2nd ultrasound and change in due date??

I had my 2nd ultrasound today at the RE’s, which went great! The bean had a strong heartbeat, measured 13.3 mm long, which is on track for 7 weeks, 4 days. But wait, I’m 8 weeks, 2 days based on my egg retrieval date of 9/4?? Except my RE calculates my due date as date of conception from my transfer on 9/9, giving me a new due date of June 2, and making me exactly 7 weeks, 4 days today. I’m so confused… I think for the purposes of this blog I’ll keep my weekly updates based on the original.

2014-10-18 15.57.26I totally expected to have at least one more ultrasound and visit, but the RE says the baby is doing great, and he graduated me! I left my 2 remaining vials of Menopur at his office to try and sell to another patient, and brought my Sharps container in to empty. He wants me to continue Progesterone until 12 weeks, or November 18 by his calculation, but I plan to stop a week early because I don’t want to deal with flying with all the supplies to Vegas for our trip, and from what I’ve read many RE’s now stop at 8-10 weeks, so I feel very comfortable stopping at 11.

The morning sickness is definitely kicking my butt, and I ended up telling 2 more of our friends this weekend since they’re staying over. It’s nice to have the company while hubby’s out of town, but I feel like such a terrible host after taking a 2-hour nap, lol.

The last pee sticks, my crazy thyroid, and symptoms

I peed on a stick for hopefully the last time ever yesterday night. These are all the pregnancy tests I had at home, and I refuse to spend a cent more since money has been flying out of my wallet much too rapidly for my taste. And we know it won’t get better when a kid (or two) arrives!

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I admit the 8dp5dt test did freak me out a little because it actually seemed lighter than 7dpfdt – but that was the same day my beta was 100, and I realized even though it was almost a 4-hour hold, I’d been pounding water leading up to it due to an A/C outage at work. Yesterday’s 9dp5dt line was much more satisfying 🙂

I wish my thyroid was more cooperative right now. I’d finally come back down to 75 mcg of Levothyroxine daily throughout my IVF cycle, after a max dose of 112 mcg while taking Clomid several months ago. As soon as I got the positive test 3 days ago, my endocrinologist told me to increase to 100 mcg daily, and we checked my labs. My TSH jumped from 1.4 to 2.48 in just a month, probably helped along near the end by the pregnancy. Strangely enough, my free T4 was a tad high at 1.6, and total T3 was normal at 97. Now I’m back up to 112 mcg and we’re rechecking in 2 weeks. So much for a break from the blood draws, but it will be worth it to make sure I carry the little one(s) to term.

Early fatigue was definitely hitting me yesterday at our dinner out with the hubby’s coworkers. I slept all the way home, and promptly went to bed at 10:15. Today I tried to make sure that my stomach was never too empty or too full, and that seems to help keep the nausea away. Work wasn’t too bad, but my back definitely started to ache more by end of day, and after coming home all I want to do is lay on the couch with my feet up. My 3 colleagues now all know, since they’ve been affected by my being in and out for the IVF, and I wanted to give them a heads-up since the first trimester could be dicey given all the risk factors.

I did email my RE yesterday to confess about my first beta, and I was getting nervous that I’d offended him because it was taking him longer than usual to respond. He finally emailed back this morning, and said what great news it was, to continue the Progesterone and Aspirin (through first trimester), and stop the Medrol (which I already did). Tomorrow I’m heading in at 8am to get my blood drawn, since I need to take my car in for service after that. I should be able to schedule my ultrasound in 2 weeks then as well. My next question for the RE will be when I can finally exercise again. I’m missing yoga and SUP, and want to take advantage while it’s still warm enough! I spoke with my aerial teacher, and I can even do relaxation flying yoga with modifications – I feel like this would help relieve some of my aches and pains, so this makes me very happy!

What the WHAT??

Ladies and a few gentlemen, the RE told me there’s a 99% chance my egg retrieval will happen next THURSDAY! Ha, not at all what I’d anticipated or told work. Oops! At least hubby’s work schedule is light that day so he should have no problem keeping me company. I have 15+ follicles (kind of lost track as he was calling out dimensions), evenly split between both sides. They range from 10 to 17mm, so he pushed the anticipated retrieval date back a day in hopes of letting the small ones catch up. All my medications will stay the same, and I’ll probably need to buy one bottle of Menopur through his office from another patient Tuesday at my next monitoring appointment to get a full dose that evening. My normally very stoic and quiet RE actually smiled and exclaimed “Great response!” just before he left the room – I think that’s the most emotion I’ll get out of him 😉 Please keep fingers crossed that the Lupron does its job and keeps me from ovulating early.

Other answers to the questions I had for him – he recommended 3 days no-ejaculation prior to retrieval for the hubby, and anticipates 5-day blastocyst transfer. He doesn’t recommend preimplantation genetic diagnosis for us, since studies show lower live pregnancy rate and we have no solid risk factors. Also said that assisted hatching is only done on 3-day embryos, since the blastocyst already has a thinning “shell”.

The waiting room was again interesting, though also informative for me. The 2 women I waited with happen to see OB/GYN’s at the clinic I work for, so it was great to hear them chat about their experiences there (all positive and making me think I may well see the male OB/GYN there, even if all the clinic nurses end up knowing my business). One was 8 weeks along with IVF twins, and her toddler looked familiar to me – who knows if I’ve run into them at work. The other had just gotten a positive pregnancy test after her 1st IVF cycle at age 39, but was waiting for her first HCG level to come back. It had been drawn yesterday, so the receptionist was on the phone with lab pestering them to give her the value. The two were bantering back and forth about how put off they were at first by the RE’s non-bedside manner, but how he’s just great at what he does, along with having the sweetest and technically briliant embryologist. All in all, I am happy I chose this office!

LATE ADD-ON: Oh yes, I hit up Victoria’s Secret to take advantage of their 7 panties/$26.50 sale. You know, since all my underwear is no longer fitting thanks to the addition of 15 pounds. Woohoo! Check out the deal this Labor Day weekend, everybody 🙂

ANOTHER LATE ADD-ON: Received the insurance check for my first medication shipment, just over 3 weeks after submitting. BANNER DAY!!

S*** people say in the RE’s waiting room

“There are TWO! He said our chances were LOW… but there are TWO in there! How is this possible??”

 – Stunned IVF patient whose 2 embryos stuck

“I’m leaving. It’s 10 minutes past my appointment time, and I can’t wait any longer. Please tell Dr. *** to call me afterwards to tell me if he recommends using a surrogate.”

– Frustrated patient (note the RE was running 15 minutes late – not bad in my book!)

“Hi. I’m returning your call about [blah blah blah…]”

– Man on the phone for at least 15 minutes (still on when I was called back)

I was lucky today and finished seeing my patients and closed all my charts with plenty of time to spare. So much time, that even after browsing a nearby dollar store, I was still 40 minutes early for my appointment. So I ended up in the waiting room for almost an hour. Bear in mind, this is a tiny triangle-shaped waiting room, with seating for 10 people tops. You hear everything, especially if you happen to be sitting near the reception desk. I had a hard time keeping a straight face hearing some of these things. And seriously, what is it with carrying on full conversations in public on the phone like that, without even a courtesy whisper? Or I dunno, stepping out in the hallway??

So of course, right after I finished my post yesterday, I went to the bathroom and saw EWCM, which has continued in full force today along with increasing belly fullness. I was very eager to see if the ultrasound would confirm what I was feeling, and it did! 5 follicles on each side, measuring 7-10mm each. The RE didn’t order blood today – whew… still bruised from last week and I have no doubts my estrogen has increased given all the EWCM. He told me I’m responding exactly as he expects. I’m to continue all my meds at their current dosages, and have a follow-up Saturday morning. Unfortunately he couldn’t pin down a retrieval date – still too early. Ugh, work scheduling will be a mess with the 3-day weekend, but not much I can do about it. For those interested, here’s how my Google calendar looks now that I’m further along in the process. Getting closer! Things should start to move more quickly in the next week.

ivfcal

Holy Lupron headache!

What the… I thought I was in the clear with avoiding the Lupron headache, but nope, after the 9th dose yesterday morning, I got a horrible right-sided occipital headache while having a crappy afternoon at work. Went to sleep hoping it was due to stress, and woke up feeling better, but by noon today, I had a dull ache at both temples that worsened despite taking acetaminophen. Boo… Going to try a cooling patch on my forehead tonight when I go to bed, but unfortunately that would probably not go over well at work.

My ovaries and lining looked nice and quiet, and ready for action this afternoon. Had my blood drawn for an estradiol level, but won’t get it back until tomorrow. Hopefully it’s nice and low, so we can proceed as planned. On Friday, in addition to the morning Lupron, I’m to start Gonal-f 187 IU in the morning and Menopur 225 IU (3 bottles) in the evening. I’ll also start an oral steroid (Medrol 8 mg a day). Sadly, this means 3 daily injections, and I understand that Menopur stings like a #%&*. In order to try and keep my injection time the same every day, I plan to bring the Menopur to work in case I’m stuck late or running errands before heading home. This way I don’t have to worry about what to do at our concert on Saturday – I can just take it before we go.

My next appointment is in a week, and it’ll be the first time we see how exactly I’m responding. Right now, the RE is planning for September 3 for my egg retrieval. Too bad my work scheduler just took me out of clinic on September 2 :/ Emailed her to see what she wants to do. I don’t want to have her drop me in, then risk having to come back out if I respond more quickly than expected.

Thank goodness for the beef broth I made a few weeks ago! For once I actually cooked myself a tasty, nutritious dinner. I used Trader Joe’s mirepoix, white beans, and kale to make a quick minestrone soup. Added a little salt to taste, and it was done in less then 15 minutes! Just forgot to add tomatoes, but will be sure to do so the next time. May also try adding quinoa if I’m feeling up to it. I love quinoa, but haven’t yet mastered how to cook it.

Eventful day

When I walked into the RE’s office this morning, I ran into a nurse from my clinic. Turns out she has had a round of IVF here, and was unsuccessful. She sat with me and chatted for a bit, then left after she picked up her records. Crazy small world of infertility…

My saline sonohysterogram and mock transfer went very smoothly. No problems found, and it was the least painful procedure I’ve had so far after one HSG and 4 IUI’s. He warned me that a pinch was coming, and I never even felt it! Very grateful for that.

Afterwards, I felt great, and was able to join up with a few of my aerial friends at a freerunning gym for some play time. We had so much fun running, jumping, climbing, and swinging like kids! I so wish I could go back, but I only have a couple weeks left before the stims start, so I won’t have much chance. We went to a craft fair afterwards, and I bought myself 2 pairs of fabulous hand-dyed socks for all the time I’ll be spending in stirrups the next month:

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Hubby and I are to start a week of Doxycycline soon to ensure clearance of any subclinical infection. Then the next big step starts on August 11, when I begin subcutaneous injections of Lupron (GnRH analog) 10 units every morning. I take my last birth control pill on August 15, then head in for the first monitoring bloodwork and ultrasound visit on August 20. Beyond that, I don’t know the exact plan, but he has faxed in an order for the following to a local compounding pharmacy: Menopur (FSH+LH), Gonal-F (FSH), Novarel (HCG), progesterone in oil injections AND vaginal suppositories (Huh? Didn’t notice until I came home so will ask why both next time), and Medrol (steroid). I’m nervous but hopeful for this plan!

Going to be a hot solstice

We drove to our future IVF clinic this morning to drop off hubby’s sample for the new testing. The waiting room was packed, I’d been warned already about this but it still didn’t prepare me for the 8 people crammed in the tiny room with 3 more waiting outside! Saw my acupuncturist’s flyer at the check-in desk. It took a little while to get payment squared away because the receptionist was swamped, but they were really nice and you just can’t beat a clinic that’s only 3 miles from home AND work. Definitely going to push for the referral after our testing is complete next month. I refuse to drive over 30 minutes each way 3-4 times in 2 weeks for an IUI.

At 8:30am, it was already 72 degrees out – unheard of in this area typically known for “June gloom”. I’d suggested going out for breakfast after dropping off the sample, but the pancake place we went to had a dozen people waiting outside already. Hubby was hangry and grumped that it was up to me, so obviously I turned the car around and drove home. :/ At least it should be pretty warm for tonight’s sunset paddle session!

Pause mode

My OB/GYN called yesterday to discuss the next steps. From what the NP had said before, I thought he would go ahead and refer me to the outside RE for IVF, but after discussing what the in-network RE was planning, he wants to wait and see the results of our tests and what her recommendations are. Depending on those results, we would either:

  • Start injectables with IUI’s – My insurance would continue to cover this 100%. This would be my preference EXCEPT for the fact that I can only have this done at an office that’s at least 30 minutes away with no traffic. With how my appointments have been going the last few cycles, I’d have to take at least 4 half-days off every month. This other office also doesn’t have as predictable a schedule where I’d always get the first morning appointment. Taking off so much work has already stressed me out enough.
  • Request a letter stating that we need IVF based on the failed treatments with Clomid so far, and see the outside RE – My insurance would cover 80% of the cost. This RE’s office is less than 10 minutes from home. I’d obviously need to take more time off from work, but at least it’s much closer to both home and work. Interestingly, my acupuncturist is really pushing for this now. I think she feels that given I haven’t gotten pregnant from 4 IUI’s despite ovulating normally all this time, then we really need to go for the big guns.

Right now, I’m going to have to go back to the office that’s an hour away at least once for the saline sonohysterogram, and then a second time to review our results and discuss the next plan. I’m trying to see about paying out of pocket for hubby to do his test at a closer private fertility clinic, to avoid the 3+ hours he’ll spend in traffic along with missed time from work – it seems worth it if it’s less than $200.

Normally, I would be all worked up about this and planning the next steps, but I’m tired of all this. I’m tired of not feeling like myself, tired of peeing on sticks, checking temperatures, timing intercourse, and obsessing about every detail. It’s just exhausting. I turn 36 at the end of this month. How much longer can I go on like this?

Jetlagged and seeing the board-certified RE

So jetlagged right now, I should be sleeping but my mind can’t seem to shut down. It was wonderful to arrive home late yesterday, but I dreaded the return to the infertility grind. After my period arrived early on in our vacation, I was actually able to enjoy myself without thinking about cycle days, temperatures, and all that other crap. We even enjoyed non-procreative sex, which I realized has become much too rare in the last year and a half.

Somehow we managed to make the hour’s drive to see the board-certified RE who’s in my insurance group. First thing I noticed is that she’s pregnant. Shocker. She had great bedside manner, and really took the time to ask us tons of questions and explain where we’re at and where we’re headed. She thoroughly reviewed everything we’ve gone through so far, and recommended we repeat some of our labs, in addition to some new tests – a saline sonohysterogram for me, and a Kruger strict morphology test for the hubby. We’re now in a waiting period since I won’t be able to get my tests done until the start of a new cycle, and I need to figure out if hubby can turn in his sample closer to home. Or else he’s stuck driving the hour away and having to produce a sample in the clinic bathroom – not fun. I really wish this RE was closer to us, she is otherwise great all around.

I haven’t heard from my OB/GYN about the outside referral to a closer RE yet, will probably try calling tomorrow. At this point I’m OK with proceeding with the testing above, since I figured it’ll be needed no matter who oversees our next cycle. I’m not really sure what I’m going to do this cycle as far as temperature-tracking and OPKs, who knows what the overseas travel has done to my cycle.

2nd IUI complete, onto the 2WW

Had my 2nd IUI done this morning. It’s so nice to actually have the same provider for this whole cycle – this NP saw me from day 3 to today’s IUI on day 16, which is unheard of at this clinic. She fought hard to make sure I was on her schedule, and I love her for it. She’s also the best at making the IUI’s the least uncomfortable. Out of the 3 she did for me, she only struggled once, but even that wasn’t nearly as uncomfortable as some of the others I’ve had. Fortunately, this morning’s went very smoothly, and I didn’t need the plastic tampon afterwards – which feels fine while it’s in, but pulling out was very uncomfortable.

She also spoke with the supervising OB/GYN yesterday about me, and he told her to send him my chart if this cycle isn’t successful. He wants to speak with me by phone at that point to determine the next best step. He also told her that my seeing the nearby out-of-group RE would be covered?! I don’t know exactly how true that is, but that would be lovely to avoid another 2 IUI’s before seeing him. I’m still going to keep my appointment with the hour-away in-group RE though – I have to drive there anyways, so why not…