What a Difference a Day Makes

Or, what a difference a doctor makes. Either way, today is a complete reversal of how I felt over the weekend. Today, I actually feel this foreign feeling. It could actually be:

Smudge's Dad says that Dr. O's technique must just be "different". Screw that PC crap. I say she's an idiot. But I feel like I have the right to say that after the IF hell she put me through the last two days.

When I got to Dr. Z's office this morning (first, as usual), my only hope was that Fran was back in the office and I was going to get to see her for monitoring. I got even better. I got Dr. Z. He only had one retrieval this morning, and he made time to see me (I haven't seen him since the middle of last week) before he got that started. The first thing he said was, "Your lining looks great." Great? Yesterday it was 12, which I know isn't anything to sneeze at, but my hallmark is nice thick linings, so 12 didn't make me happy. Today's 16.2mm makes me smile though. 

16mm of beautiful trilaminar lining! MY lining.

He got really quiet then, and was just clicking and measuring. Nothing can make an infertile more nervous that her normally talkative and smiling RE quiet. So, he started talking... mundane stuff. How was your weekend? Telling me about some boring business conference he had to go to. Asking me if I had met Dr O this weekend? That was my in. I mentioned that I had, and that she measures a bit differently that he does. And obviously, that he remains my favorite. 

By then he was done. I sat back and asked him how they looked. He said, "They look great. You're probably going to trigger tonight".

What?!

I told him that yesterday I had only had 2 follicles above 15 and the majority were 12 -13mm. He just shook his head, chuckled and showed me the numbers for myself.

I have 5 that are DEFINITELY mature (above 17mm), 3 that are PROBABLY mature (above 16mm) and 6 that MIGHT mature by retrieval (above 13mm), since they continue to mature after trigger. That might mature category includes one 15.4mm and three 14.5mm or larger. There's no way anyone can convince me that all of these sprung up from 12-13mm follicles overnight. So, thank you Dr. O for needless worry. I'm thrilled I'm not your actual patient, and I'm kind of concerned for the ones who are.

And now that is gone, out of my head, and my focus is on waiting for the phone call with my instructions for tonight and tomorrow.

If I trigger tonight, I'll be on the same timeline as my Smudge cycle, with a wednesday retrieval. Interesting note, my lining was 16mm the night I triggered for her as well.

I feel really positive (and bloated) right now. I know things are working in there. There's no question. I have NEVER felt this bloated or full during an IVF cycle, and that is just a testament to my ovaries in overdrive.

I asked Dr. Z about my estrogen per follicle theory and asked him what he thought. He said that he felt that it showed that the egg quality was going to be superior. I'll take it.

So, for now, I'm sitting here, once again staring at the phone. I'm excited. I'm hopeful. I'm a little uncomfortable.

It looks like tonight is the night. EEEEEEEEEEEK! Here we go again!

I'm Doing it Again

But seriously. Is anyone capable of not comparing cycles? If you are, PLEASE tell me how, because I'm starting to get really upset. I'm hoping part of today's giant let down is Dr O. I DON'T like her. She's completely insincere, and I honestly wonder if she's this way with all of the patients, or just the ones who aren't hers. 

I'm not even going to tell you guys my follicle sizes from today, because they just don't make sense. There are fewer than yesterday on the right, more than yesterday on the left, and one of my 14mms seems to have just up and vanished.


The good news from today is that my E2 is 963 and my lining is up to 12.4mm. (Yeah, whatever. I do not believe it went from 9-12.4 overnight. I think she measured wrong yesterday, because Fran had gotten 10 the day before.)

Anyway - now I'm just worried about too many things. They're increasing my dosage of gonal-f for tonight. And when I say "they", I mean Dr. O, because apparently she's the doctor on this weekend. So, what if she's giving bad advice. She obviously can't measure a follicle... what if she doesn't manage a cycle well either? On my smudge cycle, I triggered monday, with a ton of follicles over 16mm. My failed cycle, I triggered thursday with finally larger follicles, but they all sucked and I obviously didn't get pg. So, what if the longer I stim, the worse the quality will be? Today is stims day 10. And I'm starting to really worry. 

Again, the only good news is that with potentially (depending on her measurements)  8 follicles above 12mm, my estrogen is 963 on stims day 10, whereas with my smudge cycle, on stims day 10, I had 15 follicles over 13 and it was only 1130. So, i'm continuing to have a higher estrogen to follicle ratio. At least I keep telling myself that's good.

So - antagonist experts, talk to me. If I stim for 13-14 days, do you think I still have a chance? Did they start the ganerilix too soon (i started it with a 15 and a 14... btw, the 15 seems to have vanished)? Is Dr O just incapable of accurate measurements? Am I worried about nothing, or do I have a real reason?

I just really need someone to blow some sunshine up my butt, because I'm back on the ledge and it isn't pretty. 

I've Fallen Off of the Decaf Wagon

Okay - so it's still only a couple of ounces of caffeine per day - but this waking up at 5:30am to get to monitoring in time to be first, to be home in time for Smudge's Dad to go to work and not be late, is getting EARLIER and EARLIER every day. Enter the weekend, where they tell everyone to be there at 7am, as opposed to just between 7-9am. So, today it was doubly important to get there first, since their satellite offices are closed on the weekends and everyone goes to the main office for weekend monitoring. It was PACKED this morning. 

I was still first.

One thing was noticable this morning. With the exception of the same nice lab tech that did the bloodwork (an older woman named Janet), I do NOT like the weekend staff. There was a nurse that I have never met before and one of Dr. Z's new colleagues since Dr. B left, Dr. O.  The best thing about Dr. Z's office is the warm fuzzies. Fran hugs me before she leaves my room. Dr. Z either hugs me or holds my hand. Dr. O was all business, all the time. I guess some people need that. But i don't know. To me, if you're going to be putting cameras in places, we could at least be friendly about it. 

Anyway - Today is stims day 9 and day 2 of ganirelix.  Dr. O measured my lining at 9mm, still trilaminar. Fran measured it at 10mm yesterday. I know it's subjective, so I'm not worried about it. If Fran measured it at point A and got 10mm, Dr O could measure it at point B and get something different. As long as my E2 keeps going up, that's all I care about.  Plus, i'm still drinking the pomegranate juice, and we know how that helps thicken things. 

My right ovary is a MACHINE. Are you ready? Here we go: 14mm, 11.2mm, 13.1mm, 7.6mm, 13.5mm, 6.7mm, 11.4mm, 10.2mm, 9.3mm, 12.9mm. She only measured 4 on the left, where Fran and Dr Z have both been measuring 5. So she either missed one, or just didn't measure the little one, but the ones she measured look great: 14.7mm, 12.8mm, 14.7mm and the last one was either 11 or 13mm (i don't remember).  At this point, I'm looking at anything 13ish or higher as a potential mature egg, which still puts us at 7-8 for retrieval. I think they'll try to retrieve out of follicles even a little smaller, but if I have 7-8 mature eggs, i'll be happy. That gives us good odds, in my head, anyway.

And the news gets even better. Since it's a weekend and they want to leave as early as possible, Nurse Jennifer just called with my E2.

Drumroll please......

723!!!!!!!!!

This cycle is starting to really pick up. With 13 large follicles in my Smudge cycle on the same stims day, my E2 was 899. My estrogen per follicle is DEFINITELY higher this cycle and that can only mean good things about the maturation of the eggs. There are only 7-8 that we're counting this time. 


No med changes and I go back in the morning. May the force be with me.

The March of the Penguins

The socks were out in force this morning, and Nurse Fran has stopped laughing at me and is now laughing with me.

Yesterday, my list of measurable follicles was pretty short... today, she needed TWO screens to list them all!

page 1...

Page 2!!

Without further ado, and because I know you're all dying to know:

My lining looks great. 10mm and trilaminar. Thank you pomegranate juice.

And the important stuff... what we're all here for:

5 measurable follicles on the left: 9.2mm, 6.8mm, 12.7mm, 13.3mm, 12.3mm

10 (um, yes, I said TEN) measurable follicles on the right: 8.9mm, 7.1mm, 10mm, 8.7mm, 13mm, 8.6mm, 9mm, 15mm, 14.3mm, 12.8mm

Now, anything under 10, they're really not looking at. But there are a few REALLY good looking follicles there: 3 on the left and 4, MAYBE 5 on the right. But it looks like 7 is going to be my magic number this retrieval. Seven was the number with IVF #1, and we all know how that turned out. But this time seven is going to be lucky. Things are trucking right along, and I'm not worried. 

Right?

Because of the follicles 14mm and over, I started a new medication this morning called Ganirelix. This injectible is going to prevent the follicles from releasing the eggs too soon, and will allow some of the others to catch up. It's the med that keeps on giving. When it goes in, you're lulled into this false sense of, "hey, this one isn't so bad". Then about 5-10 minutes later, holy mother of goats, does that sucker sting. The Ganirelix comes in a pre-filled syringe, so you don't have to draw it up or anything, you just stick and shoot. Yeah, whatever. That needle is dull as a spork. So, smart cookie that I am, i empty it into a new syringe and stick a sharp needle on the end. 

Good thing too... I already look like this:

The IF landscape

Anyway - just sitting now, and waiting to hear what my estrogen is. From here on it, I'll be going to be monitored with vagcam and bloodwork every day until trigger. Fran will call me every afternoon to tell me my estrogen and if I need to adjust any doses. 

I'll leave you with this today... the reason why we're doing this. Because she deserves to have a sibling.

I'll update later.

Time to Break Out the Big Guns....

 That's right, folks. It's no holds barred now... I'm doing it and no one can stop me.

I'm wearing fleecy penguin socks in June.

Hi old friends.

These socks saw me through IVF #2, retrieval, transfer and the labor and eventual delivery of my daughter.

And now they're getting dusted off.  And just in time too. Because they worked.

Obviously, I know that there are factors in play other than lucky socks.  There are buttloads of injectible hormone stimulating medications and modern science. But HEY! If I want to give the socks some credit, then I'm going to.

And without further ado, I give you... monitoring #3.3 (have I ever mentioned that 3 is my favorite number, btw?):

My lining is trilaminar. For those paying attention, that means my estrogen is rising. So, yay! That also explains why I'm a hormonal raving crazy-monster, but who's really paying attention to EVERY little mood swing right now? (Honey, put your hand down please. Thank you.)

Now, let's discuss the follicles, shall we?

At the very tippy top, you can see a follicle. It's the black circle.

There are 5 measuring on the right with 2 small: 8.4mm, 12mm, 10.3mm, 10mm, 11.7mm

There are 6 measuring on the left with 1 small: 5.4mm, 8.3mm, 5.7mm, 10.7mm, 11.1mm, 11.4mm

Fran (my ever wonderful nurse) said for 6 days of stims, this is great for me. I'm obviously progressing and we're hoping for an E2 above 200 today.

So, now we get to wait for the phone call that will give me instructions for my meds tonight and tell me when I need to go back. I'm guessing saturday and staying the course on my meds... or maybe a SLIGHT increase if he wants me to go a little faster. But i'm not worried anymore.  I see at least 7 great follicles in my future. Now lets just hope for good mature eggs inside them.

Hold onto your penguin socks, friends... I think the ride is about to take off.

I probably shouldn't be sitting here crying, right?

I'm just beside myself right now. Yep. That's me, sitting right there, wondering WTF is going on in there.

Seriously - WTF.

I'm 36. Not 46. My FSH is normal. So normal it's scary. Everything, except for my AMH, is normal. And my AMH is tripled from last time. Yeah, it's still low, but no where near as low as last time. So, maybe that's part of the problem. Maybe I have my expectations set too high. Maybe I just expected a smooth IVF cycle, like my Smudge cycle. Maybe I'm setting myself up to be heartbroken. 

All I know is I got home from monitoring a little while ago and I'm sitting here crying.

Cycle #1, Stims day 5: 5 small on the left and 5 small on the right with one 11mm and one 10mm. My lining was 5mm and homogeneous. E2 was 52. And that sucked. AFC this cycle was 14.

Cycle #2, Stims day 5: 6 small on the left with a 10mm and 12 small on the right. My lining was 5mm and trilaminar. E2 was 143. They like it between 100 and 150. 143 was perfect.  AFC this cycle was 11.

Here we are. Cycle #3, Stims day 5: 6 "measuring" with a few small on the left and 6 "measuring" on the right.  My lining was 9mm and homogeneous. The ones that are "measuring" are between 7-9mm. None are over 10. AFC this cycle was 11.

triple stripe lining

homogeneous lining

Important fact: Uterine lining changes are estrogen driven. In order for implantation to occur, your lining has to be trilaminar, meaning a triple stripe. Last cycle, my estrogen was perfect. My follicles were growing and my lining was trilaminar. This cycle, my lining is still homogeneous, which says to me that my E2 isn't in the range they want it yet.

Which tells me that my follicles aren't maturing and my E2 isn't in range. Like cycle #1. Like the cycle that didn't work.

I sat on the floor when I got home and played with Smudge. The thought of not being able to give her a sibling is so sharp and painful.  And then it makes me so upset about the baby I lost. She HAD a sibling. And what if that was her only chance. I've already given up my dreams of a big family, but I'm not ready to accept that she might be an only child.

What if I'm just too old?

Oh, god, what if this doesn't work?

Don't ever let anyone tell you that having a baby makes infertility go away. I promise you it doesn't. Not the diagnosis. Not the emotions. And not the fact that once again, i'm shooting myself up with meds multiple times a day, getting bloodwork and vagcams daily and even still i'm sitting here in tears... because all i want is another baby. A sibling for the daughter I already have. And once again, it looks like I'm broken.

I'm so tired of being broken. Meanwhile, as usual, I'm just waiting for the phone to ring.