Friday, February 29, 2008

Update: Decision Made

Okay, so I finally heard back from my favorite nurse, whom I think I will imaginatively call Favorite Nurse. I figured I was being impatient, because she called me an hour after I started to freak, which is 30 minutes after the office closes. She’s so sweet, she said she’d never forget to call me. Awwwww.

So, she spoke with Dr. B and he is recommending the regular-old-fashioned-lots-of-needles-pump-me-full-of-drugs-IVF. M and I have already discussed our options and have come to the conclusion that it’s probably for the best. If my high FSH is an indicator, we might not want to mess around much longer.

Favorite Nurse reiterated this when we spoke on the phone. She also confirmed my fears that I am now ineligible to do Shared Risk. Damn you high FSH! The only way I’m eligible is if I use donor eggs. She politely told them no thanks, that I’m not there yet!

So…I have to run to CVS and pick up my BCP’s which I start tonight. I am stupidly excited to be starting the pill. It’s just that I’m finally moving on, there’s hope on the horizon.

My Drs. Practice has two offices. The main office is near-by (about 15 min. away) and the satellite office is a little further out (about 30 min. away). I started going to the satellite office in the beginning because I worked across the street from it. I bounce between the two depending on which is most convenient at the time or which one is open. The main office, which has 4 Drs. (including Dr. B) is very busy. The satellite office is smaller with only Dr. B working it p/t so I know everyone well (and just as important, they know me), including Favorite Nurse.

After the frustration of not receiving prompt phone calls and just feeling lost in the shuffle at the main office, I’m going to make the drive to see Favorite Nurse from now on. I think the extra time and gas money is well worth better care, especially if we’re going to be forking over huge sums of money.

I’m nervous, but excited to be moving on. I know there’s no guarantee that IVF will work, but it’s our best hope for now. I just have to call on Monday to schedule my final IVF consult, oh and figure out how to pay for everything!

No Real Decision

Still no real decisions made yet. I thought for sure I’d have an answer now that I’ve repeated the FSH test. I took it on day 2 this time, so there is no reason for me to worry about its validity.

I went in on Wednesday morning, and was told to check the e-mark voicemail for my results that afternoon. I’m surprised I didn’t crash the system calling so often. I was pissed when I didn’t get my results the same day.

I decided to wait until 12pm the next day to call the office, just in case they were slow getting the results or leaving the message. I thought maybe the nurse was waiting to discuss my results with Dr. B before phoning me with some sort of decision.

Well, no call or voicemail by 12pm, so I called and left a message for Dr. B’s nurse to call me with my results -please. So I waited, and waited, and waited. At about 5pm, I finally got a call from my favorite nurse. She apologized for the mixup and gave me my results, which were just okay.

My FSH is 9.9 this month. So, technically it’s within the normal range, but barely if 10 is the cutoff. She was very optimistic, and said not to worry too much.

I discussed my concerns with her about the day the previous test was taken, and she confirmed that taking the test on day 4 would not have skewed the results that much. She couldn’t offer any explanation for why my FSH has seemingly jumped so much in a years time. Although I have a small theory.

I also asked her what she thought I would end up doing? The real deal, or the mini-IVF? She said she wasn’t sure, but she thought I might need more meds to stimulate so that I would end up with the regular old IVF.

I even brought up my concerns about finances with her. I love her, because she gets it. She understood immediately that we’re in limbo waiting for a course of action, and that we can’t plan financially without knowing.

She couldn’t offer any real solutions, but at least she gets it.

I know that we need to plan for a full IVF. It just makes more sense to go the safest route when so much money and emotional energy is involved. I’d love to be brave and take my chances with the mini-stim and prove that it can work just as well for women with high FSH. But I don’t want to take the financial hit if it fails. I also don’t want to think “what if” because we weren’t aggressive enough.

I’m waiting impatiently for another call from one of the nurses. I hate the days of waiting, I feel like I can’t get anything done. I’m so easily side tracked, wondering when the phone is going to ring, what the news is going to be. I know I should try to keep busy so the day will go by faster, but I can’t do it.

I start to worry that they’ve forgotten about me or that they didn’t get my message. The office usually starts returning phone calls in the afternoon, sometimes after the office has closed and they’ve switched the phones over. That makes me so nervous, what if they did forget me this time and I have to wait a whole month more. Gah!

I want to call right now, and make sure that they didn’t forget, take charge of the situation. But of course I don’t want to be annoying or be one of those patients that piss’s off the staff. What's a girl to do?

Wednesday, February 20, 2008


I'm just waiting around. Today is cd 20, so I have anywhere from 8-10 days before I can repeat the day 3 FSH test. This is almost as bad as a 2ww! I'm dying to know what's going to happen next. Can you say impatient?

I caught an online broadcast that discusses infertility today. I tuned in because my very own Dr. B was the guest and the topic was of all things, mini-stim IVF. I was happy to hear more on the topic in general, there just isn't much out there.

It sounds like my clinic may be moving towards using less drugs in general. Dr. B said that they have higher success rates with fewer drugs. They're not entirely sure why, but think that higher quality eggs result therefore better quality embryos are created.

That said, he gave an example of when he would not recommend using the mini-stim protocol... if a 31 year old has a day 3 FSH of 14. He would want to use more drugs to stimulate. Well, I'm 30 and have a day 3 FSH of 11.9. Damn.

He did say that some Drs. still believe that mini-stim is appropriate for women in my situation, going back to the theory that quality over quantity is the ultimate goal. But he said that not enough scientific data has been produced to back that theory up. I want to help prove this theory?

I also looked up the shared risk plan. The idea being that you pay a lump sum larger than one IVF (around $18,000) but you get three IVF's and three frozen transfers. If it doesn't work you get 70% of your money back. It's great if you need a couple of tries, but not as great if you get pregnant on the first try. But that's a risk I think I'd take, because the downside is a baby.

Well, due to my abnormally high FSH, I won't qualify for that anymore. Unless we can some how make that test invalid (assuming that I have normal results next time), I'm going to have to look at other options to help finance, especially if we do the big IVF.

I guess I'll know something next week.

Monday, February 18, 2008

Generous Friend

As I've mentioned before, I was sad and pathetic after learning about my FSH results.

Naturally, I called my best friend, K (whom I've known since middle school) to share my bad news. Like always, she was so sweet and said all the right things to comfort me.

This time she went above and beyond friendship. She offered the most generous gift ever, her eggs.

Now, I know this isn't the sort of thing to take lightly. I'm aware that there are a slew of moral, legal, and psychological issues that would need to be considered before dragging her off for a visit with Dr. B.

For those reasons, I'm not even sure I would ever take her up on the offer.

Although...she is the perfect donor, we're the same height, weight, coloring, etc. No one would ever know that I'm not the biological mother if we did go down this road.

Serious issues aside, I can't tell you what a relief it is to have a backup plan. I feel like no matter what happens, she has my back. I can't believe how lucky I am to have such a wonderful friend.

Tyra Banks outdoes Oprah!

I just recorded and watched the Tyra Banks show on infertility. Or as they called it, “Motherhood At Any Cost”. For what it’s worth, the show wasn’t half bad. I think they did a decent job (considering the type of show) of discussing the general concept of IF treatment and the emotional toll involved.

For anyone who didn’t get a chance to see the show, I’ll go over the basics. They brought on a quasi-celebrity couple to share their infertility struggles. Not that it should make a difference, but when celebrities speak on an issue, it gets more attention so I think it was a bonus.

The couple, Trista and Ryan from “The Bachelorette” didn’t discuss in great detail what they went through. They just did an overview of the whole process from difficulties with conception to a difficult pregnancy/delivery.

I was happy that Trista was well versed (unlike Alexis Stewart on Oprah) and used words like hysterosalpingogram when discussing the treatment she went through.

Trista and Ryan also mentioned the emotional difficulties they endured with infertility. They discussed how shocking it was to have their near perfect lives go off track.

Ryan also admitted that having sex on a schedule for two years wasn’t as fun as it might sound. It’s been my experience that most people think a man would be happy to perform on a schedule, because it’s guaranteed sex, and hey, what man wouldn’t want that. Those folks aren’t thinking about how stressful it can become if one person isn’t in the mood, or doesn’t feel well, or even worse has to be out of town making that month a missed opportunity.

I was happy that the show brought to light the commonness of infertility. I was also pleased that “just adopt” was never uttered or the desire to have children (biological or adopted) was never looked down upon! That alone put's Tyra's show a step above Oprah's shows on IF.

Unfortunately, the show did go off track with a ridiculous ‘Jerry Springer’ guest. The offensive woman was having unprotected sex to become pregnant against the wishes of her boyfriend…stupid. Since that had nothing to do with infertility, I’m going to pay it no mind.

Endometriosis (my specialty) seemed to be the common theme. I was happy to see it discussed, but thought the show could have been better rounded. PCOS, low ovarian reserve, or maybe male infertility could have been brought up as additional factors. The ill-informed masses might get the impression that endo is the only disease causing IF, but then again it was only an hour long show.

Also, the different methods of treatment weren’t fully explained, although most were mentioned at some point. They did speak of sperm banks, IUI (referred to as artificial insemination) and adoption in a very positive light.

A couple in the audience stood up and discussed not only the difficulties in conceiving due to endometriosis, but the financial burden pursuing IVF is and through tears how difficult it is to lose not one, but two pregnancies. The shocker is that they shared with the world that they just found out she is pregnant again. Whoa.

Another guest, a 29 year old single woman explained that she has severe endometriosis which has required multiple surgeries. She is aware that her window of opportunity is closing and that if she doesn’t act now, she may never have a biological child. To the disappointment of some of her family, she is pursuing IUI with donor sperm in hopes of conceiving before it’s too late.

It may be a bit dramatic on its face (which is why, I'm sure she was chosen as a guest), but it brings to the forefront the difficulties facing women who are affected with a disease that causes infertility. Tyra applauded her for being so aggressive in going after what she wants, another contrast to the ‘O’ mentality of letting go.

The last guest was the founder of Conceive magazine, Kim Hahn (she adopted after several IVF attempts). She briefly went over when ovulation normally occurs in a cycle and the fact that women’s fertility declines as she ages. She even mentioned FSH as an indicator of ovarian reserve and egg quality. Whoa, real factual information.

The final moments featured a woman who (I think) works on the Tyra Banks Show, showing off her brand new baby through adoption.

So overall, I was pleased with the tone of the show. They focused mostly on the positives and showed women (and couples) as normal people dealing with a difficult medical condition. Not as crazy, pathetic or selfish.

Way to go Tyra Banks! (I can't believe I just wrote that, ha ha)

Wednesday, February 13, 2008

FSH Results

So I'm nearly done the pre-IVF gauntlet. I had the final blood draw to test my FSH last week. As I mentioned before, that was the last test required before beginning the FINAL IVF CONSULT!
That's when we’ll meet again with Dr. B for a scan, mock transfer and to solidify my protocol. Oh, and how could I forget, I'll learn how to give myself injections!

As luck would have it, it wasn't so simple. My period threatened to start on Friday afternoon, which would make day 3 Sunday (not normal business hours at the office). I called the nurse and explained the situation. She was a doll and said that I could come in on Sunday, but if my period started “full flow” after 6pm, to consider Saturday day one.

If only it were that easy. Late Friday afternoon, I started full flow for about five minutes and then stopped for the rest of the evening. That night, around 1am I really started. So I just counted Saturday as day one and did my blood work on Monday.

It dawned on me last Wednesday to check my medical voicemail (my Drs. Office has a nifty retrieval system for passing along messages from the nurse) for results of the blood work.

Everything is okay except for one thing. My FSH is… 11.9! WTF? Check this out if you are wondering what a normal day 3 FSH should be. Yeah, it's that bad.

I still can’t believe my bad dream might be coming true! I don’t know for sure what my previous FSH was, but I think it was nice and low, I went back through my medical history and found a FSH result of 4.1 from a year ago.

In the message the nurse mentioned that 11.9 is high (you think?) and that it indicates low ovarian reserve. She also said that it’s good that I’m preparing to do IVF.

I was (and am) in disbelief, so of course I turned to Dr. Google for some answers. What I found was not very reassuring. It all but said that I was screwed. Donor Eggs is a hot topic among women with an FSH above 10!!! Seriously, I’m only 30, how could I be running out of eggs? How could my numbers plummet in just one year’s time?

Naturally, I freaked the hell out and then called the nurse back. By the time she returned my call I was in a near panic. She was so calm and vague about the whole deal that it was only making me crazier. I kept asking her if it’s as bad as I think it is and she would only say that it indicates low ovarian reserve. I then asked her if I would still be doing mini-stim IVF or if that was off the table.

She talked with Dr. B and called me back an hour later. Basically he told her to tell me that mini-stim is still a possibility, but he would like to re-test my day 3 FSH. Unfortunately that wasn't really reassuring, and I had more questions than answers.

Barring a mistake at the lab, from what I’ve read, retesting doesn’t really make a difference. It’s possible to get lower results, but the highest numbers are often considered the most accurate snap shot of ovarian reserve. Even if my numbers come in nice and low how will I know which test to believe?

I e-mailed Dr. B that night, to ask him the above questions in hope of some concrete answers, and he wrote back that it’s possible the lab made a mistake, or that the test was taken too late in my cycle. Okay, maybe it was a mistake. But I have a hard time believing that half a day would make such a big difference; it’s not as if I took the test on day 6 or 8. It was day 3 and a half -maybe.

But he’s the Dr. so I’m going to wait another two weeks and take the test again. Gah! Dr. B also wrote that I might want to consider regular IVF if the numbers come back high again, but that we can discuss all of the options at the Final IVF consult.

Now that the news has settled in, I'm doing okay. But those first few days were awful. I just couldn't believe that I’d heard the message correctly. I should know better by now, but I still can’t believe this is happening.

I hate how one little test can overturn all of our plans. The Drs. Office is treating it as a simple change in protocol. It seems to me that they’re missing the bigger picture, at least from our perspective. For them it is a simple change of protocol, but for us it’s a difference of $6,000 or more. Not exactly pocket change and sad to say, money is a big factor in the decisions we make about treatment.

I think we really need to hammer out a game plan before I get back in the stirrups. I just don't know how to go about that right now.

First Steps to IVF

I have tried pretty much everything to get pregnant except IVF. Admittedly, I haven’t used injectables with IUI, but Dr. B wasn’t convinced that it would make a difference. We decided that if we’re going to spend the money for the drugs, we might as well go all in.

I also have a fear of injectables with IUI working too well, and becoming pregnant with HOM’s. While, like many, I would be happy to have twins, anything more would be pretty insane.

That said, M and I had a consultation with Dr. B about two weeks ago. Because of my age and overall good reproductive health, we were given the option of doing mini stim IVF.

As Dr. B explained it to me, it would be the same as regular IVF, just without the Lupron suppression leading in. I would still do the BCP’s and the stimulating drugs, and of course retrieval. Because I wouldn’t need as much medication, the cost would be much less. Yayyyy.

Sounds great, right? The catch is, I won’t produce an abundance of follicles. It’s likely that the number would be less than five. I know, many women have done regular IVF with similar results and gotten pregnant, so it isn’t all that bad.

All the same, my concern is there might not be enough to work with. Or there might be one or two eggs that fertilize, but I won’t have anything to freeze if it doesn’t work, and I'll have to start from scratch. Obviously, like anything else, it’s a calculated risk.

It’s a hard decision. Dr. B says that it might take up to three tries, just like regular IVF but he’s confident that it will work. The odds are supposedly in my favor...I wonder if that’s what they all say?!

Mini-stim costs a little more than half a regular IVF, so it would still be expensive, but more manageable. Even if it takes three tries, we would still be spending roughly the cost of two regular IVF’s. With this in mind, M and I have decided to take the gamble and give it a try.

Of course, if I should have abysmal results from the mini-stim, I probably will kick myself for not going ahead and doing the IVF that has the best outcome. Gah! Have I mentioned how suck ass all of this is?

After the consultation, M and I did all of the blood work necessary to get the ball rolling except for my day three FSH, well because it wasn’t day 3.

During the wait to finish my testing, I had some crazy dreams about the results… first I dreamt that I actually produced a lot of follicles. That sounds good at first, but in my dream, it meant that they would all be of bad quality, booooo. The second dream I had was about my FSH results, I dreamt that I had a number over 10! Clearly I had some anxiety about the whole thing.

For all of my anxiety, I’ve been super excited, I feel like we’re one step closer to either getting pregnant or finding out it’s never going to work. Of course I’m hoping for the best, but I think I need to keep my feet on the ground and be prepared for the worst.

Tuesday, February 12, 2008


My husband and I have great families. They are, however great in different ways. I have one sister, grandparents, five aunts, five uncles, about 11 first cousins, and the number is always growing. Most of my family lives in Maryland.

On the opposite end of the spectrum, M's family is rather small, he has an older sister, grandparents, two aunts, two uncles and four cousins. Only half of those live in the U.S., the rest are in Europe (M is first generation American).

My family has never put any pressure on us to have children, they would be happy for us if we did, but it is not in any way a requirement. They have their own busy lives, and don't feel the need to intrude in ours. I haven't discussed our problems with much of my family, but I did clue my mom in this past year. She has been nothing short of perfect. She doesn't dole out assvice, she only offers support.

By contrast, M's family feels that it is my duty to give them children. From our wedding forward, we were gently told to get busy. I realize that it might be a cultural difference, or just their desire to see the family grow. I'm not sure what the real driving force is behind their nudges, but it is just stupid and annoying.

At first, I was able to ignore their hints, back when we were still young and newly married. Plus I wanted to finish college, and his family, thankfully did allow me that break without any trouble.

Their nagging became a problem after we settled down and started ttc. We didn't tell them we were trying, because, well it wasn't any of their business and I didn't want the pressure. We just figured it would be a happy surprise some months down the road.

When the road started getting longer and harder, it also became harder to just grit my teeth when my MIL rubbed my non pregnant belly. But I was in no way prepared to fill them in on everything. I couldn't bear to hear any assvice, especially since M's sister had just given birth to her second and his mom was now truly obsessed with babies.

I'm embarrassed to admit this, but I don't like my sister in law. We haven't gotten along for the past 8 years, mostly because she is a selfish biatch. But that's for another time.

It's been especially tough this past year, M's sister just had her third baby (my how time fly's) in December. All of his cousins now have children except one. To break it down, we are now the only married couple not to have children in his small family. To add insult to injury, I'm being lapped.

The hardest aspect of all of this hasn’t been the need for medical treatment. Surprisingly, that doesn't really bother me. I'm not squeamish about getting in the stirrups or discussing my problems with the Drs. and nurses. Quite the opposite, I just want to do what it takes to appear normal. Is it crazy to just want to appear normal, not actually be normal? Although don't get me wrong, a normaly functioning reproductive system wouldn't be turned away.

It's the failure that has been hard. More specifically it's the public failure, the knowing that M's family is watching closely, whether we discuss our problems with them or not.

I know this for a fact, because no one wanted to tell me that my SIL was pregnant for the third time this past summer. I found out from our three year old niece. She told me that "mommy has a baby in her belly". Blehhhhh

After about two years of trying, and many more not so subtle hints from M's family, I've had enough. We still haven't divulged the details of our treatment, but we've told his parents that we're working on it, and it might not happen, so they can stop being annoying now. We've told everyone else in his family who makes rude comments to mind their own and that we'll let them know if anything exciting happens.

To my relief, my MIL has backed off, she is bordering on normal about the baby making. M's father still can't help himself, he makes stupid comments periodically, but at least everyone gives him dirty looks now. And I just avoid the rest of the family if possible, because I don't want to play with new babies that aren't mine.

Trying Times

I don't know what it's like to see a positive, I've never had one. I know that it's a sick rollercoaster when the positive disapears, or worse when the bleeding starts weeks later. I am glad that I've never been on that ride. Although, in some perverse way, it would be reassuring to know that it *is* possible to get pregnant in the first place, even if for just a few days.

Saturday, February 9, 2008

Part II

Okay, part two.

So M and I went to see a Reproductive Endocrinologist, we'll call him Dr. B. He is a very nice, but busy man, who upon consultation, declared that I would be pregnant within 6 months. I can't tell you how happy that made me, but I had my doubts. He also decided that a lapororoscopy would be necessary, as he suspected endometriosis.

In the mean time, since I was already taking Clomid and was near ovulation, he introduced me to the trans-vag ultrasound. I was then given some Ovidril and sent off to trigger before doing my first IUI. I even got to take home my very first sharps container! We figured what the hell, it's worth a shot before having surgery, and maybe I'd be lucky.

A few weeks later, nothing. I scheduled the surgery in hopes of getting some good answers. The surgery went smoothly. As suspected, I have mild endometriosis sprinkled with a few polyps for good measure, but overall, everything looked good. In case you’re wondering, I'm in overall good health, I'm of a normal weight (meaning I'd love to lose 10 lbs.) and I have regular cycles.

Dr. B said that my best chances for conceiving would be in the year following the surgery, so we were to begin a monthly ritual of Femara, Ovidril, and IUI. We kept that up for quite some time, finally giving in after 5 rounds and a couple of birth control pill breaks to quiet some unruly cysts.

At the urging of M. and some friends, I did seek out a second opinion at another local clinic. I was not impressed with the Dr. or his theories. He seemed a little suspect, I don't know why, but he was creepy and he said some things that seemed untrue. Being desperate for answers, I did agree to have an endometrial biopsy through his practice. He offers a test that my regular RE does not, Dr. B thinks its bunk. It's a test that looks for Integrin. Supposedly this is often missing in women with endo and is thought to be necessary for an embryo to implant. If it is missing, then a few months of Lupron should fix the problem. Well...I wasn't missing it, so back to the drawing board.

By the time we got to the 6th IUI, we were getting desperate, so I started acupuncture. I can't say that I enjoyed getting stuck by little needles, but I was willing to do just about anything if it would help. After my last IUI, I started an herbal regimen as well, but it didn't seem to do a damn thing.

M and I agreed that I could end acupuncture in February; 6 months seemed to be a reasonable amount of time to expect some sort of progress. I was not enjoying it, and it was becoming a drain on the finances. Our insurance doesn't cover any thing fertility related except labs, not even acupuncture. So we have been spending a lot of our resources each month on trying to get pregnant.

That pretty much brings us up to date.

So far, I've been laying out the basic facts of our past treatment, but I've neglected to share the emotional toll it has taken on M and me. I'll have to get around to all that fun stuff later.

Friday, February 8, 2008

First Post

Well, after lurking on so many blogs for the past year, I've finally decided to join in the fun.

I suppose I owe you a bit of back story if I expect you to follow along, bear with me; it's probably going to be long.

To begin with, I have been unsuccessfully trying to get pregnant for the past 2 1/2 years. When the journey began, I had just turned 28. Although not young, I figured I was young enough that getting knocked up wouldn't be a problem. Ha, now I realize how foolish I was for believing that age is the only factor governing fertility.

Okay, I know you're going to laugh, but my "plans" were to have my first child when I was 28 or maybe 29 if it took a few months of trying. Then I'd start on the second somewhere around 30, 31. I was really planning on having the whole baby making over and done with about now. You can stop laughing.

I actually started gearing up for the whole pregnancy thing long before M and I were ready to try. Let me explain, I was a bit slow to graduate from college (very indecisive about my major, so I changed it about three times) so I dropped out took a break. I had already met M in the dorms, and was madly in love. Since I was no longer pursuing my education, I moved with M to NY where he took his first job.

We soon got married, and lived happily together for about two years, now in MA. But I still needed to finish school. So...I left, with M's support to finish my degree in GA. During that time M, the sweet man that he is, took a job in FL to be closer to me.

Back to the point I was trying to make... I thought I'd get a head start by charting my BBT in anticipation of our settling down and doing the family thing.

I finally graduated and moved to FL with M, we were now ready to start that family. I mean, we each had grown up jobs and had purchased a house! We were as ready as we'd ever be.

Being the slightly obsessive planner that I am, I took my perfect looking charts to my gyn-y and informed her of my intentions. I can still remember her saying, "The next time I see you, you'll probably be pregnant." I'm sure she thought I was a little crazy to have that much information on paper, but I didn't care. I was excited; we were going to become parents! Ha ha ha.

So we began trying, and trying, and trying. After about 9 months of negatives, I went back to visit the nurse practitioner. She reassured me that everything was fine and to keep trying. I had permission to come back when the prerequisite year was up.

Three months later, she agreed to run a blood test. Low and behold, my progesterone was practically nonexistent, so she prescribed Clomid to help with ovulation. M also made a visit to the Dr. and was declared in perfect reproductive health.

I was excited, certain to get pregnant now that I had medical intervention. Four months later, nothing. By this time, my best friend was telling me to get myself to a specialist, so I did.

Okay, I think I've done a pretty good job of catching you up, I'll continue the rest of the story tomorrow, so be patient. Ha, patient, get it?