Mid-Cycle Ultrasound

A couple days ago, I commented to Ryan how perfect it would be if I only had a couple eggs this cycle (rather than seven like last time). I could "enjoy" the cycle as much as possible, without the pain of swollen ovaries and the worry of higher order multiples. They had lowered my dosage this time around so I was hopeful.

My wish came true during today's appointment.

Ryan was able to go with me, which I so appreciated. It is fun when he comes. We watch 30Rock episodes on my iPhone in the waiting room and I get to watch his goofy antics while we wait in the examining room.

Nurse M did my ultrasound. Sure enough, I had 2 little eggs on my right (too small to be worth much) and 2 more mature eggs on my left side. One egg was 20mm and the other 14mm (smaller, but big enough to fertilize once ovulation rolls around).

The IUI is scheduled for Friday!

Dear Follistim,

Over the course of our relationship, I have put up with a lot. And happily too, I might add. I have worked through tiredness, grumpiness, abdominal cramping and, worst of all, severe headaches.

I so appreciate the chance you have given me to become a mother. I am willing to go through just about anything for that to happen.

That being said, I don't know how much longer I can live with this current, unexpected side effect. The hundreds of small, itchy, painful bumps all over my face and neck is a hard pill to swallow. Nothing helps. Nothing. It is slowly making me insane.

I won't give up on you, and if I have to live with this for the next week, so be it. But please take mercy on me and let up just a little?

Sincerely,

RashFace

Base Ultrasound & Medication Reaction

Friday was my base ultrasound. I asked 2 questions:

1. Should we use something stronger than Prometrium during our next 2ww, considering I started my period while still on the medication?

Nurse H did the ultrasound and agreed that maybe we should try something else. She has two options for me, and they are checking if either of them would be covered through my insurance (thus far, the Prometrium has been the ONLY thing my insurance has helped with).

2. Does Follistim become less effective after several cycles (as the Clomid does)? Should we stick with our plan of 5 Follistim / IUIs total?

No, the effectiveness of Follistim does not decrease each cycle. You could technically use that method forever. She thinks if this one doesn't work, we should try 1 - 2 more. After that, we will want to weigh the increased chances of success with IVF with the increased cost and decide where to go from there.

My dosage this time is similar to last time: 100iu for 2 days, 75iu for 4 days. Mid-cycle Ultrasound is this Friday.

The last 2 months of Follistim brought me severe headaches. This time around, the headaches have been rare to non-existent. However, today (Day 2 of the stims) I developed a rash of tiny bumps all over my neck and half my face. It is itchy and painful. I tried to determine where they came from and I am fairly convinced they are from the Follistim. A read through the possible side effects confirmed that this is a good possibility. Nothing helps... Benadryl, Cortisone Cream, nothing.

My choices were to stop the cycle and wait until next month to try something new or push through it and hope it goes away. Considering I just spent $600 on this medication, I decided to push through it. I've resorted to pressing a cold, wet washcloth on my face all evening. I pray that this doesn't last throughout the whole week...

It is so amazing to me how different each cycle can be.

Feeling Happy and Hopeful

I had my mid-cycle appointment today. I had no idea what to expect. I had felt a lot of tugging and pulling last Thursday and Friday, but that tapered off some over the weekend.

I have five measurable eggs (3 on the right / 2 on the left). It appears three of them will be mature enough at ovulation to be fertilized (another one is borderline). So, while it is possible that triplets could result, it is unlikely and the chances of more than triplets are slim to none. That was reassuring. If I could guarantee that all three babies were healthy and happy, I would love triplets (once I stopped hyperventilating). But there are no guarantees in life, so I am open to whatever God gives me. Just give me something! Haha

Nurse M went on and on about how wonderful my lining looks. That made me feel good too. It seems everything is ‘perfect’ this time around. I’ve even read studies that say the first few months after miscarriage are your most fertile (some people dispute this). But I have to remind myself that even in the most perfect of circumstances the chances of this working are 18%. And there is a chance for another miscarriage as well.

So I will trigger tomorrow night, and the IUI is on Thursday. I was thinking, “Wow, it will only be a few weeks until I can post all these ‘secret’ blog postings…” but that’s not really true. If this cycle is successful, no one will be reading this until late December at the earliest. Weird! :)

What a Headache!

After the whole miscarriage roller coaster, I am once again trying to keep the timing of my treatments private. I tried that with our first Follistim/IUI, but because of certain obligations, I had to miss out on events and find substitutes and the word soon got around.

The second Follistim/IUI treatment, I was open about the timing from the beginning. So when I got my BFP, I felt I needed to tell as everyone right away, as they knew the exact day I’d be finding out anyway.

We watched the heartache of close friends and family who had waited so long for that good news, only to see it taken away a week later, and we decided we couldn’t go through that again. Somehow, someway we would have to keep this next treatment private.

So far we’ve been pretty good. My co-workers might know (because of the missed work due to appointments), but to the world at large our secret appears pretty safe.

The benefit to doing this is I can vent all I want and I don’t feel bad because no one is reading this (yet)! In the past, I sometimes tried to censor myself for fear that people would think I was trying to get sympathy. By the time anyone reads this, I will be way past this point. No sympathy needed (or wanted either!).

This cycle reminds me of our last one, but with an even stronger headache. The nurse told me that the headache is a sign I need to drink more water. I am supposed to drink half a gallon a day. On Tuesday (day 1 of the shots; day 3 of my cycle), the headache came within an hour of the first dose. I had already drunk my required half gallon of water before dinnertime and still it was there. By Wednesday morning, it was gone… just in time to take my second dose. Sure enough, an hour later it was back. I’ve just come to accept that it will be my companion during the 6 days or so that I take this medication. It is just interesting that it gets worse with each cycle, although this time makes more sense because they did increase my dose slightly.

Other than that, I am still plugging along, doing my shots and appreciating every moment. Any time I start to complain too much, I think back to where I was 2 years ago…

I was sitting in a psychologist’s office sobbing hysterically because we had too much debt and not enough money for treatments. The stock market had tanked, my career was stalled, and we were basically paycheck to paycheck. There was no light at the end of the tunnel and I was in the midst of a deep depression. No hope, no encouragement, no way out of where I was. I was so hysterical, at one point, she had me hold onto this little machine and concentrate on the patterns of the vibrations it made. Looking back, I think she was just trying to distract me enough to calm down so I could drive myself home.

Whenever I begrudge the shots, the emotions, the disappointments I am feeling now, I picture that person sitting on that couch holding onto that stupid vibrating machine. And it makes me grateful for every bit of it… even the headaches.

Baseline Ultrasound

Today I met with Nurse M and had a baseline ultrasound. Everything looked great... no cysts and my uterus appeared normal. So we will proceed with starting treatment up again.

Starting tomorrow, I will take 100 iu of the follistim for 2 days. Then I'll lower the dosage to 75 iu for 4 more days. My mid-cycle ultrasound is in one week.

I am a bit nervous about how the increased dose will work with my body. Last cycle, I took 75 iu for 6 days and I had some pretty uncomfortable side effects, not to mention 8 eggs at my mid-cycle ultrasound. But, as I've said several times, I am trusting the medical professionals as well as God above that it will all turn out how it's supposed to.

Gettin' Personal with the Nurse Practitioner... ;)

Other than last cycle, I believe the previous IUI I had done was in early 2007. I had forgotten the difference in IUI experiences between the 2 main nurses at Dr. S’ office. I quickly remembered yesterday morning.

Nurse H is an RN and does the IUI very quickly. She uses “petite” instruments, and although it is uncomfortable, it is pretty painless.

Nurse M is a nurse practitioner and uses larger instruments, takes her time and really ‘gets in there’. Although it is a lot more painful, it kind of feels like she does a more thorough job. You know everything is exactly where it needs to be, although your breath is knocked out of you during the process.

These are just my impressions, but who knows! Honestly, I think they both are capable.

Yesterday, I had Nurse M. Between her more aggressive approach and the fact I was carrying a lot more eggs, I think this is why I’ve had so much residual pain since the treatment. My stomach is huge, like a beer-drinkers gut, and it is impossible to suck it in. I’ve also had some spotting and cramping.

I was happy to have Nurse M do the procedure, as I had some follow-up questions from my last appointment. Nurse H had done my ultrasound and was conflicted about whether to do the IUI right away (and capture the large egg on my right) or grow the eggs on my left another day (and risk ovulating before the IUI). She consulted with Nurse M and, although they decided with waiting on the IUI, I hadn’t heard the reasoning.

Nurse M explained that the real reason for waiting had nothing to do with the eggs at all; it was because of the lining in my uterus. The lining needed another couple of days to get ready. That made sense because when we did my last mid-cycle ultrasound, my lining measured 8.1, and this time it was 7.1. Nurse M thought it would be better to wait and let that lining thicken a bit more.

I also asked if they could give me an ultrasound before the IUI to see if I’ve ovulated. It turns out, it’s too difficult to tell via ultrasound because the follicle doesn’t just burst at ovulation, the fluid seeps out slowly. You can’t tell for sure that ovulation has occurred for a few days.

It seems they made good call by waiting because Nurse M stated she was convinced I was ovulating yesterday. I spotted a bit before I got there, felt cramping and pulling and my cervix was wide open when she did the IUI. She also said my chances for higher order multiples are very slim, especially because many of the eggs are so small. Then she joked, “Now that I’ve said that, watch… you’ll have four!” Hardy-har-har. But in all seriousness, I feel at peace with our decisions.

So now we begin the lovely 2 week wait. After last cycle, hubby has decided to confiscate all of my pregnancy tests. He’ll give me one on the actual day I am supposed to test. I hope he’s prepared because, even though taking the tests early can be an emotional roller coaster, at least seeing all those negatives last time prepared me for the “final” negative on the actual test day. This time around, I’ll live in that undeniable 2ww hope until the day my dreams are either realized or come crashing down.

Today's Appointment

Today, we checked in on my ovaries to see how the Follistim has been working. It has been a tough treatment cycle. I was at a work retreat, and things just weren't as smooth as last time. My stomach was all bruised up and the headaches were intense. I didn't drink enough water because I didn't want to be running out of the meetings all the time to use the restroom, which just made it worse.

The cycle madness continued at today's appointment. I knew there was something going on in my left ovary because I felt a lot of pulling and cramping on that side. Sure enough the left ovary had at least 7 measurable eggs. Three of these were around 12mm and the other four were smaller, somewhere around 7-10mm. Nurse H called it a "heavy recruitment".

On my right ovary, I have one mature egg with a measurement of 18mm. No one knows how large an egg becomes before your body ovulates it. It varies for each person. It is possible that my body will ovulate this egg on its own. If that occurs, then the trigger shot and IUI will be for nothing, as I will have already ovulated. The problem is we can't tell if this will happen or if it did happen. Frustrating.

When Nurse H saw the situation on the ultrasound, she printed out the pictures and went to consult with Nurse M for a second opinion. It was a dilemma. Do we do the IUI right away in case I ovulate that egg on the right, or do we wait and grow the ones on the left, hoping I don't ovulate in the meantime?

They ended up deciding to "prescribe" sex, just in case I ovulate early, and continue with the Follistim for one more day. I took that dose today and the IUI is on Thursday.If I do ovulate early, I am not so sure I will become pregnant this month. Our odds aren't good at getting pregnant the "old fashioned way".

If I wait until Thursday to ovulate, it seems the chances for pregnancy are much greater. However, what happens if I ovulate all those eggs??? ALL those eggs! How many babies could that be??? This scares me to pieces. My babies have waited forever to get here; I want them to have every advantage possible. And cramming too many babies into my body would be devastating for them developmentally. That is not the start in life I want for my kids.

Having said that, for years I have seen women (including myself) worry themselves into a frenzy over their treatments, analyzing every little detail and second guessing every decision. Before all this treatment stuff started up again, I promised myself I would not fall into that trap. I was there last time with the Clomid/IUI cycles and I d0n't want to experience that again.

So, I am trying to think positively. Here are the thoughts I've been repeating over and over...

The doctor's office is very aware that I do not want to "selectively reduce" (abort some of the babies if you are carrying multiples). They have promised to take every precaution so that we do not end up in that situation. They would have cancelled the cycle if the risk was too great.

During one of my Clomid/IUI cycles, I had 4 very mature eggs, and I didn't get pregnant at all that time, so 8 eggs total doesn't necessarily mean 8 babies. Although I have a lot of eggs, most of them are very small, and may not amount to anything anyway.

If I ovulate early, than oh well. There is always the next treatment. Treatments 3 or 4 are typically the most successful anyway. The failure of cycle 2 doesn't mean a future treatment won't work.

Last cycle, everything went perfectly... not too many side effects from the treatment and 2 mature, perfect-looking eggs. The result? No pregnancy. This time, everything is difficult, chaotic and uncertain. A completely different experience than last time. Maybe the result will be different too.

Most of all, God knows us and He hears our prayers. We have been praying for our family: for the treatments to work if He sees fit, for comfort in case they don't, and for the right children to come into our lives, in the right way, at the right time, and in the speed or order they're supposed to.

At the end of the day, that's all we can do. Pray, make good decisions and pray again. The rest is out of our hands.

Back in the Saddle Again

The base ultrasound was yesterday. There were no cysts, which is awesome. We jumped right back into it and I started stims immediately after the appointment. We are keeping the same protocol as last time.

Yesterday, I asked Nurse H if anyone actually gets pregnant on the first cycle of Follistim. She quickly answered, “Yup! Lesbians do.” She wasn’t trying to be funny. Apparently, their lesbian clientele has the best luck getting pregnant on the first try. When you think about it, that does make sense. There hasn’t been a history of trying on your own and being unsuccessful. The only thing preventing their pregnancy is the missing half (sperm).

Ryan and I haven’t been able to get pregnant on our own for years. For people like us, Nurse H said most successes are during cycle 3 or 4. Some people get pregnant on cycle 2, but 3 and 4 are the most common. When I asked if our busted cycle 1 is any indication this treatment won’t work for us, she adamantly declared, “No way!” This was encouraging.

So I am doing the injections again. Yesterday, I learned the importance of taking the time to make sure the medicine is room temperature before injecting it. Holy cow!! I thought I had waited long enough, but I guess not. At least an hour outside the fridge! Not a minute less.

The main side effect this time (so far) is an excruciating headache. Maybe there are other things too, but I can’t notice them because my head is pounding so hard!

Doing this stims will be interesting this month, as I am leaving for a work conference. I have to take a cooler with all my ‘gear’, which is a little awkward and embarrassing. Have infertility, will travel! I am trying to keep a positive attitude about the whole situation.

All it takes is a moment to remember all the years I *DREAMED* of doing this process, and I instantly become okay with whatever I have to do to make it happen.

All systems are a go

The second ultrasound was today. All week, I have been praying that the Follistim will do its job, without overdoing it. My prayers were answered, and we have 2 great looking eggs. The one on the right measures 20mm and the one on the left measures 14mm. They will continue to grow over the next couple days, and both should be released at ovulation. My lining looks good, measuring 8.1 and showing a clear triple layer.

I will give myself the Ovidrel injection tonight at 9pm. Or, rather, Ryan will do it. He's been begging to do one of the injections. Saturday morning, I'll have the IUI.

Here we go!

Speaking of injections, Ryan suggested I have a little fun with them. After the second day, I pointed out my injection points looked like 2 little eyes. Ryan wondered why I didn't just create an entire happy face. So, I did. :) Can you see the smiley face? (You are looking at a small section of my abdomen.)

Stim Update

This morning was Day 5 of the stims. Overall, I've been really blessed.

I do have some side effects, and for some strange reason, they seem to be the worst right around 5pm. Perhaps that is when the morning's dose makes it into the bloodstream? It's strange, but that’s when I feel most crampy and nauseous. The worse night by far was Sunday, and the rest have been a lot better.

When I read other blogs about this process, many people talked about Follistim injections causing stomach bruising. I expected this to happen to me, as I tend to bruise easily. Surprisingly, I am on day 5 and I have no bruising, just little red dots. More about those in another post. ;)

All in all, I have no complaints. I was able go to work and pretty much continue with life as usual. Besides the dull cramping, I do have lots of quick, sharp cramps and twinges in my abdomen. Tomorrow, I do injection number six. Then I have my next ultrasound immediately afterward.

I am excited to see what's going on in there. We are hoping for a couple nice, mature eggs and a good lining. What are we not hoping for? Too many mature eggs. Any more than 4, and I'm thinking we'll need to cancel the cycle. Which would be tragic, emotionally and financially. We opted for a very low dose, so hopefully we'll avoid that situation.

In the meantime, I snapped a couple pics of the Follistim. I did this for a couple reasons. First, I thought it would we interesting to look back on this process someday. And secondly, I had a hard time finding the process and pictures online when I was researching this treatment option. So, on that note, enjoy!

Most of the equiptment: The injection "pen", needles, alcohol swabs, sharps container... it's a party!

Regarding the process, it is quite easy. First, take the medicine out of the fridge and allow to come to room tempurature. Load the vial into the pen. Wipe down the end of the pen and your tummy with the alcohol swab. Attach a new needle. Spin the dial at the top of the pen to the required dose. Inject the needle into your abdoman and press down on the dial slowly. Then keep the needle in the skin for about 5 seconds. Pull the needle out, recap it and dispose in the sharps container.

And this is the tiny needle that put me into a sweat on Day 1. What a baby, huh? :) I'm pretty much used to it now.

Perception

Life is all about perception. How do we choose to look at our situation? Half-full or half-empty?

Half-empty: This new treatment I am pursuing (Follistim injectables with an IUI) has an 18% success rate. This means out of 100 couples who do this treatment, 82 of them will not be successful. I could become pregnant with this treatment, but it is much more likely that I will come out of this with no baby.

Half-full: Without treatment, Ryan and I have less than 1% chance of conceiving. With the treatment, our chances are 18%. I could interpret that to mean that we are 1700% more likely to get pregnant this month than in previous months. That is quite an increase!

The half-empty side is quite depressing. I don’t want to be one of those 82 people left disappointed at the end of the month.

However, I can’t help but feel a rush of excitement whenever I think of the half-full scenario.

So for now I am choosing to be half-full. After years of waiting, I am trying to enjoy feeling hopeful again.

Day 1 of Stims

This morning, I did my first injection of Follistim. It was a bit stressful loading the injection pen and making sure everything was put together right while keeping it all sanitary. Ryan was there with me, providing commentary along the way.

When it came time to actually do the injection, I have to say I'm a bit embarrassed about how I dealt with it. It took about 10 minutes to get myself to do it. Ever since a traumatic event giving blood as a child, I have had a fear of needles. Infertility has helped to ease that phobia. I've experienced my share of needles, and even gave blood a while back (although I nearly passed out - but I did it).

For some reason though, all those phobias came back this morning. For the life of me, I could not get myself to put that needle in my stomach! And, believe me, that needle is tiny. It is nothing to be scared of. Even so, I tried and chickened out over and over. I was sick to my stomach, light-headed and my hands were seriously sweating. Ryan tried to take over, but I wouldn't let him. It was quite a process, and I felt like a total loser.

Finally, I did it, and it was no big deal (of course).

As far as side effects, I didn't know what to expect. People told horror stories about Clomid, but I had no real symptoms. I think the Follistim is going to be different. The burning immediately afterward was very strong. As the day wore on, my stomach became increasingly sore and I began to get these radiating pains from my abdomen down into my upper thighs. It makes me a tad nervous about tomorrow's shot, as my mid-section is already feeling like one big bruise.

Not that I'm complaining. Of course, this is all SO worth it, and something I have waited to do for (literally) years. Progress is the best feeling in the world, and I am blessed to be making this next step. I am nearly giddy with excitement and full of hope.

Base Ultrasound

Much as I expected, I started this cycle on Sunday the 4th, which meant I was at Girls Camp during the time I was supposed to have my first ultrasound. So, we ended up going with Plan B, and I took birth control for one week.

Today, I went into the doctor's for my base ultrasound. Hillary took care of us. There were no cysts (yay!) and everything looked great. I had so many black spots inside my ovaries on the ultrasound. Each black spot is a sort-of "pre-follicle" and I had a ton of them! At least ten on my right and more than five on my left.

Because of these fantastic results, we are going with a low dose of hormones. (We were going to use Gonal-f, but it looks like now we will be using Follistim instead. It is basically the same thing.) My dose is 75iu a day. I'll begin the injections on Saturday, July 17th in the morning, and continue them for six days. The sixth day is Thursday the 22nd.

That morning, I'll give myself the last injection and then head to my next ultrasound. At that time, we'll see if the drugs worked and if we're ready for the next step.

The best part of the day, was that Ryan came with me to the appointment. Even though he worked the night before, and even though he works tonight. Even though he was tired, and even though we waited nearly an hour in the lobby. Even though the room was cramped, and even though it was awkward so close to a 'vaginal ultrasound'. He did it all for me and I was so, so grateful!

FINANCE UPDATE: I just ordered the Follistim and Ovidrel at a cost of $600. Today's ultrasound was $95 and the Prometrium (Progesterone supplements) was $35. Of course, I had to buy some preggo tests online, at a cost of $30. Prenatals and baby aspirin were about $25. Cycle total to date: $785.

Questions and Answers

Our appointment with Dr S was awesome. This was the first real appointment Ryan attended with me. I cautioned Ryan that Dr S was a very busy doctor, and we'd be lucky to have 5 minutes of his time.

I was so wrong. Dr S came in, jumped up on the table, and proceeded to answer all of my questions, explaining things in detail. He was in with us for a long time. It was really great.

Topic: Testing

What tests do we need to repeat?

In a way, he'd like us to repeat most of them. The Day 3 blood test was done by my primary doc in August 2009, so that one is still valid (I never recorded those results on this blog, but the FSH was 6.6 in that round of testing).

He'd like a Day 5 ultrasound (to verify my ovary's are healthy and cyst-free), and a new sperm analysis. However, these can be completed during our first treatment at the end of the summer.

In the meantime, I have to re-do the HSG. The one test I'd been dreading. It's not the worst thing in the world, I just had a really bad experience last time. I'm hoping this time is better.

What tests other tests should we do? MTHRF? Postcoital? Immune Issues?

The doctor has no reason to believe I have a blood clot issue, but he noted my concerns. He suggests we continue with treatment for now, but leave the option to test for this open in the meantime.

Dr S believes postcoital tests are old news. He feels they don't give you much information, and said most IVF centers have gotten rid of them altogether. Besides, most issues that are discovered with a postcoital test are eliminated by doing the IUI.

As far as immune issues, this was a big subject of debate in the late 80s, early 90s. The immunity treatments are super expensive, and there is some doubt about how much good they do.

Dr S suggests I continue on with the treatment we have planned. He said that these treatments are just as effective for people who have "unexplained" infertility as they are with people who have an identified problem.

Topic: IUI

Is there any value to doing a monitored, 'natural' IUI cycle?

A young, very fertile couple has a 20% chance of conceiving in any given month. Ryan and I have not been able to conceive for nearly 7 years. According to Dr S, this history indicates we have less than 1% chance of conceiving on our own. An IUI increases a couple's chances of conceiving by about 2%. So, if we were to do a 'natural' IUI cycle, our chances would be less than 3%

On the other hand, the chance of conceiving using Gonal-f injections is about 16%. Combined with the IUI, that puts us at 18%, which is nearly as high as the 'young, fertile couple' described above. Upon hearing this, we opted out of doing a 'natural' cycle, and decided to go with the Gonal-f.

How can we control the amount of medication to reduce the chances of multiples?

He plans to use low doses to avoid this issue. He feels the chances are small. Don't quote me on these percentages because I didn't write them down, but I believe he said the chance of a singleton is around 78%, the chance of twins is around 18%, and the chance of triplets or more is 3-4%. So the risk is there, but it's small.

Could we switch to IVF mid-cycle if there are 'too many' follicles and, if so, what is the cost?

Yes, that can be done, and the cost is approximately $7000(!!!).

Does he feel a medicated IUI treatment plan would ultimately be successful?

He was confident that we are great candidates for a medicated IUI. He thinks we should try this for 4 or 5 cycles, and feels we are likely to be successful (although this is infertility we're talking about, so who knows!).

Preparing for RE Consultation

Wednesday is our consultation with Dr. S. It has been three years since I've been in that office. I am beyond excited to be back and to start this next chapter. I have compiled a list of questions / topics that I want to make sure we address. I hope I am not missing anything...

Topic: Testing
- What tests do we need to repeat? Day 3 bloodwork? SA? HSG? (No, not the HSG!!)
- I want to be tested for MTHFR, a blood clot issue
- Should we do a postcoital? We've never had this test, and I sometimes wonder if my body is 'attacking' his sperm? Is there value to doing this test?
- Along those same lines, I have heard that immune system problems can be the cause of many "unexplained" infertility cases. Are there any other tests that can look for these issues?

Topic: IUI
- Is there any value to doing a monitored, 'natural' IUI cycle? Or are the success rates so small, it's not worth it?
- I will not 'selectively reduce', which means we need to tread carefully through the 'medicated IUI' process.
- How can we control the amount of medication to reduce the chances of multiples?
- Would we cancel the cycle if there are 'too many' follicles? Or would we switch to IVF mid-cycle and, if so, what is the cost?
- Does he feel a medicated IUI treatment plan would ultimately be successful? Is this the treatment he still recommends for me personally?

Things to do tomorrow:
- Call blood bank and confirm blood type. (Check! I am O+ and Ryan is O-. I don't believe there is any complications there, but I'll ask anyway.)
- Call Primary Care Physician and collect last year's blood test results (Check! They will fax it over to Synn's office.)

YES!

Oh, my gosh, it’s actually happening!

I called Dr. Synn’s office today and made an appointment for a consultation. It has been three years since the surgery, four years since I began fertility treatments, and six whole years since I saw Dr. Synn the first time for testing.

The last seven years have been a long, hard road. The most difficult part by far has been these last three years, dealing with depression and feeling stagnant.

We will see how the consultation goes, but as of now we are on track to begin a medicated IUI cycle in August.

FINALLY!!!

East meets West

I have a new treatment plan...that's right, I said it. I am kissing western medicine goodbye for the foreseeable future. I have given western doctors 4 years to figure out my problem to no avail. So, I am giving the Chinese a chance.

A little background: I first went to a fertility specialist in July 2004. They ran all sorts of tests and in the end diagnosed me with "unexplained infertility", basically code words for "everything about you looks perfect and we don't know what's wrong so we are stamping this label on you". Then, they sent me down the same treatment path they send everybody: Clomid with injectible trigger shots to promote ovulation (even though by all accounts it appeared I ovulated fine), IUI (even though Ryan's sperm count was great and there was no evidence of a problem with intercourse or fertilization).

When these treatments didn't work, it was time to move to the next level, injectable hormones. Luckily, we did not have the money to jump into that, which gave me time to think.

As I thought about the next stage of treatment, I started to get a little angry. If everything about me looks so great, why are they giving me the same treatments as people with diagnosable fertility issues? Why are they concentrating on treatment, rather than finding or trying to fix the problem? And why, when I told them I felt I had luetal phase defect (the third phase of my cycle is too short, interfering with implantation) did they pump me full of progesterone, rather than figure out if that is indeed the problem and (if so) teach my body to produce these hormones on its own?

Most of all, why did I concentrate on the 17% success rate, and fail to recognize that this means 83% of the procedures fail. 83%.

So, I started to do a little research. I figured, hey, I can't afford the western treatments anyway, maybe I'll see what's out there. I bought a book on Traditional Chinese Medicine (TCM) and answered pages of questions as to my symptoms and characteristics. I won't lie to you, some of them seemed odd (fuzz on my tongue? huh?), but afterwards I found out that I have symptoms of Kidney yang deficiency, Spleen deficiency, and Blood deficiency. I noticed there was a chapter on Luetal Phase Defect. I flipped there and read that the most common deficiencies leading to this defect are the three I just listed. Bingo! Finally, validation that western doctors could not give me.

So, what's next? Well, I can tell you what I'm not doing. I'm not forking over $1200 and injecting my body with synthetic hormones. Maybe I will in the future, but not now. I owe it to myself to try a natural approach first. If nothing else, I will be a lot healthier and balanced when/if I decide to pursue the next step in western fertility treatment. And, who knows? Maybe I'll end up pregnant in the process!

The Ups and Downs

These last few days have been quite the roller coaster. All this time, I have thought that I alone carried the stress and frustration of infertility, while Ryan escaped unscathed. Turns out, I was mistaken. Sparing the details, we came to the point that all of the strain and pressure was too much. And we snapped.

Although he would like to be a Dad someday, Ryan can’t take much more of the intense emotion that has been sharing space in our marriage for years now. He doesn’t want to see his wife fall apart on a daily basis and, you know, I can’t blame him. I am exhausted with this process as well. The most frustrating thing is that I want to DO SOMETHING, to MAKE PROGRESS, to be PROACTIVE, and our current situation does not allow for that. Because, you see, procreation is expensive for those of us who must pay for it…

So after a couple of talks, we have cleared up our misunderstandings and discussed our differences. Today, I am opening another bank account. I will funnel money there, a little at a time, as I am able. Once I have saved $3500, I will use the first $2000 for sinus surgery (I have to get this done before I can pursue pregnancy). Then, I will use the remaining $1500 for a Gonal-f / IUI treatment.

In the meantime, I will go back-to-basics and pull out that dusty ovulation predictor. Yeah, I know that the doc said my chances are <1%, but people beat the odds all the time. Doctors are good, but God is greater.

And all the while, I will concentrate on being happy. Happy with my husband, my family, my friends, and all those things I am so incredibly blessed to have. And those difficult days that will inevitably come? I’ll unload my feelings here, instead of dumping them on my husband. Because all he wants to do is make them go away. But he can’t.
No one can.

Life is like a roller coaster: There are ups and downs and sometimes you just want off! But other times, you just throw your hands up and try to enjoy the ride. Because, after all, you are not at the controls.

Day One and We're Stalled...

Today is Day One. While there's no surprise that the "natural method" once again yielded no results, the surprise lies in the fact that our progress has stalled. Sigh...

The plan was to call the Doctor's office tomorrow, have a preliminary ultrasound, and start the shot treatments. However, recently Ryan has been struggling in his police training. While he's determined not to quit, his career is feeling less than stable to me at the moment. Although I have the money saved up for the first round of shots, I think it would be irresponsible to aggressively pursue getting pregnant when I am feeling so unsure about the status of our future finances. When the day finally comes that I do get pregnant, I want to feel joy and gratitude, not stress and worry that I will not be able to give my baby everything she needs.

Even though I am incredibly disappointed, I feel comfortable with this decision. I feel proud that I am making the responsible choice and not the selfish one that I wish I could make. Good mothers put their children's interest before their own. I guess it's never too early to start.