Looking forward to my anniversary and birthday month

My 7-8dpo progesterone came back at 15.62, so definitely confirming ovulation, but again nowhere near as high as the RE has been wanting it – I just don’t respond to the Clomid like they want me to, so it’s definitely time to move on. No matter the outcome of this current cycle, I’m relishing the thought of a month off of hormone medications – freedom! Or relative freedom, since no doubt I will still take my temperature here and there and use OPKs, as well as see my acupuncturist when I’m back in town, but compared to the last 3 months, it’s going to feel like a true break from this whole craziness. I will have the RE appointment and she’ll probably want to get some baseline labs again, but at least my birthday month will start with an awesome anniversary trip, and end with my sister visiting for our birthdays.

Think I’m going to start testing tomorrow morning. It’s early I know, but I haven’t truly tested with an HPT since last year (not counting the one I did after my HCG trigger), and if there’s any cycle to test early, this would be it!

The surprise 19mm follicle on CD15, and decisions, decisions…

After explaining my BBT observations and the positive OPK yesterday morning to the NP, she decided to scan me again first before doing the IUI. The 10mm follicles on the right from 2 days ago were long gone, then she swung over to the left – which she couldn’t fully visualize 2 days ago due to my intestines moving (I really need to figure out what it is that keeps setting it off because it’s making the scans really difficult). 3 follicles – the largest at 19mm, and 2 others that were probably 14-15mm. I nearly laughed out loud when she told me. So in went the sperm (which looked great per her – combined with great EWCM she saw), and I’m going in again tomorrow after all.

So we’re definitely giving it our best shot this cycle, no matter what day I ovulate. The main thing that bugs me is knowing when to test, because we fly overseas on June 2. I may have to use the Lunette on the plane for the first time. Yikes.

Now I’m at a crossroads, if I don’t get pregnant this cycle. 4 IUI’s down, 2 more to go before my insurance will cover 80% of IVF costs at a nearby out-of-group RE’s office. This RE happens to be super-close to where I live, and is smack dab in between my house and my office – but because he’s well-liked and inexpensive compared to others, he gets a long waiting list. I asked the NP, and they only give Clomid at my current clinic, no Femara and no injectables. She actually pushed me to just pay out of pocket for IVF if this cycle doesn’t take because she really feels like everything we’re doing should be getting me pregnant, and if it’s not happening this way, she doesn’t feel injectables + IUI would really give me that much of an increased chance. This leaves me with the following options:

  • I could go back to the office that’s at least 30 minutes away, because they do use injectables, but they don’t perform IUI’s on the weekends – which could end up wasting my time then.
  • I could also just try to do non-medicated IUI’s these next 2 cycles – this NP was willing, but the OB/GYN may not be – though he is very hands-off. Or I could take Clomid 2 more times, but at just the half-dose I’d read about.
  • Start the IVF referral process – because given the wait at the out-of-group RE’s office, by the time we could start, we’d probably have the 2 IUI’s done anyways.

Regardless, I’m going to self-refer to the in-group RE that’s an hour away, have her re-check my labs since it’s been a year, and then decide from there what to do.

Not a great CD13

I started to notice a little EWCM yesterday night, so I had high hopes for the ultrasound today, only to get shot down. 2 follicles on the right, the largest at 10mm. Not even close to being trigger-ready. The NP wants me back Wednesday morning for possible trigger, and IUI Thursday and Friday. I’m super confused as to what the increased dose of Clomid has done – I would have expected faster growth, not slower!

Then I rushed to my clinic for my annual review. I’m doing well, other than the increased sick leave I’ve been taking, and obviously – juggling my work schedule with infertility appointments. I held it together until the end when I teared up talking about getting treatments, and blamed the Clomid. I’m fortunate my chief is understanding. Today she revealed to me that she herself had gone through IVF a few times, not successfully. She recalled the emotional roller coaster of being on medications, and told me to let her know if I needed anything else. It was reassuring to hear from somebody else who has been through this and came out OK, even without having children.

Cranky Clomid ramblings

  • I’m taking Clomid 100 mg on days 3, 5, and 7, and 150 mg on days 4 and 6 as a compromise. I refuse to take Clomid again after this cycle. The hot flashes are in full effect, and I’m also feeling wiped. I took 2-hour naps both Saturday and Sunday, and of course couldn’t fall asleep before 2am both nights, due to feeling hot. Work was fun today… NOT.
  • I recently found out that my husband’s gym buddies – the ones who were also seeing my acupuncturist – are expecting and due in October. They managed to get pregnant just 3 months after starting up with her. I can’t help but wonder, what’s wrong with me…? I do everything “right” and it’s just. not. happening!
  • The RE I emailed last week hasn’t emailed me back. I plan to request a formal referral to her at my ultrasound appointment next Monday if I don’t hear from her before then.
  • We leave for our 10th anniversary trip in 3 weeks. We’re going halfway around the world, and I’m both super excited and somewhat terrified. We have reservations at a celebrity chef restaurant we’ve been dying to go to for a while, and I am relaxing my food restrictions while we’re there. I’m really scared of the jet lag though – the last time I traveled to Asia, which was over 10 years ago, I had really awful jet lag coming home. I’ll have 4 days to recover before I return to work – I really hope it’s enough!
  • The other reason for my terror – on the exact day of our anniversary when we’re in a different time zone, I’m due to either start my period or get a positive pregnancy test. 10 years is an amazing thing to celebrate, and I don’t want my hormones to get in the way, but the thought of getting my period on THAT day and then having it while traveling is giving me more anxiety than I want to think about.
  • So yes, that means June will be a break month, with the travel. I plan to enjoy my birthday month as much as possible, and am looking forward to the trip and my sister’s and cousin-in-law’s visits at the end of it!

Dilemma – follow the NP’s orders or not?

I had my ultrasound this morning, and again, no cysts and a nice thick endometrial lining. Because my progesterone has been minimally changed after Clomid 50 mg on day 5-9, then Clomid 100 mg on day 3-7, the NP prescribed me to start 150 mg on day 3 (today). I’m dreading the hot flashes and bloating already, and wondering if it’s really going to change anything. From what I’ve read, there’s no benefit in increasing the dose if you ovulate, but what if you ovulated before even taking Clomid?? The main thing it seems to have affected is my ability to get a positive OPK before HCG trigger. They really want to see me release a good 2-3 eggs, and so far I’ve only produced 1 at a time.

I have the book Making Babies, and in it, the RE talks about actually decreasing the dose of Clomid for somebody to 25 mg for 6 days, after being on increasing doses for 3 cycles. However, this woman was just having timed intercourse. Now I’m torn between following the prescription or trying the mini-dose.

I also emailed a certified RE in our system, though she works in a neighboring county an hour away. Waiting to hear back from her on what she advises and whether I should see her in person.

7dpo labs

My progesterone came back at 15.8, so I definitely ovulated. Not really sure what the RE’s looking for since I ovulate and have had progesterone from 12-15 without Clomid. TSH came down to 0.83 with the increased thyroxine dose just after a month. Hoping it doesn’t overshoot, and will ask for another recheck with my next set of labs from the RE.

Work was hectic this afternoon. I don’t know what it is about this week, but I’ve had 3 patients present with eating disorders. 😦 Working urgent care tomorrow morning, really hoping it’s not crazy like it has been.

Ovulation pain?

I’ve never experienced ovulation pain (cutely named mittelschmerz in the medical world) until I started on Clomid. Last month I had a dull backache on the day of a temperature dip, similar to the cramps I get on my period. Today I started feeling bloated and achy over my left lower abdomen, a few hours after the IUI. That made sense since the dominant follicle was on my left, but later in the day my right side also started to ache. Is that possible for ovulation pain??

Crazy day

After getting my painlessly-administered HCG trigger from the injection nurse (I didn’t even feel the needle go in, and no soreness/bruising whatsoever!), I hopped into my car to race to my own clinic and arrived just in time. First patient was a walk-in, and unfortunately I ended up having to admit the child to the ICU for new-onset diabetes. I felt SO awful for the parents sitting there with tears running down their face, as I explain the diagnosis and how he will need daily insulin injections for the rest of his life. Then as I was finishing seeing my afternoon patients, I get notification that a patient I saw yesterday tested positive for pertussis. Why did I check? Because the kid’s not vaccinated – AT ALL. The parents were super nonchalant, while I’m fuming because guess what that means? I examined the kid and didn’t have the foresight to wear a mask, so had to start myself on a Z-pack to prophylax against whooping cough! Guess who’s wearing a mask for every patient that has cough for a while? Yup, I’ll pretty much wear one all the time I guess.

So after that crazy day of work, I decide to cheer myself up by taking my first positive pregnancy test ever!

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It’s funny, I don’t know why I thought the line would be darker than that, but it’s more than anything I’ve ever had before! I got 10,000 units of HCG, so there will definitely be no early testing on my part. I only have 9 HCG tests at home and don’t want to waste them at this point. Though I did read that OPK’s actually pick up HCG as well – something to keep in mind for the future for when I don’t feel like buying more pregnancy tests. I plan to wait it out until 13dpo and test if my temperature is still up. Just need to get through these back-to-back IUI’s the next 2 days first!

Triggering!

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That’s my 21mm(!) follicle right there! Waiting to get my HCG trigger, then coming in for IUI tomorrow and Friday. Opted for that instead of triggering tonight and just having it Friday, since I have tomorrow off anyways, and I’m worried we’ll miss it if I don’t do one tomorrow. Fingers crossed!

Addendum: In my excitement, I took a picture of my right ovary with no dominant follicles. Oops. Oh the HCG trigger was awesome! Didn’t feel a thing! Nurse took forever to call me back but seriously was like nothing.