Estrogen Level

The nurse just called. From Friday to today, my estrogen level increased from 44pg/ml to 122pg/ml. She said that for the number of mature follicles I have (two), this is close to right on target and that J should go ahead and give me the hCG shot this afternoon. After Googling it (because Google is just as reliable as a real live doctor person), it seems low to me. I've read that your estrogen level should be around 200pg/ml per mature follicle. So, I am a little bit worried that mine is too low.

My curious mind always wants to know what is considered to be "ideal" when it comes to measurements and levels. Then again, I think that too much knowledge can be a dangerous thing for me, as it tends to bring worry and anxiety. Sometimes I think that in terms of trying to conceive, ignorance can be bliss!

Nineteen

Good news! Over the weekend, thanks to the additional injections of Follistim, my follicles grew from 10-14mm to 17.5mm and 19mm! 19mm is the largest I've ever had, so we are encouraged. And while 17.5mm is just on the cusp of being mature, the nurse said that by the time I ovulate, it will have grown a bit. Also, my uterine lining was 13mm and they are looking for a minimum of 7mm. A certain degree of thickness of the uterine lining is required for successful implantation to occur.

The nurse will call us later today. If my estrogen levels are high enough (after a rather painful blood draw from my hand -- ouch!), J will give me an injection of Novarel this afternoon, which will encourage (if not cause) ovulation.

While we were in the waiting room this morning, the woman sitting across from us broke the typical waiting-room-silence and asked how long we have been trying, if we've had any success, etc. She and her husband are dealing with a completely different problem, but it was refreshing to talk to someone that was going through something similar. She has been pregnant twice, but sadly lost both babies.

She told us about a woman she met a few months ago in the office. The woman was Nigerian, and she said that if she doesn't become pregnant soon, her husband will leave her. She said that in her culture, the whole purpose of marriage is to have a family, so if that isn't possible, it's somewhat typical for the man to leave. Imagine! You are going through one of the most difficult, frustrating things you will hopefully ever face, and you have the added anxiety of your husband threatening to leave. My heart just breaks for that woman.

Three More Days

We got a call from the nurse -- my estrogen levels are high enough that they'd like us to do three more days of injections (the free Follistim they gave us!) and return on Monday for another ultrasound. What we're hoping for is to find mature follicles on Monday. The nurse thinks we will see a big difference between now and then. If that is the case, we will continue as planned. On one hand, I am not looking forward to another ultrasound, as we've never gotten good news in the past. On the other, I'm praying and hoping for the best!

Lucky

One more thought. In ways other than reproduction, I am incredibly blessed. J and I agree that this process has done nothing but bring us closer together. We are constantly reminded of how lucky we are to have each other, and that is the ultimate silver lining of the challenges we're facing. I know that we are fortunate -- many would be torn apart in difficult times, but our love continues to mature and grow. For this, I couldn't be more thankful.

Discouraged

Just got back from this morning's ultrasound. I went into it with a nervous stomach. J had to hold my hand the whole time (thank God for him). Each cycle is a little bit harder and brings more apprehension. Like I've said before, though, luckily J has a very positive attitude to balance out my slightly beaten down one.

The results were not great. I had four follicles in the range of 10-14mm. More than last time, but much smaller. They need to be at least 18mm to be considered "mature," and hopefully even larger.

There are two nurses at my RE's office, both of which are extremely supportive, kind, gentle women. We absolutely love them. After our disappointing ultrasound, one of them drew my blood (successfully!) to measure my estrogen level. They will call us this afternoon with the results. If my estrogen level is high enough, I will give myself injections for a few more days, hoping that the follicles will mature further. Then we would return to the office for another ultrasound, hoping for better news. So, it is not necessarily the end of the road for this cycle. However, if my estrogen level is too low or my follicles don't mature any further, we'll have to cancel this cycle.

Two things I should mention.

1. I cried in front of the nurse. I was embarrassed, but couldn't manage to hold it back. Each cycle really does get more stressful. I'm worried that from now on, I may cry at every appointment, now that I've broken that seal, and crying in public is not a good look for me.

2. The nurse asked us if we had any Follistim left. We told her that we had whatever is left in the vial (they come overfilled). She then proceeded to pull 600IU of Follistim out of the fridge (the entire amount we ordered for this cycle) and gave it to us. I told you she was incredible. I later asked J why he thought she was so generous, and he said, "I don't know, but when someone hands you $500, you don't ask questions." Good point, J.

So now, we wait. Part of me is hopeful, and the other part just wants to curl up and be done with this whole thing. We could be one of those couples that has cats and travels a lot, right? Maybe not. Probably not. There are times when it starts to sound appealing, though.

Fragile

You know, under normal circumstances I would consider myself to be a fairly balanced, rational person. But I will tell you this. When J and I are mid-cycle, I could cry at the drop of a hat. My emotions run wild. I nearly shed tears yesterday in Bed Bath and Beyond when I heard "Have Yourself a Merry Little Christmas." Why? I don't know. I'm sure it's partly due to the amount of hormone meddling I'm engaging in. And also, we're always a bit anxious for upcoming appointments, news, and next steps. I would like to thank my friends and family (and most of all, J) for putting up with my antics. That is all.

Just a Little Pinch

J and I are in the middle of our second Femara & Follistim cycle. Last time we did the Follistim injections, I ended up with a nice line of bruises on my stomach -- very attractive. This time, though, I am so far bruise free! Maybe I'm getting better at administering the shots. While it's still not the most pleasant part of my day, I have definitely gotten less nervous about giving myself injections. It doesn't hurt that J is always there by my side.

On Friday, we will go back to the doctor's office to have an ultrasound and a blood test. To be honest, I'm not sure what the blood test is for. Surely they told us, but in the stack of infertility information floating around in my brain, sometimes things get lost in the shuffle. I do know that I despise getting blood drawn by nurses that don't seem to know how to draw blood. I rarely have problems with phlebotomists, but most nurses end up rooting around in my arms, struggling to find a suitable vein. They tell me that I have deep-set, thin, rolling veins, whatever that means. So, really looking forward to that. I am, however, very nervous about the ultrasound. Not the ultrasound itself -- I have become an ultrasound pro. Any last shred of modesty flew out the window months ago. I'm nervous about the results of the ultrasound. I have never had a follicle over 18mm, which is just on the cusp of being "mature." We're hoping, praying, and finger-crossing that this time will be different. Stay tuned.

All Systems Go

We got the "all clear" today. And by "today," I mean 7am, which barely constitutes "day" in my book. For some reason, all of our ultrasounds are at 7am, which is too early for serious matters such as ultrasounds. Luckily for me, J has agreed (much to his benefit as well) to reward me with McDonald's hotcakes after each doctor's visit that involves a shot or an invasive test. Anyway, I'm wandering off topic -- the point is, we're good to go! Full speed ahead!

Cycle Day 2

Finally, I started yesterday. I would apologize for that comment perhaps entering into over-share territory, but I suppose that if you're reading this blog, you are prepared for such a possibility. So, tomorrow we will go for a baseline ultrasound. If we get the "all clear," we're good to go! If that's the case, I'll take Femara for 5 days, give myself injections of Follistim (100 IU as opposed to the 75 IU of last cycle) for 6 days, and then return for another ultrasound. If I have a couple of mature follicles, J will then give me a shot of Novarel to stimulate ovulation. It sounds like a lot of "ifs," and I suppose that it is, but the "if" that I'm most concerned about is having mature follicles. In the past, I have only had one or two that have been in the low end of the "mature" spectrum (17-18mm, in a range of 18-25mm being optimal). Hopefully the increased dosage of Follistim will get things moving.

On another note, J and I received an absolutely beautiful bouquet of roses and lilies yesterday from our dear friend K who lives out west. She wished us luck and told us that she was thinking about us. It was so sweet and unexpected! It's so nice to know that our friends and family are behind us and support us during this stressful-slash-exciting time :)

Here we go again!

About two weeks from now, J and I will be getting back on the proverbial horse. We will be trying the same method that we did in July (Femara + Follistim), only with slightly higher dosages. I am hoping for the best. Praying. Begging. Bargaining. Yearning. Pleading. Willing it to happen for us this time.

October marks a year of trying to get pregnant with the help of a fertility doctor. Last year, I remember looking at my family's annual Thanksgiving picture and sadly thinking, "Darn, I really thought I would be pregnant by the time the 2008 picture rolled around." The 2009 picture is rapidly approaching, and I'm hoping, praying, (see other above verbs) that this will be our year.

It's silly, isn't it? Holding onto arbitrary benchmarks like The Thanksgiving Picture. 27th Birthday. Christmas Parties. Family Vacations. Weddings. But all of these things seem to be constant reminders of the general feeling of, "I thought by now..."

I'm scared. I'm scared to try again and to fail again. To mourn the loss of something (someone) we never had again. To be here again in a month, writing a similar blog.

I've become somewhat pessimistic about this process. My darling husband has a seemingly unending supply of hope and confidence, which is good. If neither of us felt that way, we'd be sunk. I'm starting to get the feeling that, if it didn't happen last time, why would we have success this time? I need to remind myself that we keep advancing in the severity of our treatments and with that comes increasing odds.

A friend recently told me that when this all works out, we'll look back and think, "Hey, that wasn't so bad." And he may be right. I think he is right. The trouble is, I still have that lingering feeling of, "But what if it never works? What if we never get to have a baby?"

We want a baby so badly. To, after all this time, get a positive pregnancy test. To make the announcement to our families. To experience the miracle of pregnancy. To feel a baby growing inside of me. To meet our baby. To name our baby. To have a family. To hear our baby laugh for the first time. To look into its eyes and know that we have been blessed with nothing short of a miracle.

Pleading.