Fumbling Towards Eggstacy

4dp3dt

First off, thanks sooo much to everyone who has stopped by my blog and offered me support this cycle, whether it be via comment or just positive vibes.  It is uplifting to get your kind and motivating comments, every single one has brightened my day.  And yes that sounds totally cheesy but it's true.

It's too early in the game to have any juicy news to pass along.  So here's the non-juicy news.  Since Transfer Day, I've been sleeping 12-15 hours a day.  Once I realized the progesterone is making me very sleeepy (it took until yesterday to make the connection, you'd think by now I'd have this stuff figured out), I decided to move the shots to right before bedtime so as to maximize my waking time and not feel like a complete lazy-ass.  As for any bodily feelings, I felt minor cramping up until yesterday.  I kind of wish the cramping would return, it makes me think something's going on in there.  As for weight, I lost 3.5 pounds since Saturday.  I'm sure it's water, but that's a testament to how much water was stored in my belly during stimms I suppose.  My belly has been non-stop nauseous.  We got a big dry-ice-filled box of Ben and Jerry's from my sister-in-law today to thank us for playing camp counselors for a week and I can't even get motivated to dip a spoon in.  (Get this flavor - "Imagine Whirled Peace" -- a tribute to John Lenin made up of carmel ice cream and fudge peace signs and toffee).

I am a BAD bed rest babe - on the good side, I didn't do anything stressful.  But against doctor's orders, I decided it was within the realm of bodily care to walk, so I've been walking an hour a day.  Walking has actually made me feel human again after all the nap-induced fuzz-brain.  But other than walking my dogs, and, oh yeah, a quick trip to the store to buy pineapple, my ass has been pretty much glued to a sofa.  Luckily I work from home, so I can keep working from the sofa.  If you happen to be a long-time-reader (which in the case of this blog is Feb), you may know that part of the reason I even took a job working from home (within my employer of 8 years, that is) is for all of this IF stuff.  It's a hell of a lot easier to do IVF when not doing the daily commute and sneaking into bathrooms and sneaking out for frequent doctor appointments.  And I know, I did the sneaking the first time 'round.

So anyway, back to this cycle.  My brain is fucking with me, of course.  It goes back and forth between two main themes:

#1 -- There's only a 10% chance this worked, so don't expect it to work.  If it does, that's great, but if it doesn't, don't freak.  You're older and your eggs are older, it's not a criticism, it's just a fact.

#2 - If you think positive and imagine the little embies becoming blasts and hatching and implanting, and send them love and pray to God (I'm a bad Catholic, not being a frequent pray-er, but the prayers have picked up significantly lately), then all the positive thinking and prayer are sure to have some impact.

Then there's the paranoia:

#1.1 -- It will be a bummer to have to tell people yet again that it didn't work.  People don't want to hear about failures.  It will be something you take to your death bed, that this didn't work, that you never got to leave a legacy in the form of a genetically related human.  People don't just get over this.

#2.1 -- What if you're wasting positive thinking energy by talking to and praying about embies that arrested development days ago?  That's borderline kooky.  Talking to nothing.  But then again, if time doesn't exist in heaven, then maybe a prayer today can help embies from 3 days ago. 

And then there's the emotionally-intelligent me:

#1.2 -- if it doesn't work, at least I will have given it the ol' college try.  Three tries is respectable.  And walking away from the table before you're down too far is a smart thing to do.  Plus, it will be a massive relief actually to have my life back.  No more shots or doctor visits.  Freedom from TTC.

#2.2 -- [well success doesn't require too much emotional intelligence, right?  It seems to be needed where success is lacking.]

OK I'm a big geek because I just put my thoughts in outline numbers. 

Doc has me on luteal HCG -- where I shoot it up every 3 days, last day being Friday -- so it doesn't make sense to do a HPT until probably Sunday (8dp3dt) at the earliest.  Probably for the best - I'm not a good bargain shopper, so at $10 a pop, that should save me $50.

Speaking of drugs, I convinced DH to take the remaining growth hormone, seeing as I had $200 worth of it left over.  His first reaction was "I hate needles."  I screamed, "you wimp!  I've had about a thousand shots in the last year, and you don't even want ONE!?!"  Eventually he gave in and let me give him a belly shot.  It was weird doing it to someone else.  He had the same effect from the drug that I had -- kind of wired, and insomnia.  Oh the ways we have fun in our household these days.  =)

Eggs Retrieved

My ER was today, with 10 eggs retrieved.  Not bad considering that on our last try at IVF#3, in March, I never made it to ER due to two leading follices, and cycle was converted to an IUI.  This time around, I was officially acepted by my new RE as an IUI patient with the option to convert to IVF if I had at least 4 follies, due to my "poor history," so I trumped the 4-follie criterion.

I had a 6:30 a.m. conference call for work, and then woke up DH at 7:30 a.m.  He was up til 2 a.m. last night chatting with his niece and nephew after we all went to see the Police at Red Rocks (great show!), and needless to say, was not too excited to be awakened.  Of course I think, why does he have to be a grump when we're trying to make a baby.  But then I figure, it's not like he was up late drinking -- he was up late being a very cool uncle to two teenagers who love him to death.  And anyway, he cheered up once we got to the doc.  Being a health care worker himself, he always goes out of his way to make the health care workers smile because he knows what it's like to be in their shoes.

Things were quite a bit different at Conceptions compared with CCRM.  At Conceptions today, I was the only ER patient of the day.  When I had my last ER -- with CCRM back in November 07 -- I was the 12th, and last, patient of the day and was wheeled out to my car in the dark.  Seems like the fact that they have only my eggies to focus on today is a good thing.

Tomorrow we'll get the fertilization report, and on Friday (day 2) the embryologist will be able to tell us if it's a 3-day or 5-day transfer.  At that point (day 2), the embies should be at the 2- or 4- cell stage.  Should be interesting to see what embryo quality is since last time we had high fragmentation.  With 4 straight months of 2x/week acupuncture, and HGH, I'm hoping for better quality.  The criteria for day 3 versus day 5 transfer is that, if > 4 look good on day 2, then they plan a day 5 transfer.  I prefer a day 3 regardless of what they look like on day 2, but I'll wait to see what they look like before putting my foot down.  No sense being adamant now about going against their preferred ways of doing things if I'll only have a few good ones anyway.

I'm happy that on transfer day, the embryologist is going to have a full size pic of every embryo for us to look at.  I've never got to see pictures before.  My first embryologist, in Tampa, said that taking pictures was bad for the embryos.  The current embryologist says that's not the case.

Not much to do now other than send those little embies happy thoughts.

Ice Cream

Here's Sarah McLachlan performing Ice Cream.  This is my 2nd last song / blog title from her Fumbling Towards Ecstasy album.  Not sure how to relate this to fertility, but I have plans to go to Dairy Queen tonight. 

I started stimming on Tuesday, so today is day 3 of my 2nd attempt at IVF #3.  I'm on Saizen, which is a human growth hormone produced by recombitant DNA technology.  It's actually produced from mice and then modified to equal human growth hormone genes.  So basically I'm injecting myself daily with serum from mice as well as the urine of postmenopausal women.  Just think about that for a moment.  Mouse juice and pee from strange old women.  The things we do to get what we want.

I've had insomnia since stim day 1, and since I don't recall having that side effect on any other cycle, I'm blaming it on the Saizen.  I also finally rode my new touring bike on Tuesday for the first time -- it's been sitting in the garage for 4 months, and I've been a wanna-be cycler for months now, but finally I got on the thing and went 30 miles.  DH is giving credit for that to the HGH.  Which mildly pisses me off because I want all the credit, especially for going uphill most of the way back home!  ;)

Here's the main study that corrolates GH with increased pregnancy rates.

I actually read the entire insert that came with the Saizen, since I'm oddly excited to be on it.  Here's some highlights:

• It stimulates skeletal growth, cell growth, and organ growth.
• It increases uptake of amino acids.
• It can decrease body fat (still hoping this is a side effect -- but doubting 8 days will have an impact).
• It's contraindicated if you have a malignancy (guess it helps tumors grow big and strong).
• It can impact the metabolism of cortisol (interesting esp. since cortisol is apparently toxic to eggs & embryos -- but I'm not quite sure how it impacts it).
• Overdose can lead to hypoglycemia or giganticism (freaky, nothing better get giant, especially not my feet which at size 10 on my 5'4" frame are already giant).

At my U/S today, the tech measured 9 follicles, 7 of which were over 10mm.  Things are happening fast.  I wonder if my body didn't have some left-over effect from cycling just 2 months ago.

On the home front, DH's niece (18) and nephew (16) came to visit us today from FL and are staying a week.  And I have a nice, 5-day weekend to spend time with them.  So it'll be nice to have a distraction from what my body is or isn't doing.  And very nice to be off of work during a stim cycle, for once!

Fumbling Towards Ecstasy

Here's Sarah McLachlan with Fumbling Towards Ecstacy.

All the fear has left me now
I’m not frightened anymore
It’s my heart that pounds beneath my flesh
It’s my mouth that pushes out this breath

Good thing I didn't commit to NaComLeavMo this month.  I've been a horrendous commenter, too many trips and distractions.  Maybe the big commenting month should be in January not June!!  I am very very happy for all of my newly pregnant blogging buddies, your successes bring me joy and give me hope.

I got back from Wisconsin on Monday.  I also got AF on Monday.  As much as I promise myself I won't be surprised, I have still had this feeling like I'm going to regurgitate all of my internal organs ever since I took a HPT on Saturday morning.  I had a mini-meltdown at the wedding.  Partially because I found out that a person I had been very close to for a long time had recently passed away.  And I guess partially because of the BFN.  And partially because of the bourbon I slammed.  This fertility mumbo jumbo is affecting my emotional balance more than I want to admit. 

My dumb-ass SATC wedding moment came right after I heard the news of the death, when I gently excused myself, walked down the steps towards the ladie's room, and let out a big sob as I was coming down the steps.  This also happened to be mere seconds before the bride and groom were being announced.  Instead of walking up the steps together, the groom ran up alone, went to the bar, got me a glass of water, and ran back down, while my friend watched in horror.  I am SOOOO not a drama queen, and making a mess of the intro was just an embarrasing and ill-timed event.  My DH was also at the bottom of the steps.  He gave me a very kindly worded talk of how this was a wedding, not a funeral, and how I'd have to postpone my mourning for my friend's sake.  I knew he was right, of course, but my emotions had got the best of me.  He drove me to buy visine, I fixed my makeup, and went back in an hour later with my party smile and my dancing mojo.

Today I went to see Dr. Surrey for a regroup.  I wasn't sure if I was going to even schedule it, even though he requested me to, because I didn't want to hear him say I'm a lost cause.  But he didn't say that.  Here's my Q&A with him.  His responses aren't word for word, of course, but the thought is there.

Me:  Do you think my last cycle, with two lead follicles, is indicative of a future decreased response to meds, or do you think it was a fluke? 

Dr. S:  It's hard to say, and we can retest ovarian reserve, but I doubt if your fertility has decreased that drastically in less than a year, considering your good response to meds the time prior.

Me:  If I get my ovarian reserve tests done today, would they be skewed since I just did a medicated cycle?

Dr. S:  No, it shouldn't matter.

Me:  Do you use human growth hormone in your protocols?

Dr. S:  No, Dr. Schoolcraft had used it in a study a while back, but we don't use it since it's not approved by the FDA for infertility.

Me:  Do you use DHEA in your protocols?

Dr. S:  No, there are studies that have shown it to be effective, but they are not the best studies, they didn't use controls, and they had small numbers of patients.

Me:  Would you recommend a change in protocol if I cycle again?

Dr. S:  Yes, I'd want to try antagonist with estrogen priming.

Me:  What is estrogen priming?  I've read about it but am not clear on it.

Dr. S:  We give the patient estrogen for a month prior to the IVF cycle.  The estrogen primes the ovarian FSH receptors and increases response, and also avoids a situation of lead follicles

Me:  Would it make sense to do something like stim a woman every 3 months, do a retrieval, do PGS, freeze them, and save up the embies for one transfer of only the best?

Dr. S:  It could be done, but you have the expense of drugs, plus the expense of PGS each time.  We have done this type of thing with eggs for women who aren't ready to have a baby yet, but not with embryos for women who are.

Me:  How long would you recommend I wait before trying again? 

Dr. S:  You could try in two months.  Normally we wait three, but since you didn't go through the whole thing, you could do two.

Me:  My husband is still not sold on donor eggs, but if we'd decide to go that route, how long would it reasonably take to find a donor with blonde hair and blue eyes?

Dr. S:  It seems to be cyclical the types of women that we get.  For a while we were getting a lot, but there haven't been a lot lately.  You may be better off going through a service than through our program for that.  You may have to wait six months.

Me:  I'd like to try again with my own eggs, and then talk donor eggs.

Dr. S:  Yes, I'd recommend that, I think you should try again with your own eggs.

Whew!  I didn't expect that.  I thought I was a total IVF flunkie as far as CCRM was concerned.  I had the ovarian reserve retested after the meeting.  Lab fee was $490, ouch.  I've heard that testing immediately after a medicated cycle skews the numbers -- Dr. Swanson had told me it would, but Dr. S said it would not.  But I was so damn curious that I couldn't help myself, I have to find out ASAP.

I wasn't sure if I should cycle with CCRM in 2 months or Conceptions in 4 months.  I went to Conceptions to have a baseline DHEA test too today.  I'm a total IVF junkie now.  And indecisive.  The looks of the lab at Conceptions wierded me out.  I'm wondering if their office in N. Denver metro is a bit more modern, but this one is small.

DH thinks I should go to CCRM.  The cost for us will be about $5K due to their lab and surgery center being out of network.  Conceptions would be practically free -- copays only -- maybe $300.  My gut is telling me to try with Surrey though since he's letting me.  Because they SEEM better.  Even though both docs are really good.  Thing is, I'd have to start the estrogen TODAY.  I have an RX waiting for me at the pharmacy RIGHT NOW.  Should I or shouldn't I....that's the question.

I talked to the nurse at Dr. Swanson and asked her if they do estrogen priming as part of the antagonist protocol.  She said no, they used to, but they weren't getting a good response.

It's very hard to make a decision, each doc has their own way of doing things, and each thinks his way is the best way.  Really I know my eggs matter more than any other factor in the mix.  But still, I want to make the very best decision.

Plenty

Here's Sarah McLachlan's Plenty.

I looked into your eyes
They told me plenty
I already knew

Today I chatted with Dr. Swanson, the head RE at Conceptions.  A prior patient of his told me that he used to be partners with Dr. Schoolcraft at CCRM...haven't had that info confirmed but it's interesting. 

He verified my IF history and he said sounds like an egg problem due to age, which I knew.  His plan:  first, in July, he'll retest my day 3 FSH, E2, AMH, and LH.  These numbers indicate ovarian reserve.  He won't check these numbers in June because they may be skewed due to my recent stim cycle.  If my numbers are poor, then he will not be willing to take me on as an IVF patient, but if my numbers are acceptable, then he will.  My last FSH was 7.4, which is good, but that was last August.  I know I'm at an age where ovarian reserve can take a nose dive, but I'm hopeful that mine is still in his acceptable range.

If I pass the initiation blood test, then he has a plan to get PLENTY of eggs.  He wants to:

• Up my amps of Menopur from 2 to 3 or 4 per day
• Add growth hormone. There is some evidence that this improves the live birth rate.
• Go back to an antagonist protocol. That's what I did the first time. Microdose flare has the potential for causing leading follicles which is what I just experienced. 
• No BCPs.  This is standard for them for antagonist protocols.
• Use Letrosol as a lead-in, which releases a surge of FSH & LH.
• Go back to Bravelle instead of Gonal-F.  Bravelle is natural, Gonal-F is synthetic.
• Take DHEA for 3 months prior to the cycle. Studies have shown that this increases follicular count.
• Continue acupuncture.

The cycle wouldn't take place until August / September to give me 3 months of DHEA.  He said my chances of success are 10-20%.  Not great.  I guess my past failures say a lot because his success rates for the age group of 35 - 37 are 68%.  I feel very grateful that he'd be willing to take me on, knowing that I am statistically not a clear winner.  If my numbers report well, I'm going for it.  Seems like a big risk except that, #1, insurance pays, #2, looks like it may be my last grain of hope, albeit a teeny-tiny grain, and #3, time is going to pass anyway, so it can't HURT anything.