ChezPerky

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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Let’s Review!

Me: 31 years old.
Diagnosis & History: Anovulation due to PCOS; Four (+) year history of infertility. 5 IUIs. 1 pregancy, resulting in 1 miscarriage at 12 weeks. No male factor.
Usual response to Gonadotropins: Super-responder. No problems whatsoever. Go me.
This cycle and last? SERIOUSLY MESSED UP.

Okay, so here’s the deal. If you don’t remember, last cycle, I had a little plateau problem… my E2 level went up, went back down, went up a little bit, and hung out for a couple days without doing anything interesting prior to IUI. Follicles were all wonky (splitting, disappearing, whatever). It kind of freaked me out a little bit, but it had to be a fluke, right? Yeah…No.

And now we find ourselves caught up to date for everything prior to this cycle. Now just to refresh your memory….

CD8 (Wednesday)
Right Ovary: 9.6 & 10.2. Another 10 follicles smaller than that
Left Ovary (hereafter referred to as the useless ovary: a bunch of small, meaningless, boring, uninteresting ones.
Lining: 9.2
E2: 71.5
LH: Unknown (they didn’t tell me)

CD 10 (Today)
Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Useless Ovary: 7.0, 7.1, 9.0 and 6 smaller ones
Lining: 9.6
E2: 71.5
LH: 1.85

Follicles are expected to grow at a rate of about 1-2 mm per day (I’m nearly always on the low end of the growth chart… averaging a little over 1mm per day… most normal humans are closer to 2mm per day). My biggest follicle on Wednesday was 10.2, so they would have hoped for it to be 12-14 (preferably closer to 14) today. Instead, it was 11.9. Not quite 1mm per day. And did you notice that lovely E2 level? I didn’t either. I only see the craptastic one. That is, the craptastic 71.5 that has not changed at all in the two days since the last level was checked. So again, I’m facing a plateau which might possibly mean this is all useless.

Now, the truth is, I never ever put much faith in any individual cycle. I have complete faith that eventually something will work, but I never believe any individual cycle will work. However, I’m not normally so ridiculously negative as to believe any given cycle is a waste of time. I’m beginning to feel that way now.

And by the way, should I be worried that my right ovary (hereafter lovingly referred to as the “Not-As-Bad-As-The-Left Ovary”, or NABATLO for short) is always the producer? Is my Useless Ovary really and truly useless? Is it just there for looks? Did God just want me to have a matched set, even if they don’t work? Or is it purely coincidental? I get that none of you actually know the real answer to that question, but I’m asking anyway, even if I’m not sure what kind of answers I’m hoping for.

BLEH.

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This morning’s monitoring appointment was a little less happy than it could have been. I’ve got too many follicles trying to peak out all at once. Not so fabulous. I owned up to the fact that I’d accidentally (again) increased my dosage by 8 IUs, but also noted that I’d accidentally done the same thing last month. The doctor didn’t think that the 8 IUs were really signficant, particularly in light of the fact that I didn’t have the same response last month to the same dosage. I think my second cycle (could have been the third, I can’t remember) I had a similar response (super-perky ovaries, that is) with only 33 IUs but I still only ended up with 1 mature follicle at trigger time, so I’m not too worried. But look take a look for yourself:

Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Left Ovary: 7.0, 7.1, 9.0
Lining: 9.6

Maybe I’ll have quintuplets! JUST KIDDING! Seriously!

Even my beloved Margaret (sonographer extraordinaire) asked if I could please tell my ovaries to tone it down. I told her it was all her fault since she’s the one who dubbed my ovaries “perky” oh so long ago. She has promised never to refer to my ovaries as perky again. Until, you know, the next time she does. At any rate, I’ll be going back on Sunday. No dosage change unless my bloodwork comes back all wonky. It’s all good. I mean, after all, why would I want to be anywhere but the clinic at 7am on a Sunday morning?

While I’m disappointed at my ovaries’ blatant disregard for my wishes, my biggest disappointment wasn’t seeing them rebel most annoyingly… Rather, it was that I was put into Room 1 for my ultrasound (I’m not actually serious). The problem with Room 1 is that it doesn’t have a mobile hanging from the ceiling. All the other rooms do. Dr. S. (hereafter known as Dr. Can’t-Follow-Through-With-Mobile-Hanging) once told me that he personally hung the mobiles in the exam rooms and I was quite impressed. I mean, really, what else is a girl supposed to look at during an ultrasound? But Room 1 has no mobile, so every time I’m there I harass the staff about the fact that I’m stuck in the boring room. Margaret offered up a Garfield poster, but refused to accept my suggestion of putting comics on the ceiling above the table. “In a fertility clinic? Nah!” Why not? There are bound to be some funny infertility comics, right? Now I must scour the internet for funny infertility comics and I’m asking you, my faithful readers, to help me. I have made it my mission to bring a collection of infertility comics to Margaret before this cycle is done for. So give it your best shot!

Edited to Add: Okay, sure, I COULD be looking at my ovaries during the ultrasound, but really, they’re kinda boring after a while. Plus, what about the 2 IUIs I’ve had in that room? Laying there bored for five minutes afterward with nothing to do but count the ceiling tiles isn’t so fun. Fortunately, the other 3 IUIs I’ve had were in rooms with mobiles! End of Edit

Anywhozit, Dr. Can’t-Follow-Through-With-Mobile-Hanging (Dr. CFTWMH) wasn’t the doctor covering monitoring today, so I didn’t get to harass him directly. Instead, Dr. C. was covering monitoring. He’s an extremely good doctor and very well-respected in the Washington Area (named one of Washington’s Top Doctors), but he makes me edgy. He’s very nice and personable, so that isn’t it. It’s that I tend to see him when things aren’t going QUITE as expected in my cycle and he gets this worried look on his face every time. I mean, he didn’t freak out or anything, but he sort of gave this worried sigh-like sound and that worried look flashed across his face briefly. Maybe I’m reading too much into it.

In other news, the Follistim is really getting to me this cycle. I’m moodier than I’ve ever been on Follistim (though maybe it’s just me and I can’t blame the drug) and I’m having a tremendous amount of nausea. If I didn’t know better, I’d be wondering if I was pregnant. But I do know better, and I’m definitely not pregnant. Last cycle I didn’t have nearly as much moodiness, nor nearly as much nausea. But last cycle the Follistim REALLY STUNG every time I used it, and this time I’ve barely felt the injections, so I guess I should count my blessings.

That’s all for now. I’ll keep you posted if anything changes (since I know you’re all just on the edge of your seats waiting to hear my E2 and LH levels!).

Read Full Post »

This morning's monitoring appointment was a little less happy than it could have been. I've got too many follicles trying to peak out all at once. Not so fabulous. I owned up to the fact that I'd accidentally (again) increased my dosage by 8 IUs, but also noted that I'd accidentally done the same thing last month. The doctor didn't think that the 8 IUs were really signficant, particularly in light of the fact that I didn't have the same response last month to the same dosage. I think my second cycle (could have been the third, I can't remember) I had a similar response (super-perky ovaries, that is) with only 33 IUs but I still only ended up with 1 mature follicle at trigger time, so I'm not too worried. But look take a look for yourself:

Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Left Ovary: 7.0, 7.1, 9.0
Lining: 9.6

Maybe I'll have quintuplets! JUST KIDDING! Seriously!

Even my beloved Margaret (sonographer extraordinaire) asked if I could please tell my ovaries to tone it down. I told her it was all her fault since she's the one who dubbed my ovaries "perky" oh so long ago. She has promised never to refer to my ovaries as perky again. Until, you know, the next time she does. At any rate, I'll be going back on Sunday. No dosage change unless my bloodwork comes back all wonky. It's all good. I mean, after all, why would I want to be anywhere but the clinic at 7am on a Sunday morning?

While I'm disappointed at my ovaries' blatant disregard for my wishes, my biggest disappointment wasn't seeing them rebel most annoyingly… Rather, it was that I was put into Room 1 for my ultrasound (I'm not actually serious). The problem with Room 1 is that it doesn't have a mobile hanging from the ceiling. All the other rooms do. Dr. S. (hereafter known as Dr. Can't-Follow-Through-With-Mobile-Hanging) once told me that he personally hung the mobiles in the exam rooms and I was quite impressed. I mean, really, what else is a girl supposed to look at during an ultrasound? But Room 1 has no mobile, so every time I'm there I harass the staff about the fact that I'm stuck in the boring room. Margaret offered up a Garfield poster, but refused to accept my suggestion of putting comics on the ceiling above the table. "In a fertility clinic? Nah!" Why not? There are bound to be some funny infertility comics, right? Now I must scour the internet for funny infertility comics and I'm asking you, my faithful readers, to help me. I have made it my mission to bring a collection of infertility comics to Margaret before this cycle is done for. So give it your best shot!

Edited to Add: Okay, sure, I COULD be looking at my ovaries during the ultrasound, but really, they're kinda boring after a while. Plus, what about the 2 IUIs I've had in that room? Laying there bored for five minutes afterward with nothing to do but count the ceiling tiles isn't so fun. Fortunately, the other 3 IUIs I've had were in rooms with mobiles! End of Edit

Anywhozit, Dr. Can't-Follow-Through-With-Mobile-Hanging (Dr. CFTWMH) wasn't the doctor covering monitoring today, so I didn't get to harass him directly. Instead, Dr. C. was covering monitoring. He's an extremely good doctor and very well-respected in the Washington Area (named one of Washington's Top Doctors), but he makes me edgy. He's very nice and personable, so that isn't it. It's that I tend to see him when things aren't going QUITE as expected in my cycle and he gets this worried look on his face every time. I mean, he didn't freak out or anything, but he sort of gave this worried sigh-like sound and that worried look flashed across his face briefly. Maybe I'm reading too much into it.

In other news, the Follistim is really getting to me this cycle. I'm moodier than I've ever been on Follistim (though maybe it's just me and I can't blame the drug) and I'm having a tremendous amount of nausea. If I didn't know better, I'd be wondering if I was pregnant. But I do know better, and I'm definitely not pregnant. Last cycle I didn't have nearly as much moodiness, nor nearly as much nausea. But last cycle the Follistim REALLY STUNG every time I used it, and this time I've barely felt the injections, so I guess I should count my blessings.

That's all for now. I'll keep you posted if anything changes (since I know you're all just on the edge of your seats waiting to hear my E2 and LH levels!).

Read Full Post »

This morning's monitoring appointment was a little less happy than it could have been. I've got too many follicles trying to peak out all at once. Not so fabulous. I owned up to the fact that I'd accidentally (again) increased my dosage by 8 IUs, but also noted that I'd accidentally done the same thing last month. The doctor didn't think that the 8 IUs were really signficant, particularly in light of the fact that I didn't have the same response last month to the same dosage. I think my second cycle (could have been the third, I can't remember) I had a similar response (super-perky ovaries, that is) with only 33 IUs but I still only ended up with 1 mature follicle at trigger time, so I'm not too worried. But look take a look for yourself:

Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Left Ovary: 7.0, 7.1, 9.0
Lining: 9.6

Maybe I'll have quintuplets! JUST KIDDING! Seriously!

Even my beloved Margaret (sonographer extraordinaire) asked if I could please tell my ovaries to tone it down. I told her it was all her fault since she's the one who dubbed my ovaries "perky" oh so long ago. She has promised never to refer to my ovaries as perky again. Until, you know, the next time she does. At any rate, I'll be going back on Sunday. No dosage change unless my bloodwork comes back all wonky. It's all good. I mean, after all, why would I want to be anywhere but the clinic at 7am on a Sunday morning?

While I'm disappointed at my ovaries' blatant disregard for my wishes, my biggest disappointment wasn't seeing them rebel most annoyingly… Rather, it was that I was put into Room 1 for my ultrasound (I'm not actually serious). The problem with Room 1 is that it doesn't have a mobile hanging from the ceiling. All the other rooms do. Dr. S. (hereafter known as Dr. Can't-Follow-Through-With-Mobile-Hanging) once told me that he personally hung the mobiles in the exam rooms and I was quite impressed. I mean, really, what else is a girl supposed to look at during an ultrasound? But Room 1 has no mobile, so every time I'm there I harass the staff about the fact that I'm stuck in the boring room. Margaret offered up a Garfield poster, but refused to accept my suggestion of putting comics on the ceiling above the table. "In a fertility clinic? Nah!" Why not? There are bound to be some funny infertility comics, right? Now I must scour the internet for funny infertility comics and I'm asking you, my faithful readers, to help me. I have made it my mission to bring a collection of infertility comics to Margaret before this cycle is done for. So give it your best shot!

Edited to Add: Okay, sure, I COULD be looking at my ovaries during the ultrasound, but really, they're kinda boring after a while. Plus, what about the 2 IUIs I've had in that room? Laying there bored for five minutes afterward with nothing to do but count the ceiling tiles isn't so fun. Fortunately, the other 3 IUIs I've had were in rooms with mobiles! End of Edit

Anywhozit, Dr. Can't-Follow-Through-With-Mobile-Hanging (Dr. CFTWMH) wasn't the doctor covering monitoring today, so I didn't get to harass him directly. Instead, Dr. C. was covering monitoring. He's an extremely good doctor and very well-respected in the Washington Area (named one of Washington's Top Doctors), but he makes me edgy. He's very nice and personable, so that isn't it. It's that I tend to see him when things aren't going QUITE as expected in my cycle and he gets this worried look on his face every time. I mean, he didn't freak out or anything, but he sort of gave this worried sigh-like sound and that worried look flashed across his face briefly. Maybe I'm reading too much into it.

In other news, the Follistim is really getting to me this cycle. I'm moodier than I've ever been on Follistim (though maybe it's just me and I can't blame the drug) and I'm having a tremendous amount of nausea. If I didn't know better, I'd be wondering if I was pregnant. But I do know better, and I'm definitely not pregnant. Last cycle I didn't have nearly as much moodiness, nor nearly as much nausea. But last cycle the Follistim REALLY STUNG every time I used it, and this time I've barely felt the injections, so I guess I should count my blessings.

That's all for now. I'll keep you posted if anything changes (since I know you're all just on the edge of your seats waiting to hear my E2 and LH levels!).

Read Full Post »

Let's Review!

Me: 31 years old.
Diagnosis & History: Anovulation due to PCOS; Four (+) year history of infertility. 5 IUIs. 1 pregancy, resulting in 1 miscarriage at 12 weeks. No male factor.
Usual response to Gonadotropins: Super-responder. No problems whatsoever. Go me.
This cycle and last? SERIOUSLY MESSED UP.

Okay, so here's the deal. If you don't remember, last cycle, I had a little plateau problem… my E2 level went up, went back down, went up a little bit, and hung out for a couple days without doing anything interesting prior to IUI. Follicles were all wonky (splitting, disappearing, whatever). It kind of freaked me out a little bit, but it had to be a fluke, right? Yeah…No.

And now we find ourselves caught up to date for everything prior to this cycle. Now just to refresh your memory….

CD8 (Wednesday)
Right Ovary: 9.6 & 10.2. Another 10 follicles smaller than that
Left Ovary (hereafter referred to as the useless ovary: a bunch of small, meaningless, boring, uninteresting ones.
Lining: 9.2
E2: 71.5
LH: Unknown (they didn't tell me)

CD 10 (Today)
Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Useless Ovary: 7.0, 7.1, 9.0 and 6 smaller ones
Lining: 9.6
E2: 71.5
LH: 1.85

Follicles are expected to grow at a rate of about 1-2 mm per day (I'm nearly always on the low end of the growth chart… averaging a little over 1mm per day… most normal humans are closer to 2mm per day). My biggest follicle on Wednesday was 10.2, so they would have hoped for it to be 12-14 (preferably closer to 14) today. Instead, it was 11.9. Not quite 1mm per day. And did you notice that lovely E2 level? I didn't either. I only see the craptastic one. That is, the craptastic 71.5 that has not changed at all in the two days since the last level was checked. So again, I'm facing a plateau which might possibly mean this is all useless.

Now, the truth is, I never ever put much faith in any individual cycle. I have complete faith that eventually something will work, but I never believe any individual cycle will work. However, I'm not normally so ridiculously negative as to believe any given cycle is a waste of time. I'm beginning to feel that way now.

And by the way, should I be worried that my right ovary (hereafter lovingly referred to as the "Not-As-Bad-As-The-Left Ovary", or NABATLO for short) is always the producer? Is my Useless Ovary really and truly useless? Is it just there for looks? Did God just want me to have a matched set, even if they don't work? Or is it purely coincidental? I get that none of you actually know the real answer to that question, but I'm asking anyway, even if I'm not sure what kind of answers I'm hoping for.

BLEH.

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