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

RE Appointment 5/24

My appointment went good today.  We did get lost when we first arrived.  I asked the little Korean lady at the information desk where to go but she didn't know where the "fertility clinic" or "Reproductive Endocrinologist" was.  She gave me two options.  First being the OBGYN on the third floor, for pregnancy tests, pregnancy and giving birth.  No, that's not me.  Plus when I made my appointment I was told me ground floor or lower level.  The second option was the OBGYN on the ground floor.   Hmm, I don't think that is me, but it could be?  I walk down to the OBGYN clinic and as soon as I walked in the door I notice the waiting room full and there are tons of newborns and babies everywhere.  Fuck!  I really hope this isn't the place.  Sure enough he sends me a door down to the actual fertility clinic.  This waiting room just had a couple waiting alone and a few women.  Much more my taste.

Basic Appointment Testing

Source

• Medical History - They didn't seem to care about the records that have yet to arrive.  Just asked me questions.
• Ultrasound
• Uterine Lining - Measured 15mm, too thick.  Obviously it's been some time since AF.
• Ovaries - I've never had cysts before, at least they haven't been found.  She showed me the left ovary, covered in small cysts.  Then scanned to the right ovary, also covered in cysts.  It's nickname is Ring of Pearls.  Yup, the classic PCOS cysts.
• Blood Work - I go for that tomorrow morning.  I'm having glucose done along with a few other thing, mostly stuff I've had done in the past.
• Semen Analysis - She's a little worried about Bean's low results in the past.  I'm not too concerned, they could be worse & I seen PG with less.  They are not bad enough to send us to an Urologist.

Dr. C told me there is overweight PCOS and skinny PCOS.  I have skinny PCOS.  Even with my anovulation and cysts I still don't look PCOS.  Which is probably why I've made it so long without a diagnosis.  I'm not overweight enough and I don't have thinning hair, hair in strange places or darkening of the skin.  She also said no amount of weight loss will make my PCOS better.  Though I don't like to make excuses nor am I lazy, this is something I have thought about from time to time due to the fact that my problems began when I was 16 and underweight at the time.  I actually wasn't allowed to donate blood in high school because I didn't weigh enough.  If I see the same problems at a BMI of 18 and a BMI of 29, weight probably it's related to it.  

Cervix

The description of the my cervix from the RE looks bad.  I guess most of it is gone and it's very short.  I am at a great risk for cervical incompetence and a cervical cerclage is most likely going to be needed.  This also comes with bed rest.  This scares me because I am a military wife without family in the area and very few friends.  I will have to figure out a plan once I get pregnant.  This also isn't new news to me so no surprise about the cerclage.  

She is having me met with the high risk OBGYN even before pregnancy is achieved so I know what to expect.

Overall

Even with my failing cervix, my polycystic ovaries and Bean's 23 million sperm count we are ready to move forward with IUI.

Move to IUI

I began spotting this morning, randomly without any cramping.  Not sure if this is AF, but if it is then tomorrow or the following day should be CD1.

I need to have a beta PG test done to make sure I'm not PG.  This part really doesn't seem necessary.

On CD3 I'll start Clomid 50mg for five days.  I'm not a fan of Clomid, I didn't ovulate at 150mg, let along 50mg.  My five rounds of Clomid before were unmonitored they don't know how I responded to it, other than not releasing eggs.  This time I will have ultrasounds to show the number of eggs and their sizes, along with the trigger shot to manually release them when they are ready (vs waiting for if/when my body to do it).  So I guess it's better, but I still don't like Clomid.  I've just already been down the road before and see no hope there.  

Around CD12 I'll have my first ultrasound to check the size of my follicles.  Possibly a few ultrasounds after that until my follicles are large enough.

I'll be given the Ovidrel trigger shot.

Following that will be my IUI with Bean's fresh or frozen sperm, depending on if he is home or not.  If it is fresh sperm and Monday-Friday then I'll go to Tacoma, if it's frozen or fresh on Saturday or Sunday then I'll go to Seattle.  

Next Tuesday we drive to Seattle to "drop off" some sperm to be frozen. 

Cost 

Clomid & Ovidrel are covered by my insurance, along with any blood work or ultrasounds.

The IUI is $200 for the sperm washing and inseminating me.

Freezing sperm and keeping it frozen is $250 for the first three months, then $125 every three months after that.  

This is a pretty good deal.  There is about a 20-25% chance of it working each cycle.

I'm also on the list for IVF.  It's about a year wait and costs $6000.

-Selbe

Behind the Glass

I think I'm going to have to be induced with Provera again.  It's a little upsetting.  The side effects are not the bad for me.  It's frustrating that I have to keep coming back to it.  I took it last April, then July, August and March.  I have extra here that I could take right now, but I'm saving it and holding off.  With my next RE appointment two weeks away they'll probably want to run more tests on me.  If I take the Provera now and it works quickly (probably not) then I could miss the specific testing days and have to wait another cycle for testing.  I'll just tough it out.  I'm about CD41 today and my cervix goes hard to soft over and over again.  My menstrual cramps are gone.  It seems so odd to have them so strong, then nothing.

I've been looking online for information about this doctor's office.  They seem to like to start women on Clomid before going to injectables, even if she has had no success on it before.  I did five rounds of Clomid last year, however I was never monitored via ultrasound.  Because there was no monitoring there was also no trigger shot.  With my past of not ovulated on Clomid 150mg, Dr. H wanted to get rid of Clomid all together and move me to Gonal-f (injectable) and Ovidrel (trigger).  I'm not sure that the new doctor will have the same opinion.  Clomid is not the worst thing in the world.  The side effects are not ideal, and it's not a needle.  It's just kind of territory that was already covered.  

I had a dream the other night about not being able to get the needles into my skin.  Ether my skin was leather or the needle was dull.  I just kept stabling myself over and over again in the stomach.

Attempt at Running

I went running today for the first time even pretty much.  I had a gym membership back in NH.  It's a chain gym so they are all over the US, except here.  I tried looking into a different gym here but so far the only one I like is double the price I was paying before.  This gym does have classes and other benefits that my old one didn't so I'm sure it's worth the extra money.  I just haven't come to terms with spending it yet.  I'm told I can get a free membership to the YMCA but it's a few towns over.  And an extra 10 minutes of driving time is probably going to used as an excuse for not going at all.  

I decided since I am new here and haven't seen much of the town that I'd just walk around and see it all by foot.  Which lead to running.  I'm not much of a runner.  I refer to myself as the fat kid.  I'm slow and have no coordination.  I'll see where it takes me.  My back and legs already hurt so that's good.

Still Standing

A couple people in the last few days have directed me over to Still Standing Magazine.  It's a new website launched this month about infertility and loss (pregnancy or infant).  I added myself to their monthly blog list.  They don't have too much on there yet but it does have promise. 

Behind the Glass

I did see this article, No Mother’s Day For Me, on Still Standing that mentioned Mother's Day is like sitting outside a candy store and watching everyone inside have fun.

This is interesting because I always describe it as similar.  I feel like I'm in grade school and everyone is allowed to go out for recess, but not me.  I got in trouble or didn't do my homework or something.  I have to stay inside.  Sitting next to the window I look out all my friends running around and having fun.  I wish I could be out there with them except I did something wrong and have to complete my punishment.

  

Only thing now I'm all grown up.  I'm infertile and still standing behind the window watching everyone have fun, smiling.  They are all so happy.  I can't figure out what I must have done wrong this time, what the cause of my punishment is.  How I can make it up?

I'm stuck behind the glass.  I can't find a way to the other side.  I sometimes pound on it, very few people hear me.  I am alone with tears running down my face.  Every once and awhile there is some hope, but it doesn't stay for long.

I feel like everyone I know is given something I want so much so easily.  It's just handed to them with little or no effort, sometimes they didn't even want it to begin with.  They go along with their pregnancies with little or no complications.  Their baby is perfectly healthy.   It's not like the car we want with all the features.  Or the new TV.  The want is something different.  We try and try and try, over and over again with so much hope.  Month after month, year after year.  Just hoping if this herbal tea, different drug or break from it all together works.  Then a miracle happens.  Only to find out the heart stopped, we go into labour early or the our baby is born stillborn.  We are left with nothing again.

This Mother's Day I will be behind the glass just like many other women struggling with infertility and the loss the their baby.  I will be alone and probably will not talk to anyone that day.  I will not be getting a handmade card, flower or chocolates.  Or even be getting a "Happy Mother's Day-to Be".  My child is no longer alive.  I would have been 25 weeks, 1 day on Sunday.  Any effort I have ever made at being a mother means nothing.  I will be forgotten, my baby will be forgotten.

“Happy Mother's Day”

It comes around every year;

but when you have empty arms,

it's very hard to hear.

It's a day to celebrate a mother,

for all the trials she overcame;

and a reminder to an infertile

of her loneliness and shame.

But what really makes a mother,

Is it just conception and birth?

Or is there something more,

that shows a mother's worth?

It's putting your child first,

in everything you do;

it's sacrifice and determination,

and love and patience too.

An infertile woman makes all her plans,

around a child not yet conceived;

she loves them even though they aren't here,

more than she ever could have believed.

She appreciates and understands,

what a blessing that children are;

she works hard for just a chance,

that motherhood is not that far.

All odds are stacked against her,

and yet she still has hope;

everyday is another struggle,

finding ways to help her cope.

So even though her arms are empty,

she can still be a mother too;

So say a special “Happy Mother's Day”

for those waiting for their dreams to come true!

- Saw this on a forum yesterday

-Selbe