow about 1-2mm per day.  Not sure about lining.  
My RE originally thought the thin lining was due to low Estradiol (Estrogen or E2 commonly called) levels.  That seemed odd to me since I'm normally one for high E2 levels.  They sent me for E2 blood work letting me know not to expect that high of numbers.  With two small follicles and a thin lining they didn't even except me anywhere near 100 pg/mL.
He booked my next U/S for July 3rd (CD19) for me.  I was very worried that they would miss ovulation, and the IUI all together.  But he doesn't think I'm responding well to Clomid anyways (big surprise there) so my follicles will not be much bigger in 7 days from now.  So there is a great chance I'll be labeled anovulatory and just be put on Provera again.
The blood work came back a few hours later.  I got a 175 on my E2!  They are baffled to why someone with such little growth has such high E2 levels.  They have two theories: 

• I have already ovulated ether in the past 24 hours, or maybe I will really soon.  I'm instructed to have sex tonight since it is too late for IUI if that is the case.  A 175 is too high for a 10mm follicle so they think it might belong to another much larger one.  Possibly hiding or already been released.  They are running LH blood work to see if I'm going to ovulate soon, and Progesterone blood work to see if I already ovulated.  I really think this is an unlikely option since ovulation at CD11 seems impossible for me.  The two cycles I actually ovulated on Clomid was at CD16 and CD18.  It's really not like my reproductive organs to perform extraordinary or even at normal levels.  I shoot for the bare minimum levels and I'm happy with that.
• They expect my CD10 (and 5mm) to shoot off growing rapidly soon.  So my next ultrasound is Friday now (CD15) since that don't think I'll make it to next week now.  
• Bare Minimum - I've have high E2 naturally and responding crappy to Clomid... again.

I also got the RE to prescribe Metformin after a lot of talking him into it.  He let me know it probably will not help me since I'm not insulin resistance or fat enough.  I still want to try it though, it can't do anymore harm than what my body does on its own (PCOS).  Well minus the fabulous side effects.  I take 500mg this week, 1000mg (two pills) next week, then 1500mg (three pills) the following week and stay at that dose.  Unless I have horrible side effects then I'll increase on my time.

High Risk OBGYN

Source

I felt odd going to this appointment because my original thought was "are you my new OBGYN?"  I got there and it was in the hospital part of the medical center, as in labour and delivery.  Not an OBGYN doctors office.  The doctor rambled off a bunch of percentages of preterm labour after a LEEP, cone, with and without cervical cerclage.  After awhile my mind got lost, until I asked if I need a cerclage or not.  I really just want a "yes", "no" or "maybe" answer.  The short answer is no.  The last measurement of my cervix is 1.5cm.  Which is short for pregnancy, I think they are looking for a 3cm or longer.  They will have to wait 'til I'm past my first trimester to measure the cervix again and determine if the cerclage is need.  I honestly just want to say to put it in ether way.  But then there is the risk it was cause preterm labour on its own.
So rushing my ass to this really important appointment (thanks to the RE) was pretty much a waste of everyones time.  They can't give me a definite yes or no to what I'll need or not.  And they can't help my infertile self.  But they don't think my cervix is the end all so I am moving forward with fertility treatment vs adoption.
My IVF date is April 2013.

-Selbe

Ovulation in the Future?

Fertility Friend

I'm moving into ovulation week, if I ovulate.  I've got all the predictors going: OPKs, BBT, Ovacue, saliva ferning, checking the cervix.  Not that I need all those I just would like to see which method lines up with ovulation best, for cycles I'm not monitored via ultrasound.

I bought a VIP membership to Fertility Friend.  It's the charting program I like most, for right now.  I like all the custom setting I can add and the colours.  I just wish they had an Ovacue setting, well other than the custom ones I made.

I can feel slight pain in my right ovary at night when I lay in bed.  Only at CD8 or CD9.  Maybe that ovary is doing something?  I'm not really a fan of my right ovary, well actually the scarred and tangled fallopian tube it is connected to.  It slightly worries me and I feel more comfortable ovulating from my left, just because the increased risk of an ectopic pregnancy.  Even with surgery they can't fix my tube, at least not in 2012.  If I ended up having an ectopic there is a chance I'd lose that tube all together.  Honestly I'm OK with that.  If it causes more harm than good I'd rather have it removed.  Yes, that ovary would be MIA for natural intercourse and IUI.  But I would still have the left fallopian tube, and I'm already heading straight towards IVF with two tubes or zero.  That doesn't change much.  Will have to see on Tuesday is the right ovary is the one with the dominate follicle.  Or maybe I just have a pissed off cyst.

I try not to get my hopes up too much since my record of ovulating even with Clomid is few and far between.  But at least I have a tiny chance with Clomid, vs trying out new herbal drugs, and then a different herbal drug in 30 days to induce AF when it fails to work.  I feel like I'm doing something slightly productive even if I have zero follicles in there.  

I think I chipped the enamel on one of my teeth.  I never have dental problems, not even a cavity before in my life.  It's not noticeable to anyone but I can feel that it's different.  I have an appointment with my new dentist on Monday so hopefully they can bond it, sand it or whatever they do for something like this. 

-Selbe

Guidelines for IUI

I got a packet of guidelines for my last RE for what not to do during a IUI cycle.  Most of the info is also for TI, DI (Donor Insemination) and IVF cycles  It's honestly about eight pages long so I'm just going to summarize the IUI stuff.

IUI - Source

• Cold Symptoms
• Congestion - Ocean Mist
• Headache - regular Tylenol 325mg
• Cough - regular Robitussin
• everything else - no other medication is allowed
• Fever
• if >99.0F - Tylenol listed above
• if >100.5F - call doctor
• X-Rays
• no X-rays are allowed unless in emergency situations
• Environmental Allergies
• Take nothing, even if it is just over-the-counter
• Cats - don't change litter box
• Swimming - Allowed
• Yeast Infection
• no internal medication
• can use medication externally
• Intercourse
• allowed, limit during two week wait so it doesn't interfere with implantation
• Herbal Medication
• none allowed
• Alcohol
• not allowed, mixing hormone drugs and booze doesn't end will anyways
• Exercise
• No strenuous activity after CD8, includes running
• Travel
• allowed, as long as I can make all my monitoring appointments
• once pregnant fetus must be labeled "viable" (12 weeks) before travel can be done again
• Prenatal Vitamins
• folic acid - at least 400 micrograms
• iron - at least 30mg
• Caffeine
• limit or none
• Heat
• no heating pads, hot tubs, etc.
• Others Allowed
• Novocain, if not epinephrine mixed in
• TB test
• Others Not Allowed
• Flu shots
• undercooked meat
• Others
• Chickenpox
• if exposed and unsure your immunity status, call the doctor, don't show up in person
• if exposed and immune, no need for concern
• Fifth's Disease - if exposed, call doctor

Common Side Effects of Fertility Medication

• Breast tenderness
• abdominal fullness
• headache
• fatigue
• mood swings

-Selbe

Prescription Mess

I went to pick up my Clomid today.  It became more of a mess than I ever thought picking up a prescription could be.  It seems like everything here turns the simplest things into a clusterfuck. 

I went to the pharmacy earlier in the afternoon because later on the wait is insanely long.  If I get in and out before 2PM then I'm good.  I figured it would take 30-45 minutes, I'd be home in about an hour to take the dog to the dog park on this nice day.  I showed up at 1PM, grabbed a number and waited for it to get called.  They were on 404, I was 412.  It took about 25 minutes to get to my number and I went up to the counter.

There are two pharmacies here.  This one mentioned above, Bremerton.  And the one my RE is at, Madigan.  Bremerton is a lot closer, only 15 minutes away verse the hour drive to Madigan.  Obviously I want to drive to the closer one.  The RE will send my prescriptions (like Provera last week) to Bremerton so I don't have to drive.

At the counter the lady told me my prescription was already filled at Madigan, so they can't refill my prescription here.  The RE did send it to Bremerton, but for some reason Madigan grabbed it off the system instead, poured the pills in the bottle, stuck my name of it and put it on the shelf for me to pick up.  I don't understand why they would do this.  The auto-fill option (which I didn't even know they could do) is great... if I was going to Madigan.  My only option is to drive the hour to the other pharmacy.

I tried to get a hold of the RE but no luck.  About 95% of the time they never answer the phone and it goes to voicemail.  Bean started calling too.  I got the the gas station about a mile down the road to get gas since I wasn't going to make it to Madigan anyways.  I also grabbed a soda & snack because I didn't realized this was going to be an all day thing.  The apple and water I brought was not going to last.  Bean got a hold of them and told me they would have it back at Bremerton at 2PM.  It was 1:55 so I went back to Bremerton.

I met the lady in the elevator that helped me before.  She told me not to grab a number but at 2:05 and 2:10 it went from "filled" to missing all together.  I grabbed a number just in case.  I was 460, they were on 439.  I waited a half hour, they only made it to 444.  I cut in line at a window and asked if they had my prescription in the system yet.  Still missing.  I turned around and walked out so I could just drive to Madigan.  

In the car I went to open my soda.  It exploded everywhere.  There I was in my wet pants and sticky steering wheel, even more pissed off than before.  I drove home to change my clothes.

This time Bean came with me.  I got there went right to the desk.  It was 3:15PM, I was sick of waiting.  The first person I just asked if the prescription was in, I wasn't going to grab a number to fill it if it wasn't even there.  This asshole tells me to "pick a number" and won't even help me.  I grab a number, 511, they are currently on 490.  OK, this is bull shit.  This was my third number and I've been waiting over two hours.  

I went to another window.  This lady at least looked it up.  They found it!  She told me to pick a number to have it filled.  OK, but I still don't want to have to wait.  I went over to the window of the lady I had before, the elevator lady.  (This has to be the best person I dealt with all day!)  She remembered me and put it in to get filled immediately.  About 15 minutes later my name was called and everything was set.  It was 3:45, I had waited just under 3 hours!  BTW number 511 hadn't been called by the time we left.  

Bean filled a complaint before we left because he was so upset at this.  Along with last weeks problem, when they lost my referral in early May, and Dr. Idiot refusing to do pretty many anything for me.  The IUI ($200) and IVF ($6,000) are really cheap here, that's why I stay on Tricare Prime insurance.  I can switch to Tricare Standard and get away from these people, but the cost of the IUI ($3,000) and IVF ($13,000) increase when I go out in town.

I waited three hours for them to fix someones mistake.  Least I think that's what happened.  Not sure if I just don't understand how this health care system works out here and I'm slow.  Or they are really bad at explaining it to me.  I seem to always running into trouble.  

-Selbe

Much Better Day

Special Puppy

After many phone calls and rushing my old records (which were supposed to be transferred over a month ago) we finally got what we wanted.

Provera & Pregnancy Tests

They gave me Provera.  Same 10mg but seven days this time.  I'm on day two of seven and I usually get AF 14 days after the last pill.  So CD1 in about three weeks.

Before the Provera they made me get a pregnancy test.  A urine PG test.  What is that?  I thought I would explain the two types of PG tests.

• Qualitatively - Meaning you get a "yes" or "no" if hCG is found.  Never a maybe.  This is with all urine tests (lab or at home) & some blood tests. 
• Quantitatively - You get a number of how much hCG is found.  Results are based on the number, so < 5 is not PG, 5 to 25 maybe, and > 25 is pregnant.  This is always blood and used by all REs.  I've never heard of an RE using a urine test.  This is also good because after multiple blood tests they can look at the trends in number to see if there is a problem with the pregnancy.  In the infertile world this is simply know as "beta".  

After being infertile this long I feel like a urine test is too much work for me.  Blood tests I just hop up on the chair, they stick me with a needle and then 30 second later I'm patched up and out of there.  It's more "painful" for me sitting in the overly crowded waiting room than the actual needle.  The urine test they gave me a bag with a cup, wipes and stickers and told me where the bathroom was.  Next I'm standing the the bathroom looking at the 12 steps on the wall of instruction on how to give a urine sample.   Then wondering to myself if this is enough pee to fulfill their 30ml requirement.  This is too much work, just stick me with a needle next time.  Anyways, it was negative.

Clomid Increased 

They decided to give me the Clomid this cycle, as long as I go to the high risk appointment on the 26th.  This also means I am doing Ovidrel with IUI.  Yay!

Last week they wanted Clomid 50mg for me.  After reviewing my records today they decided to increase my dose to 100mg.  Though I still hate Clomid I have more hope in 100 over 50.  

Frozen Sperm

We went into Seattle to freeze Bean's sperm yesterday.  It went well.  I don't have a count or any other numbers.  But he did produce one vial worth for freezing.  It's sperm in the freezer so I should be happy.  And we do plan on doing it a couple more times in the next few weeks.  But does one vial per ejaculation sound normal?  I'm trying to Google and it seems like only one is used per IUI.  Sustained all of Saturday, Sunday and Monday.  

I'm so grateful that Bean goes along with these ideas.  I know it's not easy to jerk off in a strange room with people walking around outside. 

Blood Work

Last Friday I has another series of blood work, seven vials this time.  I looked at my hand after he got done and it turned purple with white spots.  It was pretty amusing to me.  Today I picked up the results.

	Selbe's	Normal Range
Estradiol	134	27 - 433 pg/mL*
DHEA	205	18 - 391 ug/dL
LH	14.31	1.2 - 103.03 mIU/mL**
FSH	6.28	1.79 - 22.51 mIU/mL ***
Prolactin	10.53	3.34 - 26.72 ng/mL
Insulin	8.86	1.9 - 23 uIU/mL
Creatinine	0.8	0.6 - 1 mg/dL
ALT	32	30 - 65 U/L
Fasting Glucose	92	70 - 110 mg/dL
TSH	1.38	0.34 - 4.82 uIU/mL
Testosterone	68	2 - 45 mg/dL
HgbA1C	5.1	4.3 - 6.1 %
17-OHP	79	< 285 ng/dL ****

* Estradiol - Mid-follicular phase: 27-122;  Periovulatory: 95-433;  Mid-luteal phase: 49-291

** LH - Follicular phase: 2.12-10.89;  Mid-cycle: 19.18-103.03;  Luteal: 1.2-12.86

*** FSH - Follicular phase: 3.85-8.78;  Mid-cycle: 4.54-22.51;  Luteal: 1.79-5.12; Postmenopausal: 16.74-113.59

**** 17-OHP - Follicular phase: <185; Luteal phase: <285

A few of those with the *'s depend on where I am in my cycle.  Since I'm CD60 I'm guessing I'm in the luteal phase?  I'm sure that isn't right because I never ovulated.  The only number that is high is my testosterone and that is common for a women with PCOS.

IVF

I was told yesterday the IVF wait list is at about 9 months right now.  But it could become shorter if other people drop out of the program.

-Selbe