Don't Panic

I am waiting for the call from Dr. C's office. I am waiting on the results of my bloodwork, which will dictate how we are going to proceed.

Lefty still has the follicle, which is slowly growing- just below 5 Monday, now at 8 today. Righty is, once again, orbiting Pluto. We got a glimpse of it off in the distance, but it was honestly so painful that I was relieved when Dr. C gave up. Usually there are follicles when it behaves like this, however. And we saw two when it came in for a close-up on Monday. So I guess I will just have to hope, and wait, and see.

We're supposed to go to Carmel this weekend, but I may need to come in to the office on Sunday. In which case, we will cancel our trip. Ugh.

Just Go With It

My appointment on Thursday told the same story. Nada. Zip. Zero. On Day 14.One of the awesome office ladies informed me that per doctor's orders, I was coming back in on Monday, and if there was still nothing brewing, we would be calling Freedom Pharmacy with another whopping order. Dr. Charming is going out of town on a three day weekend, at what could potentially be a crucial time- and he wants all his IVF patients to be taken care of beforehand. So my recalcitrant ovaries were posing a problem.

"Let me get this straight", I said. "So: this three day vacation of his could end up costing us another few thousand dollars? For drugs that don't work on me?"

Sympathetic silence from the other end of the phone. Crap. 

So: the next call I made, in desperation, was to my acupuncturist. Was there anything "Chinese" I could do?  He advised that I take some of the herbs I usually take at mid-cycle- the aptly named "Mobilize". He said he had no clue if they would work, but it was worth a shot.

I also had: I don’t know how to describe it. Maybe an epiphany? I was lying in bed Sunday night, (the night before the appointment)  and The Man was snoring away, and I was just overcome. As awful as all of this is, I am so lucky to have what I have. There are people all over the world who have so much less.  I was just so grateful to be moving forward, and to still have options.  And I thanked God for my blessings, and I thought, “Well, this is it- I will know tomorrow. If there’s nothing, maybe I should just see it as a sign that this is not the time. But if there is something, then I am going to take it and run with it. And be thankful either way that I have the resources to handle whatever happens."

And then I went in yesterday and got the news that things were finally starting to happen. I had one follicle coming along on the left, and two on the right. "Mobilize" evidently did the trick. We agreed that I would take small doses of injectables- just Gonal, no Menopur this time- and hope that I get three shots at it this cycle. Which seems almost too good to be true.

And upon leaving the doctor’s office, walking on air,  I came within inches of being backed over by a delivery van.  One more step, and it would have flattened me. And instead of being infuriated at their negligence, I am just awed at my luck, and grateful that they missed. I can’t help seeing it as a sign, even though that’s a little “woo woo”- I’ve become superstitious after years of dealing with this, what can I say?

Blown away.

Today was also a big, fat goose egg. Nada. My body has pretty much closed up ship, as evidenced by zero follicular growth and blood work that showed no hormonal surge. I have to wonder if Clomid did this. Googling shows that it has this effect on some women.

To make matters much more irritating, my doc wants me to start gonaditropins from last time if I don't show any signs of follicle development on Monday. Because he is going out of town at a crucial point. So Dr. Charming's 3 day weekend may end up costing us a few thousand more dollars, on top of everything else.

The good news: I spoke with my sister yesterday, about freezing eggs. I have been worried about her- she's 35, not in a long-term relationship, I know she wants children. She called me to check in, and we ended up discussing what egg freezing would probably entail. I told her the truth: That I wouldn't want anyone- ANYONE to have to struggle with this. And to think of it like insurance- something she hopefully doesn't need, but a backup, just in case.

She called me back later that night, and said, "You know- I was thinking, but I don't want to offend you- if it turns out that you need donor eggs down the line and it's OK with you- you're welcome to use mine right? I know how hard this is for you, and if there's any way I can help, I will be happy to do whatever I can. I know how much you want this."

I cried. She cried. Mom called later that night, and I told her, and we both cried some more. All in all, it's been a pretty weepy week. 

Holding pattern

It looks like it is going to be a frustrating month.

Per wand and blood results, my cycle has stalled out. I am probably looking at a 40 day cycle- or more, as opposed to my usual 28. I am sure that the crazy drugs I took last month have something to do with this, since I am usually like clockwork.

I've been moody, and occasionally weepy, but not crazy- trying to get as organized as I can until we move.  Trying to ignore the babies everywhere. Someone brought their new bundle of joy into Dr. Charming's office for him to see- one of "his" babies. I walked into the waiting room and encountered them, right after I got the news that none of the drugs were working on me. My reaction was not good.

I am trying desperately not to panic. My time in the Bay Area- and thus with this doctor- is running out. The Man hasn't found a job, and is defensive and angry when the subject comes up. All can think is that hopefully there will be some kind of last-second miracle. This situation included. If I could afford to wait on IVF, I would, but it's clear that we can't afford to put it off any longer.

Evidently, stress can mess up your cycle too. Good to know.

I go in again on Thursday. Hopefully something will be percolating soon. Both in my interior regions and in other aspects of my life. 

Alllrighty then.

I had another appointment with The Wand today.

It's kind of a set thing, now. I go in, have a seat, get summoned, disrobe from the waist down, enrobe my nether regions in a paper tablecloth, and perch gingerly on the table until Dr. Charming and a nurse come in.

Then there's a minute of smalltalk, and then I have to steel myself for the ultrasound.

I had one teeny antral follicle on the left today- not big enough to be worth measuring. The same as the ultrasound on Monday. I think we caught a glimpse of righty at one point, but not close enough to see follicles. Even that required a lot of jabbing and teeth gritting from me.

I just wish I were normal. With a right ovary that didn't wander off, and a life that didn't include getting 2-3 ultrasounds a week and, well, the ability to have children on my own. 

Dr. Charming assures me that it's still early, he has a few other ideas, and that I should come in on Monday. On Monday, it will be Day 10 of my cycle, and if I don't have any follicles worth noting, the cycle will be cancelled.

All I can think about is eating junk food. 
 ________________________

Updated to add: I had a mini-meltdown instead. This post is evidently brought to you by Clomid, because BAM! Super emo came out of nowhere. I was sobbing uncontrollably, and then promptly got a hot flash: another Clomid side-effect I have experienced before. And then I was fine. I still want junk food, though, albeit the Paleo kind. I think I have earned it.

I take my last dose tonight. Not that it appears to have done much besides providing definitive proof that my new hippie mascara is definitely not waterproof. The Man noted that I was like this for the duration of my Clomid treatment several years ago- with the addition that I was unable to cope with anything and pretty much confined myself to my bed whenever possible, crying and eating cookies. We are hoping that this was just a one-shot deal.

Reboot

Here we go again!

Another 28 day cycle. Another Saturday start. At least some things are predictable. ;)

I went in today for the baseline ultrasound. We saw a follicle getting started (on the left, of course) and then discussed the plan. This time, some Clomid, a small amount of Gonal-F the week prior to ovulation, and then the trigger shot- plus some kind of drug that is supposed to serve as "backup" in case my body doesn't want to wait until the appointed time. It locks the egg in the follicle somehow.

I was appalled to see that the drug that serves as "backup" was about $5 out of pocket at the pharmacy.  I realize that my situation is rare but knowing that a $5 prescription could have saved us thousands of dollars, a lot of blood sweat and tears, a month's time, and a few acres of frustration is...well. Infuriating. 

So- Clomid was a doozy for me last time. We will see what we get out of it. I got great results last time: tons of follicles, along with The Crazy. So I will be really careful to avoid any movies containing babies....actually, animals or babies, since both made me cry hysterically last time around. Do Not Want.

The fridge is stocked, the yoga DVD is out, I went to the RE, then acupuncture, then took my first dose of Clomid tonight...so it should be all systems go. Fingers crossed.

The Man said he was looking at SUV's online today, "just in case". It melted my stony, frozen heart. Granted, he was very excited about one that seats 9. I think he may be getting way ahead of me, here. He tried to make the excuse that it was because the back seats could fold down so we would have room for kids and dogs. Uh-huh. 

Home stretch

Sunday, 3 day weekend. 9AM. I was expecting a nurse to show up for my ultrasound. But no: There was Dr. Charming, in his scrubs.

Things are pretty good: Lefty's follicle is now up to 19 plus, Righty is still cooking along: but I was so uncomfortable and it is so far out there, all we could detect is a far-off ovary with a shadowy "something" inside. (Narnia!) We decided that when I am under anesthesia, he will take another look, and move forward accordingly.I am hoping to get more than one follicle out of this, so I guess we will be in suspense until the last possible minute.

Soo- last shot of Cetritide was this morning, trigger shot tonight. It will be the first of three. I have done so many IUI's, but never a retrieval, so this is all new territory for me. I am scheduled for 9:30 AM on Tuesday. Incredibly nervous, and excited.   The Man has been briefed, I think we are ready.

We talked about baby names last night- something we haven't done for years now. This is such a big deal for us both- I hope the gamble pays off, this time.

I need to talk to my acupuncturist- since I will no longer be on any kind of medication, I need to see if there is anything I can do or take on my end, that will naturally help my body do what it needs to do. That should be an interesting conversation...  

All in all it's just- another shot in the gut.

Oh Cetritide! It burns us, my precious.

Just got back from my ultrasound.  Lefty came up with a 14, and Righty actually coughed up something: a teensy 7, but I will take it. I may have uttered a tiny "Gooo Righty!" when it popped up on the ultrasound monitor. Which, of course, everyone finds amusing.

So, now we are trying to decide what to do.  I just gave myself the burny Cetritide shot, so I will impede ovulation, and give the follies a few days to get their act together. Dr. Charming said he saw several smaller follicles as well, which may be noteworthy later, but didn't want to poke around any further. (Getting a peek at that follicle on Righty was stressful for all of us.) So right now, it's still all about that one follicle on the left.

We had a little chat, and my options are as follows.

A. Go ahead with this cycle, in the understanding that it's got to be "The Little Ovum That Could". Be prepared for many Highlander quotes. "There can be ONLY ONE!!!"

B. Quit. Cancel cycle, start over next month.

C. Pursue a Natural Cycle IVF approach. Get me off drugs, collect the egg or two I make on my own every month, and put them on ice (flash vitrification!) until we have a few of them.  Then do IVF. I asked about risk to egg quality, and he said it's about 10%.

D. Donor eggs. Still not ready to accept that one.

E. Killing spree. Wait to see how things look on Friday. If I have two viable follicles, go with option A. If I just have one, Option C.

Based on personal feelings and discussions with The Man, it's looking like E- "Some of the Above" is the answer, at least right now.  Actually, The Man REALLY likes Option C. Possibly because Dr. Charming used the words: "Flash vitrification is like Star Wars- you know, when Han Solo gets frozen in Carbonite?" I guess he knows his audience.

Let's go follies, let's go! *clap*clap*clap*

So far, things are par for the course, follicle-wise. Four days of injectables have produced nothing out of the ordinary. I am trying not to panic.

I have one good-sized follicle on the left (where else) and as usual, righty is actually off the reservation. We caught a glimpse of it reclining somewhere, but a close-up didn't happen. Lazy bitch! I am trying not to panic. Today is only day 7. I have another week for the girls to get it in gear.I thought I glimpsed a tiny secondary follicle on the left, but Dr. Charming didn't measure it or say anything- the jury is out. I can feel crazy twinges on the left, so maybe. I am hoping it shows up on my next check-in on Sunday, and maybe brings some cute friends. 8:45 AM, baby.  So much for sleeping in! Come on follies! There'll be punch and pie.....

I should get my bloodwork results later on tonight- they may be upping my dose of Gonal. That giant sucking sound you hear is from the enormous hole in our bank account.

I am doing OK: still upbeat, although I have been super tired and irrationally angry at The Man for "no reason". It's been so bad: I have been sitting on the couch hating his guts, and then I consider asking him if he knows why I am mad at him. Surely he must have done something, and I just forgot what it was, because OMG!!! ANGRY!!!!

Then I realize it is the hormones. The Crazy is locked and loaded.

It comes in handy when I find out things like the drama with my medical records. Kaiser, you stink. As it turns out, they decided not to run my HIV 1&2 tests, and just didn't tell me: and since Kaiser's policy is that they don't send you a printout, they just say, "You know those confidential tests you took? Alllll negative!" Well. I guess they were just talking about the Hep series. So I had to get another blood draw and have it rushed through my clinic. And my clinic also had to send three separate faxes to their medical records department: plus four or five calls from me, with me racheting up the hysteria each time- for them to finally send proof of my negative Hep results. Sheesh. But the good news is, that is finally all squared away.

I love my clinic. I may have already said this, but I seriously can't believe my luck. And it seems so....anti-climactic. I have been waiting for this for so long, and I am sure that is why. The crew thanked me for being so upbeat and fun today. Hopefully it will keep being anti-climactic. A BFP would be a fantastic first, for me.

Needled

I don't know how much I have said about Dr. Charming, but I am a fan.

That's right! I have an R.E. that I LIKE! Which is...well, if someone's going to be all up in your business, liking them should be a prerequisite.

Cycle day one was Saturday, which was basically a timing disaster. Some of my meds needed to be refrigerated, so they couldn't be shipped for Monday Delivery, and I needed to start shots on Monday: and have my baseline ultrasound.

So I called the pharmacy and the doc's office. I was worried about the pharmacy, and I finally got them to agree (after much wrangling) to ship a partial order of just the drugs I would need for Monday- which didn't need to be refrigerated, thank goodness. The culprit (Bad Cetritide!)  will be arriving with the rest of the shipment today. Whew!

The doc's office: I figured I would get a call from a service, or a nurse. what I got was a phone call from my R.E. himself, at 7PM on a Saturday night, to set up my Monday appointment. He performs every procedure in the office. Color me impressed! In the old days, Dr. Combover never deigned to see me himself,  I would always get a nurse or a lackey. Which is probably a good thing (because I didn't like him anyway), but STILL. Dr. Charming also gave me the results of my Counsyl test: I tested negative for all genetic issues that could be passed on, which is amazing news. The Man is on notice that if any potential kid we have is weird, he is to blame. ;)

I spent Sunday napping, getting things in order, and planning how to spend the next month. Taking it easy, distracting myself, avoiding stress, and generally make this as likely as possible to work. I downloaded funny books for my Kindle. I put the scale away. I am considering getting a Netflix membership, so I can watch lots of comedies. The bedroom has been somewhat revamped. I have a plan for lots of fertility yoga, meditation, and knitting. My nails and toes are painted with sparkly polish, and I am doing my utmost to feel attractive, distract myself, stay positive, and stay active- all things that are challenging during IF treatment.
 
So yesterday was crazy. I needed to pay for my cycle. We have had the requisite dinero set aside in cash for a long time, and I had to go deposit it in my bank account.  I went in, thinking, "OK, this is going to be weird, I have a banded sheaf of $100 bills, the teller will look at me like I am a drug dealer."  However, it actually ended up being more awkward, because evidently, if it's quiet at the bank branch, security will usher you over to one of the cubicle guys who usually sets up new accounts or looks over loan docs.

And of course- guess what happened to me?

So I made polite small talk, and commented on the luscious  aroma wafting over from the guy's coffee (Peet's!) and finally just decided "The hell with it." And I whomped that wad of cash on his desk and said, "I need to deposit this."

He did a triple take and asked, "Did you just win in Vegas?" Which of course, reminded me of this. I am a gambler. Hopefully, a good one. 

The actual doctor's appointment went well. I wrote checks on about 90% of the money I had just deposited. I submitted all the paperwork and signatures. I got checked out and my blood was drawn. I was told to stop taking any supplements except for prenatals. Bye Bye, testosterone cream! I won't miss you, Hopefully, you did your job. They did a "mock retrieval" (Or was it a "mock insemination"? Something like that) and said it should be a piece of cake and I had drunk the correct amount of water. Two "venti" Starbucks cups worth, an hour before I showed up. Duly noted. I was pleased to note that I have less padding on my stomach area, as they could see what they needed to see with just a regular ultrasound. Everything was pronounced A-OK, and I am supposed to go in again on Friday for a look-see.

When I got home, my box from Freedom Pharmacy had arrived. I did a quick review of the contents, and then got ready for more adventure- acupuncture.  I am usually awful about relaxing while I am supposed to be, but this time, I forced myself to leave my phone in my pourse, so web surfing was not an option. I actually did fall asleep.

I took my first shots last night- 375 IU Gonal-F, 75 IU Menopur. Holy Mackerel. I forgot the stress of making sure you get the mix right, or you can waste 700 bucks with one wrong move. I seem to have a ridiculous amount of syringes. So there was a lot of fiddling before I finally got it right. And about an hour later, I swear, I was feeling strange effects: I was hot. HOT! And had a crazy heaviness through my pelvic region. Bam. 40 lb. ovaries are coming down the pipeline. I also kept sighing. The Man seems to be getting more and more nervous with each and every sigh. "Are you OK?!" he keeps asking me, anxiety in his eyes. Concern for my welfare? Terror that The Crazy is coming down the pipeline? I probably don't want to know!

My refrigerated box showed up today: a 12" cube stuffed solid with syringes, sharps containers, a plethora of drugs, and a refrigerated packet. So that's all set.

My parents and in-laws are on board. I am sending out texts and emails with updates- something I never thought I would find myself doing the last time around. I got another text last night from Dad that said, "Good Luck: fingers crossed. We are praying for you.  Mom says she will come if you need help. Tell The Man that if he needs help, he's on his own." Bhahaha!

Mom called this morning. She keeps offering to come and visit, which is lovely, but really, there's not a lot she can do! I told her we would keep it in mind, on the off chance that I go completely nuts and The Man needs help restraining me.

She has been very impressed with her realization that so many people are struggling with this. She saw something in the comics today about two tiny birds sitting on a nest with a dozen giant eggs in it, and the father bird was talking to a friend on a nearby branch. The caption said "Just say no to fertility drugs!" She was hesitant telling me about it, as she was afraid I wouldn't think it was funny, and was obviously relieved when I laughed. Then she said," We are so excited for you honey. Just don't turn into OctoMom." I was a little horrified, and tried to explain the difference between what I was doing, and what the limitations were, and she she explained that she was only kidding. (Thank God.)

So I am getting very literal. Also, zitty. Freaking hormones.

Let's do this thing! (playing catch-up)

So! I do have another blog- where I seem to be talking about everything EXCEPT infertility. If you're interested in that, it's over here.

General update: The Man and I just celebrated our 10th anniversary. Which means, 9 years of infertility. NINE years!!!! Ugh.

But- I am jumping back into the seemingly bottomless lake of infertility treatments, and frankly: this is the only place I can talk about that. People who deal with me day-to-day probably don't want to know about crazy shizz like "assisted hatching." Hell, _I_ don't even know what that is. Yet. But I probably will soon.

Because if infertility is a bottomless lake, I am finally going to do more than just stick the occasional toe in the water. As of a couple of weeks ago, I started paddling around in the shallow end, and am girding my loins (somewhat literally) to jump off the high dive in a few weeks. IVF, baby.

So we got started with one clinic, only to decide in the early stages that they were too far away- an hour and a half isn't a great drive to have to make. They also were really lackadaisical about doing things like answering my questions, leading to situations where I got test results back and FREAKED- and continued to freak over the 4th of July weekend, with no call back. It took six days to get my question answered, and of course, by then, I had whipped myself into a frenzy. No bueno.

So the question I needed answered was-My FSH is now around 12.1: not too terribly bad, as I am now an old-ish lady of 38. It's actually improved from 2009, when it was 14.9.  The AMH however, is pretty dismal: 0.16. The frantic calls about that were the ones that caused the meltdown. I was concerned that they would flat-out refuse to treat me. So after all the googling of "low AMH"  that I did- hopefully some other woman who is desperately googling at 2AM might run across this. Neither of the two clinics I was looking at said that my low AMH was a deal breaker. In fact, they seemed intrigued. And also flat out stated: "You need to hurry."

So, that's what we are doing. All the preliminary tests have been done. The Man still has his stellar numbers. I keep calling him "The Sperminator", which he seems alternately delighted and humiliated by. In all seriousness, I think the most awkward conversations I have had have been IF related, and having a lab tech wax rhapsodic about how great your husband's numbers are over the phone has to be experienced to be believed.  Luckily, after a saline sonogram and a pelvic exam, my uterus has been pronounced "beautiful." So per medical science, I am actually beautiful inside and out. ;) And we are still "unexplained".

I didn't want to do this. I have done my utmost to get as healthy as I can, but obviously, we still have some deeper issue which is not being addressed, because we don't know what it is. the thought of subjecting my body to this roller coaster again is not one I make lightly.Unfortunately, we are to the point where we simply can't afford to sit around and wait.  

I really like my new R.E.. He is young (by which I mean close to my age- LOL), earnest, and has disconcertingly beautiful eyes. He's also roughly 1000% nicer and more charismatic than Dr. Combover was- not being difficult to accomplish, as Dr. Combover had roughly the same bedside manner as a necrotic whelk.

 I automatically checked to see if he was married, as I have many awesome single lady friends, and I am always acting in their best interests-although I may have earmarked him for my sister as a matter of course- but alas, he was wearing a wedding ring.

Also, he has a great sense of humor. By which I mean, he laughs at my jokes. How to make your RE laugh: when he points out your right ovary on the monitor during a procedure, tell him it looks like "a high pressure system coming in from the north." Evidently, not many ladies tell jokes while they are in the stirrups. And when the R.E. tells them he'll see them in his office in a minute, they probably don't cheerfully say, "Sure, I'll be right there- just let me put on some pants."

Oh man, I am so jaded. This doesn't even seem weird anymore. Hopefully I can continue along this trajectory, and not the sad, cookie-eating, hormonally incapacitated and psychotic iteration of the past. 

Speaking of ovaries, Lazy Righty is evidently cooking up a follicle this month. I am going to send it some flowers.

In other news, my temps are great. I am still seeing an acupuncturist, and my temps have slowly crept up from being in the 95's and 96's to the 97's and 98's- AKA, normal human temperature ranges. Acupuncture is once a week, and I take about a bajillion herbal supplements twice a day.

My acupuncturist and I do argue occasionally- he says I am healthy enough to conceive on my own, but after 9 years of this, and two years with him, I am more than a little dubious. I am doing my best to make it clear that I can't afford to wait anymore. We were given "permission to try" this month and last month as well, so it is go time this week. He keeps insisting that IVF is not necessary, and I told him that I would be ecstatic if we managed to do it on our own, as we would use the money earmarked for the procedure to go on a fantastic European vacation instead, and I would send him a postcard from every country we visited lauding his acupuncturey prowess. I still don't think he agrees, but at least he shut up about it.

SO! Due to my super-low AMH, my RE told me that we were going to do something "A little unorthodox", and wrote me a prescription for testosterone gel. He also warned me that the pharmacy wasn't going to handle it well, as it is typically a male-only prescription, and just to brazen it out. Having done all my research during the Low-AMH meltdown of early July, I determined that he was trying to take a little bit of a shortcut- low AMH is typically addressed with DHEA supplementation- which bumps up your testosterone levels.

All I can say is, if there is any other way to get testosterone gel than walking into Rite Aid, I am all for it. Black market? Internet pharmacy? Muscular man in sunglasses lurking in the alley? Go for it (OK, maybe not the last one.)

The Pharmacist and the tech seriously freaked out. It doesn't help that the Pharmacist has a loud, booming Russian accent, and immediately blustered, "But- this is for men only!" in a voice that carried clear over into the cosmetics area. I quietly explained the issue, and he admitted that it was not that unheard of as he had "given it to one other lady in the past." I would like to thank you, other lady. If it was this much of a shell-shocker for me, I can only imagine how it was for you!

I now have two giant tubes of really expensive testosterone gel. The pharmacist helpfully said that I would have a lot left over, and told The Man that he should try it "If he ever wanted to take up the weightlifting."
He gave me a 20% discount, but even with that- since it is out-of-pocket, it was $360. #$%^!

So now, The Man is under orders to tell me if I start developing facial hair or my voice starts cracking. I have to rub this stuff into my shoulders every night, and am paranoid that I am going to grow some furry epaulettes. I was cautioned to avoid contact with anyone until the stuff dries, and am wearing a special t-shirt to bed. Like a chump. So it begins.

So the next Day One, my schedule and meds are set. I just need to call, and I will get my baseline ultrasound. It looks like Gonal-F, Menopur, Possibly an ovulation suppressant of some kind, and then the trigger shot, and then progesterone- seemingly forever. 

Oh God. I am really doing this. Sometime this month! 

Intermission

I am stalled.

That's the news I got during the ultrasound today. I still have one dominant follicle on the right, one on the left, but they are still where they were on Monday. The two smaller follicles seem to have joined forces, so I actually can expect three follicles this cycle...but the IUI has been postponed.

I have to order some more pens of Gonal-f, and also Menopur on top of that.

I am feeling disillusioned, and also, am freaking out because this is costing a lot more than I was expecting.

When I said something to this effect, along with the fact that if it's just egg production that they want, Clomid seems to produce better results and is covered by my insurance, the tech said, "Well, would you like to see the doctor?"

Confession: I haven't seen the actual doctor since my laprascopic exploratory surgery checkup over a year ago. I have to get to work and order my new meds, so I'll expound on all of this tonight.

IUI is rescheduled for Monday.

Beauty is in the eye of the beholder

Ok, I'll just get down to the brass tacks.

Well, and then I will waffle. We all know how I love waffles!

I was worried due to lack of twinging, but lo! something must be working. My first clue was this morning, when I had a protracted battle with the top button on my jeans. And then proceeded to need to pee every 10 minutes. But it's all worth it. Thank goodness.

Here are the stats for IUI cycle #5! (Holy crap. FIVE!)

Once again, I have four follicles: two big fat 14's, one each for Lefty and Righty, and then as usual, Lefty is the overachiever with two smaller follicles, eight and ten. My levels are at 290.

300 more IU of Gonal-f tonight, and again tomorrow. Then another ultrasound on Wednesday. If all goes well, I trigger Wednesday night, and the IUI is Friday morning. Righty, if you go south on me, you are getting evicted. I mean it. You gotta earn your keep around here.

On a more entertaining note, I got to hear my uterus described as "gorgeous", which is a new one for me. I also evidently have "perky" ovaries. Is it just me, or is that bizarre? Like being told that your spleen is charming.

Plus, the adjective "perky" always makes me think of Katie Couric. However, considering how many uterii and ovaries this woman has seen in her lifetime, I think I have to choose to believe her.

Somehow, I don't think this is what was meant by "pretty on the inside."

So yeah. My reproductive system is a 10! However, so far it has been purely decorative. Come on, girls. This is the month!

I ordered another stinking pen of Gonal-F. That's six 300 IU pens. I am wondering why my RE ordered this way, instead of two 900 IU pens. Could it have something to do with the "leftovers" inside each 300 IU syringe? When I do the math, there's only a $3 or so price difference, so it doesn't matter much either way (except that priming the pen each night is getting old, and that's a lot of packaging to clog up landfills each month.

Anyone know about this? I'm confuzzled.

They debated about prescribing Menopur as well. Anyone have experience with this? They didn't end up doing it- the consensus was that everything was coming along nicely and that it was unnecessary.

While I still have not seen Dr. Combover, which is another post in itself, the ultrasound tech did say that she will personally reviewing my case. I don't know her name, or her title, or anything else.

Ordinarily, I would be freaking out about this, but....this cycle is weird. I feel very zen, for lack of a better term. Like this is all happening to someone else, and I am taking a detatched and clinical interest in it.

Since I can't remember the last time I was ever detatched and/or clinical about- well, anything, this is one hell of a change. Huh.

Okay. Almost time for work. And since my pants don't fit anyway, I may as well extract myself from them (maybe the Jaws Of Life would work) and eat a boatload of chicken nachos.

If you build it, they will come.

The ultrasound went well this morning. They found Righty(I am picturing it with glasses and a stripey hat, like Waldo)with a minimum of difficulty. No cysts. Lining where it should be for Day Three.

"And!" said the ultrasound tech, "We are going to get at least FOUR follicles out of you this time!!!"

I thought (but did not say) that there were four follicles last time, until Righty took a hike sometime between Day 10 and Day 14.

But damn. I am taking 300 of the Gonal-F for the next SEVEN DAYS.

You hear that Righty? You should be quaking in your boots. Or you would be, if ovaries had boots.

The credit card should also be quaking in its boots. Oy. I have to order two more vials!!!

The visit went as well as it could go, and I finally bit the bullet and asked about IVF.

They gave me a price sheet. And a pamphlet on financing options. And a small lecture about patience and waiting and seeing.

I know all these things. I am trying so hard to have faith in these procedures, and I am going to go out on a limb and let myself hope, this time.

I am going back to walking, and have actually cracked the cellophane on Yoga For Fertility, which I bought on Amazon about a year ago. I have all my meds together, and am making sure I get at least 8 hours of sleep a night.

The Man asked if there was anything he could do to help, and I am going to hit him up for massages. He has also promised to walk with me and to take his vitamins.

We're going to eat Chez Sais Quoi as much as possible, so we can eat more healthily.

The big leap, however, is the cleaning out of The Room.

We are very careful never to call it anything else. It's Jenna's Craft Room, The Third Bedroom...it's become kind of a catchall. And in the process of getting rid of the metric tons of clothing that I have managed to accumulate, and dispersing all my crafty stuff, The Third Bedroom is slowly becoming a blank slate.

This is my leap of faith. I'm putting it out there. And words cannot express how terrified I am. This is going to work. I am doing everything in my power to succeed this month, and the notion that it might not work (again) has paralyzed me and kept me from accomplishing this for two years.

I hope the universe doesn't smite me down.

Follicle Follies

I did manage to make it to the lab this morning without incident (on one hour of sleep.)

The ultrasound was scheduled at 11:15, and I was at the office at 11, wearing my most expansive pair of Hanes For Her cotton Gramma panties. At my RE's office, they are all about the lube. They like to pile it up in the receptacle like it's a soft-serv ice cream dispenser. I am beginning to think that they all moonlight at TCBY.

I did get my favorite ultrasound tech. She's very bubbly and we have a similar sense of style. She always comments on my pedicure, which I suppose is one of the most acceptable things you can comment on, seeing as she is up close and personal with my nether regions under a flimsy paper tablecloth.

So, the competency of Righty was greatly exaggerated. It took awhile to even find the little chickenshit, which is literally hiding behind my uterus as we speak, having given up the ghost sometime between Monday and today. Those follicles which were measuring at 12 and 14 are now a sad 10 and a 5. OK, Righty, you get points for at least making an effort this cycle. I was afraid that you had run off and joined the circus.

Lefty did come through for me, though- I have a 16.5 and a big fat 19! I'm totally sending the fruit basket.

Once again, must think positive. So I trigger tonight, as planned, and the IUI is scheduled for Friday AM.

I am exhausted, and feeling distinctly un-witty...so I think I am going to go crawl under a rock and snooze for awhile. Right after I devour a metric ton of peach cobbler.

The Power Of Positive Thinking

"Positive", get it?

Yeah, I know I am lame. Once again, I am awake at 1 AM, and we all know what that means....blood draw and ultrasound this morning.

I have looked up the location in Google Maps AND Mapquest. I have laid out my clothing. I have stocked my purse with Target Brand Hoo-Ha Wipes. It doesn't get any more prepared than this.

Yes, I was a Girl Scout.

Hmmm....if there was an infertility merit badge, what would it have on it? A syringe? A stork? A petri dish? A straitjacket?

Perhaps a maniacally grinning sperm carrying a rose in its teeth?

So, I am trying to do the follicular math. Meds were about $1000 this cycle, so that means we paid about $250 per follicle, not counting the cost of three ultrasounds and the IUI.

I know, I know. This way lies madness.

After doing some reading, I feel a lot better about my four follicles and their measurements. As far as I can tell, average growth is 2mm per day, which will (theoretically)put me smack in the 17-18 mm category for all but one come tomorrow.

I mentioned in the previous post that my Right (Prodigal) Ovary was identified as being "heavy" during the last ultrasound. So heavy that it has actually dropped into the place in my pelvic region where it is technically supposed to be. (Where does it normally hang out? My esophagus?) Maybe my threats to send it to the glue factory are working! Left, AKA "Ol' Faithful", is still going strong, and my uterus is "right on target." All great news.

So, continuing in the positive thinking vein, hopefully they'll do the ultrasound and see the uterine equivalent of the HOT NOW neon doughnut sign, so we should trigger tomorrow, and the IUI would be Friday...which would be ideal, because The Man has the day off, so he would actually be able to be in the room with me during the procedure.

Fingers crossed.

That ache in your throat

You guys all know that feeling right? Your face gets hot, and your throat does that hurty thing, and your eyes water, and you can feel that vein in your eyebrow throbbing like an angry, angry tribal drum. Sometimes it culminates in the tear explosion.

I experienced all of these this morning. In addition, I wanted to punch someone. Perhaps several someones. Please allow me to explain!

Frustration, she is a beeyotch.

I woke up this morning, threw on my clothes, and headed to Quest Diagnostics. There are at least five of them right by my house, but I was told to go to the First & Shields location, and get my blood drawn NO LATER THAN 7:30. Yes, in the morning. Sadistic bastards. There was no explanation for the timing or the location. I figured that maybe the timing was some carefully orchestrated chemical thing, and the location would be the only one open at that ungodly hour.

For those of you who don't live in Fresno, First and Shields is a pretty major intersection. Two strip malls, adjacent to each other. As a veteran of many Quest Lab visits, I assumed the lab would be in one of them.

I was wrong. I circled and circled like a hungry shark, then finally called 411. They had two addresses for me, and neither was the prescribed location. I called them anyway, and got the eternally ringing phone.

I looked again at my instructions. No phone number for the lab, no address, just FIRST/SHIELDS scrawled under DRINK WATER/LIMIT SALT.

I looked at the clock. 7:15.

Shit.

I called the doctor's office, and got forwarded to their exchange. I listened to the "Thank you for your patience" shpiel several times before I lost patience. I looked at the lab slip and called the Quest headquarters in Sacramento. I pressed "1" for "patient care" and it basically said, "We don't give out results over the phone! Thank You for calling! Have a Super Day!" *click*

Now it's 7:20. I know because I looked up after wedging my head between my knees and screaming profanities loud enough to startle the seagulls in the Food For Less parking lot.

I called the clinic again, was put on hold for the exchange, and got Barbara, who is an angel disguised as a mere mortal walking the earth. The woman heard the impending tears and sprang into action.

Barbara tried desperately to reach my doctor's office, to no avail. She finally checked the phone book, verified that there is no Quest Diagnostics listed on First or Shields, but mentioned that she found a location which had opened at 7AM, and was 5 minutes from my house. (But 15 from where I was now.)

At this point, it's 7:35, and I would have cheerfully walked up to a box in an alley staffed entirely by feral cats in order to allow them to claw my blood out of my arm. I thanked Barbara profusely, threw my phone across the car, and threw myself on the mercy of the nice ladies at the lab. They got me in and out of there in 5 minutes. No claws.
(Love. Them.)

Then I went into my ultrasound at 9:45 and explained, and they looked at me like I was a moron.

"It's right behind the Target! They are the only location that has the means to read the sample ASAP!"

I said (rather tartly) that if they hadn't seen fit to supply me with that info, how could I be expected to know which directive was more important? Time, or location?

In any case, it doesn't matter. My ovaries evidently do weigh about 8 lbs each (Righty is SINKING due to the extra weight, which is a little daunting) But he came through for me on this cycle...sort of. Two follicles on each side, 13 & 14 mm on the left, 12 and 13mm on the right.

I have to order another freaking pen of Gonal-F though. And do a new blood draw and ultrasound on Wednesday.

I have concrete plans...so why am I feeling so disappointed? Maybe I just need to have a good cry. I am so frustrated with this doctor's office.

This time, they gave me a pre-printed sheet explaining that it's actually 7:30 AM or at least two hours before your appointment. Oh, and it has an actual address and contact info for the lab. Why the hell didn't I get this last time?

At least I am not taking Clomid, so I know that I am not the insane person in this scenario.

So anyway, thanks for making it this far, and if you get a spare minute please send some happy "Miracle-Gro" type thoughts in the direction of our 4 follicles. And to my mother'ssmoking credit card (5 pens of Gonal-F! Aiiiigh!)

Edited to add: Here (because I CANNOT let it go) is the First/Shields Map:


View Larger Map

And here is the map for where the lab actually is:


View Larger Map

No wonder I couldn't freaking find it!

Borderline (Come on! Sing Along!)

Feels like I'm goooooing to loooose my miiiiind!

Before I go into all that, welcome to all of the Stirrup Queens (and SPJ's) who found me via the Lost and Found Page. It's great to start a new blog and see actual traffic, and I am pleased to have finally bitten the bullet and joined the online infertility community and been made to feel so welcome so quickly. You guys rock.

I met with Mom for lunch today, and she seems to have assimilated the conversation of last night. I do count myself as being incredibly lucky- she and Dad are offering to subsidize my drug costs. Never underestimate the determination of Armenians who want to be grandparents.

Well, plus they probably don't want another Christmas Day when my aunt in Chicago calls to announce that my cousin is going to make her a grandmother for the fourth time, isn't it amazing! I'm a fourth time grandma! And your Dad doesn't have any grandkinds yet, and he just turned 59! You guys better get crackin'! I ended up choking back tears over the post-dinner Scrabble fiasco.

In my defense, it was exacerbated by the fact that my freshly married brother bought his new bride an SUV with third row seating, and I added one and one and made three, and then panic set in. I'm not the only one whose done this. Right? Right?

It turned out that no, they're not pregnant, they're just yuppies. (Actually, they want the room for their Jack Russell Terriers. Go know.)

So. Ultrasound. Otherwise known Chez Jenna as "My date with the all-seeing dildo."

Yes, I am that classy.

Evidently, my ovaries are happy little sacks of sunshine and rainbows. No cysts. They found Righty with a minimum of problems, so perhaps he has made up his mind to actually do some work this cycle, as opposed to resting on his laurels. Whatever the ovarian equivalent of laurels might be. Lefty (AKA Ol' Faithful) was as usual present and accounted for. When I finish this whole thing, I think I want to send him movie tickets and a gift certificate to Chili's.

As for my uterine disco lounge, it is open for business.

The ultrasound lady also told me the inspirational story of a woman with the same stats as me- three cycles with Clomid, luteal phase defect, got pregnant on her first cycle of Gonal-F.

So, everything was par for the course. I put my clothes on, went into room 5 (which whould have my name on the door, I feel like I live in there.)

I am going to be doing 225 IU for the first 5 days, 150 IU for two days after that, then bloodwork and ultrasound, then another IUI, followed by progesterone suppositories from hell.
(I had to call Freedom Pharmacy to order another 300 IU pen to make up my full dosage.) They showed me how to prime the Gonal-F pens, and the ghetto method of siphoning out the extra meds with a spare syringe. I was feeling pretty good, until I started to ask questions.

I waited until I had mastered the Gonal-F pen, and then made a squinchy face and said,

"So, what do we know, exactly? My husband and I are both basically fine, right?"

"Right."

"Except for the luteal phase thing."

"Right."

"Ok, so there's no way of testing if my eggs can actually be fertilized until an IVF procedure, right? Are we just going by the fact that I am under 35, as far as egg quality goes?

"Well, your FSH is borderline, so...."

Hold the phone. Because nobody has ever mentioned that any of my levels were anything but stellar, so this came as kind of a shock to me.

"What exactly do we mean by borderline?"

"We ideally want something under 8. You're just above, at 8.4. It's not a big deal. We just usually pursue more aggressive treatment if the FSH is up above the 9 range."

So, have they been wasting my time with the whole Clomid thing? Because that's how I feel. I am PISSED. Super pissed. Because if I had known all of this, I would have started injectables three freaking months ago.

I think I am going to look into my other options. I am not necessarily attached to Dr. Combover, and while I like his office staff, if we are going to be shelling out thousands of dollars out-of-pocket, we better get results.

According to my OB-Gyn (whom I love) this clinic is the best game in town. However, going out of town is an option. Luckily, we're three hours away from both L.A. and San Francisco, so if it gets to the point of IVF, I have a feeling we are going to go with another clinic...and realistically, I am going to have to get my name in there pretty soon if I want to stick to our timetable. I need to look at success percentages and see how the clincs statewide measure up.

Ok. Off to go prime my pen!

Edited to add: Ok, what was I worried about? After Ovidrel, this stuff is cake!