Thursday, March 29, 2012

IVF consult & Mock Embryo Tranfer (a very very difficult one)

The mock embryo transfer was a huge disaster. My inner organs are drastically misplaced. My cervix is way high up (that's why my HSG took 2 tries), uterus is retroverted and right ovary is high up and can never be seen with a vaginal ultrasound. What fun. As if going through infertility is not enough, my body makes it even harder.
As per norm I went with a full bladder. The nurse came in to check if the bladder was full enough and decided that I need to drink another cup of water. The doctor came another 15min later and tried to reach my cervix. He had to use an ultra long speculum and after awhile inserted the catheter. They tried for about 15min to see the catheter and the uterine fundus on the ultrasound with no luck. The 15min was quite painful as they are constantly pressing and prodding and poking and pulling and pushing (all of this with a speculum, clamp & catheter inside me). Finally they decided that I need to empty my bladder. After that the doctor inserted the catheter and with a lot of difficulty and manipulation they were barely able to see the tip of the catheter and the uterine fundus on the ultrasound. So they decided that embryo transfer is going to be challenging.
The IVF consult with the doctor was about an hr long and very informative. He explained the whole process in detail and answered all my questions. With my age and AMH value he thinks that I have a good chance at IVF. But since my right ovary is high up they might not be able to harvest all the eggs from it. In the end it was decided that I am going to need another mock transfer a week before the retrieval to see how things have moved after I start the stimulation. I fall under the 0.01% of women who need to do the embryo transfer with an empty bladder.
The following sums up my whole situation:
1. Stimulation phase - High risk of over stimulation because of PCOS
2. Egg retrieval - Right ovary higher than normal and might not be able to retrieve all the eggs.
3. Embryo transfer - Cervix high up and retroverted uterus makes it real hard for catheter insertion and visualization on ultrasound.
I personally feel all of the above is going to bring my chances of success down. I have read everywhere that a difficult traumatic transfer can cause cycles to fail as the uterus starts contracting and pushes the embryo out. Mine he had to clamp my cervix twice during the trial so I guess it is considered quite a difficult transfer. Even after all that, they could hardly see the top of the uterus (fundus, which is the perfect spot for implantation). Anyway I have been on birth control pills for a month now and will be starting the second set in a week. They did not have any availability till May with their embryologist, hence the 2months of bcp's. The first week of BCP's were horrible. I had a mild headache all the time and was super emotional and cried a lot. Now my body is slowly getting used to it. I will be on the standard long lupron protocol and will be starting lupron in the end of April.
Things are getting better with DH. He has agreed to be more understanding and more helpful. But he definitely does not want me to tell friends or family. So friends from the blog world are my only vents and support system. I am a little scared about getting through retrieval and transfer and the rest without involving our friends or family. We are planning on telling our nanny so that she can do additional hours around that time. My doctor wants me to start acupuncture now and I start stimulations in May and it feels a long time from now. Hopefully I get to relax and rest a little in the next month.

Wednesday, March 21, 2012

Moving on to IVF

After lots of research we have decided to go with Albrecht Womens Care. I love Dr.Albrecht and the staff there. Even though CCRM has the best lab, since this is our first shot at IVF and with no previous miscarriages or genetic issues I think we do not need to spend the extra 5k to go to CCRM yet. This might change in a few months though.

So far the plan is to be on Birth Control Pills for about 2 months and to start stimulation in May. I stopped bcp's about 5years ago and being on them again has reminded me how awful they are. I have a mild headache pretty much all the time and sometimes a full blown migraine episode. I have been feeling really low and depressed and keep crying for everything. I hate being this emotional and sensitive but do not have much control over it. It also does not help that I am going through all of this alone (as we have not told any friends or family) and can't discuss much with DH as I am really scared that he might go back to not wanting another child.

We also did our infectious disease screening and some additional testing for me last week. I am low on vitamin D and iron and will have to start taking supplements for those (as if I am not taking enough medications already). I am also borderline high for a blood sugar test and have to start exercising (yeah I have so much free time between appointments, full time and looking after a very active toddler).

Infertility sucks (no matter first time or second time). Tomorrow is our IVF consult with the doctor along with consent signing, medication teaching and mock transfer. Since his clinic is 1.5hrs away from home we are trying to get as much done as possible with our visit tomorrow. I already have my list of questions ready for the consult and hoping to hear some encouraging information.

Tuesday, March 6, 2012

Cycle3, CD40, 16DPO - BFN

So far this has been the hardest of all my cycles. It could be because I had to switch clinics mid-way or it could be because I used so much medication (66vials of Menopur) and it took forever for the follicles to grow or it could be because I had great follicle size, great lining and amazing sperm count during my 2 IUI's or it could be because I had the best progesterone value so far (44.5) and it kept increasing during the luteal phase (66) or it could be because I had lots & lots of pregnancy symptoms this time (sore boobs, lower abdominal cramping, yeast infection, light headed) or it could be because my doctors office has already called me three times to actually confirm that I have started a period as they were also sure that this cycle worked. On the whole it has been freaking crazy. I still cannot believe that this cycle did not work. My doctor & the nurses cannot believe that it did not work. I think I cried a lot yesterday and I cannot actually remember the last time I cried so much (it was that bad). On top of it all DH keeps changing his mind about wanting another baby. His reasons are really not valid  and he is being sooper insensitive to what I am going through. I am already in so much pain (physically & emotionally) that this cycle did not work and he wanted to tell me yesterday that he does not want any more kids. He could have waited a few days to make this announcement cos we are not doing anything this cycle but just resting. Anyway after further discussion he is open to one more round. IVF is going to be our next option. It is going to be very expensive, very time consuming, very stressful and mostly I will have to go through it alone. None of our friends or family know about this and I don't think I can lean on my husband for support anymore. He would mostly be a little more than a sperm donor. I am trying to tell myself that I am strong and can do this on my own. My dd is a huge support as seeing her gives me all the courage I need for now but I am scared (a lot). We still have to decided between clinics and so far are considering the following 3 clinics:

pro - nation wide excellent rating, great lab, great doctors, 30min drive from my place, my favorite nurse from conceptions works here now
con - most expensive of the 3

pro - about 3K cheaper than CCRM, great lab, 25min drive from my place
con - my Aug-Sep and Sep-Oct cycle was with them and did not like their approach. I started my Jan cycle with them and they had me cancel halfway through (when I actually moved to Dr. Albrecht and he helped me continue the cycle)

Albrecht women's care:
pro - Absolutely love Dr. Albrecht (he was with conceptions when I cycled for my first child), Love the nurses, least expensive
con - 1.5hrs drive from my place, not much info about their IVF success or lab on the Internet

As of now the approximate quotes I have from the 3 places are CCRM - 16K+, Conceptions - 13K+, Albrecht - 10K+. It will be nice to hear feedback from fellow IFers in the Denver area.

Thursday, March 1, 2012

Cycle3, CD35, 11DPO

Symptoms so far:
10DPO - lots of lower back pain with continous standing in the evening
11DPO - lot of cramping in the lower abdomen with 2hrs of shopping

My day 23 progesterone came at 65, again a very good number. Also the cycle I got pregnant we triggered on Day 23 same as this cycle. So my hopes are crazy high and if things don't work out its gonna be bad.