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Today’s stats

Having visited my second-home, Shady Hell, for the FOURTH time in a week this morning, there are a few things to update about.

First, yesterday I had my consult with my RE so that we could talk about doing my next cycle as an IVF cycle instead of yet another boring IUI. We talked about the cycle I'm in the middle of now, and the side effects I've been experiencing with the Follistim. Apparently, I'm a rare duck in that Follistim makes me throw up. A lot. Every day. Whoo hoo! Provera, by the way, does the same thing to me. And the good news? If I respond so strongly to such tiny itty bitty doses of these hormones (no kidding… I take 50 IUs of Follistim every night… many women I know start with 150, 200, or 300 IUs every night), then odds are good I'm going to have incredibly awful morning sickness. Joy! When we'd finished talking about this cycle she reiterated that hopefully the IUI will work this time and the rest of the consult will be unneccessary. That's fine. I'm happy to pay for an IVF consult I never need. Seriously.

Then we moved onto the real topic at hand: IVF. My doctor drew me lots of pretty pictures (upside down!) and explained how the cycle would go if I started an IVF cycle. Mostly she didn't tell me anything I didn't already know, either because so many of my friends inside the computer have been through all this, or because I've been through much of it already, just by doing injectible FSH/IUI cycles.

What I really wanted to know was how PCOS plays a role in an IVF cycle. I know that even with my IUI cycle, they have to approach PCOS patients slightly differently, because we are the lucky super-responders to FSH. They have to give teeney weeney doses to carefully tease a follicle or two into the forefront, because otherwise they just end up with a bazillion little follicles and a canceled cycle, and, well, that's no fun at all, is it?

My main concern was whether I'd be at an increased risk of OHSS (Ovarian Hyperstimulation Syndrome) which is, well, kind of evil, from what I've read. The short answer is yes, there is an increased risk of OHSS with PCOS patients. The long answer includes a bunch of statistics that I don't understand which boil down to: "but it's still really rare." So PCOS patients, because they are SUPER-Responders, stay on Lupron at higher doses for longer than the average patient. Lupron, boys and girls, ain't cheap. (I'm a lucky duck in that I have insurance coverage for much of this, but I feel for the poor women who have to pay for this all on their own) Anyway, I guess the idea of staying on the Lupron is to continue suppression for a bit longer, and to help avoid early ovulation. No problem.

Okay, there's a problem. I was really hoping (as disgusted as I am by the idea) that even with an IVF cycle, they'd let me keep taking prometrium suppositories (yeah, I know, yuck) instead of PIO (progesterone in oil) IM injections. But no such luck. I do not know why, but this paralyzes me. Ridiculous, right? I can handle subcutaneous shots. I can handle the IM HCG Trigger. I can handle the oh-so-pleasant-sounding egg retrieval. I can handle HSGs. I can handle all manner of unpleasantness, so why am I so freaked out by the PIO injections? They sound so icky! And they seem so painful! And everyone I've talked to has told me how ridiculously EVIL they are. Crap. Have I come this far just to be paralyzed by one really huge syringe? Seems that way.

Well, I suppose we can always hope that this IUI cycle works. (Hah! I almost said that with a straight face!)

Speaking of this cycle, I was back at Shady Hell this morning for more monitoring. I have to say, it felt a lot more normal to be on the second floor. I swear when I was brought into my doctor's office on the fourth floor yesterday I almost took off my skirt, because well, what else do we do at the office? It was completely odd to remain fully clothed for the entire appointment. Today put the world back into balance, though.

Dracula had a hard time finding a vein in my arm, so she snagged blood from my hand. Actually, I'm grateful… it sure beat having to have her poke around in my arm. So even though it hurt like heck, there's no bruise and it feels fine now, and it only took one stick. I heart Dracula. She's way better than the other phlebotomy flunkies.

The doctor covering monitoring today is a nice Jewish doctor from South Africa. He is very soft-spoken and sweet, and has a delightful accent. Anyway, I was worried that they were going to tell me today to trigger tonight and that would just be sucky because that would have meant a Saturday IUI and that would so not work for me (I'm Jewish, and Saturday is the Sabbath and comes with a million and one rules, one of which is no driving, so getting to the clinic would be nigh impossible). Anyway, without me saying anything about it, he said, "Well, it looks like you probably need to go another day, so you'll probably come back tomorrow and trigger tomorrow night, you'll be good for Shabbat [Sabbath], and back on Sunday for the IUI." A call a few minutes ago from my nurse confirmed his guess, and I'll be going in on Sunday. Whew!

I have a lovely 16 mm follicle on the right side just begging to pop. I've been feeling pain on my right side for a couple of days, so hopefully after tomorrow, that pain will go away and we can move on.

I made the mistake of actually being a tad hopeful in my last cycle, so I was pretty horrified at my repeated negative HPT attempts and the eventual appearance of my period. Yes, I'm a pee-stick addict. I know I'm not supposed to test before the blood test after the IUI, but I can't help myself. I go crazy knowing that I'm doing nothing (Nothing!) during the two week wait. I hate that time. I spend so much time up until the 2ww going from one appointment to another signing one form or another, sticking myself with needles, getting up close and personal with the cooter cam every three days, calling my financial coordinator, writing checks, and then all of a sudden… Nothing. A black hole of hand-wringing, fidgety, nothingness.

Right. So I'm just happy to be finishing this cycle with a plan in place for next cycle, knowing that there probably will be a next cycle, and knowing that we'll likely be just moving on to the next step and saying goodbye to the IUI chapter of our reproductive lives.

Have I mentioned that I want a baby? I mean really, really, really want a baby so badly I can almost feel a baby in my arms? What's amazing is that when I see my wondermous husband with someone's baby, I think that sometimes he aches for a baby more than I do. I mean, I really, really, really want a baby. But my husband? Yeah, he does too, even though he doesn't talk about it much. We have an amazing foster son, an almost-three-year-old who is so much fun, but we never got to have a baby (we got our foster son when he was 13 months), and I just know my husband really wants to experience babyhood from a father's perspective. I just wish my ovaries would cooperate and I could give that to him. And me. Don't forget me. Because, you know, it's ALL about me.

Today’s stats

Having visited my second-home, Shady Hell, for the FOURTH time in a week this morning, there are a few things to update about.

First, yesterday I had my consult with my RE so that we could talk about doing my next cycle as an IVF cycle instead of yet another boring IUI. We talked about the cycle I'm in the middle of now, and the side effects I've been experiencing with the Follistim. Apparently, I'm a rare duck in that Follistim makes me throw up. A lot. Every day. Whoo hoo! Provera, by the way, does the same thing to me. And the good news? If I respond so strongly to such tiny itty bitty doses of these hormones (no kidding… I take 50 IUs of Follistim every night… many women I know start with 150, 200, or 300 IUs every night), then odds are good I'm going to have incredibly awful morning sickness. Joy! When we'd finished talking about this cycle she reiterated that hopefully the IUI will work this time and the rest of the consult will be unneccessary. That's fine. I'm happy to pay for an IVF consult I never need. Seriously.

Then we moved onto the real topic at hand: IVF. My doctor drew me lots of pretty pictures (upside down!) and explained how the cycle would go if I started an IVF cycle. Mostly she didn't tell me anything I didn't already know, either because so many of my friends inside the computer have been through all this, or because I've been through much of it already, just by doing injectible FSH/IUI cycles.

What I really wanted to know was how PCOS plays a role in an IVF cycle. I know that even with my IUI cycle, they have to approach PCOS patients slightly differently, because we are the lucky super-responders to FSH. They have to give teeney weeney doses to carefully tease a follicle or two into the forefront, because otherwise they just end up with a bazillion little follicles and a canceled cycle, and, well, that's no fun at all, is it?

My main concern was whether I'd be at an increased risk of OHSS (Ovarian Hyperstimulation Syndrome) which is, well, kind of evil, from what I've read. The short answer is yes, there is an increased risk of OHSS with PCOS patients. The long answer includes a bunch of statistics that I don't understand which boil down to: "but it's still really rare." So PCOS patients, because they are SUPER-Responders, stay on Lupron at higher doses for longer than the average patient. Lupron, boys and girls, ain't cheap. (I'm a lucky duck in that I have insurance coverage for much of this, but I feel for the poor women who have to pay for this all on their own) Anyway, I guess the idea of staying on the Lupron is to continue suppression for a bit longer, and to help avoid early ovulation. No problem.

Okay, there's a problem. I was really hoping (as disgusted as I am by the idea) that even with an IVF cycle, they'd let me keep taking prometrium suppositories (yeah, I know, yuck) instead of PIO (progesterone in oil) IM injections. But no such luck. I do not know why, but this paralyzes me. Ridiculous, right? I can handle subcutaneous shots. I can handle the IM HCG Trigger. I can handle the oh-so-pleasant-sounding egg retrieval. I can handle HSGs. I can handle all manner of unpleasantness, so why am I so freaked out by the PIO injections? They sound so icky! And they seem so painful! And everyone I've talked to has told me how ridiculously EVIL they are. Crap. Have I come this far just to be paralyzed by one really huge syringe? Seems that way.

Well, I suppose we can always hope that this IUI cycle works. (Hah! I almost said that with a straight face!)

Speaking of this cycle, I was back at Shady Hell this morning for more monitoring. I have to say, it felt a lot more normal to be on the second floor. I swear when I was brought into my doctor's office on the fourth floor yesterday I almost took off my skirt, because well, what else do we do at the office? It was completely odd to remain fully clothed for the entire appointment. Today put the world back into balance, though.

Dracula had a hard time finding a vein in my arm, so she snagged blood from my hand. Actually, I'm grateful… it sure beat having to have her poke around in my arm. So even though it hurt like heck, there's no bruise and it feels fine now, and it only took one stick. I heart Dracula. She's way better than the other phlebotomy flunkies.

The doctor covering monitoring today is a nice Jewish doctor from South Africa. He is very soft-spoken and sweet, and has a delightful accent. Anyway, I was worried that they were going to tell me today to trigger tonight and that would just be sucky because that would have meant a Saturday IUI and that would so not work for me (I'm Jewish, and Saturday is the Sabbath and comes with a million and one rules, one of which is no driving, so getting to the clinic would be nigh impossible). Anyway, without me saying anything about it, he said, "Well, it looks like you probably need to go another day, so you'll probably come back tomorrow and trigger tomorrow night, you'll be good for Shabbat [Sabbath], and back on Sunday for the IUI." A call a few minutes ago from my nurse confirmed his guess, and I'll be going in on Sunday. Whew!

I have a lovely 16 mm follicle on the right side just begging to pop. I've been feeling pain on my right side for a couple of days, so hopefully after tomorrow, that pain will go away and we can move on.

I made the mistake of actually being a tad hopeful in my last cycle, so I was pretty horrified at my repeated negative HPT attempts and the eventual appearance of my period. Yes, I'm a pee-stick addict. I know I'm not supposed to test before the blood test after the IUI, but I can't help myself. I go crazy knowing that I'm doing nothing (Nothing!) during the two week wait. I hate that time. I spend so much time up until the 2ww going from one appointment to another signing one form or another, sticking myself with needles, getting up close and personal with the cooter cam every three days, calling my financial coordinator, writing checks, and then all of a sudden… Nothing. A black hole of hand-wringing, fidgety, nothingness.

Right. So I'm just happy to be finishing this cycle with a plan in place for next cycle, knowing that there probably will be a next cycle, and knowing that we'll likely be just moving on to the next step and saying goodbye to the IUI chapter of our reproductive lives.

Have I mentioned that I want a baby? I mean really, really, really want a baby so badly I can almost feel a baby in my arms? What's amazing is that when I see my wondermous husband with someone's baby, I think that sometimes he aches for a baby more than I do. I mean, I really, really, really want a baby. But my husband? Yeah, he does too, even though he doesn't talk about it much. We have an amazing foster son, an almost-three-year-old who is so much fun, but we never got to have a baby (we got our foster son when he was 13 months), and I just know my husband really wants to experience babyhood from a father's perspective. I just wish my ovaries would cooperate and I could give that to him. And me. Don't forget me. Because, you know, it's ALL about me.

Today’s stats

Having visited my second-home, Shady Hell, for the FOURTH time in a week this morning, there are a few things to update about.

First, yesterday I had my consult with my RE so that we could talk about doing my next cycle as an IVF cycle instead of yet another boring IUI. We talked about the cycle I'm in the middle of now, and the side effects I've been experiencing with the Follistim. Apparently, I'm a rare duck in that Follistim makes me throw up. A lot. Every day. Whoo hoo! Provera, by the way, does the same thing to me. And the good news? If I respond so strongly to such tiny itty bitty doses of these hormones (no kidding… I take 50 IUs of Follistim every night… many women I know start with 150, 200, or 300 IUs every night), then odds are good I'm going to have incredibly awful morning sickness. Joy! When we'd finished talking about this cycle she reiterated that hopefully the IUI will work this time and the rest of the consult will be unneccessary. That's fine. I'm happy to pay for an IVF consult I never need. Seriously.

Then we moved onto the real topic at hand: IVF. My doctor drew me lots of pretty pictures (upside down!) and explained how the cycle would go if I started an IVF cycle. Mostly she didn't tell me anything I didn't already know, either because so many of my friends inside the computer have been through all this, or because I've been through much of it already, just by doing injectible FSH/IUI cycles.

What I really wanted to know was how PCOS plays a role in an IVF cycle. I know that even with my IUI cycle, they have to approach PCOS patients slightly differently, because we are the lucky super-responders to FSH. They have to give teeney weeney doses to carefully tease a follicle or two into the forefront, because otherwise they just end up with a bazillion little follicles and a canceled cycle, and, well, that's no fun at all, is it?

My main concern was whether I'd be at an increased risk of OHSS (Ovarian Hyperstimulation Syndrome) which is, well, kind of evil, from what I've read. The short answer is yes, there is an increased risk of OHSS with PCOS patients. The long answer includes a bunch of statistics that I don't understand which boil down to: "but it's still really rare." So PCOS patients, because they are SUPER-Responders, stay on Lupron at higher doses for longer than the average patient. Lupron, boys and girls, ain't cheap. (I'm a lucky duck in that I have insurance coverage for much of this, but I feel for the poor women who have to pay for this all on their own) Anyway, I guess the idea of staying on the Lupron is to continue suppression for a bit longer, and to help avoid early ovulation. No problem.

Okay, there's a problem. I was really hoping (as disgusted as I am by the idea) that even with an IVF cycle, they'd let me keep taking prometrium suppositories (yeah, I know, yuck) instead of PIO (progesterone in oil) IM injections. But no such luck. I do not know why, but this paralyzes me. Ridiculous, right? I can handle subcutaneous shots. I can handle the IM HCG Trigger. I can handle the oh-so-pleasant-sounding egg retrieval. I can handle HSGs. I can handle all manner of unpleasantness, so why am I so freaked out by the PIO injections? They sound so icky! And they seem so painful! And everyone I've talked to has told me how ridiculously EVIL they are. Crap. Have I come this far just to be paralyzed by one really huge syringe? Seems that way.

Well, I suppose we can always hope that this IUI cycle works. (Hah! I almost said that with a straight face!)

Speaking of this cycle, I was back at Shady Hell this morning for more monitoring. I have to say, it felt a lot more normal to be on the second floor. I swear when I was brought into my doctor's office on the fourth floor yesterday I almost took off my skirt, because well, what else do we do at the office? It was completely odd to remain fully clothed for the entire appointment. Today put the world back into balance, though.

Dracula had a hard time finding a vein in my arm, so she snagged blood from my hand. Actually, I'm grateful… it sure beat having to have her poke around in my arm. So even though it hurt like heck, there's no bruise and it feels fine now, and it only took one stick. I heart Dracula. She's way better than the other phlebotomy flunkies.

The doctor covering monitoring today is a nice Jewish doctor from South Africa. He is very soft-spoken and sweet, and has a delightful accent. Anyway, I was worried that they were going to tell me today to trigger tonight and that would just be sucky because that would have meant a Saturday IUI and that would so not work for me (I'm Jewish, and Saturday is the Sabbath and comes with a million and one rules, one of which is no driving, so getting to the clinic would be nigh impossible). Anyway, without me saying anything about it, he said, "Well, it looks like you probably need to go another day, so you'll probably come back tomorrow and trigger tomorrow night, you'll be good for Shabbat [Sabbath], and back on Sunday for the IUI." A call a few minutes ago from my nurse confirmed his guess, and I'll be going in on Sunday. Whew!

I have a lovely 16 mm follicle on the right side just begging to pop. I've been feeling pain on my right side for a couple of days, so hopefully after tomorrow, that pain will go away and we can move on.

I made the mistake of actually being a tad hopeful in my last cycle, so I was pretty horrified at my repeated negative HPT attempts and the eventual appearance of my period. Yes, I'm a pee-stick addict. I know I'm not supposed to test before the blood test after the IUI, but I can't help myself. I go crazy knowing that I'm doing nothing (Nothing!) during the two week wait. I hate that time. I spend so much time up until the 2ww going from one appointment to another signing one form or another, sticking myself with needles, getting up close and personal with the cooter cam every three days, calling my financial coordinator, writing checks, and then all of a sudden… Nothing. A black hole of hand-wringing, fidgety, nothingness.

Right. So I'm just happy to be finishing this cycle with a plan in place for next cycle, knowing that there probably will be a next cycle, and knowing that we'll likely be just moving on to the next step and saying goodbye to the IUI chapter of our reproductive lives.

Have I mentioned that I want a baby? I mean really, really, really want a baby so badly I can almost feel a baby in my arms? What's amazing is that when I see my wondermous husband with someone's baby, I think that sometimes he aches for a baby more than I do. I mean, I really, really, really want a baby. But my husband? Yeah, he does too, even though he doesn't talk about it much. We have an amazing foster son, an almost-three-year-old who is so much fun, but we never got to have a baby (we got our foster son when he was 13 months), and I just know my husband really wants to experience babyhood from a father's perspective. I just wish my ovaries would cooperate and I could give that to him. And me. Don't forget me. Because, you know, it's ALL about me.

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Welcome to the Club

So I've decided to start a blog devoted exclusively to my infertility posts. Well, not that I promise never to let a bit of my real life pop in now and then, but mostly I'm figuring that a lot of my friends inside the computer really don't want to have so much information about my reproductive life. Still, I do desire an online outlet for my infertility craziness, so here I am. I don't know yet whether I'll tell any of my friends in real life about this blog. I obviously won't object if they stumble upon this blog one way or another, but sometimes I wish I were a bit more in-the-closet than I am. I always intend to keep my mouth shut about things, but then I just blurt out information. I'm hoping that having a blog where I don't have to censor myself as much will make it easier for me to censor myself in real life.

So here's a bit about me:
I am 30 years old, married 3 1/2 years, and have a beautiful 2 1/2 year old foster son. My husband and I have been trying to conceive, well, since our wedding day, I suppose. Before we got married, we knew we might face some challenges, because I have PCOS and had an extremely irregular menstrual cycle. We tried charting and all the normal stuff. A year after we married, we talked with my OB/GYN about what else we should be doing and she gave me Clomid. Five cycles of Clomid later, and still no pregnancy, I was good and bored. Oh, I was ovulating for sure, based on my temperature charts, but no pregnancy.

I think in September or October of 2005 we finally went to a Reproductive Endocrinologist at "The" Clinic to go to around here, much to the annoyance of my OB/GYN. I get the impression that the two professions don't exactly love each other too much, and I'm not really certain why.

All tests came out as expected for a chick with PCOS. No other problems found. HSG was negative, SA was stellar, I had (not surprisingly) polycystic ovaries (duh).

The RE didn't want to do anymore Clomid cycles, as I'd come close to reaching the lifetime limit on how much Clomid they like women to take. So… on to IUI with injectible FSH it was. Whoopie!

Cycle 1: My first FSH/IUI cycle was February 2006. Picture perfect cyle, for the most part, and as everyone expected I would, I responded brilliantly to extremely low-levels of Follistim. Life was good. I romantically made my husband come with me to the actual IUI appointment figuring if we were going to conceive a child, it would be nice if he could at least be in the room. Hah! The IUI was quick and painless and rather, if you'll excuse the pun, anticlimactic. "That's IT?" I asked, incredulously. That's it. I almost felt like there ought to have been at least a little discomfort for my trouble. Not that I'm asking for unwanted pain or anything, but sheesh! There was no WAY this could work if it were that painless! Unfortunately, I was right. Cycle 1 (or 6 if you count the five failed Clomid cycles) was a failure.

Cycle 2: Took up all of March. It was the cycle that would never end. Slowly, slowly, my dosage was inched up bit by bit. I was still responding really well, but no follicles were jumping up and saying "Pick me! Pick me!" So that cycle I had 10 ultrasounds in 29 days. My IUI was on CD31. Two weeks later, I was out of town, so couldn't have my Beta done, but I didn't need it anyway, since CD1 reared her ugly head in the middle of my vacation.

Cycle 3: was a blessedly quick cycle. CD1 was June 12, 2006, and the IUI was a mere four ultrasounds later on June 27th (CD16). Though the cycle failed, I'm still very grateful that it was such a quick cycle because I threw up every single day that I took the Follistim. Every. Single. Day. In the first two cycles, I had some mild side effects from the Follistim and some truly evil side effects from the Prometrium suppositories that I took for two weeks after the IUIs. But this cycle… oh boy did it suck. Every evening I would take the Follistim shot, and an hour later I was start to feel nauseated. I would be up all night feeling sick and then throwing up most of the day. I usually felt better in the evening after work, and then I'd take another shot before bedtime and an hour later… lather, rinse, repeat. "How odd!" said my nurse. "I've never had a patient with that side effect," said my doctor. "Well, it could happen," said my pharmacist husband. Duh. Of course it could happen. It DID happen! Anyway, Cycle 3 failed, so on to…

Cycle 4: Present day. Cycle 4 started 13 July 2006. As usual, I'm responding well to the drugs, but since I have PCOS, I'm super-sensitive to Follistim, so they have to be very careful not to give me too much. My current status is that I have a bazillion little follicles (hence the sonographer's usual "My, but we have perky ovaries today!" which led to this blog's title), and 4 worth measuring, only 2 of which are likely leaders. Left Ovary (never the forerunner, it seems) has follicles measuring 9.9 and 8.9 mm and Right Ovary has follicles measuring 13.4 and 10.4 mm. My estrogen level is up from two days ago at 113. So far so good. The follistim still makes me feel nauseated, but I haven't been throwing up as much, which is great.

Tomorrow I have an appointment with my RE to talk about what to do after this cycle. Originally, the RE wanted to do 5 IUI cycles before talking about moving on to IVF. Her reasoning is sound. There doesn't appear to be a medical reason that IUI wouldn't work for me. She believes it is simply a matter of time. My numbers look good, I respond well to the FSH injections. Can't ask for much more. However, I don't want to do a fifth IUI cycle at this point, particularly in light of the fact that Follistim makes me so ill all of a sudden. I mentioned this to her at one of my monitoring appointments and she said no problem and that we could lay out the IVF protocol at my consult and just hope that I never need the information since Cycle 4 is obviously going to be successful. Hah! I can't even type that with a straight face!

So here we go…