What do my follicles and Peter Pan have in common?

They are in no hurry to mature. We have two that could be considered mature (just barely), but the other 4 are not ready for retrieval yet. So my doc increased my Follistim dosage to hopefully help speed them along and will measure again on Friday. It sucks because it means another $800 for just the next 2 days of meds, but I certainly want to have the best chance of as many eggs fertilizing as possible. If even just the biggest two of the four that are still too small mature enough, that would give us 4 good contenders. I would be thrilled with 4. Four would be better than 2. So that's it for now; we'll see if there's been any progress Friday morning and go from there...

Slow and Steady...

Just a quick update after this morning's appointment: follicles are growing! We still have 5 or 6. There are follicles on my right and left ovaries. I don't know about the integrity of the eggs in my right ovary since that's the one that's only partially there, so I am glad there are 2 or 3 in the left too. The biggest is only 14mm so we still have a little ways to go yet. We go back Monday am to get measured again but I am still betting they won't be mature enough and ready for retrieval before the end of next week. My doc is holding off on the Viagra for my uterine lining until Monday, but I am willing to bet he's going to have me start on it as well next week. Walgreens told me about a new program they have with New Life Agency that's an awesome deal for their cash paying patients: you buy their Pharmacy card for $25 and you get $100 off instantly for every $1,000 spent. And then they sent me a $25 Walgreens gift card!

So I'll update again after our appointment Monday. I am really looking forward to the w/e. My husband is treating me to a mini getaway at a hotel here in Dallas with a nice dinner and everything. We can certainly use a little R&R :)

Uncovered

Today was our first monitoring appointment! It went well; I feel better. I was pretty nervous about it. I figured we'd have some eggs at the end of all of this to retrieve, but I have been nervous that it'll be a situation like our 3rd cycle on inj's and timed IC back in April where we only had 1 mature follicle. But this am doc saw what he thought were 5 follicles - 2 on my left ovary and 3 on the right. The biggest two are only 10mm so it's still really early (they'll need to be at least 18mm before they're ready for retrieval). We go back Friday morning to have them measured again and he'll check to see where my uterine lining is in terms of its thickness, since that has been an issue. But I have been on an estrogen priming protocol so hopefully that will not be the case this time. And the nurse mentioned this am that she thinks doc is going to go ahead and have me start on Viagra suppositories on Friday, which also addresses my thin lining issue. So our goal is to have 5 -6 mature follicles for egg retrieval, which is about standard for women w/ DOR. If at least 3 of those fertilize and make it to blastocyst on day 5 we'll transfer all 3 to give us the best chances that at least one will make it, and if we have any more than 3 make it to blast we'll freeze, just in case. That's the plan. We still have a little ways to go yet; I know we won't have any mature follicles much before the end of next week.

I had a pretty rough w/e. I have been so nervous about this IVF. So much is at stake: all the money we've spent, and continue to have to spend, the fact that this will probably tell us whether or not my eggs are any good or if we're just chasing rainbows (it sucks we won't know that until the very end), and of course I think about what we'll do if this doesn't work. How will we fund another IVF cycle before it's 'too late'? Or will another IVF cycle even be an option? How will I make it through emotionally? And if it does work? That's a much better scenario to contemplate, but one that brings its own set of anxieties.

So I had a hard time this w/e, and the only reason I didn't succumb to the depression I feel lapping at my heels everyday is my husband. For those that know us, I don't have to tell you how great my husband is. For those that don't know us, I'm sure you know all to well that infertility isn't something you can get through alone. It's so crucial to have a strong support system; people that you can lean on when you're at your weakest. Because there are so many weak moments in infertility. And my husband has been so incredibly strong and supportive for me. I have been very hard to live with these past couple weeks since starting the meds for this IVF cycle. So yesterday when I decided I was going to wallow in my depression, my husband could have ignored it, chose not to deal with it, because that would have been the easy thing to do. But he talked me off the ledge again. He reminded me that we still have much to be hopeful for, and he reminded me that we can still make plans if this IVF doesn't work. But what made me feel better was just knowing how much he cares, how much he's invested in our future, and not just IVF and babies but me. He just wants a future where I am happy and it was really nice to be reminded that it's not always going to be up to me. That I have a partner who has my best interests, my needs and my wants, at the forefront. In infertility it's usually about sacrifice and uncertainty. There's so much fear and anxiety as a result. But my husband saved my sanity yesterday because he looked into my eyes, into my core, and told me he'll always be here to take care of me. My happiness and well being will always be his number one priority. How can I feel hopeless knowing that?

I don't know why God has put us in this situation but I know why God brought my husband and me together. Without him I would still be hiding under the covers.

Welcome to What If Land

Our first, and God willing only, IVF has begun. I took my first Lupron shot this morning. I start stims the week of the Aug. 15th, so that will put the egg retrieval probably somewhere around the 25th and the embryo transfer around the 30th.

Anyone that has done this before knows all the emotions that go along with it; and anyone that hasn't can probably imagine: everything from anticipation to pure fear. I have to make a conscious effort not to go to What If Land everyday. It's a scary place and I know I don't belong there, especially now, when I need to force all the zen and positive energy out of myself I can muster. I truly believe in the mind/body connection, and I know that now it is so critical to the success of this cycle that I ward off as much stress, anxiety and depression as I can. But I feel like I am already failing at that.

I am going through transitions at work (new position, losing my fantastic, super supportive, cheerleader boss that I miss already), attempting school, and now of course IVF, and it's just too much - too stressful and too overwhelming. So I have to fix that as quick as I can, which unfortunately means one of them has to go. IVF isn't an option, and I have to work for reasons I can't really seem to remember right now....oh yeah, we just spent $15,000 on IVF; so that leaves kicking school to the curb. It sucks because it's something I really want, but I can't do it and IVF and start a new job. Or I could, but I don't know if I should. If I sabotage this cycle due to my mental state, I'll never get over that. I will regret it for the rest of my life.

I've been feeling quite sorry for myself over this dilemma, yet another gift of infertility, the gift that just keeps on giving. But I imagine it'll be nothing compared to how I'll feel if this IVF cycle fails. See, there I go on my one way trip to What If Land. It's really too bad I don't accrue any frequent flier miles. I could probably fly from here to Australia every week and back for free at this rate.

That's all I've got today. I still listen to my gospel music everyday, but I just can't seem to find my voice to sing along with it lately.

I Smile

I challenge you to listen to this song and not feel good. Or at least better...
'I Smile' Kirk Franklin

Well, I am still technically "on break" from my IF treatments, but we all know there is never a true break from IF. Here's a quick rundown of some of the tests and the results I've had recently with my new doc:

• Hysteroscopy was normal, so my uterus is in good shape. I felt like I should've bought it a drink after that one!
• Insulin Resistance test was normal. Thankfully I don't have to say goodbye to my carbs.
• My new doc looked at the image of my HSG, the test that checked my tubes for blockage, and pointed out that my left tube is coiled. It's not blocked but that could complicate the passageway to my uterus. Another apparent oversight of RE #1. I am confident she did not review the image, just the report from the doctor that performed the test saying there was no blockage. I believe my new doc's assessment is accurate b/c in my 1st two cycles my mature follicles were in my left ovary only. Those two cycle were BFNs. My last cycle, the one in which I had the chemical pregnancy, I had one mature follicle only in my right ovary. So the embryo made it through my right tube, but possibly embryos never made it down my left.
• The last thing my new doc looked at was my AMH. This is a test to see if I have an adequate supply of eggs. Well, turns out I don't. This was really no surprise b/c I was a relatively poor responder to the gonadotropin inj's. So I have a new diagnosis from my new doc - diminished ovarian reserve. Awesome, huh? Way back in '98 I had a huge cyst on my right ovary. It was the size of a grapefruit. Don't ask me how or why I had no clue it was there until it was discovered by my GYN. Ironically that exam was my first GYN exam ever. Traumatic much? Anyway, when she removed it unfortunately about 70% of my right ovary went with it. So again, no surprise I'm coming up short on eggs..

So all of this means we need to do IVF to have the best chance at conception. I was really hoping it wouldn't come down to this but it has. My AMH is 0.72 and once it gets as low as 0.3 my egg supply will be all but gone. And we all know what that means. So not only do we have to do IVF but we have to move fast while I still have something to work with. The older we get, the more time that passes, the less eggs women have. We are born with all we'll ever have. IVF also makes sense now b/c it's very possible my left tube is degenerate, as is my right ovary. It's almost laughable, really. Ha. Ok, enough humor, I don't want to hurt myself.

So this week and next week my husband and I are scrambling to prepare financially for our first IVF cycle, which will happen hopefully in Aug. It's going to cost us roughly $15,000 for everything. We don't have any insurance coverage. It makes me physically nauseous to think of all the other things we could have spent 15 G's on. Oh, and my doc gave us about a 30% chance of success b/c of my low egg count. Fewer eggs means less chance of getting a good egg and hence a good embryo to implant. I'm sure you see my turmoil. But, beggars can't be choosers and I am certainly a beggar at this point. Only God knows...

Speaking of which, I've been listening to a lot of gospel music lately. I have Sirius radio in my car and I've had it on the gospel station just about every am on my drive to work. So the other day I have to stop at the gas station. It's pretty nice out in the mornings so I had my windows down, "God Blocked It" by Kurt Carr blasting. I pull into the station next to a car with an older black lady getting out of it. She hears my Gospel Mobile coming, freezes in her tracks, waits for me to turn off my car and get out, then hollers over to me as I'm closing my door and heading to the pump, Amen baby! as she raises both of her hands in the air, a big smile on her face.

"And I've got life to live
And there are blessings
He wants to give

God blocked it
He wouldn't let me fall
He wouldn't let it be so
It was the Lord
Nobody but Jesus"

Amen indeed.

Watch This

I am an Oprah fan. I loved her show, her magazine is my favorite magazine. I drop everything to read it as soon as it shows up in my mailbox. I've read her books from her bookclub, I've participated in her "Best Life" stuff. I love the people she's sculpted - Dr. Oz, Suze Orman. I just LOVE me some Oprah, and I love her because when she speaks she says things that are worth listening to. I believe she gets It.

So naturally I have watched her "Master Class" series on OWN. And I recently, finally, caught the episode of Oprah's own personal Master Class episode. If you aren't familiar it's a series that features celebrities giving these monologues about their life lessons and experiences, like memoirs. There is one lesson in Oprah's episode in particular that I just had to share. I've watched her and listened to her teach this lesson. I've watched over and over and over. And I've cried over and over and over. And with each tear, with each viewing, I feel a little more of me surrender. When you watch it, and I hope you will, you'll see why.

I'll preface the video, since it cuts out some of the story. You might know Oprah was in the movie, "The Color Purple." But you might not know that Oprah was really, really obsessed with "The Color Purple." It's her favorite book of all time. She stalked her local bookstore at the time it was released and bought every copy in the store to give away to people - friends, family, coworkers, even random people on the streets. She loved it so much because she related to the story and the characters, and it enriched her life by bringing about an acceptance, an understanding, and ultimately a healing from her tumultuous past.

Oprah reaches out to everybody in Hollywood that will listen when she learns of the movie production. She desperately wants to be cast in the movie. After all, she is the book's biggest fan. No one lived and breathed and loved that story more than she did. She could practically recite the entire book word for word she'd read it so many times. So this video starts with her describing what happens after the audition.

As you watch the video, replace "The Color Purple" with infertility. And it's my story. It's your story. But more importantly it's our lesson to learn.

http://www.youtube.com/watch?v=oS8QPj6lrKE&feature=related - watch the first 7 minutes

Revelations

Before I say anything else, I want to thank everyone from the bottom of my heart for the comments you left me on my last post; to those that sent me encouraging emails, texts and phone calls; to those that have kept me in your thoughts and prayers this week; and especially to my husband and my family, who held my hand and dried my tears, and maybe even shed some of your own - your love and support will forever hold a place in my heart. Know that I couldn't face each day without you. There are no words to express my gratitude so I will always try my hardest to be as good to you as you have been to me.

Now with that all said, I am feeling much better today. Last night was the first night of restful sleep I've had in a week which I really needed. I didn't wake up this morning feeling weighed down. I did wake up with some pretty intense cramping and some spotting, but my guess is that my period is soon on its way. I think I am ready for it. It will be the final nail in the coffin - my body telling me it's moved on. My hCG was down to 14 on Thurs. I consider myself lucky that it dropped on its own.

On Friday we had a consultation with a new doctor. Last week we learned that our first RE just wasn't paying attention. She didn't even bother to call me herself during last week's "events." Not a, I'm sorry, here's maybe what went wrong or here's what we may do differently next time. Maybe that's not standard protocol but it's not acceptable to me. It's also not acceptable to me that, after reviewing my records from her, she sent us on our merry way after our last u/s without bothering to mention the fact that my lining of 6.1mm might be an issue. Instead she just told her nurse to send me home with a couple estrogen patches and call it a cycle. I know better now.

So we went to a new doctor and we are going to start seeing him instead. Here's what we learned from him:

• The first RE told me she didn't think I would respond to Clomid. I never asked her why. She just said we needed to do gonad. inj's right out the gate. According to the new doctor, yes, the chances of conceiving w/ inj's vs Clomid is slightly higher, but by slightly he means about 2%. Call me crazy but I don't think the $1,300/month difference between the inj's and Clomid justifies that 2%. So for the next cycle I'll be on Clomid instead. We'll see how I do. I am certainly willing to give it a try.
• He also said that had he seen my uterine lining was that thin so far into the cycle, he would have just cancelled the cycle. He said there was "no way" I could have sustained a pregnancy with a lining that thin. I told him she put me on the patch the day I triggered but he said I would've needed to have it on about 2 weeks earlier for my lining to thicken in time. I'm sure now that my lining was to blame for this miscarriage b/c as soon as I took off the patch and stopped the progesterone my hCG dropped right away. So next time I will wear the patch or do a Viagra suppository much earlier on. Interestingly, Viagra is used to address thin uterine linings b/c just in the way it works to enhance blood flow to the penis in men, apparently it does the same to the uterus in women.
• Before we start more treatments, he is going to run some tests. I'd always wondered in the back of my mind if I needed more diagnostics so I am all for it. He's going to check my AMH first and foremost. That'll test my ovarian reserve to make sure I'm not coming up short. My response to the drugs has been ok but he wants to rule it out completely before we go any further. He's going to check my insulin and blood glucose levels to rule out any insulin resistance. This is b/c I have PCOS variance, (my 1st RE gave me the same diagnosis). What's odd though is that unlike most PCOS patients, I am not very sensitive to the drugs. I have responded with at least one mature follicle each cycle, but most PCOS patients will have much more than that. And third, he's going to do a hysteroscopy to check out my uterus to see if there's anything in there that's not allowing my lining to grow like it should. He said my estrogen levels have been ok - good enough that I should have an adequate lining. But that's not the case so he wants to do some more investigating there.
• So once these tests are done, and if everything comes back normal, we'll proceed w/ the Clomid plan. I think I'm going to have the tests done in June, and then if we can, we'll start our next cycle w/ him in July.

It helps to have a plan and some answers, and it helps to feel like we have someone who is going to pay attention. It's given me a little bit of hope again. I am trying to think of this as a new beginning.

While I was in church this morning, flipping through the Bible, I just happened to open to John 16: 17-33. It's the "ask and you shall receive" message. He uses a woman in childbirth going through agony only to have it replaced by pure joy with the birth of her baby analogy. Jesus says, "Now is your time of grief, but I will see you again and you will rejoice, and no one will take away your joy." I read those verses over and over, realizing that I didn't randomly flip to that page in my Bible. All week I cried and prayed and begged to God to show me something, anything to let me know that's He's here, that He's listening.

I think He showed me.