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Archive for the ‘IUI #6’ Category

Maybe not so useless after all?

Is it possible that my formerly-useless left ovary might actually be the producer this cycle? That might, indeed, be a first. Well, a first in the last 6 IUI cycles, anyway. Probably not the first time in my life, though I suppose that's possible. Anywhozit, I had an early-morning monitoring appointment today. It would probably have been more pleasant had I not been babysitting for a friend (I know, I'm a saint) until 1am. I got to sleep around two and was NOT happy when the alarm went off at 6. Oh well. I figured I'd better, you know, shower and all, since I was pretty sure Margaret would be there today (I was right!). Gotta look nice for Margaret.

I got called back for my scan first (No! Throwing off my whole routine! I always get bloodwork drawn first! No fair confusing me!) and after I'd undressed and climbed up on the table (seriously, have they never considered that their patients might be short and fat? Why are those tables so frickin' high?), I briefly considered turning the stirrup covers inside out a la Julie, but changed my mind when I heard the door opening. (I swear, Margaret is desperate to see me in all my glory… she keeps giving me less and less time to get undressed and has walked in a couple times before I've done so successfully. Sheesh! Like she doesn't see enough of me??)

Ahem. Back en pointe. Focus, people! Margaret breezed in all cheery and happy, as always. Dear heavens how does that woman manage cheery at 7 in the morning on a Sunday? Sheesh! She said "We're going to get you pregnant this cycle, gosh darnit." Meh. I shrugged. I'm not counting on it, gave my usual shpiel about how I never count on any individual cycle. And besides, IUI is so last year, don't you think? I'm so not into this cycle, no matter how hard I try to pretend that it's got any chance of success. I mean, it DOES have 20% odds, and that's better than zero, right? Margaret said she likes to tell people she's not a pessimist, she's just an optimist who's been disappointed a lot. Heh.

And so, all pleasantries aside, on to the show! My ovaries, as per usual, were perky and eager to please. Today we saw a dramatic shift in dominance. The useless left ovary seems to be a little insulted at all the nasty things I've been saying about her (her? it? Certainly not him…), and she is rebelling by actually showing some positive growth. In fact, it seems that she is racing against the formerly useful right ovary in a fight for dominance. Observe:

Right Ovary: 13.8, 13.1, 12.2, 12.2
Left Ovary: 15.3, 14.4, 12.9, 8.5, 8.0
Lining: A beautiful 13.77mm today!

Now, I know you're all aquiver with excitement, just like I am, but lest you forget who we're talking about, my E2 and LH levels aren't back yet. For all I know they've plummeted into the depths of despair again. But odds are good that they haven't plummeted, but are rather on the rise, so I might just hold my breath for my next phone call. (though I really would do well to remember that I'm rarely on the GOOD side of fertility odds)

Since I know you'll all be refreshing your screen madly awaiting the E2/LH update, I promise, you'll be the first, er-second, er-third? to know after I receive my daily phone call. I expect to return to Shady Hell tomorrow, but I suppose we'll see. I'm a little irritated at having to return tomorrow, actually, because the earliest appointment they had available was 7:45. I'm normally at work by 7:30, so a 7:45 appointment is REALLY FREAKING ANNOYING. Plus, traffic's a lot worse then. But I'm not bitter.

Edit! Holy Shmoly! Could it be? Could this cycle be turning itself around? at 10:30 my home phone rang and it was Shady Hell. Slightly annoying since the contact number I supplied today was my cell phone number in case I was out when they called. But I'm just happy I was home to get the call. Either way, the numbers are in and they're looking good!

E2: 302 (!!)
LH:
4.38 (up from 2.54)

Holy Cow! I've never, ever had an E2 that high. Seriously. The cycle that worked (sort of) my E2 only got to 113 before I triggered. I'm still not expecting this cycle to work, but the good thing about my levels going up is that it suggests an end in sight. This is a phenomenally good thing, because I'm hoping this means trigger and IUI before Sunday, since that's when we're supposed to be leaving for Florida. Yippee!! End of Edit

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Lest you think that today’s E2/LH levels will shed any more light on my peculiar puzzle, I should update you on my call from my nurse this afternoon.

Three more days, two more clicks of the pen. I’m up to 108 IUs for the next three nights. Apparently Dr. Amazing is bored and ready to move on to IVF, which is good, because I’m ready to move on also. I return on Sunday for more ultrasound fun! Whahoo! I asked Mary (my nurse) what my E2/LH levels were and she said she didn’t want to tell me because it was only going to irritate me. I promised her I could take it.

E2: 110 (down from 113, but that’s really just a plateau)
LH: 2.5 (it went from 2.5 on Sunday, to 2.2 on Tuesday, back to 2.5 today)

Mary is pleased with my LH because she doesn’t want it spiking yet because that would mean I was about to ovulate on my own and that would be bad, since apparently my eggs are too immature. They’re like teenagers trying to break out into maturity, but still stuck with some rather childish behaviours and development. Curses!

I forgot to tell you all the funniest part of my ultrasound this morning. After Dr. S. left the room I was talking to Margaret, sonographer extraordinaire, and she said (JOKINGLY), “gosh what IS going on with those ovaries of yours? Whatever they tell you to take, you should take double and see what happens.” I told her I’d considered it, but that would be wrong. Wrong, I say! Do I sound convincing? I reminded her that doubling my meds was probably the easiest way to land myself with a canceled cycle from overstimulation. “True,” she said, “but they can’t stop you from having lots of sex!”

Of course, sex has never helped us have a baby before, but if I had four perfectly mature, ripe, beautiful follicles ovulating all at once, you can be damned sure this would be the one time I’d end up pregnant. With quadruplets. And I gotta tell you… I really don’t want quadruplets. Not even a little bit. Seriously!

Anywhozit. The point is my ovaries are doing absolutely nothing. I think I ought to have S provide a “sample” for cryopreservation, because I suspect what’s going to end up happening is that I’ll end up needing an IUI when I’m supposed to be in Florida. At least if we had some swimmers on ice, I’d be able to stay here while S and J go to Florida without me (or maybe just have me catch up with them later or something). And anyway, if I plan for that contingency, I won’t end up needing it, and all this worrying will be for nothing, right??

Edited to Add: Anonymous makes a good point in the comments that I could always go for the well-timed intercourse in Florida idea in lieu of the IUI. The IUI itself doesn’t really increase our odds, since our whole problem appears to be me not ovulating naturally, so well-timed intercourse COULD do it, except for a couple things:

1. We’ll be staying at my dad’s … and well, GAH!
2. Timing has never worked out particularly well for us, but we could still give it a shot.
3. I need to find out whether my RE would count this as one of my 2 last IUI cycles before moving on to IVF if I skipped the IUI part. I suspect he would, but I’m not entirely certain. But I am NOT doing another one of these cycles if I don’t have to. It’s time to move on. My insurance coverage for IVF runs out in September or October. After that, I start fighting an uphill battle. Bleh.

Still, I haven’t entirely ruled out the possibility of just resorting to “the old fashioned way” if necessary
End of Edit

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Dragging along

Last March I had the longest IUI cycle in recorded history. Or at least in MY recorded history. And since it was only my second IUI cycle, my recorded history wasn’t very extensive. That cycle went on forever. hCG trigger was on CD 31. Thirty One! IUI on CD 33! Dr. S. called me a “two-pager” meaning that in the old days of paper charts, I would have been one of those patients whose cycle notes went on to the second page.

Not to worry, he assured me. Because historically, two pagers had a remarkably high pregnancy rate compared to shorter cycles (you know, the cycles where trigger happens on Day 12 and IUI is on Day 14 like a textbook?). I remember I really appreciated his reassurance (actually, I still do), but the long cycle was slightly problemmatic because I had a one-day trip scheduled to go to Florida (to see my father and a friend from Scotland) when I figured I’d be in the two week wait, but was actually not even close to IUI day. Dr. S. said no problem and let me push off my next monitoring appointment an extra day, figuring it wouldn’t be too big a deal. It wasn’t, and the cycle dragged on another week or two after I got back before I triggered.

That cycle ended horribly and dramatically while I was away for Passover. It was probably the worst bleeding I’d ever had until that point, and that’s saying something. It was unbelievable amounts of pain, componded by the fact that I was away from home, living in a hotel for a week, not able to start a new cycle because I was nowhere near my fertility clinic (a 10 hour drive each way seemed extreme just for CD3 monitoring). I snapped a lot at my husband that week, had very little energy most of the time, suffered from migraines throughout the trip, and cried a lot. (Believe it or not, I still had a tremendously good time on that trip, especially considering the circumstances)

Do I have a point? Not really, actually. But fast forward to today’s CD16 monitoring appointment. Last cycle I triggered on Day 14 and had an IUI on Day 16. This cycle I am not anticipating triggering anytime soon. Dr. S. was covering monitoring today, so I needled him about the fact that Room 1 doesn’t have a mobile. He said they were waiting for a donation and I said that for what I’m paying this place… he chuckled. On to the ultrasound, the funnest part of the day!

Follicle growth is weird. The follicles on the Right Ovary seem to have stalled, while the follicles on the Left Ovary (previously known as the completely, utterly, evil, underperforming, useless ovary) made a little bit of progress.

Right Ovary: 12.3 (down from 12.6), 9.6, 9.4, 9.0
Left Ovary: 12.0 (up from 10.7), 11.0 (up from 10.0), 9.4
Lining: 11.41 (down from 11.75, should I be worried?)

No word yet on my E2/LH, but Dr. S. was not worried about the lack of growth of my follicles. He said that I had a beautiful jump in E2 on Tuesday (67.5 to 113!) and that we should expect to start seeing some more growth soon, based on that estrogen jump. I trust him, I believe him. I mentioned that I thought this was going to be another two-pager cycle and he laughed that I remembered that, but reminded me that historically two-pagers have relatively high success rates. When I told him that my last two-pager cycle was a resounding disaster he said, “and that’s my cue to exit stage left!” (except he was wrong, it was stage right)

Anywhozit, the bottom line is that there is very little progress happening in Ovary-Land, perky or otherwise, so I’m sorry to give you such a boring update. Not to worry, I’m sure I’ll have some dramarama for you soon!

(You know, for example, the fact that I have a trip scheduled to go to Florida for three days Feb. 18th-20th…Since I figured this cycle would be similar to last month’s I figured this IUI would already be over, at the end of the 2ww, and failing by Feb. 20th. Now I’m wondering if my IUI is going to end up being scheduled right smack in the middle of that trip, meaning I have to cancel either the cycle or the trip. I haven’t seen my father in almost a year and my father hasn’t seen J in a year and a half so I really, really, really don’t want to cancel this trip, but I also don’t want to skip this IUI. DRAT, DRAT, DRAT!)

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Lest you think that today's E2/LH levels will shed any more light on my peculiar puzzle, I should update you on my call from my nurse this afternoon.

Three more days, two more clicks of the pen. I'm up to 108 IUs for the next three nights. Apparently Dr. Amazing is bored and ready to move on to IVF, which is good, because I'm ready to move on also. I return on Sunday for more ultrasound fun! Whahoo! I asked Mary (my nurse) what my E2/LH levels were and she said she didn't want to tell me because it was only going to irritate me. I promised her I could take it.

E2: 110 (down from 113, but that's really just a plateau)
LH: 2.5 (it went from 2.5 on Sunday, to 2.2 on Tuesday, back to 2.5 today)

Mary is pleased with my LH because she doesn't want it spiking yet because that would mean I was about to ovulate on my own and that would be bad, since apparently my eggs are too immature. They're like teenagers trying to break out into maturity, but still stuck with some rather childish behaviours and development. Curses!

I forgot to tell you all the funniest part of my ultrasound this morning. After Dr. S. left the room I was talking to Margaret, sonographer extraordinaire, and she said (JOKINGLY), "gosh what IS going on with those ovaries of yours? Whatever they tell you to take, you should take double and see what happens." I told her I'd considered it, but that would be wrong. Wrong, I say! Do I sound convincing? I reminded her that doubling my meds was probably the easiest way to land myself with a canceled cycle from overstimulation. "True," she said, "but they can't stop you from having lots of sex!"

Of course, sex has never helped us have a baby before, but if I had four perfectly mature, ripe, beautiful follicles ovulating all at once, you can be damned sure this would be the one time I'd end up pregnant. With quadruplets. And I gotta tell you… I really don't want quadruplets. Not even a little bit. Seriously!

Anywhozit. The point is my ovaries are doing absolutely nothing. I think I ought to have S provide a "sample" for cryopreservation, because I suspect what's going to end up happening is that I'll end up needing an IUI when I'm supposed to be in Florida. At least if we had some swimmers on ice, I'd be able to stay here while S and J go to Florida without me (or maybe just have me catch up with them later or something). And anyway, if I plan for that contingency, I won't end up needing it, and all this worrying will be for nothing, right??

Edited to Add: Anonymous makes a good point in the comments that I could always go for the well-timed intercourse in Florida idea in lieu of the IUI. The IUI itself doesn't really increase our odds, since our whole problem appears to be me not ovulating naturally, so well-timed intercourse COULD do it, except for a couple things:

1. We'll be staying at my dad's … and well, GAH!
2. Timing has never worked out particularly well for us, but we could still give it a shot.
3. I need to find out whether my RE would count this as one of my 2 last IUI cycles before moving on to IVF if I skipped the IUI part. I suspect he would, but I'm not entirely certain. But I am NOT doing another one of these cycles if I don't have to. It's time to move on. My insurance coverage for IVF runs out in September or October. After that, I start fighting an uphill battle. Bleh.

Still, I haven't entirely ruled out the possibility of just resorting to "the old fashioned way" if necessary
End of Edit

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Dragging along

Last March I had the longest IUI cycle in recorded history. Or at least in MY recorded history. And since it was only my second IUI cycle, my recorded history wasn't very extensive. That cycle went on forever. hCG trigger was on CD 31. Thirty One! IUI on CD 33! Dr. S. called me a "two-pager" meaning that in the old days of paper charts, I would have been one of those patients whose cycle notes went on to the second page.

Not to worry, he assured me. Because historically, two pagers had a remarkably high pregnancy rate compared to shorter cycles (you know, the cycles where trigger happens on Day 12 and IUI is on Day 14 like a textbook?). I remember I really appreciated his reassurance (actually, I still do), but the long cycle was slightly problemmatic because I had a one-day trip scheduled to go to Florida (to see my father and a friend from Scotland) when I figured I'd be in the two week wait, but was actually not even close to IUI day. Dr. S. said no problem and let me push off my next monitoring appointment an extra day, figuring it wouldn't be too big a deal. It wasn't, and the cycle dragged on another week or two after I got back before I triggered.

That cycle ended horribly and dramatically while I was away for Passover. It was probably the worst bleeding I'd ever had until that point, and that's saying something. It was unbelievable amounts of pain, componded by the fact that I was away from home, living in a hotel for a week, not able to start a new cycle because I was nowhere near my fertility clinic (a 10 hour drive each way seemed extreme just for CD3 monitoring). I snapped a lot at my husband that week, had very little energy most of the time, suffered from migraines throughout the trip, and cried a lot. (Believe it or not, I still had a tremendously good time on that trip, especially considering the circumstances)

Do I have a point? Not really, actually. But fast forward to today's CD16 monitoring appointment. Last cycle I triggered on Day 14 and had an IUI on Day 16. This cycle I am not anticipating triggering anytime soon. Dr. S. was covering monitoring today, so I needled him about the fact that Room 1 doesn't have a mobile. He said they were waiting for a donation and I said that for what I'm paying this place… he chuckled. On to the ultrasound, the funnest part of the day!

Follicle growth is weird. The follicles on the Right Ovary seem to have stalled, while the follicles on the Left Ovary (previously known as the completely, utterly, evil, underperforming, useless ovary) made a little bit of progress.

Right Ovary: 12.3 (down from 12.6), 9.6, 9.4, 9.0
Left Ovary: 12.0 (up from 10.7), 11.0 (up from 10.0), 9.4
Lining: 11.41 (down from 11.75, should I be worried?)

No word yet on my E2/LH, but Dr. S. was not worried about the lack of growth of my follicles. He said that I had a beautiful jump in E2 on Tuesday (67.5 to 113!) and that we should expect to start seeing some more growth soon, based on that estrogen jump. I trust him, I believe him. I mentioned that I thought this was going to be another two-pager cycle and he laughed that I remembered that, but reminded me that historically two-pagers have relatively high success rates. When I told him that my last two-pager cycle was a resounding disaster he said, "and that's my cue to exit stage left!" (except he was wrong, it was stage right)

Anywhozit, the bottom line is that there is very little progress happening in Ovary-Land, perky or otherwise, so I'm sorry to give you such a boring update. Not to worry, I'm sure I'll have some dramarama for you soon!

(You know, for example, the fact that I have a trip scheduled to go to Florida for three days Feb. 18th-20th…Since I figured this cycle would be similar to last month's I figured this IUI would already be over, at the end of the 2ww, and failing by Feb. 20th. Now I'm wondering if my IUI is going to end up being scheduled right smack in the middle of that trip, meaning I have to cancel either the cycle or the trip. I haven't seen my father in almost a year and my father hasn't seen J in a year and a half so I really, really, really don't want to cancel this trip, but I also don't want to skip this IUI. DRAT, DRAT, DRAT!)

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Too Tired for Eloquence

It’s 8:10 pm and if the three year old weren’t WIDE AWAKE, I would have been in bed 2 hours ago. Ugh. I have a cold, but also the Follistim makes me exhausted. Bleh.

Anyway, I’m too tired for an expansive post, but the bottom line was that there was decent news this morning. It appears that one follicle has decided to be dominant and the others are shrinking away. So much for quadruplets…

As always, the details are in my Google Spreadsheet for IUI #6.

Oh, and good news: While it is still quite low compared to what a normal human would expect, my estrogen finally went up! It was 113 today. Whoo hoo. Dr. Amazing was covering monitoring today and he reminded me that this is my last IUI cycle. I’m glad he hasn’t forgotten, because I sure haven’t.

That’s really all I have energy for. I hope you all are well. I’ve been reading, but have been so swamped, I haven’t been able to comment much. Sorry!

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Too Tired for Eloquence

It's 8:10 pm and if the three year old weren't WIDE AWAKE, I would have been in bed 2 hours ago. Ugh. I have a cold, but also the Follistim makes me exhausted. Bleh.

Anyway, I'm too tired for an expansive post, but the bottom line was that there was decent news this morning. It appears that one follicle has decided to be dominant and the others are shrinking away. So much for quadruplets…

As always, the details are in my Google Spreadsheet for IUI #6.

Oh, and good news: While it is still quite low compared to what a normal human would expect, my estrogen finally went up! It was 113 today. Whoo hoo. Dr. Amazing was covering monitoring today and he reminded me that this is my last IUI cycle. I'm glad he hasn't forgotten, because I sure haven't.

That's really all I have energy for. I hope you all are well. I've been reading, but have been so swamped, I haven't been able to comment much. Sorry!

Read Full Post »

Too Tired for Eloquence

It's 8:10 pm and if the three year old weren't WIDE AWAKE, I would have been in bed 2 hours ago. Ugh. I have a cold, but also the Follistim makes me exhausted. Bleh.

Anyway, I'm too tired for an expansive post, but the bottom line was that there was decent news this morning. It appears that one follicle has decided to be dominant and the others are shrinking away. So much for quadruplets…

As always, the details are in my Google Spreadsheet for IUI #6.

Oh, and good news: While it is still quite low compared to what a normal human would expect, my estrogen finally went up! It was 113 today. Whoo hoo. Dr. Amazing was covering monitoring today and he reminded me that this is my last IUI cycle. I'm glad he hasn't forgotten, because I sure haven't.

That's really all I have energy for. I hope you all are well. I've been reading, but have been so swamped, I haven't been able to comment much. Sorry!

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Another monitoring appointment this morning. I have 3 follicles on the Right Ovary measuring 11.8 and one measuring 11.6. If I end up with four mature follicles at trigger time, my doctor will cancel the cycle. My completely useless Left Ovary has one follicle measuring 8.8. Not impressive, but that’s fine since I’ve got four contenders on the Left.

I’m not too worried about this cycle being cancelled because of over-responding. I’ve certainly never had that problem, even in the cycles when it looked worrisome at this point. I’m more concerned about my wonky estradiol levels and the fact that these follicles are only at 11.8 on CD12, which is quite a bit smaller than in my last cycle at this point (on the same dosages). It almost seems as if my response has gotten worse with each successive cyle, but it might be me overreacting. In fact, it probably IS me over reacting, since I know they’ve been fine-tuning my protocol with each cycle, so I wouldn’t necessarily have the same response as previous cycles. For example, my 2nd IUI cycle went on FOREVER, in part because of the teeney weeney dosages. But now I’m on slightly higher dosages which means faster, but different response. I get that in theory, it’s just frustrating right now. I’m sure I’ll feel better once I get my E2 and LH levels back. I’m somewhat annoyed right now.

Actually, the reason I’m annoyed is because I had a sonographer and not a doctor today. It really irritates me that I haven’t been getting an actual doctor on the weekends. It’s one thing when it’s my beloved Margaret running the ultrasound. But no offense to Julie (the person covering today), but she’s just not Margaret. She didn’t let me look at the ultrasound display at all, so I couldn’t see anything for myself. And I also know that when there are different people measuring each time, it’s not necessarily great for comparison, since some people measure differently. Plus, I know I could have asked Margaret to send in Dr. O (the doctor theoretically covering monitoring today, even though I never saw her). I really wanted to ask if there was any possibility that my wacky estrogen response this cycle and last could be fallout from the miscarriage. I know it probably isn’t related, and it won’t make a difference even if it is, but I wanted to ask. It’s very rare that I have questions for my doctor because honestly, I’m pretty well-read on this stuff, and I trust the care I’m getting. But it would have been nice to have the option to speak with Dr. O today. I think I’ll call Dr. Amazing this week.

I’m to return on Tuesday unless I hear otherwise after my bloodwork comes back. I think it’s possible that they’ll ask me to return tomorrow, but not necessarily likely. My guess is I’ll stay at the same dosage (which was bumped to 83 IUs as of Friday), but I suppose it doesn’t much matter. If I go back tomorrow, I won’t call Dr. Amazing, since I’ll be speaking to my nurse in the afternoon. I love my nurse… she knows me very well, and while we had a bit of a rocky start (she used to have a hard time remembering specifics about me), I’ve been around long enough at this point that she knows me really well, remembers the important things, and we have an incredibly good relationship. When she called me with my results and protocol on Friday she said that I should increase to 83 IUs and return on Sunday. I said that was fine and that I’d already set up an appointment for Sunday and she said, “I don’t know what I’m going to do when you get pregnant! I’m going to have to find another patient who always knows exactly what to do.” I told her I was pretty sure I could do this without all the doctors and she agreed. She’s been there, done that, and has twins via IVF, so she gets it.

One final note: Thalia mentioned in a comment to my questions post that in the UK I’d be required to take a couple months off between IUI cycles because any kind of ovarian stimulation is regarded as needing a break between cycles. I can understand this to a point, but it still confuses me a bit. I do understand that you don’t want to muck too much with your body’s natural processes. But on the other hand, is it not reasonable to believe that there’s an enormous difference between trying to stimulate ovaries to produce one egg and trying to stimulate ovaries to produce 20 eggs. So while I could see taking a month or two off after every two or three IUI cycles, I find it odd that there would need to be a blanket policy of taking 2-3 months off after EVERY IUI cycle. I would think one would want to look at that on a case by case basis. Probably none of my readers know that I’m a dual citizen of the US and UK and it is my goal to move to the UK eventually, but the timing has never been right. We can’t move out of the State we live in, much less the country given the status of our foster son at this point. And beyond that, I’m not certain I would want to move while in the middle of all this fertility stuff, particularly since protocols between the US and UK seem to differ widely. I don’t think one protocol is better than the other, but moving to something completely different seems overwhelming, at best. Ah well, I hope it will happen eventually.

UPDATE: Shit! (pardon my language) Not so much with feeling better now that my levels are back. E2: 67.5, LH: 2.5. This means my E2 levels have dropped. In fact, I snuck a look at my record after my monitoring appointment (they left it up on the computer monitor, so I couldn’t resist a peak) and my E2: level had actually be 71.8 on Wednesday, not 71.5 as it was on Friday. So it’s dropped twice in a row now. DRAT! Why in heaven’s name is my body doing this? This is utterly ridiculous. Anywho, increase dosage to 91 IUs tonight and tomorrow night and return on Tuesday. Joy of freaking Joys.END OF UPDATE

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Another monitoring appointment this morning. I have 3 follicles on the Right Ovary measuring 11.8 and one measuring 11.6. If I end up with four mature follicles at trigger time, my doctor will cancel the cycle. My completely useless Left Ovary has one follicle measuring 8.8. Not impressive, but that's fine since I've got four contenders on the Left.

I'm not too worried about this cycle being cancelled because of over-responding. I've certainly never had that problem, even in the cycles when it looked worrisome at this point. I'm more concerned about my wonky estradiol levels and the fact that these follicles are only at 11.8 on CD12, which is quite a bit smaller than in my last cycle at this point (on the same dosages). It almost seems as if my response has gotten worse with each successive cyle, but it might be me overreacting. In fact, it probably IS me over reacting, since I know they've been fine-tuning my protocol with each cycle, so I wouldn't necessarily have the same response as previous cycles. For example, my 2nd IUI cycle went on FOREVER, in part because of the teeney weeney dosages. But now I'm on slightly higher dosages which means faster, but different response. I get that in theory, it's just frustrating right now. I'm sure I'll feel better once I get my E2 and LH levels back. I'm somewhat annoyed right now.

Actually, the reason I'm annoyed is because I had a sonographer and not a doctor today. It really irritates me that I haven't been getting an actual doctor on the weekends. It's one thing when it's my beloved Margaret running the ultrasound. But no offense to Julie (the person covering today), but she's just not Margaret. She didn't let me look at the ultrasound display at all, so I couldn't see anything for myself. And I also know that when there are different people measuring each time, it's not necessarily great for comparison, since some people measure differently. Plus, I know I could have asked Margaret to send in Dr. O (the doctor theoretically covering monitoring today, even though I never saw her). I really wanted to ask if there was any possibility that my wacky estrogen response this cycle and last could be fallout from the miscarriage. I know it probably isn't related, and it won't make a difference even if it is, but I wanted to ask. It's very rare that I have questions for my doctor because honestly, I'm pretty well-read on this stuff, and I trust the care I'm getting. But it would have been nice to have the option to speak with Dr. O today. I think I'll call Dr. Amazing this week.

I'm to return on Tuesday unless I hear otherwise after my bloodwork comes back. I think it's possible that they'll ask me to return tomorrow, but not necessarily likely. My guess is I'll stay at the same dosage (which was bumped to 83 IUs as of Friday), but I suppose it doesn't much matter. If I go back tomorrow, I won't call Dr. Amazing, since I'll be speaking to my nurse in the afternoon. I love my nurse… she knows me very well, and while we had a bit of a rocky start (she used to have a hard time remembering specifics about me), I've been around long enough at this point that she knows me really well, remembers the important things, and we have an incredibly good relationship. When she called me with my results and protocol on Friday she said that I should increase to 83 IUs and return on Sunday. I said that was fine and that I'd already set up an appointment for Sunday and she said, "I don't know what I'm going to do when you get pregnant! I'm going to have to find another patient who always knows exactly what to do." I told her I was pretty sure I could do this without all the doctors and she agreed. She's been there, done that, and has twins via IVF, so she gets it.

One final note: Thalia mentioned in a comment to my questions post that in the UK I'd be required to take a couple months off between IUI cycles because any kind of ovarian stimulation is regarded as needing a break between cycles. I can understand this to a point, but it still confuses me a bit. I do understand that you don't want to muck too much with your body's natural processes. But on the other hand, is it not reasonable to believe that there's an enormous difference between trying to stimulate ovaries to produce one egg and trying to stimulate ovaries to produce 20 eggs. So while I could see taking a month or two off after every two or three IUI cycles, I find it odd that there would need to be a blanket policy of taking 2-3 months off after EVERY IUI cycle. I would think one would want to look at that on a case by case basis. Probably none of my readers know that I'm a dual citizen of the US and UK and it is my goal to move to the UK eventually, but the timing has never been right. We can't move out of the State we live in, much less the country given the status of our foster son at this point. And beyond that, I'm not certain I would want to move while in the middle of all this fertility stuff, particularly since protocols between the US and UK seem to differ widely. I don't think one protocol is better than the other, but moving to something completely different seems overwhelming, at best. Ah well, I hope it will happen eventually.

UPDATE: Shit! (pardon my language) Not so much with feeling better now that my levels are back. E2: 67.5, LH: 2.5. This means my E2 levels have dropped. In fact, I snuck a look at my record after my monitoring appointment (they left it up on the computer monitor, so I couldn't resist a peak) and my E2: level had actually be 71.8 on Wednesday, not 71.5 as it was on Friday. So it's dropped twice in a row now. DRAT! Why in heaven's name is my body doing this? This is utterly ridiculous. Anywho, increase dosage to 91 IUs tonight and tomorrow night and return on Tuesday. Joy of freaking Joys.END OF UPDATE

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