Cycle 5, FET1, CD30 - BFN

Aug30 - CD24 - Endometrin
                           Symptom - hot flashes

Aug31 - CD25 - Endometrin
                           Vivelle patches - 5
                            Symptom - migraine

Sep1 - CD26 - Endometrin
                        Symptom - migraine
                        HPT - BFN

Sep2 - CD27 - Endometrin
                         Vivelle patches - 5
                         Symptom - migraine
                         HPT - BFN

Sept3 - CD28 - HCG < 1, E2 - 245.75, P4 - 6.81
                          Endometrin
                        
Sep4 - CD29 - Endometrin
                         Vivelle patches - 5

Sep5 - CD30 - Endometrin

I do not understand why my clinic wants me to continue all medication till my second beta even thought my first one came at less than 1. I so badly want to be done with this cycle and move on. I cried some over the weekend when the HPT's turned up negative and so was prepared for the actual beta results. Tomorrow I go for my second beta and then I get to stop all medication (personally I do not have any hope and feel like wasting the medication). Slowly a fear of not being able to have another child is creeping in. We still have 2 more frozen embryo's to try. Hopefully that should work.

Cycle 5, FET1, CD23

Aug23 - CD17 - Doxycycline
                           Medrol
                           Endometrin
                           Vivelle patches - 5

Aug24 - CD18 - Doxycycline
                           Medrol
                           Endometrin
                           Acupuncture before and after transfer.
                           Symptom - mild cramping

Transfer was a little harder than the previous time but not too painful. Transfer was done with an empty bladder and that cause some difficulty in visualizing the catheter through ultrasound. The doctor finally saw the catheter and transferred two embryo's. The 4AA embryo thawed perfectly, but the 3AA was not so good. The picture for the 3AA one looked quite different. Came home and started my 3 days of light activity.

Aug25 - CD19 - Doxycycline
                          Endometrin
                          Vivelle patches - 5
                          HCG Booster shot
                          Symptom - mild cramping, bloating, tiredness

Aug26 - CD20 - Endometrin
                           Symptom - sleepiness, tiredness

Aug27 - CD21 - E2 - 174, P4 - 6
                           Vivelle patches - 5
                           Endometrin
                           Symptom - hot flashes, lower back pain

Aug28 - CD22 - Endometrin
                           HCG Booster Shot
                           Symptom - hot flashes

Aug29 - CD23 - Endometrin
                           Vivelle patches - 5
                           Symptom - hot flashes, coming down with cold, mild  
                                             nausea                                                     
I am going from extreme belief to extreme denial that this cycle is going to work. I really want it to and cannot believe I need to wait 5 more days for my first beta. As usual my clinic does not call after the first beta so I will have to call the lab directly and find out the results myself. I cannot do HPT's this time as I am giving myself the HCG booster shots. I am planning to do one on the day of beta - Sep3.

Cycle 5, FET1, CD16

The last few months I have tried to distance myself from the upcoming FET cycle. Somehow I did not have the compulsion to read about it, to track it or even write about it. The obsession has gone and I am not sure if it is good or bad. Today I received some not so good news and hence wanted to write a post to keep track of things incase I have another cycle coming up.

I was on birth control pills for about 5 weeks.
Aug1 - Started Lupron 10units

Aug7 - CD1 - Lining  - 4.5mm
                       Estradiol - 18
                       Lupron - 5units
                       Vivelle patches - 2

Aug8 - CD2 - Lupron - 5units

Aug9 - CD3 - Lupron - 5units
                      Vivelle patches - 4

Aug10 - CD4 - Lupron - 5 units

Aug11 - CD5 - Lupron - 5units
                        Vivelle patches - 4

Aug12 - CD6 - Lupron - 5units

Aug13 - CD7 - Estradiol - 80
                         Lupron - 5units
                         Vivelle patches - 4

Aug14 - CD8 - Estradiol - 170
                         Lupron - 5units
                         Vivelle patches - 5 (added one new)

Aug15 - CD9 -  Lupron - 5units
                          Vivelle patches - 5

Aug16 - CD10 - Lupron - 5units

Aug17 - CD11 - Lining - 15mm
                           Estradiol - 210
                           Lupron - 5units
                           Vivelle patches - 5

Aug18 - CD12 - Lupron - 5units

Aug19 - CD13 - Vivelle patches - 5
                           HCG trigger shot

Aug20 - CD14

Aug21 - CD15 - Doxycycline
                           Medrol
                           Estradiol - 118
                           Endometrin
                           Vivelle patches - 5

Aug22 - CD16 - Doxycycline
                           Medrol
                           HCG booster shot

Transfer is scheduled for Aug24. We are still debating on transferring one or two embryo's. We have really good quality embryo's (3- 4 AA's and 1 - 3AA). We absolutely do not want twins as we both work full time and have another child and also no family around. But with the low estrogen value and too thick lining we are both leaning towards transferring two. Will have to make a decision by tommorrow evening.

Cycle4, IVF1, CD16 - Egg Retrieval story

05/15/12 - CD14:
Morning - No meds (in preparation for ER)
Noon -  No meds
Evening - No meds
Night -  Metformin, Inositol, Cinnamon+Chromium, Doxycycline, Cabergoline, Chlor-trimeton

We went to the lab at around 8:15am and they took us back around 8:45am. The doctor answered our last minute questions and then I was taken inside. DH had to go for sperm collection. Once inside I was given the sedative through my IV and I was in my happy place (as the doctor called it) in seconds. I remember waking up in the recovery room and the nurse told me that they got 31 eggs. The whole procedure only lasted 20minutes. That was a really good number and the doctor was able to get to my right ovary too. I came by really fast and was able to keep down water and crackers, so they kept me in recovery for about 20min and then let me go home. I was asleep for most of the way and came home and dozed on & off till about 6pm. I think because of the pain medication I was totally fine till then. At 6 I started having pain, bloating and uncomfortable feeling in the tummy. I took tylenol for it and took it easy for the rest of the day. Sleeping was hard and I kept tossing and turning. They also told me that I am at high risk for hyperstimulation and so have been watching my weight since then. The cabergoline and chlor-trimeton was added to help prevent this.

05/16/12 - CD15:
Morning - Baby aspirin, Metformin, Inositol, Cinnamon+Chromium, Doxycycline
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Doxycycline, Cabergoline, Chlor-trimeton

The nurse called me with the fertilization report. Out of 31 retrieved only 15 were mature (this was quite shocking to us) and out of 15 mature eggs 11 fertilized with ICSI. We were a little down for the rest of the day as we were expecting a bigger number and the nurse re-assured us that PCOS does produce a lot of eggs but many immature ones. The symptoms were the same with pain and bloating in the tummy and looking 5 months pregnant. Still no weight gain or breathlessness.

05/17/12 - CD16:
Morning - Baby aspirin, Metformin, Inositol, Cinnamon+Chromium, Doxycycline, Endometrin
Noon -  Cinnamon+Chromium, Iron, Prenatals, Medrol, Endometrin
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Doxycycline, Cabergoline, Chlor-trimeton, Endometrin

The nurse called me with the embryo status this morning. Out of 11 fertilized embryos 10 were still growing. We have 4 at grade 1 (excellent), 4 at grade 2 (good), 1 at grade 3 (ok) and 1 at grade 4 (not ok). She said that it was a great report and most likely I will be having a 5dt. I am still waiting for her confirmation call after checking with the doctor. Today's news has been more promising and we hope and that we have atleast a couple grade 1's to pick from for our transfer. I will be nice to have some frozen ones too. We are sure that we want to put back only one grade 1 embryo if possible.

 

Cycle4, IVF1, CD13

05/08/12 - CD7:
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/09/12 - CD8:
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/10/12 - CD9:
Ultrasound - Lining 13mm, Left ovary - 12 follicles, Right ovary - 12 follicles
Estradiol - 1339
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/11/12 - CD10:
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 150IU
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/12/12 - CD11:
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 150IU
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/13/12 - CD12:
Ultrasound - Lining 8.3mm, Left ovary - 10 follicles, Right ovary - 10 follicles
Estradiol -4298
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 150IU
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU, Ovidrel trigger shot

05/14/12 - CD13:
Morning - Baby aspirin, Metformin, Inositol, Cinnamon+Chromium, Doxycycline
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Doxycycline

Because of the number of follicles and high Estradiol values I am at a high risk for hyperstimulation. ER is scheduled for tomorrow morning and I will start additional oral tablets to prevent OHSS along with progesterone suppositories and estrogen patches. The whole process seems so much out of control and I am in a daze. I have lots of abdominal bloating and discomfort and have already gained around 2 pounds in 2 days. Hopefully I will only see the milder side effects and be OK for a fresh transfer.

Cycle4, IVF1, CD6

The second month on bcp's was pretty much the same. Headaches, nausea, tiredness and mood swings. I started Lupron 10units on 04/25/12. The shots were easy to administer and apart from some itching (for about 2min) I do not have any other side effects. I started my IVF cycle almost a week ago and it has been really hard keeping track of all the medicines and shots that I need to take everyday.

05/02/12 - CD1:
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium
Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units

05/03/12 - CD2:
Ultrasound - Lining 6.5mm and no cysts
Estradiol - 9
Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium

Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units

The nurse said that the lining was a little too thick and it would nice to have a bleed. Somehow my body listened and I started bleeding that night. I had full flow bleeding for 2 days and then it was just spotting. Also there was a confusion about my medication. Their charts indicated that I was supposed to start Gonal-F whereas I got Follistim from the pharmacy. Finally they told me that either one is fine.

05/04/12 - CD3:

Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU

Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

I am doing the Follistim and Menopur on my tummy and the Lupron on my thigh. Got my first bruise from the menopur two days ago.

05/05/12 - CD4:

Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU

Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/06/12 - CD5:

Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU

Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur 150IU

05/07/12 - CD6:
Mock Embryo Transfer 2:
         Today we tried the mock embryo transfer again. I still have some spotting but still they were able to go ahead with the transfer trial. I went with a full bladder and was extremely uncomfortable by the time the doctor came to check me. He finally decided that my uterus is not visible with a full bladder and had me empty it. Then they were able to get the catheter in with a little difficulty and with some prodding and probing the were able to see it on the screen. The doctor was happy and has made lots of notes on my chart as my transfer is going to be quite unique.

Ultrasound - Lining 10.5mm, Left ovary - 5 follicles, Right ovary - 3 follicles
(I am a little concerned about their lining measurement as it was 6.5mm 4 days ago and I have had some significant bleeding since then and was expecting it to be either less or the same).
Estradiol - 252

Morning - Baby aspirin, Dexamethasone, Metformin, Inositol, Cinnamon+Chromium, Follistim 300IU

Noon -  Cinnamon+Chromium, Iron, Prenatals
Evening - Cinnamon+Chromium, VitD
Night -  Metformin, Inositol, Cinnamon+Chromium, Lupron 5units, Menopur150IU

I am developing a mild headache in the nights ever since I started the stimulation. Also last night I was really light headed for a while. I also have my share of the usual tiredness, nausea and hotflashes that comes with going through IVF. So far it's all manageable and I am hoping it stays this way.

Based on today's results I continue the same protocol for 3 more days and go back for bloodwork and ultrasound on 05/10/12.

Preliminary blood work for IVF

Both me and DH went for our preliminary infectious diseases blood work last week. It all came back negative. In addition I had some other things checked and now I am low on vitamin D, anemic and borderline for sugar. My thyroid levels were all normal.
TSH - 1.2 (normal 0.4-2)
Free T4 - 1.09 (normal 0.76-1.46)
VitD25 Hydroxy - 22 (normal 25-80)
Hemoglobin A1C - 6.0 (normal 3.5-5.9)
TIBC - 28 (normal 28-170)
Ferritin - 5.3 (normal 11-307)
I need to watch what I eat and also eat lots of iron rich foods. I am also on supplements for vitamin D and iron. Hope the sugar thing was the side effect from eating unhealthy during the holiday season.

I finished my first month on bcp's and started my bleed over the weekend. It has been really heavy and I feel tired and drained all the time. I start the second round of bcp's today for another 4 weeks and then start my IVF cycle. I hate being on bcps's and because of the clinic's busy schedule I have to be on it for 2 months. I get crazy mood swings, I cry a lot and feel depressed and since I do not have anyone to talk to that just adds to this. The only thing that keeps me going is my daughter. She gives me such precious hugs and kisses and told me this morning that I am her baby. I hope that I don't hurt her in my quest of another child.

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.

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.

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:

CCRM:
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

Conceptions:
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.

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.

Cycle3, CD34, 10DPO

Symptoms so far:
          1DPO - Heaviness in lower abdomen, pain, bloating
          2DPO - Heaviness in lower abdomen, pain, bloating
          3DPO - bloating
          4DPO - cramping in the lower abdomen
          5-9DPO - Pretty much nothing except the occasional twinge in the lower abdomen (this could also be the work of my infertile mind over analyzing).

I was on antibiotics in the middle of this cycle for a cold and now have a very bad yeast infection. I tried Monistat 7 two days ago and was in unbearable pain. The itching, burning increased a lot and I had to stop using the Monistat. This morning my nurse checked me and confirmed that it is indeed a yeast infection and has given me a prescription for Difflucan. A lot of people have mentioned that difflucan is not a good option during pregnancy so I am still a little concerned about taking it. For now I am going to use the external Monistat cream and hope it gets better. If not I will have to end up taking the difflucan. Also because of the internal exam I am having some cramping now.

I went for my day 21 (7DPO) progesterone draw and the value came up at 44.5  which I think is really good. I have never seen anything this high. My past cycle values have been 5, 10, 15 and 19. This cycle has been really really hard for me so far. It could be because I used a lot more medication that I have in the past or it could be because both DH and I are still mad at each other about multiples or it could be because I had to switch doctors in the middle of the cycle or it could be because I have to now drive 1.5hrs (one way) to my doctor's clinic instead of the 25min that  I used to. I hope this was all worth it and I get some good news soon. My beta is scheduled for next Tuesday and I am thinking of testing at home on Saturday which would be 13DPO.

Cycle3, CD26, 2DPO

After all the drama from the previous weeks this cycle did end up with an IUI (If this works I might have to go back to my previous clinic and tell them that they were wrong).

CD18-CD19: 300IU Menopur
CD20:
lining - 11.1mm
rt ovary - 12.5mm
lt ovary - 11.1mm, 12.6mm, 11.6mm, 11.6mm
estradiol - 759

The nurse spoke to me about both follicle reduction and foetal reduction. I was open to the follicle reduction at that point.

CD20: 300IU Menopur + Ganirelix
CD21: 225IU Menopur + Ganirelix

CD22:
lining - 15.49mm
rt ovary - 12.5mm
lt ovary - 18.3mm, 14.3mm, 13.3mm, 13.3mm
estradiol - 853

CD22: 225IU Menopur + Ganirelix

CD23:
lining - 11.86mm
rt ovary - 19.4mm
lt ovary - 21.4mm, 19.7mm, 13mm

They again offered follicle reduction but we decided against it. Our chances of getting pregnant with twins was less than 8% and chances of triplets were less than 5%. We also decided to do 2 back to back IUI's.

CD24: IUI 1
DH's post wash count was 105million.The IUI was easy, with very less discomfort.

CD25: IUI 2
DH's post wash count was 71million. I had some mild heaviness, bloating and pain in my abdomen and so the nurse did an ultrasound after the IUI. Everything looked OK and she said that I was ovulating.

Now I am officially in the 2 week wait. I will be doing HCG shots for luteal phase progesterone support on 2/21, 2/24 and 2/27. I will also go in for progesterone tests on 2/27 and 2/29 and for beta on 03/06.

This cycle my body has needed about 66 vials of Menopur and 3 Ganirelix shots to produce 3 good follicles. The doctor thinks that I would be a better candidate for IVF and we are also beginning to accept the idea. IVF is definitely more expensive but we always run the risk of multiples and over stimulation with injectables in my case and it also takes forever and uses a lot of meds. For now I am hoping that this cycle I would get pregnant with a singleton.

There is lots of tension in the home front because DH wants to go for a foetal reduction in case of multiples and I am completely against it. Now he even thinks that he does not want another child. I am hoping that its just his fear of multiples talking and he will calm down soon. Life is hard and hopefully I will get some much needed good news in 2 weeks.

Cycle3, CD18 - A Big Rollercoaster Ride

CD12-CD13: 300IU Menopur
CD14:
lining - 9.52mm

rt ovary - 8.73mm, 7.34mm, 7.47mm, 5.62mm, 5.52mm
lt ovary - 9.94mm, 8.89mm, 8.27mm, 6.94mm, 6.12
estradiol - 114

The nurse called me last Thursday and asked me continue with the same dosage of Menopur and come back again on Friday (CD15).

CD14: 300IU Menopur
CD15:
lining - 9.17mm

rt ovary - 8.25mm, 7.88mm, 7.90mm, 7.73mm, 6.2mm
lt ovary - 8.7mm, 8.05mm, 7.02mm, 6.62mm
estradiol - 183

The nurse calls me in the evening and wants me to cancel. I did not see that coming. They were in complete panic mode and kept saying that if I continue I would definitely overstimulate. I was confused and very disappointed.

When I went through all of this 3 years ago I saw Dr.A at the same clinic. However since then he has moved out of the clinic and started his own which is about 1.5hrs away. Since the current clinic is only 25min away from my house I decided to go with the same clinic but different doctor (Dr. V) who is much younger and with less experience. So after Friday's drama I decided to change my RE and called Dr.A's clinic to see what they recommend (I had seen Dr.A 2 months ago to get a second opinion on how to proceed). Surprisingly they were happy to take me mid-cycle and wanted me to come on Saturday. The current clinic refuse to give me my stim sheets so I took all the numbers from my blog and went to see Dr. A. He was more than happy to have me back and was amazed that I had kept such good notes for all my cycles (Thanks to blogging). On Saturday's ultrasound the follicles were all still below 10mm and since my Estradiol is not high he wants me to continue with the same medication. We are back on track and even though I have to drive about 3hrs (both ways) every other morning I am more than happy to continue this cycle. We have used a lot of medication already and I don't know how much more I am going to need. Hopefully I get pregnant this time.

CD16-CD17: 300IU Menopur


CD18:
lining - ?
rt ovary - small ones less than 10mm
lt ovary - 12mm, small ones less than 10mm
estradiol - 397

I go back in 2 days for my next ultrasound.

Cycle3, CD12

We did a repeat SA on my DH in December. The morphology increased from 1% (in September) to 7%. I guess the supplements are working. We waited till Jan for the new insurance to kick in. I switched to a new insurance that claimed to cover up to 8000$ for infertility testing and treatment. After many phone calls to the company we have realised that they only cover procedures and not medication. In my case I spend about 2500-3000$ per cycle for medicated IUI's. My nurse thinks that I should consider moving on to IVF to get the most out of my insurance coverage but I am not too sure yet. Both me and DH have our own concerns about IVF and I will have to write a post about that later.
So we started this cycle on Jan 27th with a progesterone induced withdrawal bleed. During my injectable cycle that worked (resulting in DD) 3yrs ago, I used about 30 vials of Menopur. For the Femara-Menopur combination cycle in August I used about 29 vials of medication and for the Sep-Oct Menopur only cycle I used 49 vials of medication. The doctor decided to start at a higher dose of Menopur this cycle in hopes that my body would need less. So far I don't think its working.

CD2:
lining - 4.9mm

CD4-CD6: 225IU Menopur

CD7:
lining - 7.77mm
rt ovary - 4.9mm, 4.18mm
lt ovary - 7.43mm, 7.26mm, 6.42mm, 4.16mm
estradiol - 50

CD7-CD9: 225IU Menopur

CD10: (at the main office)
lining - 9.62mm

rt ovary - 5.98mm, 5.72mm, 4.8mm, 4.31mm
lt ovary - 9.5mm, 8.29mm, 7.41mm, 7.23mm, 6.17mm
estradiol - 59

CD10-CD11: 225IU Menopur
CD12:
lining - 8.7mm

rt ovary - 9.56mm, 7.57mm, 6.1mm, 4.95mm
lt ovary - 9.39mm, 8.15mm, 8.13mm, 8.1mm
estradiol - 53

Since the follicles are all still small and estradiol has gone down they are upping my dose to 300IU for 2 days and I go back for blood work and ultrasound on Thursday. I am already losing hope on this cycle and beginning to think that it will be cancelled because of too many follicles. If that does happen then I am moving to a diff clinic for the next cycle, simply because I believe that this current doctor does not know how to treat me and produce less follicles. I so badly want this to work.

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.

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.

CD2:
Lining - 4.5mm
E2 - 13

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

CD6:
Lining - 6.4mm
E2 - 47

CD6-CD8: 150IU Menopur

CD9:
Lining - 7.5mm
E2 - 31

CD9-CD11: 225IU Menopur

CD12:
Lining - 10.4mm
E2 - 77

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

Cd14:
Lining - 9mm
E2 - 124
Rt ovary - 11mm

CD14: 300IU Bravelle
CD15: 300IU Menopur

CD16:
Lining - 9.4mm
E2 - 415
Rt ovary - 14mm
Lt ovary - 13mm

CD16-CD17: 300IU Menopur

CD18:
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

CD19:
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.

Cycle1, CD20 - IT SUCKS

IUI CANCELLED DUE TO OVER STIMULATION

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.

Cycle1, CD15

Ultrasound:
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.

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.
CD10:
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.

CD13:
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.