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Saturday, January 30, 2010

3dpIUI, My Proof That There Are Other Things Going On In My Life Besides TTC

When I started this blog I kind of thought I would stick to IF/TTC related stuff. Nobody wants to know about my life anyway, right?

But I loved A's post about her current obsessions, and also Egg's post that inspired it, and I started to think about what my current obsessions are.

At first I drew a complete blank. Because I'm obsessed with getting knocked up, and that's pretty much it.

And then a couple things popped into my head.

And then I realized, there are other things going on in my life!

And not only that, but I really should both acknowledge and embrace those things! Because the last thing I want is to be defined by IF.

So, without further ado, here are some of my current obsessions:

I just bought one of these juicers off etsy and I'm now totally obsessed with fresh squeezed OJ! And I love that I didn't have to buy something that plugs into the wall to get it - this is so 19th century!

Okay, I know this one is a little Olsen Twins, but I'm obsessed with slouchy cardigans! I'm a big believer in layering and slouchy sweaters are so comfy!

I'm totally addicted to decaf green tea. With honey and milk, I could drink this stuff all day! I'm trying to drink more water, and I think this totally counts (right?).

And finally... KenKen.

So, I'm a big bedtime reader. I love to get a chapter or two in before I fall asleep. And then one day, I don't remember what it was that possessed me to do it since I'd always scoffed at Sudoku (putting numbers in a grid - pshaw!), I bought a Sudoku book. It was one of those that has 4 sections: easy, medium, hard and really hard; and about 300 puzzles overall. I became obsessed. I gave up my nighttime reading and did Sudoku instead. And I couldn't do just one. At first, with the easier puzzles, I'd do 2 or 3 a night and they would take about 10 minutes each. Then, as they became more difficult they took longer to solve, and I was still doing 2 or 3 but they were each taking 30 minutes or more each and I was staying up an hour or more after DH went to sleep doing these puzzles. Well, I ended up getting through about three quarters of the book, and I had reached the really hard puzzles, where sometimes I would just stare at a puzzle for 10 or 15 minutes without making any progress at all. That's when I burnt out, and I put the Sudoku book away, and went back to reading.

Then, the New York Times started publishing KenKen. It's similar to Sudoku but involves basic arithmetic. I scoffed once again. Arithmetic! That sound like work! Until, about a month ago, I tried one. I'm hooked. I will not buy a book this time, though, lest, once again, puzzles take over my life! So I do them in the newspaper and that's it.

Thursday, January 28, 2010

1dpIUI, 2ww, We Meet Again

Highlights from my IUI:
  • I did not shave my legs for the IUI. I thought, f- it, this ain't no beauty contest. Bad decision. I was capital E Embarassed. Who knew?
  • Dr. "Young" looked at DH's "sample" count and said we could populate a small country (!).
  • He also told me this was my "best cycle yet" (wha-what?!)
  • After the IUI he asked me how I felt and I said "Good. But we'll see how I feel in 2 weeks" and then I realized I might have a bit of a bad attitude. I've got to work on that.
  • Dr. Young asked me if I wanted to test at home or come in for a beta. Wha-what? I said "I haven't been given that option before..." I think I looked so utterly confused that he just went ahead and scheduled the beta. 2 days early: Feb. 8th (CD12) (!).
  • We took a cab home. Good decision. Ah, luxury!
  • We took a nap when we got home. Best. Decision. Ever. Like a little bit of paradise in the middle of the day.
So, it's done.

Hello 2ww.

We meet again.

Tuesday, January 26, 2010

CD20, At Last My IUI Has Come Along

My u/s yesterday showed that my biggest follie is now 24mm. So it grew from 15 to 24 over the weekend. Let me remind you that it took one week for it to go from 11 to 15. The only change was that starting on Friday I went from 75iu of gonal-f to 112.5iu per day, and I stopped the estrogen patches. And my estrogen is now at 613, which I'm liking a lot.

My RE (Dr. "Young" this time) was super extremely positive about it all.

Dr. Young: "It looks like things are going really well this cycle!"

Me: "Really?"

Dr. Young: "Yes, I think you had a really nice response and have some nice follicles."

Me: "Well, I really only have one follicle that's still in the game at this point, right?" (and yes, I really did say "in the game," and I liked it after I said it because I was imagining a little 24mm follicle with a football helmet running around the field all by itself with all the other littler follicles cheering it on from the sidelines. Anyway, I digress...)

Dr. Young: "Oh no, it looks like you have 2, maybe 3 more follicles at 12mm that could release mature eggs."

Me: "Ummm... okay. But it also took me a really long time to get to this point."

Dr. Young: "Sometimes that's how it works. But I think things look really good! Let's hope that this cycle is successful!"

Me: "Yep, that's what I'm hoping for." (Okay, I didn't say that because it would've sounded really sarcastic, but that's probably what I wanted to say.)

Oh, and at some point in that conversation he said that the 24mm looked like it was "ready to pop."

So the plan is IUI tomorrow morning! And finally, finally, finally I will be in that horrible interminable 2ww. Yay!?

Friday, January 22, 2010

CD16, All About My Follies

Well. I cried in public today.

It feels like some sort of rite of passage.

What happened was that DH forgot that I was going to the RE this morning. Was not even on his radar. "Yes, DH, once again, I am going to get stuck with a needle, violated by a dildo cam, and probably told that my follies are still the same size they've been all week. But glad you're not letting it occupy you much."

Then, we met for lunch, and he forgot again that I had gone to the RE, and didn't even ask me about it!

So I proceeded to:
  1. Accuse him of living in his own little world
  2. Accuse him of not supporting me
  3. Accuse him of not caring whether or not we ever have children
And then I cried.

Anyway, we made up eventually. Or at least I calmed down enough that he considers that we made up. Whatever.

Okay, on to follie news.


What is it with my follicles this cycle? My biggest is 15.43 today. Wednesday it was 14.29, Monday 13.73, Friday 11.63. It's growing 1mm every 48 hrs. WTF? And after that one follie, there's not much else. Everything else has decided that 11m is some sort of follie paradise that they don't want to leave behind. If this cycle gives me just one follie, which by the way I can produce perfectly well on my own without 14 days of injectable fertility drugs, I might have to strangle my RE (Kidding! I'm just kidding. Mostly, that is. Okay, I'm not kidding at all. He'd better watch out.).

Last cycle, at double this dosage, I had 5 follicles between 15 and 16mm at CD9... It boggles the mind.

But, they've finally upped my gonal-f to 112.5iu/day now, and my lining has decided 9mm is just fine, thank you very much, and that's fine with me and my RE, too, so I'm stopping the estrogen patch tomorrow.

My estrogen went up to 277 (from 169) on Wednesday. But today it only went up a little more, to 295. Can't figure that one out, either.

And I go back Monday. For my 6th u/s this cycle.


Tuesday, January 19, 2010

CD13, Dude, Where's My Estrogen?

My estrogen from yesterday's b/w came back and it's 169. My RE actually called me and left me a voicemail with this number, which he's never done before, so that got me worried and, of course, I started googling estrogen levels. From what I've found out it seems really low, especially for CD12, and especially with a Friday IUI.

In his voicemail my RE gave me the number and then said he was just confirming that I would be coming in on Wednesday for more monitoring. Um, I just saw him 5 hours ago, why does he need to confirm this? The only thing I can think, since he didn't mention the IUI, is that now, based on my low estrogen, he's rethinking the Friday IUI. Which I guess is good, although that would probably move the IUI to Monday, CD19, which seems really late (although in non-medicated cycles I often ovulate on CD18 or 20, so maybe this is actually more natural for me?).

Ugh. I hate this part, the week leading up to the IUI. Last cycle it was all that crazy octo.mom BS of too many follicles. I really wanted last cycle to have been a learning experience that would make this cycle absolutely perfect, with a lovely lining, a few nice sized follies and a well-timed IUI, but now it seems like maybe the gonal-f was too little this time? Or is there something wrong with me? When I saw the RE yesterday he was very positive and told me I had nice ovaries and was having a good response based on my follicles... but I'm just worried, worried, worried.

It's just that I'm tired of these IUIs. With only a 20% success rate (if that), and especially because now they're not completely covered by my insurance, it's starting to seem like we're throwing our money away. If they were covered by insurance, I might feel like we could just keep trying until finally we find the right amount of stims, but now I feel like it would be foolish of us to do more than one more IUI after this one. Which means I've been thinking a lot about IVF, to the point that maybe I've already given up on IUI mentally and emotionally, which makes it even more frustrating when things don't seem like they're going right.

It just makes me want to throw in the towel and get on with IVF.

Phew. Good to get that off my chest. I'm feeling more positive already. Funny how writing it all down helps, isn't it?

Monday, January 18, 2010

CD12, Grow Follies, Grow!

Another RE appointment today. The big news is my lining is now 9mm! Dr. "Young" had many compliments for me on my thick and beautifully formed lining! So that takes care of goal #1 for this cycle (lining >8mm)!

The not so good news is that my follicles barely grew over the weekend. My biggest follicle on Friday was 11.6mm, and my biggest today was 13.5 (or so). The next biggest follies today were 10 or 11mm. I was really expecting to have some 14s or even 15s today. I asked Dr. Young if he thought they were growing too slowly and he said he didn't. He said he was very pleased with my response and thinks everything is looking really good, and that I should keep going with the same amount of gonal-f.

But, since apparently I need to see the negative in everything, I'm still very concerned. He wants to do the IUI on Friday and I'm just not convinced that we're going to meet my other 2 cycle goals (at least 3 mature follicles, and follicles being 18-20mm at trigger) with the IUI that soon. Since it took 72 hours for my biggest follicle to grow 2mm, if that rate keeps up then the lead follicle will barely be at 15mm when I trigger. Oh, and I also asked my RE how big they needed to be before we trigger (I have always heard 18-20mm, but I wanted to hear what his opinion was) and he said he was comfortable getting to 16mm. Now, I have to assume that this is because he's seen other women get pregnant with follicles that were that size, so I'm trying to put my trust in his experience... but I have to admit that I decided I'd do my injection early today. Technically I'm still following doctor's orders! It'll just give the gonal-f a little more time to work it's magic before we trigger.

And of course there's always the possibility that at my next u/s (Wednesday) he'll change his mind and decide to do the IUI Saturday. I can't imagine him wanting to wait to do the IUI until Monday, though (and they're closed on Sundays).

Geez! This is why I like the 2ww (at least the first week of it). You can relax and not have to worry about all this stuff!

Friday, January 15, 2010

CD9, My Advocate, Myself

Today was my first u/s for this cycle, and so far so good. As of today I have 4 follicles on my right ovary and 6 on my left. The biggest ones on the right are at 8mm. On the left 2 are at 11mm and one is at 10.5. Last cycle on cycle day 9 I already had 5 follicles between 15mm and 16mm, so things are going a little slower this time. Which is good.

My lining last cycle on CD9 was 6.5. This cycle I convinced my RE to put me on estrogen, to "fluff" it up, even though he seemed to think it wouldn't do me much good. So today on CD 9, after 7 days of estrogen, my lining is...

wait for it...


So, no change. Score one for the RE.

But, here's the thing: so my lining is the same as it was last cycle, but the big difference here is that last cycle I was told to trigger 36 hours after my lining was measured at 6.5 and then I had the IUI on CD12. This cycle, because my follies are growing more slowly, I have to go back on Monday, CD12, for another u/s, and my guess is my follies might still need a little more growing time. I'm guessing my IUI will be Friday, CD16, meaning my lining will have 4 more days to thicken than it did last cycle. And all I want is 8mm... so I'm hopeful.

Oh, and I saw the third RE today. Yes, the mysterious "third" RE. She is technically in charge of their egg donor program, so I don't think she consults with the infertiles much. I've only seen her once before. She's very nice. Anyway, she asked me about the gonal-f and I told her I'd started injections on day 4, that I was told to do 4 days of injections, and that my last injection had been Wednesday night.

"Wednesday night?" she said. "You didn't do an injection yesterday."

"No, I was told 4 days of injections, starting on day 4, so Wednesday was the 4th day of injections."

"That's not right. You should be doing injections every day. Well, it won't make a difference in the end, but you should do an injection every day."

Which, by the way, is exactly what I was thinking when Dr. Young told me "4 days of injections." He had given me these instructions before my period started. He told me to stop the BCP, and he predicted I'd either get my period on Thursday or Friday, and I knew that if I got my period on Thursday there would be a gap in injections. I thought it was weird, but I didn't really challenge him on it.

So after seeing the "third" RE today, I started thinking that maybe I'd misunderstood his directions. Maybe he never said to do injections for 4 days, maybe he'd just said start on day 4. But I really don't think it's possible that I misunderstood because I wrote down his instructions. He was giving me a lot of instructions that day and I kept repeating back to him what he was saying to make sure I understood and remembered, until finally he asked me if I wanted to write it down. So, what I wrote was:

Day 4 - gonal-f 75
Come back Jan 15th.

And I wrote it right in front of him.

Grrr... It just pisses me off because I thought it sounded wrong and yet I didn't say anything.

I must be my own advocate.
I must be my own advocate.
I must be my own advocate.

I'll get it eventually.

Wednesday, January 13, 2010

CD7, Insurance Basterds

I cannot believe I'm about to write this super boring post, but I figure this is a big part of the IF experience, too, so I might as well take note of it.

Insurance woes!

(I'm going to try to keep this short.)

I'm a little worried about my insurance coverage.

2 weeks ago I was under the impression that we were fully covered for IUIs, and then I got a voicemail from my RE's office saying "can you please call us, we need to talk to you about your insurance." I got the voicemail at around 7pm, so I had to wait to call until the morning, and I couldn't believe how much agony I was in for those 12 hours. I thought for sure they were going to tell me that my insurance had cancelled me or something (how that would even be possible I don't know, but I was thinking worst case scenario). Turns out that I'm not covered for IUIs after all. Wait, what? I've already done 2 IUIs with you guys, and I spoke to someone in your billing department who told me "you're definitely covered, I checked twice to make sure." But now I'm not? Apparently now my insurance company is saying I'm not covered, I've never been covered, end of story. So, the good news is, it seems I'm covered for b/w and u/s and office visits. The bad news is the IUI itself is not covered, and it's $500. Which means as of right now I already owe them $1000, and in another week I'll owe another $500. Okay, not the end of the world, but certainly not good news.

Then today I opened a bill from the lab that processes my b/w. It was for $247 from a hcg/progesterone/beta test from 9/28/09. What? I've had a TON of b/w already and I've never been billed before. I then noticed in my drawer that I had a bill for a $20 copay from this same lab that I paid back in October, also for hcg/progesterone/beta, on 9/30/09. This one said that my insurance had covered it. Weird.

So, now I'm worried. And now I'm starting to think, maybe I'm actually not covered for anything... and maybe they just haven't been sending me the bills yet? Or maybe they've covered some of the b/w and u/s by mistake, and if I call about this bill it will alert them to the mistake and they'll tell me that I now have to pay for everything.

But, I couldn't just ignore the $247 bill, so I called the lab and asked why the b/w from 9/30 was covered, but the same b/w from 9/28 was not? They told me that they submitted the b/w that was not covered to my insurance company, and because my insurance was not "in network" with them, it was not covered. But the other b/w was submitted to my same insurance, but in a neighboring state (what?!) and that insurance company covered it.


Anyway, she told me she would go ahead and resubmit the bill to the insurance company that covered the other one and I could, for now, ignore the current bill.

I am so confused. And worried. If we had to pay $247 every time for the b/w, that would be about $1000 each cycle, plus the $500 IUI. And if it turns out the u/s and doctor's appointments aren't covered either, we could be looking at $2500 a cycle, I'd say. At that point I would consider it no longer worth it to do IUIs. $2500 for a 15% success rate doesn't make sense when you could spend $10,000 for a 50% success rate. Right?

Ugh, I don't know what to do. I'm too afraid to call my insurance company and draw attention to myself in case they've been unwittingly covering things that aren't really covered.

This was a much longer post that what I'd planned. And even more boring than I'd thought it would be! Sorry!

In other news, my last shot of gonal-f (75iu) is tonight. No shot tomorrow and then RE Friday morning, and we'll see if these estrogen patches have "fluffed" (thanks to Such a Good Egg for that lovely way of phrasing it!) my lining to a nice pillowy thickness!

Oh, also, I realized that in my next to last post (the one about the changes I was making this cycle) I wrote "no alcohol until I'm knocked up." As if I will begin imbibing again as soon as I see that second line. Let me clarify: no alcohol until after I'm done making (or not making, as the caase may be) a baby(s). Now let's see how long I can stick to that one...

Tuesday, January 12, 2010

CD6, Honest to Blog

I never thought I'd say this (and I really never thought I'd write it), but I heart blogging. If you'd asked me a year ago my opinion on blogging, I'd of said "I don't really get it." You know, the whole putting your life online for the world to see, your innermost thoughts now public, and the narcissism of thinking that anyone would actually read it... not something I really understood.

And then, after almost a year of BFNs, and after my first failed IUI, I got online looking for women who were going through the same thing that I was. And as soon as I saw that there were blogs out there, and that the women were struggling with their anger, their disappointment, their frustration, that they ranted and they raved about the unfairness of it all, and they philosophized about the meaning of it all, and they commiserated with one another, and they sent out "hugs" and "good lucks" and "I'm so sorrys" through their comments, and suddenly I knew that I needed to be a part of that world.

And so, I have officially replaced my infertility obsession with an infertility blog obsession!

No longer do I think "my RE is an incompetent fool and that sucks," now I think "I am SO going to blog about what an incompetent fool my RE is and how much that sucks!"


I feel much better!

Saturday, January 9, 2010

CD3, Ch-ch-ch-changes! Oh, and some goals, too.

Today is CD3. Yesterday I put on my first estrogen patch. Tomorrow I start gonal-f. We're underway for IUI#3!

Okay, um, so that exclamation mark probably makes me sound super excited, but instead you should read that sentence with an air of hopeful desperation.

Because I'm tired of cycling.

"After 2 IUIs?" you say. "Humph! You've barely begun!"

I know. It's just... I've been around a lot of mothers with young children lately. They all look to be around my age and they all have 3-5 year olds. I feel like I missed my window. Why didn't we start trying earlier? DH and I have been together since I was 27. At 27, the last thing on my mind was kids. But 30 would've been a good time to start. But I wanted to enjoy my youth, and I didn't want to grow up. Now I'm 34. I'll be 35 in 3 months. And, God bless him, DH just turned 50. We need a baby, stat!

Anyway, I'm getting serious this time. I'm making some changes, and setting some goals. Here they are.

Changes for this cycle:
1) No alcohol until I'm knocked up. Before I was just refraining during the 2ww, but then I read this: IVF Couples Warned Over Drinking (and another article here). Basically, it says that in couples where both the man and woman drink up to four drinks a week, chances of conception are reduced by 26 percent (!). Although we're not doing IVF, I can't help but think this could be an issue for anyone TTC. I've also shown this to DH, since it seems to also affect him, and he's agreed to cut back (although he had 2 beers last night: grrr!)
2) No more tampons. I have read various opinions that tampons are associated with endometriosis and infertility. I'm not going to post any specific links because I don't think this is in any way proven. But I figure it can't hurt.
3) Trying to maintain a BMI>18.5. I'm a little underweight and always have been. Since being thin is so valued in our culture, I've always actively kept my weight lower than is "average." No more! Dessert and second helpings, here I come!
4) Still working on cutting back on the caffeine. This is going to be the hardest. I love my coffee.
5) Drinking more water. People are always telling me that I don't drink enough water. I never really gave it much thought because I don't do anything differently than I ever have: I drink a glass of water with every meal and that's it. But... I am giving up my stubborn refusal to change, because, well, you never know what might help, and it couldn't hurt. I will now drink water... gasp!... between meals.
6) Exercise. Don't get enough of it. Must. Get. Away. From. Computer.

And here are my goals for this cycle:
1) 3 follicles would be perfect. Please no more than 4 (way too many last cycle).
2) A lining >8mm (I've never had a lining that measured greater than 6.5).
3) No trigger until follies are at least 18mm, but better if they're 20mm (last cycle I was instructed to trigger 36 hours after my largest follicle measured 15.9mm, and I think it was too early).

Also, some big congratulations to Nixy at Infertility UGH and Stefanie at Baby Blakely on their BFPs! I can't wait to hear about the new road you find yourselves on! Congrats, ladies!

Monday, January 4, 2010

CD15, There Will Be Lining

I thought about titling this post "a person who doctors oneself has a fool for a patient," or maybe "careful what you wish for," or even "who gave me the medical degree, anyway?"

Okay, let me back up a bit.

So, I'm a big supporter of the "you must be your own advocate" philosophy. I watch a lot of "Mystery Diagnosis," and I've learned from that show that if you sit back and let the doctor make the decisions, your rare-but-curable-if-caught-early-brain-cancer will probably be mis-diagnosed as a "virus" and you'll be sent home with a prescription for motrin and you'll suffer in pain until you finally make someone listen to you. I know this. I watch the show. And I also know how hard it is to speak up to one's doctor. I mean, they're a little intimidating. But as I learn more and more about this IF thing, and as I'm on my 4th cycle with my RE now, I've got some opinions. And some emotions, let's not forget those.

I'm emotionally opinionated.

About my lining.

Because when you've had periods your whole menstruating life of 4 to 5 days of medium to heavy bleeding and then 1 or 2 more days of light bleeding, which I understand is probably even a little heavier than average, and then you go to 36 hours of light to medium bleeding and then 5 days of pathetic little spotting, that doesn't feel normal. It feels like "no wonder I can't get knocked up, because I'm barely having a period at all."

So it seems that the 2 REs at the clinic I go to have very different opinions about my lining. Up until now I've been referring to them as RE#1 and RE#2, because up until now they've been pretty interchangeable in my mind. No longer. So I've decided to start referring to them as Dr. Young (RE#1) and Dr. Old (RE#2). They are neither all that young or all that old, but it's enough of a difference that that's what I'm going with.

Dr. Young is my assigned RE, but Dr. Old is the head doctor at the clinic. Dr. Old was the one who told me that pregnancy tests don't test below 50hcg. Dr. Young is the one who said that doing an IUI with 9 follicles was not irresponsible because he "does it all the time." So, that's them.

Anyway, met with Dr. Young today. My ultrasound showed my leftover follicles were now gone and we began to talk about moving forward with the cycle:

Dr. Young: "I see that you talked to Dr. Old about your lining last time you were in..."
(indeed I did...)
"...but the fact is that some women just have a thin lining..."
"... and there's not much we can do about it anyway..."
(umm... starting to disagree with you here...)
"...we could give you estrogen but it would only maybe increase it by a millimeter, and your estrogen levels were fine anyway..."
(well... really? You just lost me a little bit...)
"...and anyway what I really want to talk to you about is whether you want to do IVF this cycle."
(ummm, say... what?)

Me: "IVF? Why is that something we're considering?"

Dr. Young: "Well, we were considering it for last cycle."

Me: "Yes, but only because I responded too well to the gonal-f, and ended up with so many follicles. We had talked about doing 3 IUI cycles on injectables before moving on to IVF."

Dr. Young (defensively): "Okay, that's fine, we can do more IUIs if you want to."

Me: "Good, okay, so back to my lining. Last break cycle you had me start an estrogen patch at day 21 and my period was much heavier that cycle than it's been in a long time, so I think I would respond to estrogen. And my last period barely lasted 36 hours and I just don't think that's normal for me."

Dr. Young: "Okay, then here's what we'll do..."

He then proceeded to tell me that he'll prescribe me estrogen patches for this cycle, we'll do another IUI, and we'll cut back on the gonal-f.

Just what I wanted.

And so it kind of feels like when I would beg and beg my parents to buy me something and they would tell me all the reasons why they didn't want to buy it for me but then they would finally give in and then I would wonder if they had been right all along, and that maybe they were just saying yes so that I could realize it for myself. Yeah, it kind of felt like that.

So, the good news is, I got exactly what I wanted: estrogen. The bad news is, my doctor doesn't seem to agree that it's what I need or that it's going to do any good but he prescribed it for me anyway.

So, here's the rundown:
Today (1/4/10): stop BCP.
Thursday or Friday (1/7/10 or 1/8/10): predicted CD1
CD2: Start Estrogen patch, change every 3 days
CD4: Start 75iu of gonal-f for 4 days.
1/15/10 (predicted CD9 or CD10): Next u/s and b/w.