Viva Las Vegas!

We have officially decided to do IVF in Las Vegas. I spoke with Dr. F at the S.HER Institute on the phone today and then with their office manager/financial manager and we made our deposit. We have officially reserved a spot for early February.

We qualify for their micro-IVF program and also standard IVF. And although our final decision is up in the air, we also meet the requirements for a special discount program. So we will very likely be doing standard IVF at a rate that is about half way between Micro IVF and Standard IVF. Still a boat-load of money any way you spin it.

Dr. F recommended that I come out to LV for two weeks and although I thought I could arrange it, when I told my boss, she nearly had a heart attack. She has already arranged for about $6000 worth of marketing for a special hearing aid promotion the week before I would head out, she is afraid that the appointments will run into the week that I am gone and also that the patients see before going will need to be seen for follow ups while I am gone.

She has graciously offered to fly me back and forth as needed so that I can essentially be in two places at once. Although I don't know the details yet, Dr. F did say that he has people who stay for 2 weeks and people who fly back and forth. As of right now, it looks like I will be driving myself the 10 hour one-way trip for pre-retrieval monitoring (and whatever other prep work needs to be done), flying back home to work for a day or two, flying out with the husband for egg retrieval, flying back with the husband to work, then flying out for transfer and driving myself back. Hopefully it will be less back and forth and only one trip back in the middle instead of two. I won't know until I talk to the nurse next Thursday.

The one thing that all of this hinges on is my being able to get my records sent from the RE in El Paso. Although I don't think that he can deny me access to my chart, I'm sure his staff will find a way to make it a pain in my ass.

Stay tuned for updates in hopes that things move very quickly over the next month or so.

Side Note: I hope that you all had a Merry Christmas and we'll all have a wonderful New Year!

Phone Call

Me: Hi yes, this is Michele C*****, I just started my period and would like to set up an appointment for my next IUI

Secretary: Dr. N**** has stopped all cycles for the month as he will be out of town for the holiday. Please call us on the first day of your next cycle.

Me: Ok...um...bye

I had surgery in June and was told to try for 3 cycles naturally. He told me at the time of surgery that after the 3 natural cycles that we would do 4 IUI cycles before moving on to IVF.

To me that means 7 cycles before IVF. I asked at the time, what the reason for moving on to IVF at that time was for. I was told that the endo grows back over that period of time and that the likely success of a natural cycle or an IUI is greatly diminished by this regrowth.

I can do math, see:

3 natural cycles, plus 1 more natural cycle because I had to wait have a consultation before I could do an IUI, plus 1 failed IUI, plus 1 cycle sitting out due to a follicular cyst, plus 1 cycle sitting out due to the holiday=7 cycles

Does that mean we are on to IVF?

Is it wrong of me to assume that they would have informed their cycling patients that they would be closed for the Holidays? I was never told, so I just assumed they would be open. And yes, I know many bloggers who are upset by this each year as their offices close for the whole month.

Do I wait another month to be seen to try another IUI that presumably won't work?

Do we move on to IVF with a doctor who does care for his patients and has one of the highest rated embryologists in the country but is rather lackadaisical with issues like time and time sensitive procedures?

Do we do IVF elsewhere and kill ourselves financially and with our schedules to make it work with someplace that is out of state?

I am going to be making some phone calls, but I would appreciate any input or opinions on this situation.

Bullet point update

It's been a while since I updated and nothing major is going on so I thought I'd just summarize the happenings around here. I know everything is better with pictures, but Nate is hogging the computer and I can't upload them.

• Speaking of hogging the computer, Nate is completing his final papers and projects for the semester, I have not done this much homework since...well...never. He is a professional procrastinator and has required my help for most of the work. He would drop out tomorrow if I would let him. But then he would just be a stay at home dad to 6 dogs, and, frankly, that is unacceptable.
• Between Nate's finals and my traveling I have had no personal time or space in about 2 weeks. I don't think that I mentioned it before, but last week, Monday through Friday, I spent my time at two separate trainings. The first was in Chicago and the second was in Phoenix.
• Maybe it was ok that I didn't cycle this month, I was away during ovulation. If we had paid for the meds and then could do IUI or even try naturally, I would have been upset. Nate would have been REALLY pissed off!
• While I was in Chicago I met up with my brother and my sister-in-law for dinner. I was finally able to update them with the infertility stuff that we have been going through. And by update...I mean tell them anything at all. I simply didn't think it would take this long. Because we talked about it, and my sister-in-law felt bad because she didn't know, I told her about this blog. She has been reading old posts to catch up.
• While I was in Phoenix, I made a trip to the Scottsdale mall by myself to have a few watches serviced at a store. Nate was so worried that I was going by myself and that something bad would happen. Nothing bad did happen...except that I thought I lost my wallet at the mall...and I let people know at the 3 stores that I had gone into that I thought I lost it. The girl at Loft made me retrace my steps mentally and my wallet was found...inside my purse...in the zippered pocket. Doh!
• I'm back home and feverishly trying to finish Christmas stockings for my sister and her boyfriend...that she requested last year. I'm almost done, really I am!
• I have future travel dates set for January and February. Anyone out there live in Tucson, AZ? How about Orlando, FL? I wish I lived closer to any of you so that we could meet. My work and training does take me all over the country, but never anywhere where I know that some of you live.
• Maybe all of those bullets could be put into a cohesive paragraph as they are seemingly related, but whatever.

He should have said "no"

I'm sort of freaking out here. Not sure why exactly, but it could be that I've googled the phrase "can a cyst on CD3 turn into a pregnancy," and about a million other slight variations, repeatedly since I had my CD3 ultrasound.

I didn't see the RE for the ultrasound on CD3 but rather saw someone who I'm still not sure who he was. I didn't feel comfortable asking all of my questions, but was told that I would receive a call later in the day after they spoke with the RE.

I had asked the guy who did the ultrasound whether or not he thought that a 21.5 mm follicle on CD3 could result in a pregnancy and he said "Maybe." He should have just said "no."

I did get a call from the MA who said that the husband and I should have sex on the days when I experience clear cervical mucous. But she had no further information. She said to call if my period starts or with a positive pregnancy test.

I'm not on birth control pills to control the cyst. I don't know if or when I'll ovulate. I don't know how long it will be before my period.

Help! I'm freaking out!

Cycle cancelled

I'm still waiting for a call from the RE but in all likelihood this cycle will be canceled. I have a residual follicle/cyst from last cycle on my left ovary at 21 mm.

I believe it was the PA who saw me and did my CD3 ultrasound today, but he really didn't introduce himself. I could tell that something was off the second he panned over to my left ovary [cue scary noises] and I saw the big black blob.

The most positive scenerio is that I actually ovulate this follicle early and have a very short cycle. With my currently thin lining due to menstruation, it is unlikely that anything will happen even if I do ovulate. The most negative scenerio is that the follicle becomes cystic and needs to be drained. In actuality it will likely be something in-between that lingers and needs to be monitored and treated with birth control pills...you know, just long enough to make a person crazy.

Depending on the outcome, we may decide to go straight into IVF with the next cycle. I think I have Nate on-board with that idea. Actually I alluded to it on the car ride home until he brought it up on his own, then we high-fived on it after having come to the "mutual" decision to go that route.

Thanks to Thanksgiving...

AF showed this morning. CD1 is today. Because of the Holiday this Thursday, I will be seen for my CD3 ultrasound on CD2. Meaning that I miss a half day of work, go back in to work for the afternoon and then have a 4 day weekend.

It makes this work week reeeeeeeeealy short...and I like it.

Side note: I think that I'm going to have to start posting other stuff on here. This infertility shit is getting really old.

BFN

I missed my FMU yesterday because we had no pregnancy tests at home. So we went to the store and got a two pack...by the way, what a rip off, tests from the store are so expensive.

I tested yesterday afternoon and again first thing this morning just incase...BFN both times...

Nate was very frustrated with this result and for the first time he was the one throwing around the what-ifs. You know, what if this never happens? What will we do?

We're ok, just waiting for AF. Hopefully it doesn't make our next cycle interfere with Thanksgiving this Thursday. It will be nice to have a 4 day weekend though.

Anybody have big plans for the holiday...(any plans for just a regular Thursday for those of you who do not live in the US)?

Michele

Sent from my iPhone

Still here, still waiting

It's been more than a week since my IUI, but I promised my husband that we wouldn't test until the day that the Dr. said...which is this coming Saturday. A true 2 week wait.

Since I didn't test out the trigger shot, I'm now worried that if we test earlier, there could be a false positive, and thus we continue to wait.

It's OK though, I'm resigned to wait at this point, I mean what difference does a couple days make...

I'm afraid to jinx it but I do feel very positive about this cycle. Maybe it's just the knowledge of actually having had a chance this cycle, because I'm definitely not having any outward noticeable signs. Maybe it is the knowledge that we can finally try, cycle after cycle without waiting, until this finally works.

Other than continuing to wait, nothing special is going on here.

An uneventful IUI

We had our IUI this morning, and it was uneventful...just like I like for things to be (finally...right?!?!)

I shouldn't say that it was totally uneventful though, because they did a sperm count on the sample (unlike our first 3 IUIs) and we finally got good news...or someone else's sperm (just kidding). The count was up to 225 million post wash in this sample. All previous semen analysis (not done during IUIs) have shown a maximum of 60 million without washing. It looks like the recent issue that my husband had, for lack of a better phrase, "cleared out the pipes!"

I finally have the chance to feel excited and like we might be successful. Which means that, even though we are at the start of the 2 week wait, my mind has had the chance to picture what it might be like to be pregnant, what our guest room might look like as a nursery, and how our six dogs will react to me getting up in the middle of the night to take care of our child.

I am exhausted though, I've had three long days in a row where I had to get up at 5 AM and then be functional and productive all day, so today I took a nap when we got home...a 4 hour nap.  But now that I'm awake, I need to find things to occupy my time and my mind during this 2 week wait. Since I spend a portion of each day in the blogosphere, that means I need all of you guys to write some frequent posts so that I have something to do!

We will be doing a pregnancy test if AF doesn't show by 14 dpo, not having a beta unless the at home test is positive.

And we are a go!

I had my follicle scan today.

But only after a scary GPS experience where I was directed to go into Mexico as a "shortcut" to the RE's office...oh how inaccurate "shortcut" is. I was only using the GPS to make sure that I could get to the appointment on time in morning traffic. Long story short, I didn't know that I was on the bridge to Mexico until it was too late to take another exit, I then had to make a 3 point turn at the border patrol crossing in front of about 20 border patrol agents and 100+ cars. Mind you I wasn't really that far off course, you can see into Mexico for the last 10 miles of the drive as you drive along the highway to the office.

Anyway, I got to the office on time, but was locked out because apparently the knob gets hit easily by patients. What doesn't go wrong with my appointments?

I was finally seen for my scan, where I was advised that a resident would be doing the scan. OK, fine, they need to learn, I get it...but he put old Wandy in and proceeded to futz around like he didn't kow what he was looking at.  Even I knew when he was looking at my uterus. Anyhow, the RE came in and in 2 minutes or less, measured my uterus and follicles.

Uterus: 8.3 mm and triple-striped
Follicles: Righty- a few, but all 13 mm or less, Lefty- 21.5 mm, 14 mm, 13, mm

I was advised to take one vial of Meno.pur tonight and do my trigger tomorrow at 5 pm for a Saturday morning IUI. Yay for a Saturday appointment and not taking another day off work!

It looks like I will be doing my trigger shot myself somehow as I will be working at the office that is one hour away from where I live. (it does have to be intramuscular, so a hip/butt injection)

3rd injection

I took my last Letrozole/Fe.mara pill last night and I gave myself my third and final injection of Bravel.le before my follicle scan tomorrow. We are scheduled for 8:30 AM tomorrow November 1st, any bets on when I will actually be seen?

The final injection went much like the first shot but with just a tiny bruise. Not nearly as dramatic as the second injection and not nearly the same size bruise.

Lets all hope for 3 follicles or less!

Has anyone successfully given themselves their own trigger shot? I don't think my husband can do it, but I don't know how I am going to shoot myself in the ass.

I'm so hoping that this cycle will go well, even without a BFP, we will know how I respond to injectable medication. My only side-effect so far is a rip-roaring headache that started yesterday afternoon and has yet to go away.

Vlog on second injection

Hey guys!

I just wanted to post real quick, I'm at work and wanted to show you my lovely bruise from my second injection. The camera is better on this computer and easier to use than the one on my home computer. 

Basically, I'm a dunce. I gave myself the first injection on Friday without a problem, no bruise, no pain, no nothing. However, the second injection didn't go as smooth. I was doing the injection and noticed an air bubble in the syringe, I panicked and knew that you weren't supposed to inject yourself with air, so I pulled the syringe out half way through and tapped the syringe to bring the air to the top then forgot to push the plunger to get the air out. I stabbed myself a second time, very near the first injection site and pushed the plunger down injecting myself with air and all. Honestly the air bubble was rather small, but I had to google it. It turns out that for air to be a big problem, you have to inject a lot and have to inject it directly into a vein, my belly fat will not be a problem. All that worry for nothing, and a bruise as a result.

Hope you like seeing my face and hearing my voice as I've included a video below. (let me know if you can't view it, I used the video uploader within blogger to record and upload)

I had to stick myself

I'm now past the chaos that is the essence of working with my RE...and the online pharmacy...and the local gyno.

I received the all clear yesterday on CD3. Which, oddly enough, included an US on the belly in addition to my old friend from last year, Wandy.  However, it was done here in town (finally a move in my favor). I was the last appointment of the day and worried that the results wouldn't get to the RE on time, but I got a call from the RE's medical assistant while driving from the hospital back to my office, so it must have worked out just fine.

Then, my meds arrived today at the house while I was at work (freaking out about the tracking info that showed my meds hadn't been picked up from the pharmacy...stupid discrepancy with the tracking number, which they changed after they sent me the e-mail with the number)

As if things weren't screwed up enough, my husband had to leave town this morning. So I was left all to myself for my first injection. Several girls at the office offered to come over and do it for me, which was a bit creepy...they were very excited to volunteer...but I sucked it up and did it myself (while laying back on the couch in case I passed out...I'm not scared of needles, but you never know). Then when I was texting my husband to let him know that I had done it, he was emphatically trying to tell me to get someone over to do it for me (he is scared of needles). I don't think he would have been any help had he been here. I must admit that I felt uneducated and unprepared (I had no class or instruction on injections, just a note on what meds to take when), so I just followed the directions that came with the meds. It turned out ok and I didn't even have to google anything.

For my own notes: I've been instructed to take one 2.5 mg tablet of Letrozole/Femara for 5 days (CD 4-8), and one injection of 75 IU Bravelle for 3 non-consecutive days (CD4, CD6, CD8), I have Menopur, which I have been instructed not to use yet, and Novarel for a trigger for later.

Do those meds seem accurate for someone who does ovulate on their own? They said it was a low dose because they don't know how I will respond.

Ready...Set...Go!

So I know that this topic has been debated to know end, but I've finally found the true answer.

How do you get AF to start when you are anxiously waiting on her?

Tell the dental assistant that you can't have x-rays because you are trying to get pregnant and don't know yet about this cycle.

CD1 started yesterday afternoon and I'm trying to get my CD3 ultrasound scheduled.

If you predicted that I would have difficulty getting this scheduled with the local doctor, then 10 points to you because you are right!

I've placed a call to the local doc's scheduling assistant, but had to leave a message, we had tentatively scheduled an appointment on Monday, but obviously that will be too late. I have also put a call into the RE for back up, but I really don't want to have to cancel out a half day or more of patients to drive to El Paso. I'm waiting to hear back from both, but have to see patients today too so I've made my assistant aware that she is to go ahead and answer my cell if they call that number, but either way to go ahead and make an appointment. 

My other blog

Some of you may know that I've dabbled with writing other blogs.

I have a family blog that I have yet to link to over here, mostly because I don't write much on it. But also I want to be able to share more details that I currently feel are appropriate for this space.

However, I do want to like up to the blog that I just started. I've posted here about my pyrex collecting, but decided to write about it in it's own space.

It still needs some work, but come check me out at http://pursuingtheperfectpiece.blogspot.com/

We have a plan...again...

Finally met with the RE again yesterday. It turns out he does want a consult with his patient prior to doing a procedure...I asked. So it looks like I should just keep that in the back of my mind for future reference. However, there were new girls at the front desk, so who knows how it's actually supposed to be, maybe he was just covering for them.

We set up a plan for the next few months. A plan that I'm actually happy with. A plan that doesn't leave me feeling like I'm just sitting around. However, it was nice to try naturally again while having hope that it would work.

We will be doing injectable IUIs. Each month until I get pregnant with a maximum of 4 cycles. He said that if we needed a break emotionally we could take a month off.

The plan really sounds like most I've read about online.

I am to call on CD1 to schedule a CD3 screening ultrasound. They will check for ovarian cysts, fluid in the uterus and any other abnormalities. If CD 1 occurs on a Thursday or a Friday I am driving to El Paso on the weekend for the ultrasound. If it happens any other day, I can go to a local doc to have this done and save myself the 4 hour round trip drive (and a half day or more off of work). The local doc trained under the doc in El Paso, but is technically just a gynecologist, not an RE (that would be too convenient).

If I get the all clear, my meds will then be shipped directly to me so that I don't have to go back and pick them up. I have a list of meds, but not with me as I type this, it would be interesting to me to compare to you girls as I wasn't paying much attention as others were going through their meds when they were doing IUIs.

I will then schedule a follow up ultrasound for a follicle count and measurement. This has to be done by the RE in El Paso. From the paperwork I was given, it sounds like this will be 6-9 days after the original ultrasound. I will then be given a time and date for trigger and IUI.

However, he did say that we could continue to try timed intercourse if for some reason we can't get an IUI done with my work schedule. He says that the IUI only improves our odds by 5-10% per cycle.

He said that he would not recommend IUI or timed intercourse with more than 3 mature follicles.

Because I asked, he gave me the following statistics. I have about 25% chance of getting pregnant each cycle using IUI. With 4 cycles I have up to about a 75% chance of pregnancy total. With 3 mature follicles at trigger, 2 out of 10 women will get pregnant with twins and 1 in 300 will get pregnant with triplets. However, the increased estrogen of medicated cycles will cause my endometriosis to grow back. Therefore the likelihood of success decreases with each subsequent cycle.

I just hope I get pregnant at all.

I will be calling for more detailed quotes, but he through out the number of around $1000 per cycle. That seams reasonable to me, but I bet it will be more like $1500.

I still think that for a woman who has the financial means to afford these fertility treatments, it's been an awful long wait to get where we are, which is still no further than when we first started, or so it seems to me.

Back on the Weekly Wednesday Weigh-ins...

I know that I sort of stopped with the Weekly Wednesday Weigh-ins without any sort of explanation. And...well...I didn't have a good enough excuse to post here. I had lost 12 lbs and felt good and felt like I looked better. Then I had the lap for endo, and I just sort of quit trying. Well, I'm back up 4 lbs and still had 8 more lbs to lose originally...So I'm back on the wagon now.

1. Reiterate my goal and where I stand in reference to this goal. (BMI info from this website)

Starting weight: 145        
Last Week's Weight:132 (last time I did a www post)

Current Weight: 136 (-9 lbs total, 11 lbs to goal!!!)   
Goal Weight : 125       

Starting BMI: 26.5
Last Week's BMI: 23.4

Current BMI: 24.1 (In the normal range!!)
Goal BMI: 18.5-24.9 or exactly 22.1 for goal weight

2. Discuss what I am going to do to achieve my goals.

Progress on last week's activities:

I've missed yoga for 3 weeks straight, first she cancelled class, then I felt sick, then this week I had an online webinar to watch. Plus...I've been lazy.

 

However, I have been on 3-4 leisurely bike rides in the last few weeks, however, it hasn't been enough.

Activities for this coming week:

At least 3 times a week, I'm going to pack my bag for the gym before I go to work. One day will be yoga and 2 times will be weight lifting or cardio. 

I will go on one bike ride each week, likely on the weekend.

3. Post a (reasonably healthy) recipe that I've tried, a cooking tip, a new idea for working out for people to try, a photo update of my weight loss, or anything else I feel like sharing. 

 

I had put off losing the rest of this weight because I didn't want strenuous exercise to affect my fertility. But who was I kidding, I despise strenuous exercise. My version of exercise is mild at best. However, exercise does work, so I'm back to it now.

3 year anniversary!

Today is our wedding anniversary! 3 year ago I married the sweet wonderful man that is my husband. 

I sort of can't believe it has been that long...

Don't mind the beer in his hand, I just thought it was a cute picture of us

I loved the candid shots more than the photographer's actual pictures