Uncharted Territory

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Monday morning I had a monitoring appointment to check my lining, in preparation for my transfer. They brought me in sooner than they normally would have since I have had so many issues trying to get this FET on track. As the doctor began moving the wand around to view my uterus and lining I knew what was going to happen before he said anything. My lining measured at 8.4mm, my ovaries were quiet, and there were no large, ominous blobs indicating the return of either of the cysts. It is transfer time this Saturday.

Dr. C finished the ultrasound, and told me I’d speak to the nurse after. The nurse gave me instructions for the day of transfer, and my new meds regime, discontinuing Lupron and adding vaginal progesterone. I take my Estrace and my progesterone 3 times daily now, and will continue on for 10 weeks if we achieve pregnancy.

I am excited, scared, nervous; all of the above and more, about the transfer. I know the process itself will be ok. I’m sure I will be dying from having a full bladder, but that’s survivable. We’ve never been this close before, and it is exhilarating, hope-inducing, and frightening all at the same time. I’m trying not to hold out too much hope but at least we are moving forward with something. The wait is going to kill me, this I know. It could be a really good Christmas, or a really bad one. Teetering on the brink, which way will we fall…

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A Date with Destiny

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I started bleeding again on Wednesday, for the third time since Oct. 25. I have still been taking Lupron despite the fact that at my last monitoring appointment I had a 5cm (2″) cyst, my lining was approx. 5.5mm and my estrogen was in the thousands. By rights I probably should have been cancelled but my Dr. decided to keep me on Lupron for another 10 days to see if it would help shrink the cyst, and lower my estrogen. I had my doubts and hated that I was told to continue waiting. I’ve felt as though I have been waiting for the inevitable; a cancelled cycle.

I was booked to do bloodwork on Saturday and have another monitoring appt on Sunday but when I started bleeding on Wednesday afternoon I called the clinic and they told me to do my bloodwork and come in today. Technically right now is around the time of my expected period (slightly late but that’s been the norm as of late) so more than likely the bleeding I had a couple weeks ago was just some breakthrough bleeding, and residual from my cancelled Suprefact cycle.

Leading up to last weeks monitoring appt I was having discomfort and pressure localized to my right ovary (where the cyst lives) and I was still having that pain into the beginning of this week. I figured if I could still feel it, it hadn’t gone anywhere and hence would still be pumping estrogen into my body. As of Wednesday the pressure had subsided and I was no longer having any pain.

Since I am having a seemingly normal period, and I can no longer feel my cyst I got really nervous for my monitoring appt. Nervous because I was starting to have a sliver of hope. I felt like I was getting ready for a really big date; I tidied up my lady business and shaved my legs last night. Laid out my clothes for this morning (for the necessity of getting ready faster, I had to be out of the house by 6:15 this morning). My stomach was in knots all this morning (though that’s nothing new for clinic visit days).

I got to the clinic excessively early, despite the slow drive due to the 3ft of snow that has fallen in the last 24 hours. Checked in, and second in line for my ultrasound, my morning was filled with a lot of hurry up and wait (a familiar theme in my life). To my surprise Dr. M walked in to do my ultrasound, even though the whiteboard in the waiting area said Dr. C was doing ultrasounds today. I was pleased to see him as that meant I might be able to get some answers as to what we were going to do now.

He asked if I was in for an FET baseline ultrasound (seriously, why do doctors not read charts before walking into a patients’ room?). I gave him a brief rundown of my situation and mentioned we were checking my cyst, lining and estrogen levels. I mentioned that I hadn’t been having any discomfort from my cyst and perhaps it had shrunk. As he moved to the right, nope, there it was. Big as ever. And another small one had developed on the left. I felt annoyed and disappointed but Dr. M said we can fix it, and that he would have to drain them. He went to check my bloodwork and speak with a nurse about next steps. As I was getting him changed I could hear him telling the nurse my estrogen is still too high (mother lovin’ cyst!).

As I came out of the change room the nurse beckoned me to come with her. She put me in a consult room and told me she just has to see if Dr. M is ready to do the draining. I looked at her, wide eyed “He wants to do it now?!” She told me yes and asked if I was busy today… I told her I was meant to be at work but could adjust. She asked what time I worked at and I told her 9:30 (It was 8am at the time). She gave me a bit of an eyebrow raise to which I asked if I’m going to make it in to work at all? She made a face and said she’d find out when Dr. M wanted to have me in. When she returned she told me I was booked in for 12:30 and that it wouldn’t take too long. As I left I called work to tell them I’m wasn’t coming in at all. No point in going to work when I’d just have to leave again shortly after arriving. Especially with the terrible weather and road conditions. They probably thought I was taking a snow day, but oh well.

I returned for the cyst aspiration and the prep was the same as if I was doing an egg retrieval or a transfer. Gowned up, I returned to the same room where my eggs were retrieved. The procedure was not comfortable. It is essentially the same as an egg retrieval without the good drugs. They only had to poke in twice as opposed to many times as they do when aspirating follicles, but still. They did use a freezing agent on my cervix and to be fair it was very successful. But once the needle penetrated and was going into the cyst, that was another story. Dr. M had a hard time getting the needle through the wall of the cyst and it was up there with HSG pain. But it had to be done.

When the nurse was prepping me to go back she mentioned starting my estrace in the next couple of days. Say what?! I was prepared to have to wait until my estrogen levels came down but apparently once the cysts were emptied and no longer producing estrogen the level didn’t really matter anymore as they will now be artificially manipulating it.

So I have a schedule, and it looks like this one is actually going to happen. Estrace starts tomorrow, continuing on with Lupron as well as five days of antibiotics for hubby and I as a prophylaxis. I have an ultrasound to check my lining on Dec. 8. As of today my lining is 5mm which still seemed a bit thick to me but my period hasn’t finished yet so it could potentially get thinner and Dr. M wasn’t concerned. I’m not so sure my lining will be at 8mm by Dec. 8 but they just want to keep a close eye on me since I have had so many issues. But if it is at the proper thickness, transfer could potentially be Dec. 13 or 14 at the latest it could be a few days before Christmas.

I am hoping for the former so I can at least get a beta (or more, if needed) in before we leave for Hawaii on New Years Day. I called J afterwards to give him the rundown and he says its going to work. After all of the setbacks he thinks this will happen, and it will work for us. I’d like to share his optimist… But I’m a pessimist at heart, and don’t want to get ahead of myself.

But I have googled our potential due date. And I’m hoping we can finish the year off with a bang.

The Heaviness of Infertility

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I started my Lupron injections Friday morning, and all went well. The needle is very small (and sharp), as is the dosage. I feel like injections are old hat as they became routine throughout the course of my IVF cycle, and personally I find the injection preferable to the 5 times daily nasal spray that was tried for my first cancelled FET. So after retrieving my meds from the fridge, and administering the dosage, I got ready for work and headed out. Around 11am that day I felt sort of weird, like I was having a lot of discharge (sorry, I hate that word) or something. So off to the bathroom I headed, and I was shocked to find blood. Apparently my period had started, on CD21. I was stunned, and horrified. I had to buy a tampon from the little vending machine on the wall (you’d really think I’d be a little more prepared and have some hanging out in my purse). I guess the pain and spotting I was having the week before last was the writing on the wall.

I called the clinic and left a message for them, advising that I had an unexpected arrival and I wasn’t sure what to do from that point. They usually return same day calls in the afternoon, so I was a zombie all day, trying to be productive but not succeeding. Nurse M finally called me back around 3:30, and her response to my situation was “You are one messed up lady!” (with a giggle). Yeah, thanks, I know. She told me that Dr. M wasn’t back in until Sunday (today) and that I should stay on my Lupron until then, and she would call me after they had discussed the situation, and what to do. She didn’t sound hopeful for the cycle continuing, as she agreed with me that this was not good.

The following hours were like living in a waking nightmare. I had to go to dinner with my mom and aunt, for my mom’s birthday and it was difficult to act normal, when my head was spinning. (I know, the fact that I don’t discuss IF with my mom is an issue for another post). My mother has problems of her own, anxiety and depression which leads to insomnia, which leads to more depression and anxiety. She is currently off work, and not in the best state. She has had these issues since I was very young, so growing up I haven’t always felt as I could lean on my mom, as she has her own demons to battle. I think this has a good lot to do with why I haven’t discussed our IF with her. But again, there is another whole post in there about her and my relationship.

My “period” had already stopped Friday evening and there was nothing all day Saturday. This morning when I went to the bathroom there was more blood, so I used a tampon but when I removed it later on there wasn’t much there. Certainly not a full flow. I waited on tenterhooks all morning for Nurse M to call, as they often call first thing in the morning if returning a call from a previous day. I had plans to go to the movies this afternoon so I was really hoping she didn’t call when I was in the movie, and have to be that person answering the phone. Thankfully she called about 30 minutes before I was about to head out.

The first thing she asked was if my period had continued to be full flow, and I told her, “actually, no”. I explained to her what had been happening and then she wasn’t sure what to tell me. Apparently Dr. M had just left, so she couldn’t speak to him about it. She asked me if I had stopped my Lupron, and I told her no, that she had told me to stay on the Lupron until she could talk to Dr. M to decide what to do. I had her at a loss, initially Dr. M had wanted me to come in to the clinic tomorrow, but now things had changed. She told me since I was still on Lupron, there was no big hurry for me to come in. So she is having me to wait until she can talk to Dr. M and she will call me tomorrow with the next steps. I’m thinking I am still going to have to go in eventually, and I would have preferred to just get it over with tomorrow, because now I have to wait one more day, and delay the inevitable.

At this rate, I can’t see this cycle continuing without some sort of miracle. I may hold the record for the fastest start and end to an FET cycle. At this rate, if this cycle gets cancelled, we will not be starting again until the New Year. We are away in Hawaii for 12 days for the first part of January, so depending on how my next cycles go, we may not be able to do anything until after we return. I’ve been very up and down emotionally this weekend. Sometimes I can put the pain, sadness and frustration down and walk away. But mostly it’s been the cloak on my shoulders, weighing me down.

One Bitten, Twice Shy

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“Hello, Lupron”…[said in the tone of Jerry Seinfeld to “Newman”].

Today is the first day of our second attempt at an FET. I begin my Lupron shots this morning, and will await the start of my next cycle when I will be adding estrogen, and the progesterone to the mix. I’ve been somewhat worried that this day was going to be delayed again, as I was having some concerning spotting last week around CD11 – 13, and then some unusual pelvic/uterine/ovarian pain Friday and Saturday. I told myself I would call the clinic this past Monday if any of the prior symptoms continued, but fortunately everything calmed down. My best guess is that I was ovulating from the same side as my cyst and perhaps the rupturing of a follicle in the vicinity aggravated the cyst. That is a totally uneducated guess, but allows me to somewhat rationalize…

I am trying not to get too far ahead of myself in case there is some roadblock that I have not yet anticipated. My goals right now are to take my Lupron at approximately the same time every morning (7am). It’s not specifically in my instructions, but probably best for the sake of continuity, and routine. I also want to get to bed between 10:00 pm – 10:30 pm (which I failed at last night, not turning in until well after midnight). Limit my intake of caffeine (I’m going to be realistic here and not cut it out entirely), as well as attempt to get to the gym more (meaning more than never). I pretty much stopped going to yoga entirely after my retrieval…which yes, was back in July (the end of July to be fair). Take it one day at a time, try not to make myself do things I don’t want to (beyond reasonable tasks). I am trying to limit my stress, and by not doing obligatory or unenjoyable tasks I hope I can be more peaceful (or at least less stressed).

Life is still pretty hectic after the move, though we’re pretty well settled in our new place, but we’ve not had a lot of downtime since. Our new tenants are moving in this weekend, as well our new appliances are being delivered. We have quite a few social engagements coming up, Christmas shopping, holiday activities, parties, ect. It’s a bit of a tricky time to try and reduce stress. Although the holidays are an enjoyable time, they are busy. In a sort of divine intervention I found out I am over my allowable limit for vacation time to be carried over into the next year, therefore I have 6 days off in the middle of December. If we make it through the whole process, my time off will coincide with the transfer. I don’t plan on becoming couch bound after the transfer but at least the time will allow me to get organized for Christmas (since we will be spending it in the mountains with J’s parents), and then our holiday to Hawaii on New Year’s day (so looking forward to that).

I am going at this with cautious optimism, as nothing with infertility is a sure thing, not even the chance to make it to transfer. So here’s hoping for FET 2.0 to be uneventful, besides getting that embryo home, and keeping it there for 9 months.

The Age of My Heart

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On Sunday I had to go in to my clinic to redo my SHG, (my clinic does them every 6 months to ensure no polyps or fibroids have grown), but more importantly, find out what the new plan was for my next FET attempt. The SHG was a piece of cake this time. It was most uncomfortable when he inserted the catheter into my uterus but all the rest of it was rather dull. He took lots of glamour shots of my uterus. Everything looked good.

Dr. M moved the wand over to my ovaries, just to have a look, and again there was nothing going on with lefty, but when he moved to the right a good sized orb appeared on the screen. The cyst was still there, though I sort of expected that seeing as it had not resolved itself during my last period, as seen on my CD4 ultrasound. It also appeared as though I may be ovulating from that side as there was another smaller orb tucked in with the cyst. The cyst was measuring at 30mm but Dr. M seemed very unconcerned.

He was a bit more serious with me than he normally is. He’s a very chatty fellow, usually making somewhat off the cuff remarks regarding how he’s going to get me good and pregnant, yada yada. He was still sociable this time, but asked me why we were doing this again in a rhetorical way. I told him I didn’t know, and I had hoped it wouldn’t come to this. He lamented with me, in a somber way I’ve only seen from him once prior; when he told us we’d be best to pursue IVF after 3 failed IUIs. When he finished he didn’t give me any indication of what was to come just told me everything looked good and he would see me later. I realise he has lots of patients but I don’t think he even read my file beyond the fact that I was there for an SHG.

After I got redressed I went to wait for the nurse. She took me into the consultation room, I’m beginning to get all too familiar with these rooms, and told me another nurse would come soon to discuss my protocol. They always put me in a room and then just let me sit and stew for a while, it is probably the worst part because I usually have some idea what’s going on so I worry, but I don’t know enough to be looking forward.

The nurse came in and had a new protocol for me. So I wasn’t going to have to wait long for my next crack at this. And luckily because my period came so swiftly after I stopped Suprefact I will almost certainly be transferring before Christmas. She told me it is a protocol that they’ve borrowed from another clinic and is usually used for donor gametes (as that’s actually what it said on the top of the instruction sheet). She crossed out donor transfer and wrote FET on top instead. The protocol is near identical to their standard protocol with the main difference being that instead of using suprefact nasal spray to down regulate, it used Lupron instead. That’s right, I’m going back on injectables. Apparently it is supposed to suppress better, since my body pretty much overrode the suprefact.

Dr. M is the one who comes up with the new plan, so I know that he’s looked at my file and decided the best course of action but I’m once bitten and twice shy now. The excitement over beginning anew has evaporated and been replaced with concern over the protocol not working. Besides subbing in Lupron for suprefact, there is no additional monitoring scheduled, and not much difference in the protocol. I peppered the nurse with questions but she didn’t have a lot of good answers for me. I asked about the cyst posing a problem, and she just asked me if Dr. M was concerned. I told her no, and that seemed to be that. I told her I was concerned about my lining being too thick, my estrogen being too high, ect. but she seems to think none of it will be a problem this time. She couldn’t even tell me how much Lupron I am taking daily. It just said one unit, she told me the pharmacy would know, and go over everything when I picked up the meds.

The only reason I had early and extra monitoring on my last attempt was because they had modified my FET schedule around my Vegas trip. At first, when the last cycle got cancelled I was pissed at myself for trying to have my cake and eat it to, berating myself for not just delaying by a month to make sure Vegas didn’t interfere with the FET. Now I’m wondering if it wasn’t a blessing in disguise; if I wasn’t going to respond well to suprefact, I would have rather found out when I did instead of getting so much closer to the transfer only to have it unexpectedly ripped away.

So now I am due to start Lupron Nov. 14 and wait until my next period starts. At that point I call the clinic, they will advise me to start my estrogen and antibiotics CD3 and then after 12 – 14 days of estrogen they will have me come in for a lining check. It still just seems odd to me that they don’t do any checks before then… If all looks good on my lining check (as in I am at 8mm triple stripe) they will start me on progesterone and after 5 days of progesterone when my body is artificially ready to accept my day 5 blast, it’s go time. I am trepidatious about even getting to transfer. I’ve just seemed to have the worst luck in this whole process and I don’t want to get ahead of myself as I am wont to do.

Because my SHG/FET WTF (is that enough acronyms for ya?) appointment was on a Sunday I was very dressed down. Normally I am on my way to work after my appointments so I am dressed professionally with my hair and make up done. This time I was wearing a ball cap, old jeans, my converse sneakers and a zip up sweater. I have a boyish figure, and I’ve always looked younger than I am (I’m starting to appreciate this, but did not as much when I was a teenager). As I left the clinic, the nurse patted me on the arm and said “you look so young”. She said it almost in a sad way, like I was too young to be there.

In the grand scheme of things I am still considered young, at 27 years old. Especially given the fact that we are dealing with MFI, I am in an excellent position for IF treatment. People will say time is on my side and that I have lots of it. Though this may all be true, I feel as I’ve aged well beyond my years through this process. I may appear young, but ask me the age of my heart.