Ultrasound and Bloodwork #2

J and I had an appointment yesterday morning to check my estrogen level and the size of my follicles. This is our first time on a Follistim-only cycle so we're new to the protocol, but it seems like everything went very well! So far, I have 7 follicles on one side and 8 on the other, 4 of note: 12.5, 12.5, 13, and 16.5. My estrogen level was 233, which is almost twice what it was at the end of the last cycle! We are taking this to be good news. RE instructed us to continue with the Follistim injections and come back tomorrow morning for a third ultrasound. If I have enough mature follicles, we will probably trigger in the next day or two. If not, we will simply continue with the shots and return later in the week to check again.

The "danger" of this cycle is that my ovaries may become OVER-stimulated, which is the opposite of what we have had to worry about in the past. The nurse told me that if we end up with five or more follicles of 16+ and an estrogen level of 900-1500, we may be able to continue in the cycle, but they will be very careful to read us all of the fine print before we make that decision. In other words, there will be a much higher risk of multiples. If we reach the point of having even more than that, I believe that they will advise us to cancel, unless we are interested in having our own show on TLC. We all saw how well that worked out for John and Kate.

I'm not too worried. I can almost hear your heads cocking to the side in confusion. But really, because they are monitoring me so closely, I think we should be fine. For the first time in two years, we are actually very optimistic! The nurse agreed that it seems like we have finally found something that my body responds to.

Surprise!

The weirdest thing happened on Saturday -- I started my period! Unprovoked! 6 weeks after the last one! I'm taking this as a sign that my body is working more normally for whatever reason (supplements? yoga? diet?) and that we should be hopeful.

I called my RE's office this morning and, after a massive game of phone tag, found out that there would be a possibility that I would need an ultrasound and bloodwork done during the time that J and I will be out of town for his (first!) marathon. The nurse told me that if we could find a place in Orlando that would be willing to see us and send the results back in record time, we could continue with this cycle. If not, we should scrap it to avoid the possibility of spending $1,000+ and having to cancel mid-cycle.

So, here's the plan. We are going to do a Follistim-only (no Femara) cycle in hopes that I will produce more mature follicles while maintaining a high enough estrogen level. We go in for a baseline ultrasound tomorrow morning at 7am to get things rolling. If we get the "all clear," we will do 4 days of Follistim at 150IU and return on the 5th day for the ultrasound that measures the size of the follicles and the endometrial lining. We will then have ultrasounds approximately every other day from that point on until the follicles are at the ideal size, which they will hopefully reach eventually. If one of our ultrasound dates falls during the time that we are in Orlando, we were approved to go to the Center for Reproductive Medicine (in Orlando) to get that done. We had to figure that out by 3:45pm today in order to be able to begin this cycle and not have to wait until next month, so the past two hours have been a crazy whirlwind of activity around here!

This cycle is a little bit more hardcore than the last, but we are really hoping that it will work! Please send us all of your prayers, finger-crossing, positive thoughts, and general encouragement!

Brief Moment of Self-Pity

A friend of mine is pregnant. She was very thoughtful and told me before the news hit Facebook, as she knows what J and I have been going through. I'm so happy for her, because she recently changed employers (and insurance) and was forced to wait longer than she wanted to start trying to get pregnant. She told me about a year ago that she and her husband would like to start trying but had to wait until August 2009 for her new insurance to kick in. I remember thinking, "Well, J and I have already been trying for nearly eight months. So, by August 2009, my GOD, I'll definitely either be pregnant or have a BABY!" Baby math, as I call it. And yet here I am, December 2009, far from with child.

I realize that it isn't helpful to compare myself to the fertile women around me, but it's hard not to. If you can't wallow in self-pity on your blog, where can you?

J and I spent some time with his family last weekend, which includes our adorable nieces, 5 and 3. They are such sweet little girls and I absolutely adore being with them. They are blonde, blue-eyed little angels that could certainly pass for our children. Being with them makes me realize that much more how eager I am to have a baby with J. Hopefully 2010 will be our year!

Christmas Cards

I caught an interesting post over at Life Happens When You're Making Other Plans. She mentioned the letters we all receive each year around the holidays from friends and family complete with every update on their lives that you could ever want. You know the kind. I suppose that I understand their purpose, but for some reason they have a tendency to get under my skin. Anyway, I had to empathize/laugh/frown/smile at this part of her post:

I don't think anyone would want to get a Christmas letter describing shots in the belly, bruises, ultrasounds, vagaegae cams, egg retrievals, egg transfers, frozen embryos, leaky progestrone meds, mood swings, and miscarriages. Even Santa wouldn't want to receive a letter like that!

Ain't it the truth! I guess it isn't really all that funny, but it made me smile. I know what she means.

Why I Blog

Blogging has been such wonderful (and free!) therapy for me. It has given me the opportunity to vent, complain, and scream, but also to keep records and to give thanks for the good things in my life. I realize that blogging in and of itself may seem like a fairly self-centered activity. We live in a world now where, thanks to Facebook, MySpace, Twitter, Blogs, etc., our stuff is OUT THERE! For all to see! But I am of the opinion that this is mostly not a bad thing.

I never know how much our friends and family want to actually hear about what J and I are going through. I don't know if they want the dirty details of each appointment, cycle, or new prescription. This is another reason why the blog is perfect! If people wish to keep up with us and our IF journey, they can do so at their own pace. And if not, or if they wish to simply ask from time to time, also fine! Believe me, I don't expect everyone to check my blog every day and then hang on my every word once I've updated it. It's probably not all that interesting to anyone but me, and I know that my writing isn't of J.K. Rowling caliber.

I think I just felt the need to put that out there. I am blogging for me. If you want to come along for the ride, fantastic. I really appreciate all of the comments and support, in and out of cyberspace! I've said it before and I'll say it again -- J and I really are supremely blessed with a fantastic support system, without which this rollercoaster ride would be a lot bumpier.

Answered Questions

Yesterday, J and I saw our RE (the actual doctor!) for the first time since February. He joked that we need to get pregnant soon because we're making him look bad! We took that as a sign of encouragement. We wrote down several questions to ask him and got some answers:

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Q: Why have my estrogen levels been low? What can we do?

A: Femara could hinder estrogen levels, so next time we will do Follistim (injectibles) only in hopes of stimulating my ovaries AND keeping my estrogen levels high enough.

Q: Should I schedule hysterosalpinogram to test for blocked tubes?
A: Not necessarily; no reason to believe they would be blocked, and it is an expensive test. However, RE will check with our insurance to see if they will cover it, citing it as a "medical necessity." If they go for that, we'll run the test. May as well!

Q: Is IUI (Intrauterine Insemination) right for us?
A: Not really. J's sperm count and quality are A+, so much so that RE mentioned twice that he should consider being a sperm donor. Most likely a joke (?).

Q: What will our next step be?
A: We can do 2 or 3 cycles of Follistim at a higher dose and for longer (8-10 days). If that fails, we will move on to IVF (In vitro fertilization). Apparently, I am an excellent candidate for IVF because I am young and have none of the problems that can interfere with the success of IVF.

Q: What are our chances of becoming pregnant?
A: "We'll get there." Because of my PCOS, my eggs are just "stubborn." Our main objective is to get them to mature.

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J and I both feel a bit better after meeting with our RE. We think (hope) that our meeting encouraged him to cater our treatments more specifically to our situation. We have to take this month off so that my body can rest, and then I will begin taking Provera again to bring on AF. Then, back on the horse we go!

January is Looming

January will mark two years since I threw out my birth control. It's laughable to me at this point that I ever took birth control. What a joke. It is my opinion that two years is longer than most humans take to do just about anything, let alone produce another human.

Not Pregnant. Again.

Subject line sums it up. More later.

Side note -- I don't know what I would do without J, or my Mom. They are simply amazing. As are the rest of my family, and my friends. You all make this journey so much more bearable!

Questions

Waiting, waiting, waiting...

We will find out in the next week or two. I've managed to keep most of my wits about me, but I'm worried that in the next few days, I'll spiral into craziness. Some questions that are starting to pop up in my nutty head...

How will we feel if we're not pregnant this time? How will we afford to keep doing this? What if we have to go to IVF? What if THAT doesn't work? Why do people keep mentioning the "adoption option?" Why does the mention of adoption make me feel like people are betting against our fertility treatments working? What if I miscarry? How would I deal with a miscarriage after all of this work to get pregnant? Am I more likely to miscarry because of my PCOS and fertility treatments? Has my doctor tested me for EVERYTHING that could be causing problems? What if I have blocked tubes and don't know it? Why is this happening to us? Why isn't it easy for us? Are my friends judging us for spending all of this time/money/effort on trying to get pregnant? Do people have opinions about what we're doing? Are people sick of hearing about this? Is EVERYONE pregnant? How will I feel if person A, B, or C gets pregnant before me? Will I ever get pregnant?

Just a peek inside my messy brain.

Man, this baby-making stuff is pricey!

You know, I think actually having children will be less expensive than trying to conceive them. Because we had to go in for an extra ultrasound and blood test, we owe an additional $277, bringing our grand total for the month close to $1,500. Those darn whippersnappers had better be worth it! I suppose we aren't in a place to complain, though, since they essentially handed us $500 worth of medication last week.