Tuesday, October 11, 2011

Cycle2, CD35, 15DPO -- BFN

My progesterone on 7DPO was 10. Most of my hopes for this cycle ended there. And 2 nights ago I had some cramping before bedtime and AF started in the middle of the night. So now I am on CD2 of the next cycle but we have decided to take a break. My DH has been on a vitamin regime since Sep15 (because of 1% morphology from his SA). Hopefully we go back in 2-3 months and do another SA. If his morphology does not improve by then, IVF is our only option. I have had a migraine everyday for the past 10days and too much stress and tension with DH. I think I need a break from all of this. Sometimes I feel that I need a break from DH too. He just does not get it. He says all the wrong things at the wrong times and I feel that he is very insensitive to what I am going through. He does share a lot of work load at our home, but still we end up arguing and fighting for every single thing. Next week is my birthday and I turn 32 years old. Being pregnant would have been the best bday gift for me this year but its not happening. I've decided to give myself this week to mourn and then get back to normalcy by next week. My DD does make all of this a lil easy on me. She is in a phase where she wants only me all the time and keeps showering me with kisses, hugs and I love you's.
We have huge decisions to make in the next few months, as insurance does not cover any of this. Typical IUI cycle costs us about 2.5k-3k and IVF would cost us 15k-18k. We might be able to afford one IVF cycle but after that its going to be hard. Also just last night DH announced that if we did IVF he will only agree to put back a single embryo. I am too drained and tired and depressed to even argue with him anymore. Hopefully the next SA will bring us some much needed good news.

Tuesday, September 27, 2011

Cycle2, CD21, 1DPO

After the cancelled cycle last month the nurse practitioner that I regularly see called to answer all my questions. She did not agree with the cancellation. She explained that all that matters is the number of mature follicles before the trigger and not two days later. Since it was a weekend I had gone to their main office (not the one closest to me that I regularly see) for the IUI and there was a different nurse there who cancelled my IUI. Anyway since nothing could be done after that I waited for AF. AF came early at 12DPO and I started cycle 2. The plan was to be more cautious and go with only injectables (no Femara) this time. Also we decided to do a sperm analysis on DH since his last was done on Apr 2008.
The results were not good. His count and mobility were great, but morphology was bad.
Count - 114million (normal - greater than 20mil)
Mobility - 65% (normal - greater than 50%)
Morphology - 1% (normal - greater than 14%)
The doctor is not sure what could be the reason but with such low morphology our chances of getting pregnant even with an IUI is really really low. We got the results on CD10 and I had already taken about 15 of the Menopur vials. So we decided to continue with this cycle. They have recommend lifestyle changes and vitamins for DH and it might take up to 3months to see an effect. Below are the details of this cycle.

Lining - 4.5mm
E2 - 13

CD3-CD4: 150IU Menopur
CD5: 150IU Gonal F

Lining - 6.4mm
E2 - 47

CD6-CD8: 150IU Menopur

Lining - 7.5mm
E2 - 31

CD9-CD11: 225IU Menopur

Lining - 10.4mm
E2 - 77

CD12: 300IU Menopur
CD13: 150IU Menopur + 150IU Gonal F

Lining - 9mm
E2 - 124
Rt ovary - 11mm

CD14: 300IU Bravelle
CD15: 300IU Menopur

Lining - 9.4mm
E2 - 415
Rt ovary - 14mm
Lt ovary - 13mm

CD16-CD17: 300IU Menopur

Lining - 11.7
Rt ovary - 17.1mm, 12.1mm, 9.5mm, 8.4mm, 7.5mm
Lt ovary - 15mm, 10.8mm, 9.1mm, 8.5mm

CD18: 300IU Menopur

Lining - 9.9mm
Rt ovary - 20.5mm, 12.8mm, 9.9mm, 9.3mm, 9mm

Lt ovary - 18mm, 10.8mm, 10.6mm, 10.1mm

The reason for a mix of medications is because I kept running out of meds and my favorite nurse tried to help me with whatever she had at hand. In fact one day FedEx misplaced all their packages from the fertility pharmacy and so I had to get some replacements from my nurse. I am beginning to think that the universe is conspiring against me.

HCG 10,000IU trigger shot on CD19. Because of my husband's low morphology we decided to do 2 back to back IUI's on CD20 and CD21. The IUI's did not hurt and his post wash count was a good 55.5million on CD20 and 33.3 million on CD21. So officially I am in the 2 week wait. Because of my risk of over stimulation we are not doing the HCG booster shots for Luteal phase support. Instead I am going with the progesterone gel (Crinone) for 2 weeks. I go back in a week for my progesterone test (to see if I ovulated).

On CD18 (Saturday) I had to go back to the main clinic 1.5hrs away for my ultrasound. The nurse there convinced me that I need to go 2 more days, but I insisted that I want to be checked the next day. I drove another 1.5hrs on Sunday and I am so glad I did. My follicles suddenly grew fast and were the right size for trigger. If I had listened to the nurse then they would have been too big on Monday and I might have had another cancelled cycle.
I am slowly beginning to not like this clinic as they are not too aggressive and all of the nurses are never on the same page. Also my favorite nurse is leaving. We have a really really low chance of pregnancy this time with only 2 mature follicles and 1% sperm morphology. We have decided to take a break for 3 months to see if his morphology improves. At the end of 3 months he goes back for another sperm analysis. If the morphology improves we try another injectable cycle (with IUI) with another clinic. If the sperm analysis results are the same, then IVF with ICSI is our only option. So far I have spent about 6K on meds and tests for the past 2 cycles. Since insurance does not cover any of this, the cost of IVF would be about 20K. With our savings we might be able to do one IVF cycle without going into debt. I am really hoping that we get pregnant soon and not have to go the IVF way.
Also at home things are not easy and both me and DH are getting mad at each other for everyday things. I think the 3 month break would be good for us and also help us think with a clear head on what to do next. Although the head understands all of this the heart wants to be pregnant asap. What to do I am a heart person for the most part. So now I am onto micro-analyzing my symptoms, stopping my morning coffee and telling the eggs & sperms to fertilize & implant.

Monday, August 29, 2011

Cycle1, CD20 - IT SUCKS


Friday Ultrasound:
Lt ovary: 21mm, 17mm, 16mm, 14mm
Rt ovary: 14mm, 13mm, 12mm
Lining: 12.9mm

I was given the go ahead to do the trigger shot at 10pm that night and IUI was scheduled for Sunday morning 10am. I was really excited that this time we had 2 good ones to work with. Sat night I have some mild stomach bloating and pain.

Sun morning before IUI I asked the receptionist to check with the nurse if I needed an ultrasound because of the pain and they said that I didn't. So my husband went ahead with the sperm collection and we were waiting for the IUI. Since my insurance does not cover any of this we paid for the IUI too. Just before putting the cath in the nurse suggested that we do an ultrasound to be sure. My ovaries usually are not that visible during vaginal ultrasounds so the tech had to do it abdominally. Then we are back in the room waiting for the IUI, the nurse walks in and says that I have too many follicles and hence we need to cancel. She goes on about multiples and the risks associated with it. I guess I had 5 above 16mm and 2 around 15mm. The lining was at 20mm. Both me and my DH were so disappointed. The on-call doctor (a different RE from the same practise) also walked in and told us the risk involved and was trying to push us to towards IVF for the next cycle. We told him that it was too expensive for us (without insurance coverage) and also it was too early as we've only tried one cycle. I was still in shock and didn't know what to do. We came home and I was upset the whole day.

Today when I look back at Friday's results I am so confused. I did have a lot of 14mm and 16mm on Friday so why did they not cancel it on Friday itself? Also they did not recommend an ultrasound before the IUI so did that mean that they were not worried about the other ones maturing? Why did they not do the ultrasound before the sperm collection (We have ended up paying for a cancelled IUI)? Can the lining go from 12.9mm to 20mm in 2 days? Why did they increase my dosage from 225IU to 300IU on Wednesday? I have spent about 2100$ on medications this cycle and that's a lot of money for a cancelled IUI. My RE's office has still not returned my call. So I am still mad and with no answers.

Wednesday, August 24, 2011

Cycle1, CD15

Lt ovary - 15mm, 12mm
Rt ovary - 10mm, 10mm
Lining - 11.3mm
Estradiol - 152 (a lil better)

Last time my lining was at 10.4 during trigger so I am beginning to worry that its going to be too thick (even though the nurse assures me that its OK). Also the follicles are taking forever to grow. The plan is to take Menopur 150IU and Bravelle 150IU today and Menopur 300 IU tomorrow, and go back for an ultrasound on Friday (CD 17). Hopefully I should be able to trigger then and have the IUI over the weekend. I am still waiting to hear about the estradiol values.

By Friday I would have used 23 Menopur vials (75IU) and 6 Bravelle vials (75IU). The last time I used 30 Menopur vials (75IU). So I guess we are pretty much close to that and the additional Femara this time has done nothing except causing low estradiol values. My body does take its own sweet time to grow eggs and never grows more than one in a cycle. Lets see what happens this time.

Tuesday, August 23, 2011

Cycle1, CD14

HSG on CD7: After some initial difficulty finding my cervix they were able to find it and cath it. The radiologist came and the die was inserted. The uterus looked good and both the tubes were open and good. The whole process lasted about 20-25min and my husband was allowed to stay in with me. I had some minor cramping for the next two days but nothing too bad.

I took Femara 5mg between CD3-CD7 and Menopur 150IU between CD8-CD9. Estradiol on CD3 was 65.
Ultrasound showed no significant follicles yet.
Lt ovary: a lot of small ones
Rt ovary: one at 10mm
Lining: 8.4mm
Estradiol: 21 (low)

The plan was to increase and continue the Menopur. Took Menopur 225IU between CD10-CD12.

Ultrasound revealed some good follicles.
Lt ovary: 13mm, 9mm
Rt ovary: 10mm, 9mm, 8mm
Lining - 9mm
Estradiol: 38 (still too low)

They think the Femara is still in my system and is causing these low Estradiol values. Plan is it to increase the dosage to 4 vials - 300 IU. I did not have any medication for yesterday hence the clinic gave me some Bravelle to take instead of Menopur. I am not sure if it is good to switch during the cycle but do not have another option. So took Bravelle 300IU on CD13 and will be taking Menopur 300IU on CD14. Will be going back for ultrasound & blood test tomorrow morning.

I am slowly beginning to loose hope as it is taking too long (as usual) and the estradiol values are so low (something that's never happened before). Hopefully I will have some good news tomorrow.

Tuesday, August 16, 2011

Cycle1, CD7

So I started this cycle last week and went for the usual baseline ultrasound (on day 2).

Left ovary: 19 eggs
Right ovary: 15 eggs
Uterine lining: 5.3mm

Everything looked good and I believe the blood tests were normal too as I was given the go ahead to start the leterozole. This cycle we are doing a combination with leterozole and menopur. So far the plan is to take leterozole for days 3-7 and then menopur (150IU) for 3 days. I go back for an ultrasound on Friday and based on that I will take the menopur for more days if needed. I also have my HSG scheduled for this afternoon. Hope they find my cervix this time, else this cycle is a bust. Also if they find something wrong with the tubes or the uterus, then this cycle is a bust. It will suck as I would have finished taking the entire leterozole by then. This cycle we are also going with an IUI, as that's what worked last time.

Things are so different this time around as I do not have a lot of free time worrying about the whole process. My daughter and my job keeps me busy for the most part and I am too tired to stay up and think. I hope less stress means good news for IF so lets see how things progress.

Tuesday, August 9, 2011

Back again for the second round

My daughter is about 2 years old now and we think we are ready for the next one. For the first year after her birth my cycles were regular. Then they started getting irregular typical PCOS style. We went back to the clinic 2 months ago and met with the doctor to come up with a plan. The plan is to test AML (mine was at 6.2 again its high which indicates PCOS) and do a HSG before starting any other treatments. I also went back on Metformin extended release 1000mg two times a day. This time the metformin is giving me a lot of nausea and I am hoping that my body will get adjusted soon. I did go for a HSG 2 weeks ago but it was a major flop. The guy tried for 45min and could not find my cervix. The whole process was both painful and uncomfortable but not too bad. I do have good pain tolerance I think. It was also day 10 of my cycle so I could not schedule another one this cycle.
I am back on progesterone to bring on a bleeding and once I start the next cycle I will get the HSG done at a different hospital. Also we are going with leterozole and injectables for the next cycle as the cost might be a little less doing a combination instead of only injectables. My insurance does not cover any infertility treatment costs. My body does not do well with both clomid or leterozole. The last time I did leterozole I got a lot of migraines and the egg growth was slow. I am hoping that the combination might work better. The doctor is also worried about overstimming but knowing my history (3 clomid rounds, 1 leterozole round, 1 injectable round) I have never grown more than one egg per cycle, I am not so worried.
DH is still not completely on board with this as he thinks its a little too soon but I want to start as we never know how long it is going to take this time. Just because it happened in 6 months last time does not mean it will be the same this time. Also I have a very active toddler to deal with at home and a full time job.
I did continue reading some of favorite blogs and I guess pretty much everyone I followed has a kid now. That's a lot of good news. Wish me luck friends and here's wishing loads of luck to all of you out there.