Feeds:
Posts
Comments

Archive for the ‘and this is where it started to go downhill’ Category

Reading Between the Lines

Posted in 2ww, and this is where it started to go downhill, IVF#1 on February 15, 2009| 6 Comments »

Get it? Reading between the lines? Like, if I had two lines and you had to rea… oh forget it, they always say that it’s not funny if you have to explain the joke. Onward and upward…

ANYWHOZIT: The point, for those still reading (and I wouldn’t blame you if you’d stopped bothering after that lame-assed joke), is that I recognize that I’ve obscured the facts somewhat in the last few posts. So let me clear it up for those who have emailed me (though, to be fair, most of you HAD seemed to understand where I was going with it all)…

Yes, I have POAS’d. No, there were not two lines. Well, I mean, if you took TWO of the tests and put them together, you’d get two lines, but I doubt that’s what any of you meant. Yes, this was a direct violation of my doctor’s orders. But it’s not like it was going to change the end result. Wednesday’s beta will still be whatever Wednesday’s beta is going to be. Plus, SuperNurse said I could pee on anything I wanted, so long as I was going to be sane about it (e.g. not call her every five minutes with the latest test results freaking out).

I’m very uncomfortable, both because of the giant lumps on my, ahem, posterior, and because I am extraordinarily crampy. I have little question in my mind that if it weren’t for the blasted PIO, I’d be on CD-something right now based on how I’m feeling. Yes, I’ve tried a heating pad for both pains. No, it’s not helping. Thanks for the suggestion. The warm heating pad sure is snuggly, even if it doesn’t help. And the cats like it, too (bonus).

And now I get to hang out until Wednesday when I have my beta and can ask what my next steps are. I might call on Monday to schedule an appointment for a consult with SuperDoc, preemptively. I know it’ll take a while to get an appointment with him, so I may as well get it on the books. I could always cancel it if (hah!) today’s test results were somehow mistaken.

To answer Lori’s comments….

I know my clinic did not allow back-to-back cycles. Your body needs a little downtime after all that.

Different clinics have different protocols. And some are satisfied that the month on BCPs = sufficient downtime before starting over. That isn’t the same as going straight into another stim cycle, which is what back-to-back IVFs would actually be. A month of BCPs IS actually time off between cycles. I just don’t know if that’s sufficient for my clinic because in my efforts to be more “go-with-the-flow” than I naturally want to be, I just forgot to ask.

If your beta is negative do you have a consult before the next cycle? My clinic did. You should SO push for a cycle without Lupron.

They don’t require a consult between cycles – that’s really my call. I don’t currently have a consult scheduled, but I might schedule one. I haven’t really decided what to do. As for pushing for a cycle without Lupron… to be honest, I’m tired of pushing. I pushed and pushed through my first round of infertility treatment, and I’m really done with that. I have full faith and confidence in my doctor and his expertise. I don’t have the emotional energy or the mental capacity left to play back-seat-patient. Certainly, I will ask what he thinks of doing an antagonist protocol instead, but I will not push for it. If he has a reason he doesn’t think that’s the answer, I’m not going to rock the boat. The headaches from Lupron suck mightily. There’s NO question. I would love to be without them. But the fact of the matter is that if the protocol ultimately works and I get to hold a baby in my arms sometime in the next year or two… I won’t give two hoots about the headaches (though I reserve the right to complain about them here, while I’m going through the process).

Finally, I know it ain’t over ’til it’s over, and the fat lady hasn’t sung yet (wait, I *did* sing bedtime songs to my kids tonight…), but I know that the reality is that this isn’t going anywhere. Many of you have emailed me directly to express your sympathy for this (and boy, will *I* feel stupid if I end up with a positive beta on Wednesday! Hah!), and I do appreciate it. I’m okay, though. I’m sad about the lost time and the lost chance and the fact that only 2 opportunities remain without some seriously creative financing, but I’m really okay with giving this another go. I’m eager, in fact, to keep moving. And like I’ve said all along – the good news is I love SuperDoc, SuperNurse, M (sonographer extraordinaire), J (Marketing Supervisor Extraordinaire)*, and everyone at my clinic. So is it really so bad to have to spend some more time with them?

—————————-
*Er, not that J has anything to do with my treatment cycles or anything, because of course he does NOT. But at least I get to barge into his office now and again and drop random boxes of cookies on his desk and harass him. That part is fun for me. 🙂

Read Full Post »

Too Late to Say it's Too Early

Posted in 2ww, and this is where it started to go downhill on February 15, 2009| 2 Comments »

I will now postulate that at 8dp6dt, aka 14dpo, it is now too late to say it’s too early to tell anything.

No news. I don’t expect this to change come beta time. Still don’t know what the plan is – whether I have to take off a month before rolling in to BCPs or whether the month of BCPs IS my month off. Different clinics have different policies, and I don’t know what my clinic’s policy is. I do remember back in 2007 when I had my original IVF consult with SuperDoc he had said that I wouldn’t be able to do back-to-back IVF cycles, but that could still be that he was referring to the BCP month in between.

I don’t love not having a plan.

Frankly, I don’t even know how we’re going to pay for another set of coinsurances/copays again right now anyway – we just had a major huge crisis in our house which will likely involve digging up our entire yard to fix a broken water pipe to the tune of several thousand dollars, so it may be out of my hands for a while regardless, but I’m hoping not. We’ll just have to see.

Anywhozit, we’ll just see what happens. Wish I could just stop taking the PIO, but I’d probably get yelled at by SuperNurse on behalf of SuperDoc if I did that before beta day. So stick it out (pun intended), I shall.

I do not like not knowing the plan.

Read Full Post »

I don't care if it only takes one

Posted in and this is where it started to go downhill, embryology report, IVF#1, transfer on February 3, 2009| 12 Comments »

Yes, people, I know it only takes one. I get that. But the cliche isn’t helping me right now. I have a right to wallow for a few hours in my less-than-stellar news, and that’s precisely what I’m going to do now, because today’s news was even less promising than yesterday’s news.

Let’s Review:

Going into Retrieval: We were expecting 4-6 eggs (not stellar news, but at least we were expecting not stellar news)

Retrieval Day: 10 eggs retrieved! (Double what we expected! A great number, all things considered)

Day 1 Fert. Report: Of the 10 eggs retrieved, 9 were mature (1 post mature) and all 9 fertilized and were 2 celled embryos (unbelievably good news! I was stunned and overjoyed by this news!)

Day 2 Embryology Report: 1 didn’t make it at all, 6 2-celled embryos still (1 with no change; not a good sign), 2 6-celled embryos (with 10-15% fragmentation, not good). Not a good enough report to warrant a 5 day transfer. Transfer scheduled for day 3 at 2pm. Disappointing news at best as with Single Embryo Transfers, they always try to go to blast in order to find the cream of the crop when possible.

Day 3 … (Today):

I’m on my way in to work and the weather is crappy, my head is pounding, my tushie is sore from the PIO shots, I’m cranky. You get it, right?

I’m walking out of my parking garage on my way into my office juggling my keys, my briefcase, a couple shopping bags (I bought candy to re-fill the candy jar I keep for people to snack on in my office), and my phone rings. I’m fumbling for it, but I have to pull off my glove (did I mention it’s snowing?) to get it open and turn it on; I almost miss the call. It’s my nurse at Ye Olde Fertility Clinic.

“Hi Perky One*, it’s NurseAwesome*. SuperDoc wants to talk to you.”
“Yeah? All right,” I sighed.
“You okay??”
“Yeah. Yeah, I’m fine.” I said, knowing that this just wasn’t going to bode well.
“Okay, hang on, here he is.”

Why the man couldn’t have just dialed the phone himself is beyond me. Because that introduction is exactly what gave me the anxiety I had, you know. But whatever. I do love him, and I know he has my best interests at heart. And for all I know it was NurseAwesome that wanted to make the call to me so that she could guage how I was doing, since she knows how pissy I’ve been all cycle. (Update: It turns out that SuperDoc did call me directly himself – but he called me at home and left a message at 8:45. Of course, I wasn’t home – I was on my way to work. NurseAmazing knows better, and she knows me well enough to know that I probably wouldn’t have been okay with just hearing a voicemail on my home number … which I may or may not have checked before I went in for my appointment this afternoon, by the way … so she probably said, “Yeah, no, we’re going to call her cell phone now.” That’s why I love her.)

So he said he took a look at the embryos with the embryologist this morning and what I’ve got is a 7-cell, a 6-cell, a 5-cell, and 2 four cells. If I were any other patient, with their normal criteria, he’d be recommending a two-embryo transfer today (day 3), but he does NOT recommend that with my history. With HOMs at home, and with my pregnancy history (e.g. not good) and with my need to ensure I do not get pregnant with twins (unless, you know, they’re monozygotic, in which case, we just had no way of controlling that risk), he is wholly opposed to a 2-embryo transfer. Which is good, because I am also opposed to it. My exact words were “absolutely not.” And he responded, “We are on the exact same page, don’t worry, I’m not recommending it – I would caution against it.”

My embryos look pretty crappy. They do not meet the criteria to go to a 5 day blast, but given the choice between picking a crappy single embryo for transfer today as planned or trying to grow one to blast by Thursday or Friday, he thinks our chances are better if we wait. He believes we are likely to have one at the blast stage if we wait.

So what happens if we don’t have any blasts by Thurs/Fri? We transfer whatever the best we’ve got is. And what if there’s nothing? We scrap the whole thing and start over. After all, we were all set to cancel this cycle last week before we got to retrieval, remember? It’s really no different, except that now we’ve been through a lot more hell than if we’d canceled ahead of time. But at least now we’ve got more information, right? What I don’t know is whether this would count as a full IVF cycle for insurance purposes if we don’t make it to transfer. My guess? Once you get to retrieval, it counts. That being said, my doctor is confident that we’ll have something to transfer either Thursday afternoon or Friday morning, it’s just a question of quality.

And so it goes.

*Note, she did actually use our real names… she doesn’t refer to herself as “NurseAwesome” though she’d be perfectly justified in doing so.

Read Full Post »

Change in Plan

Posted in and this is where it started to go downhill, IVF#1 on January 26, 2009| 2 Comments »

Update from SuperDoc – raise Follistim dose to 150IU. Back on Wednesday for monitoring. Wednesday is the worst possible day for me to deal with monitoring. My husband is going to work at 6:30am and I’m on duty at home until 7:30 and then have a myriad of other things to do. Dammit.

My nurse thinks we’ll get 7, not 4. I guess we’ll just see. I’m inclined to scrap the whole thing, frankly. This just hasn’t been going as expected, but I guess – when has it ever?

Frick.

Read Full Post »

Calling all Assvice

Posted in and this is where it started to go downhill, IVF#1 on January 26, 2009| 8 Comments »

Right: 19.6, 12.1
Left: 14.8, 13.1, 13.9, 13.4, 9.9, 9.8

Basically, my doctor is hoping that 19.6 just floats away and that MAYBE we’ll get the others to grow enough by tomorrow to trigger. That would mean retrieval on Thursday, my 33rd birthday. And maybe get four eggs.

Four.

Originally, we were really worried about hyperstimming me. Don’t get me wrong – I’m extremely happy that didn’t happen. But… Four? Now, if I were forty, I’d take four joyfully. If I had premature ovarian failure, or even unexplained infertility, I’d take four. But I have frickin’ PCOS, for crying out loud. Four?

What if we go through all this, retrieve four, at best, and then only 3 actually fertilize, and only one makes it to blast? Or what if none make it? Gah. There are too many “what ifs” involved here. I don’t know what to do.

My doctor is inclined to go ahead with just four. But his original prediction of a 40-45% chance of pregnancy with an elective single embryo transfer (their normal rate of pregnancy with elective single embryo transfers is 67%) is now down to 30%. Me? I’m inclined to cancel. It just seems like an awful lot of work, time, money wasted for … four.

I have three IVF cycles covered per live birth. If we cancel before retrieval, this doesn’t count against my three. I get that I’m “only” on my first, but if that fails, I’m down to two. That’s 30% down.

Oh, there was another option. We could have triggered today and converted to an IUI. Over my dead body. I would have been risking quadruplets if I’d agreed to that.

SuperDoc had students with him today, and while they were poking around at my ovaries I was being as lighthearted and joking away as I could. As he reviewed my previous cycle with them to see what they would think retrospectively, I mocked him a little “Oh no, this cycle will never work. We’ll trigger you early, blow this cycle off – we know you’re moving on next cycle anyway. No possibility you’ll even get pregnant let alone with HOMs!” He said if I weren’t back for more he might pay attention to me. A fair point. I apologized later to one of the students for being such a pain in the ass, but she said it was great comic relief.

SuperDoc was jovial and calming as always, but once I sat up, I got more serious and so did he. I wasn’t happy. He was calm and seems comfortable with proceeding, but I feel like I’m being followed by a shadow. He did note that if we cancel and start over, we’ll start my Follistim at 220 IUs and we’ll be much more likely to see the 15 follicles we expected. Still, like I said, he’s comfortable proceeding as is. Me? I’m not so sure.

I waffle. The Lupron sucks so badly I’d hate to think I took it for two weeks just to cancel.

Sigh.

Update: Thanks, Bean, for noting that I should double check my insurance – I did just that on my way out of the clinic this morning… I checked in with the financial counselor to find out what the financial implications of canceling would be and whether it would count against the three, and the long and the short of it is that each of the monitoring appointments would get billed separately to my insurance and I’d have my copayment for those and coinsurance for all the labwork. I had her double check to make sure that the cancelation would not count against the three cycles and it will not.

Another Update: the 19.6 is not the one. By Thursday, it’ll be gone. Definitely good points for moving forward, but it’s a lot of money I stand to lose.

Read Full Post »

Sigh *Update*

Posted in and this is where it started to go downhill, IVF#1 on January 25, 2009| 2 Comments »

Not great news this morning. When I was doing IUI I never could get a dominant follicle to grow at the right time. Now I’m doing IVF and I don’t want a dominant follicle and guess what I’ve got? Yep. That sucker is still growing and coming out on top. Lots of good medium ones, though, so maybe they’ll just let that one go. I didn’t like the looks of it and neither did the sonographer extraordinaire, M. No doctor in monitoring again today. I’m feeling the love, let me tell you.

Probably have to go back tomorrow, but will update more later when I hear from my nurse. But for now, not feeling the warm fuzzies.

Right: 17.0, 10.5, 8.1
Left: 12.5, 12.0, 10.9, 10.0, 7.7, 7.6

Yeah, not looking so hot. Possible they’ll just let that 17 go and hope the others take over. But the risk with any dominant follicle is that it’ll take over and suppress the others. Doesn’t seem to be happening so far, but who knows. I suppose anything goes at this point. I also don’t love the fact that I’m still not looking at a lot of follicles – considering my typical antral follicle counts, this is suprising (My typical antral follicle counts are in the thirties). I know it only takes one to work, but seriously, I have to have something to worry about, right?

Meanwhile, headaches still suck (possible sign that my estrogen is still in the crapper – typical for me), and my ovaries feel like they’re the size of baseballs, though from the looks of today’s monitoring that’s probably not the case.

Update: My estrogen level is 226 (not great, but good rise from Thursday when it was 99). Meds stay the same, back tomorrow morning. Unfortunately, the only appointment time they had available meant canceling two meetings. Not good. Sigh.

I am not expecting great news tomorrow. Am hoping a doctor actually shows his or her face in monitoring, at least.

Read Full Post »

« Newer Posts