We had a consultation with the RE regarding our options should this next cycle not be successful. It was a bit overwhelming. We really have several different options and no one option is necessarily the best option.
1. We can continue with the same protocol. It appears that I am responding well to the clomid. However, the RE believes that there is a small possibility that underneath it all this drug might not be our best option. This particular medication works by tricking they hypothalamus into releasing more hormones that tell the pituitary gland to drain more LH and FSH that then causes the ovary to produce more eggs and more follicles. So with this drug success is dependent upon the quality of the FSH being produced by my body. Therefore, if the quality of my FSH is below optimal, then the quality of the eggs contained in the mature follicles may be less than optimal. And unfortunately the only way to evaluate egg quality is through IVF. The RE believes that our chance of success with each cycle would be between 10% and 25%.
2. We also have the option to use another drug called letrozole that is similar in nature to clomid. However, there might be a chance that my body would react differently to this particular drug. The RE again believes that our chance of success with each cycle would be between 10% and 25%.
3. We could move onto injections. The injections, unlike the previous drugs, rely on synthetic FSH to cause the ovary to produce more eggs and more follicles. Therefore, we are not dependent upon the quality of the FSH being produced by my body. The chances of the egg quality being optimal increase with the use of injections. The greatest downside to the use of injections is the cost. We would be spending a substantial amount of money each month simply on the cost of the medication. The RE believes that our chance of success with each cycle would be between 20% and 30%.
4. We could move onto IVF. We are nowhere near pursing this option at the moment. So we will just leave this section blank!
5. I call our final option "The Elephant in the Room". There is a possibility that I have endometriosis. This is a condition in which tissue that behaves like the cells lining the uterus (endometrium) grows in other areas of the body. The endometriosis, depending upon its severity, can unfortunately lead to problems with fertility along with a wide-range of other problems. There is much debate in regards to how endometriosis is actually correlated to fertility problems. I have always experienced symptoms that are indicative of endometriosis. I made the decision about eight years ago to go on BCP in hopes that the BCP would suppress any potential endometriosis. I was on continuous BCP. This means that I very rarely allowed my body to shed the lining of my uterus or have a "period". The BCP were a life saver. I regained my life. I came off of the BCP in October 2010 in anticipation of trying to get pregnant. I have been fortunate since that time to not experience any severe symptoms of endometriosis. I still have somewhat painful periods but the pain is no way at the level it was prior to being on the BCP. The only new symptom I have is significant back pain leading up to the days before my period. The RE has recommended a laparoscopy because there is still a chance that I could have endometriosis. There are many women who have this disease and have little to no symptoms of it. The laparoscopy is an outpatient surgical procedure in which the RE would insert a camera through a small incision in my abdomen to get a clear view of all my reproductive organs. If there was evidence of endometriosis, then the RE would remove as much of the endometriosis as possible. This procedure would be covered by my medical insurance.
Now you can understand why my brain hurts!
We have decided that if we do not get pregnant on this current cycle then we are going to move forward with the laparoscopy.
This was not an easy decision. It has actually been a topic we have been discussing since we began this journey in January 2011. Our RE had actually suggested we do a laparoscopy prior to doing any cycles. We disagreed with this assessment at the time. I do not make light of any surgical procedure. However, we feel that our next best option should this cycle not work is to move forward with the injections. Because of the cost associated with the injections we want to be 100% certain of what is going on with my reproductive organs. And the only way the RE can get a clear picture of my reproductive organs is through the laparoscopy. There is also a possibility that if I were to be diagnosed with endometriosis then my medical insurance would subsequently cover infertility treatments. This would mean that the injections would be covered and the costs associated with each cycle would be significantly decreased. I also understand that there is a strong possibility that I do not have endometriosis. That would be wonderful. If that ends up being the case, then Kara and I are prepared to move onto the injections with hopes that we get pregnant very quickly.
We are both hoping that none of these options actually need to be used in the coming months. We are instead praying with every ounce of strength that we can muster that we get pregnant this cycle.
Mary
Thursday, June 30, 2011
Wednesday, June 22, 2011
cycle # 6
I had an interesting visit with the RE today. I made the decision to try to cycle again this month. I was scheduled for my baseline u/s today. And I am thrilled to report that I have NO cysts! Yep. My body finally did something right. And to say it was totally unexpected news is an understatement. I actually made the RE repeat himself. I know I got this big ass smile on my face. And to get a smile on my face while some strange man is rummaging around my nether regions with a big ass probe is quite an achievement. And it was also decided that we would go all out this month too. That means I am upping the clomid dosage to 50mg this month. It is time to bring back the big boys! I go back next week to see how things have developed. I am hoping for the best but also bracing for not so good news. I know that because I am upping the clomid dosage this month there is a slight possibility that I will be overstimulated this month. And I am okay if that does in fact happen. I just think Captain America needs more than two targets to focus on. His soldiers apparently have really bad aim!
Kara and I are also scheduled to have a consult with my RE next week. We want to get a game plan together should this cycle not be successful. The plan from the beginning was to only try four cycles following this protocol before reevaluating our game plan. I want to get a plan of action together this month so that we are not forced to sit out another month simply to develop a plan. If we get a plan of action together now, then we can jump right into it should this cycle not work out. I will be honest. My expectations are really low this month. However, I am still really glad that I at least get to try this month. I am just glad to finally get some good news. It does wonders for my mood.
Mary
Kara and I are also scheduled to have a consult with my RE next week. We want to get a game plan together should this cycle not be successful. The plan from the beginning was to only try four cycles following this protocol before reevaluating our game plan. I want to get a plan of action together this month so that we are not forced to sit out another month simply to develop a plan. If we get a plan of action together now, then we can jump right into it should this cycle not work out. I will be honest. My expectations are really low this month. However, I am still really glad that I at least get to try this month. I am just glad to finally get some good news. It does wonders for my mood.
Mary
Saturday, June 18, 2011
this is hard
BFN.
To be honest I have been dealing with the impending bad news for a few days now so this morning when I found out with all certainty that this cycle failed I was not completely crushed. I actually feel a bit relieved. However, the past few days have been a completely different story. I knew that a BFN was inevitable as I had been getting negative HPTs for the past several days. So over the past few days I was completely numb to the emotions but I could not shut off my brain. The simplest of tasks proved to be too complicated. I even turned down the wrong street while going to my parent's house one afternoon last week. I did not want to talk to a single person. It was super difficult to be at work. I even for the first time had a hard time being around my really good friend at work who is pregnant. I just felt crushed. And for the first time I started to feel as if this would never happen. I would never be pregnant. I think I am just coming to terms with the fact that this journey is going to be a bit more difficult than I originally anticipated. I never in a million years thought that I would still not be pregnant in June. But I am also trying to think of the positive aspects. I am so glad that we started this journey being as aggressive as possible. And I will continue to think in that mindset. I think too how much time we could have possibly wasted had Kara and I decided to try on our own before seeking out medical interventions. I am also so blessed to have a really good friend in my life who has been on a similar journey. The knowledge she has given to me cannot be replaced. I also feel as if I have found a good RE. I think she will be willing to listen to my concerns about these past failures and I also think she will be as aggressive as Kara and I chose to be. But even with these positive aspects I can't help but feel the anxiety creeping over me at all hours of the day. I toss and turn at night. My appetite ebbs and flows with my moods. I have a hard time concentrating on the tasks that need to get done each day. But I also know that I will get pregnant. And I will have a baby. It just might not be on my own timeline. And I have to respect that a greater plan exists for me. So our next steps ... ??
I will call the RE next week to set-up an appointment to discuss our options from this point forward. I know that our current plan of action needs to be reevaluated. I know that something needs to be changed. I do not think that I will attempt to cycle this month as it would be inevitable that I have a cyst as a result of the medicated cycle. It has happened every other time. So instead I would like to develop a new plan of action and be ready to go on my next cycle. I know my RE is out of the office this coming week so I am crossing my fingers that it does not take too long to get an appointment. So that is where I am at this morning. I am sad. I am confused. I am frustrated. I am angry. I am positive. It is a wide range of emotions that seems to change each and every moment of the day.
Mary
To be honest I have been dealing with the impending bad news for a few days now so this morning when I found out with all certainty that this cycle failed I was not completely crushed. I actually feel a bit relieved. However, the past few days have been a completely different story. I knew that a BFN was inevitable as I had been getting negative HPTs for the past several days. So over the past few days I was completely numb to the emotions but I could not shut off my brain. The simplest of tasks proved to be too complicated. I even turned down the wrong street while going to my parent's house one afternoon last week. I did not want to talk to a single person. It was super difficult to be at work. I even for the first time had a hard time being around my really good friend at work who is pregnant. I just felt crushed. And for the first time I started to feel as if this would never happen. I would never be pregnant. I think I am just coming to terms with the fact that this journey is going to be a bit more difficult than I originally anticipated. I never in a million years thought that I would still not be pregnant in June. But I am also trying to think of the positive aspects. I am so glad that we started this journey being as aggressive as possible. And I will continue to think in that mindset. I think too how much time we could have possibly wasted had Kara and I decided to try on our own before seeking out medical interventions. I am also so blessed to have a really good friend in my life who has been on a similar journey. The knowledge she has given to me cannot be replaced. I also feel as if I have found a good RE. I think she will be willing to listen to my concerns about these past failures and I also think she will be as aggressive as Kara and I chose to be. But even with these positive aspects I can't help but feel the anxiety creeping over me at all hours of the day. I toss and turn at night. My appetite ebbs and flows with my moods. I have a hard time concentrating on the tasks that need to get done each day. But I also know that I will get pregnant. And I will have a baby. It just might not be on my own timeline. And I have to respect that a greater plan exists for me. So our next steps ... ??
I will call the RE next week to set-up an appointment to discuss our options from this point forward. I know that our current plan of action needs to be reevaluated. I know that something needs to be changed. I do not think that I will attempt to cycle this month as it would be inevitable that I have a cyst as a result of the medicated cycle. It has happened every other time. So instead I would like to develop a new plan of action and be ready to go on my next cycle. I know my RE is out of the office this coming week so I am crossing my fingers that it does not take too long to get an appointment. So that is where I am at this morning. I am sad. I am confused. I am frustrated. I am angry. I am positive. It is a wide range of emotions that seems to change each and every moment of the day.
Mary
Monday, June 13, 2011
my life
All of this waiting. It messes with my mind. This is a sample of a conversation I often have in my mind ...
"God. I'm hungry."
"Oh. Maybe I am pregnant."
"Idiot. You're not pregnant. You're just a fatty with nothing better to do than stuff your face."
I have a million such conversations over the course of less than two weeks. Here is another conversation ...
"My boobs hurt."
"Oh. Maybe I am pregnant."
"Idiot. You're not pregnant. Your boobs hurt because you are grabbing at them every five minutes to see if they hurt."
And another ...
"I got up and peed two times last night."
"Oh. Maybe I am pregnant."
"Idiot. You're not pregnant. You got up to pee so many times last night because you drank two gallons of water before bed."
Yeah. This is my life.
Mary
"God. I'm hungry."
"Oh. Maybe I am pregnant."
"Idiot. You're not pregnant. You're just a fatty with nothing better to do than stuff your face."
I have a million such conversations over the course of less than two weeks. Here is another conversation ...
"My boobs hurt."
"Oh. Maybe I am pregnant."
"Idiot. You're not pregnant. Your boobs hurt because you are grabbing at them every five minutes to see if they hurt."
And another ...
"I got up and peed two times last night."
"Oh. Maybe I am pregnant."
"Idiot. You're not pregnant. You got up to pee so many times last night because you drank two gallons of water before bed."
Yeah. This is my life.
Mary
Monday, June 6, 2011
"no reason this shouldn't work"
Those were the words from my RE right before the IUI yesterday. My response. You are telling me!
I have been inseminated. Again. We once again had stellar numbers from Captain America. The total motile sperm count was 22 million. This is a different way of looking at the quality of our vial. Typically, the only numbers the RE gives me before the IUI are the total sperm count and motility percentage after the vial has been thawed. However, this time I was given the total motile sperm count which takes into consideration total sperm count, motility percentage, and morphology (aka the shape of the sperm) to give an overall number of sperm that have a chance of fertilizing the egg. I believe the RE wants at least a total motile sperm count of 10 million. So Captain America exceeded those numbers. It only takes one!
There was nothing out of the usual with this IUI. However, I had my good luck charm with me this time ... the lovely Kara. I was really glad that she could be there with me. Though I think she was a bit confused as to what she should be doing during the actual IUI. She refused to make eye contact with me because she was afraid that she would bust out laughing. I tend to make funny faces all the time. And I am definitely more likely to make faces when it appears from my end of the table that the RE is mining for gold down in my nether regions as opposed to doing an IUI. So instead each time I glanced over I would catch her looking at the ceiling. It was cute. It was just nice to have her in the room with me while I did the post insemination relaxation. It was nice to have someone to talk to. Plus, it would be great if we could tell our child one day that we were both there at the moment he or she was conceived (give or take a few hours!).
The weekend ended up being somewhat relaxing for the both of us. I think I will have fond memories of the weekend if I end up pregnant this cycle. If things do not work out this cycle, then I will probably look back and regret the craziness of the weekend. I called this entire weekend a big old clusterfu*k. However, while the weekend may have not been the most relaxing, it was just nice to get away for a bit. We spent some quiet time together and we also go to sit by the pool and enjoy the sunshine.
The more this process goes on the more it becomes a part of my day to day routine. Don't get me wrong. I was still a nervous wreck for the actual IUI but I now find myself at moments actually forgetting that I am in the dreaded 2ww. I actually woke up this morning and totally forgot for a few minutes that we had even done the IUI. And that was nice. I also find myself able to dive into other tasks without as many "mental" distractions. But I am also nervous. I am prepared for it to not work again. But I'm not sure how I will handle the emotions this time. I think it will be hard. The letdown definitely does not get easier with time. But ... I cannot think about that at the moment. I must believe that in two weeks I will be staring at a positive pregnancy test. A girl can dream ... right??
Mary
I have been inseminated. Again. We once again had stellar numbers from Captain America. The total motile sperm count was 22 million. This is a different way of looking at the quality of our vial. Typically, the only numbers the RE gives me before the IUI are the total sperm count and motility percentage after the vial has been thawed. However, this time I was given the total motile sperm count which takes into consideration total sperm count, motility percentage, and morphology (aka the shape of the sperm) to give an overall number of sperm that have a chance of fertilizing the egg. I believe the RE wants at least a total motile sperm count of 10 million. So Captain America exceeded those numbers. It only takes one!
There was nothing out of the usual with this IUI. However, I had my good luck charm with me this time ... the lovely Kara. I was really glad that she could be there with me. Though I think she was a bit confused as to what she should be doing during the actual IUI. She refused to make eye contact with me because she was afraid that she would bust out laughing. I tend to make funny faces all the time. And I am definitely more likely to make faces when it appears from my end of the table that the RE is mining for gold down in my nether regions as opposed to doing an IUI. So instead each time I glanced over I would catch her looking at the ceiling. It was cute. It was just nice to have her in the room with me while I did the post insemination relaxation. It was nice to have someone to talk to. Plus, it would be great if we could tell our child one day that we were both there at the moment he or she was conceived (give or take a few hours!).
The weekend ended up being somewhat relaxing for the both of us. I think I will have fond memories of the weekend if I end up pregnant this cycle. If things do not work out this cycle, then I will probably look back and regret the craziness of the weekend. I called this entire weekend a big old clusterfu*k. However, while the weekend may have not been the most relaxing, it was just nice to get away for a bit. We spent some quiet time together and we also go to sit by the pool and enjoy the sunshine.
The more this process goes on the more it becomes a part of my day to day routine. Don't get me wrong. I was still a nervous wreck for the actual IUI but I now find myself at moments actually forgetting that I am in the dreaded 2ww. I actually woke up this morning and totally forgot for a few minutes that we had even done the IUI. And that was nice. I also find myself able to dive into other tasks without as many "mental" distractions. But I am also nervous. I am prepared for it to not work again. But I'm not sure how I will handle the emotions this time. I think it will be hard. The letdown definitely does not get easier with time. But ... I cannot think about that at the moment. I must believe that in two weeks I will be staring at a positive pregnancy test. A girl can dream ... right??
Mary
Friday, June 3, 2011
never make plans
I had my mid-cycle u/s today (cd 11). I am always ready on cd 11. Not so much today. And of course Kara and I had made plans to go away this weekend. We had these grand ideas that we would have the IUI on Saturday morning and then we would escape into the warmth of the sun for the weekend. I have two follicles at 19mm and 16mm. The RE thinks that they will both continue to grow and I should be ready for an IUI on Sunday morning. My lining was once again at 8mm. Kara and I decided to still go away this weekend. We already had reservations to board the dogs so we are going to make due with a bit of inconvenience. I will do the trigger shot tomorrow morning. Well actually I am going to make Kara do the trigger shot! I'm actually not all that nervous to do the shot myself. I think I was actually too calm because the RE kept making sure I understood what I had to do. This doesn't mean that I won't be nervous when the time comes. But I listened closely to the nurse and I think I have the process down. We plan to still travel to our intended destination on Saturday morning. We will then travel back to town for the IUI on Sunday morning. We will only be two hours away so we are just going to think of the trip back to town as a mini side-vacation. We plan to go back and finish our mini-vacation after the IUI. I am really excited because Kara will actually be able to go to the IUI with me. This is a first. And I am trying to take it as a positive sign. My really good friend also gave me her lucky socks and necklace to wear to the IUI. She wore the socks during her fourth attempt at IVF and that IVF resulted in her current pregnancy. So hopefully the luck will rub off on me. I am optimistic and really looking forward to a relaxing weekend.
Mary
Mary
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