IUI#3 is Tomorrow Morning!

I think after all the CRAZY DRAMA I've been through this cycle that this one has GOT to be the one that works, right?

To recap

7 follicles, OMG, can we convert to IVF?

9 follicles but low estrogen, what's going on?!

9 follicles, still low estrogen but IVF approved!

9 follicles, estrogen went up a bit but not enough, convert BACK to IUI

So that brings you to Friday.  I continued my meds and kept my day off that I had scheduled for my egg retrieval tomorrow.  The nurse told me to trigger tonight between 6 and 9 and then come in for my IUI at 10:30.

But, you see, I didn't want to trigger between 6 and 9.  I wanted to trigger at exactly 10:30 a.m., which would put me at 24 hours before the IUI.  I had read most doctors reccomend triggering between 24 and 36 hours befor ean IUI so it didn't make sense to me to trigger so late.  If I don't ovulate until 24 hours after the trigger and washed sperm can only live 5 hours, triggering at night would mean all the sperm would be dead by the time my egg drops, right?

I know I'm not a doctor but I play one on the Internet.

Anyway, this story should end with me triggering and all ready for tomorrow's IUI but that would be boring.  Instead I prepared the needle and, oops, it didn't pierce my skin and before I realized that I pressed the plunger down and lost all the medicine.

Cue panic.  Cue hysterical phone calls to four area pharmacies followed by more phone calls to my on-call nurse.  End of the story is that I was able to get another trigger shot for the low low price of $150.  Eek.

So we're almost all set for tomorrow.  Except I may actually be out of needles now.  Stay tuned....

Great News and Less Great News

Sorry I kept everyone hanging after my post on Friday about SEVEN crazy follicles.  This week has been SO weird and if I were to be abducted by aliens tomorrow I frankly wouldn't be suprised at all.

When we left off it was Friday and I had seven follicles and a really really high E2 level - 1284 I believe.  After hearing my cycle would likely be cancelled I left the office in shock but luckily rebounded a few minutes later and called the office back to ask about converting the cycle to an IVF.  I got to work, posted to the blog and waited for news.  Finally I hear back from the less than awesome nurse that, while we still needed to get an authorization from the insurance, I should keep on my regular medication routine (not skip the Gonal F as I had been instructed to do earlier) and we would see where I stood on Monday.

Monday came and I now had NINE follicles - holy snap!  Everything looked good in the office and I was told to plan on an egg retrieval on Friday.  I still hadn't heard from the insurance but frantic googling had told me I had a good chance of being approved.  I got into work so excited at the prospect of retrieving NINE eggs in just a couple of days.

Monday afternoon, however, I was able to get my lab results online and saw that my E2 had plummeted.  It was now only 143.  This didn't look good.  I frantically called the nurse and asked her how this would affect the cycle.  She told me that my doctor said maybe I was having a late reaction to the Ganirelix and I was directed to increase my Gonal F to 150.

(There was also some crazy drama with the entire United States being out of Ganirelix just as I needed to order more and lo and behold I am never working with that nurse again but I digress.)

Yesterday I went back for another follicle check.  There were still nine - 16, 17, 14 and 14 on the Lefty, and 17, 16, 15, 18 and 11 on the Righty.  The new (and amazing!) nurse explained that the follicles may even be bigger but they get crowded when there's so many.  I knew at that point that retrieval wouldn't be Friday but was still hoping we could schedule it soon.  I drove to work and anxiously awaited the results of my blood work.

The verdict: my E2 only rose to 186.  I was instructed to double my dose of Menopur and we will check again tomorrow.

Meanwhile I asked for Monday, Thursday AND Friday off from work for unspecified medical reasons.  If that wasn't awkward enough now I'm faced with the prospect of coming into work anyway if this cycle gets cancelled.  I'm really hoping for good news tomorow and there will be a miraculous rise in estrogen.

BUT the REALLY EXCELLENT WONDERFUL news is that my insurance company approved me for one cycle of IVF!  It just may not be right now.  Stay tuned.....

Snow White and the Seven Follicles

Well crap.  I'm not really sure what's happening right now.  I went in for an ultrasound on Wednesday and was told I had three follicles at around 10 mm each.  I was told to continue the Gonal F and Menopur and to start Ganirelix on Thursday.  Done and done.  They also told me my third IUI would likely be Tuesday or Wednesday of next week.  Sounds good to me.  I wasn't worried about three follicles because I had never gotten pregnant when we had two and then one so how bad could three really be?  They may not all grow anyway.

But today I got some alarming news.  I have seven nearly mature follicles.  Seven!  What on Earth?  Three are hanging out on my Lefty at 16, 13, and 14 mm respetively.  Four are chilling on the Righty at 16, 13, 15 and 13 mm.  So....this is not good.

The nurse was less than helpful.  She told me to keep taking the Menopur and the Ganirelix and come back on Monday but there was a good chance my IUI would be cancelled.  As soon as I walked out of the office, however, I had so many questions.

Should I be abstaining from sex?

What were the likelihoods that all seven follicles would grow?

If I'm going to get cancelled anyway why am I still taking fertility drugs?

Is there any way we can covert this cycle into an IVF?

I had told my doctor before starting injectibles that I was afraid of overresponding and winding up with higher order multiples and he had mentioned that we could convert if that was a risk.  I'd say SEVEN sounds like a risky area to be in, right?

I put a call into the Insurance Coordinator almost immediately after leaving the office.  It's been three hours and no call back yet.  Maybe they're waiting to talk to the doctor or waiting on my blood work.  I don't know.  I really really want to be converted.

Send happy insurance vibes my way please!

Cycle 8, Day 12

I am back from my long awaited and much needed anniversary jaunt to Montreal.  My second wedding anniversary is tomorrow but we took the long weekend to celebrate. But just before I left I got confirmation that my cyst had disappeared and I was given the go ahead to start injectibles - specifically Menopur and Gonal F.  So we traveled up north, cooler on board, for a little R&R, with a side of daily fertility injections.

Let me just say this - the needles weren't bad at all.  Although I had used an hcg trigger my past two IUI cycles I never had to inject the needle myself because I brought it to my monitoring appointment and the nurses took care of it for me.  I wasn't really sure what to expect but other than the learning curve of figuring out how to mix the medication, it was totally fine.  My husband did the first few shots and I took over last night.

I had a monitoring appointment this morning and everything looked good.  No measurable follicles yet but I'm sure they are growing because my estrogen was at 279, nearly as high as it was on the day before my first (Clomid) IUI.  I'm still learning how these drugs are different and I don't really know what to expect because they told me to expect to stim for at least ten days before starting another drug that will suppress my natural ovulation, but as of this morning the nurse said my IUI could be as early as next Monday.  It would be nice to know these things in advance because my husband has a bit of work travel to expect next week, but such is infertility.

Speaking of infertility, it has now officially been ONE YEAR since my husband and I began trying to get pregnant.  Like literally to the day.*  TMI I know!  I say this because I've previously expressed feeling like a "faker" among the rest of the ALI community since my struggle hasn't been nearly as long and difficult as others.  But, after one year, most experts agree that we are pretty much infertile although I just recently stumbled upon the word "subfertile" and I like it a lot better.

According to this study, after one year of trying to get pregnant naturally a subfertile couple's chances decrease to about 5% on any given month.  Not that it that statistic really means anything to me since I have been trying "unnaturally" for a number of months.  And a bunch of other studies say that most couples who aren't successful after one year are successful after two.  If you give me a while I can probably find some studies to debunk those studies too.

Anyway I'm in the club.  And I don't feel good or bad about it now that it's here.  I think subfertility has been my reality for a while so the "year mark" hasn't really affected me so much other than being sort of a sad note on an otherwise happy wedding anniversary.

*TMI story from one year ago today:  To celebrate our anniversary I took my husband back to the lakeside town we were married.  It was July 16th, so the day before our anniversary.  We had a romantic dinner at the hall where our wedding reception had been and then stayed in what was supposed to be a quaint lakeside motel.  Well, let's just say my husband wasn't feeling well and the motel was a little too "rustic" for our style and I was so mad because it was the 14th day in my cycle after ditching birth control and OMG I needed to have sex to get pregnant!  I can't even remember if we did it that night or waited until the next day.  Needless to say, it did not work.