Stubborn


MH is stubborn.  He’s so funny.  I’ve been asking him to sit with me with his hand on my belly to try to catch one of Roo’s little kicks that she gives me at night.  MH will do it for about 2 minutes and then is over it. He gets so frustrated so quickly.  Then, when she starts to kick up a storm and I tell him, he gets stubborn and won’t come back. I’ll let him come to me and I know in time he’ll feel her.  She’s an active little girl and I know she’ll let her Daddy feel her kicks soon!

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If you’re here from ICLW: Welcome!  I’m in the middle of my second trimester of my second pregnancy (first one I lost at almost 6 weeks) with my first take-home baby – I hope and pray!  After our loss, we tried and tried each month with each cycle ending in tears and disappointment.  Six months after our loss, I went to a fertility specialist.  Because of my age, they did all the requisite testing and came up with a DOR diagnosis – finding me with fewer than half the amount of eggs I should have during a CD3 follicular u/s.  I was very disappointed – actually devastated.  Following that diagnosis, we tried a couple of IUIs with Letrozole without success and I started to look for answers elsewhere.  That elsewhere came up with a diagnosis of elevated natural killer cells.  We were told that my chances of getting pregnant and keeping the pregnancy beyond the first few weeks of conception were slim.  More devastation.  After much debate/discussion/research, we decided to move onto IVF.  The last natural cycle before starting the BCP for the IVF cycle, we were surprised with a BFP.  In all, our journey from going off BCP right after our wedding to our loss to this pregnancy was a year and a half.  That’s not as long as many but it was long enough for me to seek out the infertility community, which embraced me with open arms.

Today, I’m taking this pregnancy day-by-day.  It definitely has its ups and downs.  I try not to complain because I’d rather be here than not be pregnant.  I try to embrace the positive and negatives of pregnancy but accept the fact that as much as I wanted to love being pregnant especially because of the many trials that we encountered to get here that being pregnant is not my cup of tea!!  I hope you continue to read and follow my journey even after ICLW for March is finished!  Leave a comment and I’ll be sure to stop by and follow your journey too – we all need support and cheerleaders no matter what stage in this adventure we are in.

 

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Second Opinions…


I’m still stunned by my call with Dr. Sher yesterday.  It was scheduled for 4pm and I didn’t get a call until just about 4:45pm which is fine.  I was expecting him not to call on time – I have doctors in my family so I know what their lives are like.

He was very gracious and I was surprised to hear that he has a British accent.  I don’t know why but I was…and that is COMPLETELY irrelevant.  Anyway, after he gave me his “spiel” that he must give to everyone having an initial consultation, he went through my history and stopped to talk about the thyroid and my slightly elevated TSH levels.  He said that his biggest concern for me is that because of my thyroid “issues,” which he is not too concerned with, is the possibility of an autoimmune disorder.  The two that he mentioned are Hashimoto’s and natural killer cells, both of which I guess inhibit pregnancy much beyond implantation.  I need to do more reading on these.  So, he recommends that I get blood work done to rule out both of these possibilities.  Takeaway: get blood work to rule out autoimmune issues.

Next he went on to tell me about how great Letrozole is for women who don’t ovulate.  However, he said that since I ovulate on my own that I should NOT be taking the medication.  That it does not make for a “stronger” ovulation as my current RE indicated.  He said that it in fact could inhibit a perfectly good ovulatory cycle.  He also said that the dosage of Ovidrel that I’ve been using would need to be doubled in order for it to do a proper job.  Also, MH’s sperm count, etc. are fine and IUI with normal counts don’t increase chances of pregnancy.  So, he essentially said that me doing a medicated IUI cycle is a waste of money and an emotional roller coaster that I don’t need to ride (that’s for sure).  Takeaway: no IUIs.

Lastly, he went onto explain that the blood work and ultrasounds that led my current RE to give me a DOR diagnosis are incorrect.  My levels are appropriate for my age that while he agrees that I may be on the verge of DOR that I do not have it.  He says that he believes an antralfollicle count of fewer than six along with elevated FSH and corresponding AMH results would lead to a DOR diagnosis but my numbers don’t match up.  While I have had a follicle count of seven, I also have had a follicle count of 11.  He said that people including well-trained physicians frequently don’t perform follicle counts correctly.  Takeaway: I don’t have DOR.

As the conversation unfolded, I kept wanting to interrupt and ask one of my two pages of questions that I had for him.  He just kept on speaking and I was stunned.  I was expecting him to agree with the DOR diagnosis and to tell me that IVF would be the next step.  I thought he was going to tell me that I didn’t have time to waste.  Instead he said, “If you aren’t pregnant in one to one and a half years, call me and we’ll do IVF.”  He said take any money you were going to spend on infertility treatments and go on vacation.   Finally, the words that brought tears to my eyes were, “Call me when you get pregnant.”  Takeaway: Have lots of sex after the LH surge is detected.

I feel incredibly blessed and lucky to have spoken to Dr. Sher, in part because of my new friend, Lisa B.  I came across her blog a couple of months ago when I decided to start this blog.  I sent her an email asking about her experience with Dr. Sher and because of her response to me I make an appointment.  Yesterday, Lisa also had a call with Dr. Sher.  Her call didn’t go as well as mine.  Today she is facing the devastating reality that she may never carry a child in her body or experience the pains of childbirth.  I’m thinking and praying for Lisa and everyone else who is dealing with the devastation of infertility that miracles can happen for them.  Please stop by Lisa’s blog if you have a moment and give her some <hugs>.  She’s given them to me when I’ve needed them and I want her to know how grateful I am to her.

In the meantime, MH and I are waiting for an offer letter to come in from a company where he interviewed a couple of weeks ago.  If the letter has everything that we think it will based on several phone conversations with the hiring manager, we may be moving in less than four weeks to another state but still on the West Coast.  We had already decided that if I don’t get pregnant this month that we’re taking the next cycle off to deal with moving, etc.  When we get to our new city, I will find a new RE and get a third opinion.  I’m hopeful and I trust that what Dr. Sher has told me is correct but I also feel like I need validation.  Call me crazy but I do.  I also want to make sure that there are no underlying autoimmune issues that we’re dealing with that might be preventing a pregnancy.  So, we’ll see.

The journey is far from over though.  I still need to get pregnant and I still need to stay pregnant for 40 weeks.

Thank you for ALL of your support.

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In other news, I’m currently 11 days post IUI and 13 days post trigger.  I have pretty much ZERO symptoms, which is similar to last month.  I don’t understand because in so many of my previous cycles I had every possible pregnancy symptom imaginable.  So, I wait.  If I’m not pregnant and my body is the same as the last cycle, I’ll get my period on Sunday.  I won’t have to stop taking the progesterone in order for my period to start.  It won’t wait.  So, fingers crossed.  Sunday is the day!!  I pray that it is MH’s and my turn.

Side Effects


Last night at 2am I woke up to the worst nausea ever accompanied by hot flashes.  I was dead asleep, woke up because I was sweating like mad.  I pushed the covers off my body and then immediately pulled my legs up to curl my body around my stomach.  I thought I was going to vomit except I knew that I just felt like it.

I couldn’t fall asleep for quite a while.  I didn’t want to get out of bed because I was afraid that I would throw up and I didn’t want to stay in bed because I was so uncomfortable.  I clearly just didn’t know what to do.  So, I laid there.  Still.  Curled up.  Upset.  Confused.

Eventually, I fell asleep again.

I’m guessing that these were side effects of the Letrozole.  I’m on such a high dose: 7.5 mgs on CD3-7.  I’m not surprised that I had some side effects.  I’m surprised that it took until the last night for the side effects to hit me.

Sigh.

Now onto waiting for the LH surge.  I start taking my ovulation predictor tests on the 10th.

Here’s to hoping that the nausea and hot flashes are over until I get a positive pregnancy test – at which point, I’ll (un)happily welcome those symptoms because it will mean I’m carrying a little one inside of me.

And so begins IUI cycle #2


This morning was my CD3 ulstrasound to confirm that I have no cysts lingering and that I can start to take the Letrozole to prepare for IUI number two.  Everything looks good.  My antrafollicle count is OK – 4-5 on the left side and 8 on the right side.  I asked my questions and got answers that were vague but confident on his end.  I’m not so confident but I have to trust that he is the expert and has been doing this for years.

I asked my question re: dose of Letrozole resulting in thin lining and overly large follicles: his response – we never know how a body responds to a medication but I’m not concerned about your lining, it worked out fine in the end and yes, follicles can be too large so let’s bring you in on CD12 to see where your follicles measure.  Let’s leave the dose as it is.

I decided to leave the HSG question alone for right now.  I will do my own research on where I would get it done, pricing, etc.  And, I’ll ask my OB to order the test to be done.  If this IUI fails, I’ll be prepared and ready to make my decision.

And, so begins preparing for this second IUI.

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Yesterday evening I had a complete meltdown.  It was the emotional meltdown that I thought I would have had either earlier in the last cycle as a result of the Letrozole or on the day I got my period.  But no, I held out for 24 hours.  I had a great morning.  I was over my initial disappointment of getting my period.  I had a great new business meeting, which resulted in a signed client at least through the end of the year and I signed a contract with another client for a smaller two-month project.  So, good news!

I was feeling so positive that I decided to treat myself to an eyebrow wax and tint.  It is something that I do to feel better and it has been a while since I’ve been in save-money-for-infertility-treatments mode.  But, the girl f’ed up and left the tint on too long.  I look terrible.  I probably feel worse about it than it looks.  AND, my sister-in-law sent me an email that pretty much, if I read into it correctly, confirms my fears that she is pregnant and isn’t ready to share the news yet.  THEN, as I was cooking, which in addition to writing is my comfort, a tiny splash of hot oil hit me in the face.

All of those things were the perfect storm and I fell apart.  MH was running late and wasn’t responding to my text messages because he was on the phone.  So, I got worried and started to imagine the worst case scenario that he got hit by a bus or a car on his way home from work.  I was a complete mess when he walked in the door.  I was pretty much hyperventilating because I was sobbing so hard.

My sweet husband held me in his arms.  He reminded me that all of these things individually would be nothing in the scheme of it and that if we weren’t struggling so hard that I would be fine.  He reminded me that it is OK to cry and be sad.  He reminded me that I need to be happy for my sis-in-law and brother because when it is our time, they will be happy for us.  He reminded me that he loves me and married me not because he wanted me to give him babies but because he loves me so much that he wants to be by my side for the rest of our lives.  I love my husband so much.  I feel so lucky.  I’m glad that since we’re forced to go through this challenge in life together that it is he who is by my side and not one of my previous relationships.

I lost control last night.  I’ve been devastated and sad and cried before about this crappy situation – once when the doctor in the ER confirmed the miscarriage and again when I heard the diminished ovarian reserve diagnosis.  But, I held it together with those for the most part.  I cried with MH, we wiped my tears and went on.  Last night, I felt out of control.  I could have cried all night.  I don’t know why.  Maybe I’m odd and my hormones kick in after…who knows.  But, it felt good.  I could use another good cry again soon (but maybe I’ll save it for when I’m home alone).

Temperature Drop and BFNs


Well, alas, my instincts are proving to be correct once again.  Darn it.  I woke up this morning with a temperature drop.  Yesterday’s waking temp was 98.9.  This morning I woke up to a 98.5.  That’s a huge drop and one that I believe is a sign of an impending period – at least once I stop taking the progesterone.  I suspected this though because I’ve taken two Internet HPTs.  One on Friday and one yesterday.  Both were STARK white.  Plus the fact that I had pretty much ZERO symptoms is a pretty big sign in itself.

I’m upset but not as upset as I thought I would be.  However, I usually get REALLY upset as soon as AF truly shows up and I think that will be the case here too.  I’m also disappointed to say the least.  I was counting on this working.  But, if I admit it, I knew deep down inside that it didn’t work.  I know that MH is going to be upset too.  He might even be more upset than me this cycle.  I know he was counting on it too.  And, I know that last night as he blew the candle out on his birthday cake that he wished that I am pregnant.  Sadly, my body is failing me once again this cycle and I won’t be able to make his wish come true.

I know that I’m a newbie to this whole infertility thing but I was hoping and praying that I would be one of those lucky ones.  One of those lucky ones who beats the odds.  But, I guess that I’m not.  It makes me effing mad.

So, I need to prepare my list of questions for my doctor at the CD3 ultrasound:

  1. Is 7.5mgs a day of Letrozole too much?  My lining was almost too thin and the follicles were HUGE (over 30mm when I triggered).
  2. Should I get a HSG if the IUI doesn’t work after this next cycle?

I don’t know what else to ask.  Any ideas?

I also got the courage to reach out to the Sher Institute for Reproductive Medicine, thanks to my new friend, Lisa.  I’m going to follow through and complete the paperwork and request for my medical files to be sent to them.  It might be time to see what a different set of experts say about my case.  I know that it is early but it can’t hurt.  I’m tempted to also see what the Colorado Center for Reproductive Medicine says but that consult will cost $$$, so I might wait for another cycle or two to bust before shelling out additional funds.  We’ll see.

I guess I see what so many courageous women dealing with infertility have done before me and I see some of them saying that they wished they were more aggressive at the start.  So, should I be more aggressive now?  At the start?

Acupuncture


In my journey to try to have a baby, I’ve done a lot of things that I never imagined that I would ever experience including acupuncture and drinking traditional Chinese herbal medicine tea.  I never would have thought that this was a path that I would take until a friend of mine recommended her acupuncturist that she saw while TTC – she got pregnant at 46 and has an adorable child (she used a donor egg).

Going to the acupuncturist is actually one of the highlights of infertility and TTC.  I really enjoy lying on the table and relaxing with my eyes closed listening to soothing music for 45 minutes.  I don’t have to worry about a thing, which is odd considering there are between 5-12 needles sticking out of my body.  But it is.  I’ve complained about different aches and pains separate from TTC and she is able to fix them for me using needles, while at the same time helping to boost my uterine lining.  I love it!

The traditional Chinese medicine teas were scary at first.  I didn’t know what I was drinking and I was supposed to drink three cups a day.  They certainly helped me reach my goals of drinking more fluids every day!  But, like the acupuncture, I grew to enjoy drinking the tea.  It became a ritual for me and three times a day, I took time out to fix my tea, sit in silence and drink it.

Now that I’m on Letrozole, I don’t take the herbs but I’m still enjoying the weekly acupuncture sessions!

Supplement Popper


Along with all of the other medications that are prescribed by the doctor, I and MH take a handful of other supplements.  I used to be that person who put nothing in her body.  I hated taking anything except for The Pill because I feared getting pregnant more than anything…how ironic.

But now I put almost anything in my body to help me get pregnant again.  So in addition to the Letrozole, Ovidrel, and Prometrium, I take a host of other medications and vitamins that I hope gets my body to the point where it will conceive and carry a baby to full term.

  • levothyroxine: to help my thyroid get to the perfect levels for conceiving
  • Prenatal vitamin
  • Vitamin D: I’m slightly deficient and so I take 2,000 IUs a day
  • Vitamin B6 to help lengthen my LP and to reduce PMS symptoms
  • Omega 3 supplements
  • Calcium
  • Vitamin B12: my acupuncturist gave it to me because of my thin uterine lining and light periods; she says it will help the blood in my body – I just started taking this one…

MH takes:

  • Zinc
  • Vitamin C
  • Men’s daily vitamin

I can’t imagine adding anything more to this regimen.  MH jokes that I should get my own shelf at our local drugstore.  In spite of saying that I wouldn’t add to this list, I would if I knew it helped make our dreams for having a baby come true.

Diminished Ovarian Reserve


Hearing those words at the RE’s office was a kick to the stomach.  I don’t think that I understood much of what the doctor said to us after he told me why we had been struggling to get pregnant after our miscarriage.  He was very kind but very straightforward.  He said that my risk of miscarriage is higher and that my chances of getting pregnant on my own are lowered tremendously.  AND, if we need to go to IVF that they like to try to get 15-18 eggs at the time of retrieval and that my body would probably only produce 8-10 at most during that IVF cycle.  (Note: I know that there are people out there with less positive outcome scenarios than me and I’m sensitive to that but I’m only speaking about my own diagnosis here and my feelings about it).

I held it together in the office for as long as I could.  The moment we got to the elevator bank and pushed the down button, I grabbed MH’s hand, put my sun glasses on and let the tears slide down my face silently.  The doors to the elevator opened and we got in with another woman.  We rode down still in silence with more and more tears sliding down my face.  I couldn’t stop them from coming.  As soon as we got outside, I couldn’t hold any of my emotions back.  I was broken. Devastated.  I felt almost as much despair as I did when the doctor in the ER confirmed that I was having a miscarriage.  All of the hope, the possibilities that I had in my head that I imagined the RE would provide me were almost nearly shattered.

In doing research and connecting with others, I still am concerned about my diagnosis.  I wonder if my RE is not being aggressive enough or if we are rushing too fast.  This entire process if a contradiction.  I’m 35.  I should still be fertile but I’m not.  I’m facing a challenging but not impossible diagnosis.

I’m trying to find hope in the midst of this and I do have it.  It actually saves me but it also slays me.  I get so hopeful during the TWW – I get my hopes up and I truly believe that this is it!  This is the cycle that I will get a BFP.  That this cycle will be like the doctors say: the one where she got pregnant before she had to resort to the x or y medical intervention.  I prayed and hoped that would be during the last cycle.  The last natural cycle we would have before starting on meds.  Now, I’m hoping and praying that Letrozole, the trigger, the IUI and the progesterone are the magic combination that gives me a BFP on August 1 – MH’s birthday.

At this VERY second (8:13am PT), I’m not feeling very hopeful.  In past cycles, I have almost always gotten some very strong symptoms of PMS/pregnancy very early in the TWW.  I’m now 5dpiui and I have NONE.  Nothing of note.  So, I’m not too hopeful based on the signs.

Only time will tell.

I’m committed to facing this challenge: DOR.  Head on.  In trying to find the silver lining, I’m grateful that MH’s swimmers are healthy, fast and abundant.  I’m praying that one of the 80 million saved from the sperm wash the other day found both or one of the two large follies!  I’m trying to envision them connecting and burrowing deep into my lining and staying there, warm and comfortable.

I’m hoping — even though sometimes I think my hope might jinx it.  I’m hoping that I will be carrying a baby in my body on my EDD, which is August 30.   But, there I go again.  I’m probably jinxing it.

The Possibility of Twins


Being on a fertility drug like Letrozole or Clomid brings the risk of multiples.  I’ve been told that the risk of twins is increased by 10%.  With two large follicles, the possibility of me having twins is certainly there.  My preference would be to have a singleton pregnancy especially because I’m a fairly petite woman with a small frame but as long as I have a healthy and safe pregnancy resulting in a healthy babies, I would take twins.

With twins, I would automatically be considered a high risk pregnancy as well as a face a number of other risks, including:

  • Higher risk of premature delivery
  • Babies with a low birth rate
  • Preeclampsia
  • Gestational diabetes
  • Placental abruption

As much as I love the idea of twins because it would be so cute and I wouldn’t have to deal with the stress of trying to get pregnant again, I would much prefer a singleton pregnancy!

For now, I’m just praying for a positive pregnancy test at the end of this TWW!

IUI #1 – Check!


This morning, our first IUI was completed.  It happened so quickly that I wasn’t sure that it was done.

At 9am, I dropped off MH’s “sample” to be washed.  I returned two hours later.  Because my lining had been so thin, my doctor checked it once more.  It wasn’t measured but it was fine.  I verified the sample with both of our names and I lay back on the table.  I literally felt nothing other than the speculum going in.  I was expecting slight pain and/or cramping with the procedure but I felt nothing.  After, I lay on the table for about 8 minutes and then headed home!

Tomorrow night I start progesterone and in 14 days I take a home pregnancy test.

My dream and prayer now is that MH’s super strong and healthy sperm find my two REALLY large follicles that grew as a result of the Letrozole.  I pray for a positive pregnancy test at the end of this two-week wait (TWW).