My stuck little ovaries

Went for my baseline this morning. My lining looks good and no cysts. Dr. P did his foot holding thing, it is so cute. He holds my foot while he wands me, like he was holding my hand. I love it!

Last night I had a rough night’s sleep, I had severe side pain that kept me up. This happened last IVF cycle too - day three of my AF after going off BCP. Same exact thing. At 3am I got up to take some tylenol and finally got some sleep. I told Dr. P about it and he looked at my insides a little more closely. He said that my ovaries are “stuck” to my uterus - he has never said this before. But he showed me what he was talking about — there is no gap between the ovary and the uterus, they are touching. He said that sometimes this can cause ovarian pain, and the combo of Lupron and the BCP could magnify the effect. Sounds like a weird explanation to me, but he is (supposedly) the expert. Of course I immediately asked if these “stuck” ovaries could cause any problem with implantation or pregnancy, and he said that it shouldn’t matter.

Anyway, the good news is that I am off and running for IVF #2. I got my first Follistim shot this morning by the nurse. My protocol:

5 units of microdose Lup.ron in the a.m.
225 units of Folli.stim in the a.m.
5 units of microdose Lup.ron in the p.m.
225 units of Folli.stim in the p.m.
150 units of Meno.pur in the p.m.

FIVE shots per day. OUCHIE! I also start the baby aspirin tonight. She warned me about the Menopur - she said it is going to sting because it will be really concentrated. I am going to try icing it up first. I am going to start shooting my legs because I save my tummy for the Lupron.

The doctor said that he didn’t want me to pay for ICSI yet, because he is not convinced we need it. WHAT? Apparently last time they did 50/50 ICSI and since all the eggs fertilized they think that it isn’t necessary. On the one hand we would save $2000, which would be very nice. On the other hand I worry that none of the eggs will fertilize if we don’t do it. He said that the embryologist will make a decision when they thaw the sample (remember, TW won’t be here for any of this!). I think I will decide on “to ICSI or not to ICSI” when we know how many eggs we have to work with. If we have lots more eggs than last time, then we can forgo ICSI. If it is 7 or less eggs, then I would feel better with ICSI. Anyone have any advice on this?

Oh — the doctor gave my ovaries “codes” this time, I don’t remember him doing that before. My left ovary was a “9″ and my right ovary was a “7″. What the heck does that mean? I was going to ask, but I was too worried about my ovaries being stuck to my uterus, and I forgot.

I need to remember to stay hydrated….and NO wine anymore!

Ugh, the Follistim gave me a nasty headache.

Please, let this one work!!!

The Schedule

I am SO irritated right now. I just looked at TW’s schedule and he has a trip from November 7-11 and then another one on November 14-15. Hmmm. Guess what? My egg retrieval is scheduled for November 11 and the transfer on the 14th (estimates, but still). Guess what else? Those trips are the only ones on the calendar…he isn’t working (so far) the rest of the month! How can I be so lucky! I called my friend A to see if she could come with me if TW isn’t around, and of course she said she would, but I would much rather have my husband there. I mean, if I am going to get pregnant, it would be nice if my husband is in the same room!

I am going for my injections class tomorrow and I am going to ask if I can take two more days of BCP. This would push things up by 2 days and would work much better with TW’s schedule. Shouldn’t be a big deal to start 2 days later, I don’t think?

The one thing that I was happy about was that TW didn’t just shrug his shoulders and say, “Oh well, guess I won’t be there”. He did seem concerned and really wants to be here. The problem is he cannot change the work trips, there is no flexibility - I understand that. So if this is going to work out, I am going to have to shift my schedule by a couple of days.

On the remodel front, I am going to meet with the window dealer today to choose our new windows! This is my first shopping expedition for the house. Very exciting!

Side Note

We ended up staying, we blew off the mountain trip. TW has been helping the contractors and decided it would be a good idea to try out the jack-hammer. Yeah, well… he hurt his back and didn’t want to drive 6+ hours yesterday. It was pouring rain too, and on a Friday night the traffic would be horrific. I was secretly relieved but didn’t say anything (I hate doing short trips with long drives).

I saw the sperm analysis results: 5 million per mL and only 1.1 mL. Only 24% motile. That means he only squirted out 1.32 million motile sperm. No wonder I wasn’t getting pregnant! I kept asking the nurse whether they got enough, and she assured me. They froze it for a back-up. I convinced TW that he should still plan on doing it again the day of retrieval if he is around, and he agreed. At least we have a back-up ready to go.

We made a final decision that we are going to do the 4 cycle package. That gives me 24 months to get pregnant and would include 4 fresh cycles if needed, and all the frozen cycles possible.

Oh - I mentioned to the nurse that I was going to acupuncture and she asked me who I see. I told her about K, and she said, ‘OH! K comes here and does acupuncture on the day of transfer if you would rather not go to her office for it.’ I wonder why K didn’t mention this? She did tell me to plan for two sessions on the day of transfer, but didn’t tell me she would do it at the IVF clinic. I will check in with her about that on Monday morning when I go next time.

I had an acupuncture session on Thursday after work (still love it) and asked K if she was a doula. She smiled and said she was going to get her training done soon because it would work well with her on-call gig at the hospital. However, she doesn’t want to advertise that she is a doula, she will just do it for her established acupuncture patients. Something to think about — I am not sure if I want a doula, but since I already know (and love) K, it sounds more attractive!

Please let this work! I feel like I have placed all my eggs (and hopes) in one basket, but it is the only basket that was left, so I had to take it. I am at the point where I cannot imagine that it won’t work. Which on the one hand is amazingly optimistic of me (Ms. Doom & Gloom), but on the other hand, I am setting myself up for a BIG disappointment.

The Big Picture

We had an appointment with TW’s endocrinologist today. I heart the endocrinologist. He is soft spoken, patient, and he never seems in a rush to get to his next appointment.

The bottom line is that TW’s sperm counts, motility and morphology are horrible and the bromocriptine is not helping. Dr. L. told TW that he had a couple of choices…1) to throw in the towel and just move forward with IVF, or 2) to double the dose of bromocriptine in case it may help. I was floored when TW asked a whole bunch of questions and then said he wanted to double the dose. Flash back to several months ago — TW would fight me tooth and nail about the meds and going to the doctor. I was dragging him to go to appointments, forcing him to take his pills, and we were fighting all the time. I accused him so many times of not really wanting a baby.  He willingly and happily went to see Dr. L. today and he had thoughtful questions to ask. For once I did barely any of the talking. He agreed to take a double dose of his meds, and then in three months get some more blood work and another sperm analysis.

TW is really coming around. When I started explaining the IVF process to him and mentioned that  I would need SHOTS several times a day, his face went white and he basically said he couldn’t do it. I ended up asking a girl friend of mine (actually she offered without me even asking!). I told TW this last night, and he said, “I am going to give you the shots. I am going to do whatever you need me to do”.

I think that accepting the fact we are not able to have kids on our own steam was really hard for TW. Especially considering that as far as we know (at least according to the evidence we have collected thus far), it is his sperm counts that are the obstacle we are trying to overcome. He had this naive attitude for so long that it would just happen. And I think he is finally understanding the reality: it is not going to happen without A.R.T. It interesting how the processing is so different between the two of us. The minute we got the first sperm count, I was like, “OKAY — we will use donor sperm!” He — not so much.

So — he is getting the big picture now. And he has decided that taking the double dose of meds is a good idea, in case IVF doesn’t work, then maybe we will have a chance naturally. We also had a good conversation with Dr. L. about nutrition…TW isn’t the best at eating his fruits and veggies, especially when I don’t put them in front of him. I am going to try to do something about this. Maybe prepare some cut up fruit and veggies and leave them in the fridge for some good snacking choices. And I am going to make a vegetable every night with dinner.

Interesting: Dr. L. said that there is no clinical evidence that vitamins and supplements have any benefit. He said it is much better to do it with diet (like adding colorful veggies and fruits). He even went so far as to say that supplements and vitamins can do damage. He then said that people may be even better off eating organic (truly organic) meats and cheeses and leaving out the fruits and veggies altogether unless they are organic too! I am going to do my best to buy organic stuff from now on…I never pay attention but I am going to start.

Prolactin - Normalized

Huh. TW’s blood work came back and his prolactin is no longer flagged as high. It is on the higher end of the scale (17.7) - the reference range is 1.61 - 18.77 - but it is still considered normal. His prior result was 28.9. So, the Bromocriptine seems to have made a difference. You know? This really pisses me off. Supposedly a lower prolactin level was going to make his sperm pretty and healthy and strong and populous. WTF? I was hoping his prolactin would be the same because then Dr. L would tell us to try a higher dose. I wonder what Dr. L will say. I think I can take a guess: “Have you thought about IVF?”

Is a milkshake food?

So, TW is finally going for the blood test he should have done 4 months ago. He takes his prolactin meds at night, so Dr. L. told him to eat breakfast and then fast the rest of the day, and go in for the blood work at 5pm (as late as possible before the lab closes). So I reminded TW gently this morning that he can eat breakfast but that he needs to refrain from anything until after the blood test. He just called me and said, “Is a milkshake food”? OMG, I almost lost it! Luckily he called BEFORE buying the milkshake. I told him that any dairy will artificially raise his prolactin levels and he would have to get stuck again tomorrow. What a dork!

The New, New Plan

Last night TW and I got into a war. He was supposed to get his blood test done today, but he decided to work and won’t be able to do it. I was so angry I said some horrible things about sperm banks or finding a random guy with good sperm who would be happy to father my child. As you may have guessed this didn’t go over so well. He said some horrible things back to me, and there were tears and raised voices, and the puppy was scared. We got it all out. I think we just needed to explode for a moment to get rid of some of this negative energy. We both feel better now. I am still mad that he decided to work but he is taking the day off on Monday (he PROMISED) and will do the test on Monday (he hadn’t taken the day off today, he just didn’t have anything scheduled and then something popped up). I guess 3 days really isn’t that big of a deal, but it was the principle. I envisioned it as him choosing work over our future baby. I was being a drama queen. I am just so stressed!

This morning I got an e-mail that gave me goose bumps and brought tears to my eyes. My friend KH that I met on a babycenter.com bulletin board (I don’t go there anymore…but I kept up with 6 people and we started our own mini-private group) just got her very, very first BFP after a long 4 year journey of trying, add in male factor, many IUIs, and 1 failed IVF. Her first IVF went super well (we all thought), but when it was time for her beta, she got a BFN - devastating. Her 2nd attempt at IVF worked and she got her BFP yesterday! She and I were traveling on parallel paths, but she was a little ahead of me. It seems like she was one of the few girls I have met over the last couple of years who had also never had a BFP. I am so, so, so happy for her.

This jumped started my whole new plan. Why wait 3 months to see if TW’s meds will work if we increase the dose. We can still increase the dose, but there is no point in waiting. I want to do IVF, and I want to do it now. If the meds end up working that is great too. But there is no point in just sitting around to see. I have to get proactive. I am not getting any younger. I am calling my RE today.

The New Plan

We have a new plan. And with a new plan, there is renewed hope. TW is going to get his blood work done on Thursday.

If his prolactin levels are still high, it means that the dosage of his meds is too low. Dr. L will prescribe a new dosage and we will wait 3 months for another S/A and try naturally all the while. If the S/A shows improvement, we could be in business. Please, Please, Please let this be how it goes.

If his prolactin levels have normalized, it means that he has responded to the meds, but his sperm counts haven’t normalized like they are supposed to. We will have to accept the fact that we don’t have enough sperm to get pregnant naturally. So, we will go straight to IVF - ICSI. This scares the crap out of me. The shots, the prep, the retrieval and transfer. I worry that TW won’t be around at the right time…I hope we can work around it. I hope that we can freeze some of his swimmers? Does anyone know? I know that freezing kills off 50%-75% of sperm, but if they only need a handful, maybe it would be okay?

The other thing that scares me is the cost. We aren’t loaded and the $15,000 that it takes to do IVF-ICSI is going to definitely sting. And if it doesn’t work the first time, I don’t know if we will be able to do it again. I have read so many stories of 3, 4, 5 IVFs before success. But maybe I will be one of the lucky ones with the IVF slot machine? I drop $15,000 worth of quarters into the slot, and get a baby in return? That would be the jackpot.

I was looking at a clinic’s policies and they have one of those financing plans where you can pay for 3 IVFs up front and then get some of your money back if you don’t have success. However, their criteria is that you have to be under 38 years old with a day-3 FSH of 9 or less. WTF?!?! My FSH is a healthy 5.8, and it pisses me off that they would do this for a 23 year old with an FSH of 9, but not for me.

So as you can see, I am anxious and nervous, but I am also hopeful. IVF may be in our not-so-distant future. We will know more on Thursday.

Sperm Count Unchanged

I just broke into TW’s on-line medical site to see if he got his results. He did. Not good. The subject line of the message from his doctor is “Sperm Count Unchanged”. Here is the note from the doctor:

Unfortunately the sperm count, morphology and motility are not improved. It looks like you never rechecked a prolactin level on bromocriptine. I had wanted you to do this some time ago to prove that you were taking a corrective dose of the drug. Have you stayed on the bromocriptine? If so, you should have a fasting prolactin level measured before your morning bromocriptine dose to prove that the dose is adequate. I’d also suggest seeing me again at your convenience to discuss long-term strategy.
Thanks, Dr. L

Can I be any more disappointed? I feel like we are cursed. He has been popping the pills religiously, every night (sometimes he remembers on his own, other times I hand it to him). When he is out of town, I call him to gently remind him. I have taken a picture of the pill bottle on my phone and sometimes I send it to him when I need to remind him. He has been on the pills for almost 4 months. And. Nothing. Has. Changed. FUCK. FUCK. FUCK. So much for my “This is the Day” mantra. And now I am kicking myself for not bugging, nagging, screaming, yelling at TW to go get his fucking blood test. 4 months wasted. I kept thinking it wasn’t a big deal because we would see if the pills were working when he did his Sperm Analysis. What an idiot I am. I didn’t realize that the Doctor could assess the dose with the blood work. I guess if the prolactin levels are lowered, then the dose is correct but the sperm counts didn’t respond. If the prolactin levels are not lower, then the dose could be increased. So now we are back to the drawing board. I am SO frustrated! Why can’t this happen for us? The doctor said that most men respond well to the medication and the sperm counts/motility/morphology normalize in 3 months. I was so hopeful that TW would be in the “most men” category. I can go to acupuncture until I look like a needle whoring drug addict but it won’t help anything if I have so few sperm to work with. Here are the results, in case you are curious:

Volume 2.6 mL (normal 1.5 - 5.0)
Motility 2 hour 40% (normal >60)
Progressive Motility Score 2+ (normal 3-4)
Sperm Abnormal Morphology 83% (Normal <40)
Sperm Count per cc 13 (normal >60) mL

This is such a roller coaster ride. I felt so hopefully yesterday. And now I am in a black, black, hole.

Can I rent an erection?

This morning walking into work from the locker room (well, walking my bike, because I rode my bike to work but stupidly brought a skirt to wear…now I realize that riding my bike in a skirt is a BAD idea) I saw this truck with this painted on the side:

“BRAND Scaffold Rental and Erection”

Maybe if I could rent an erection for the day, I wouldn’t have to worry about TW’s male factor issues. Ironically, last week I saw a truck with this painted on the side:

“BFP”

It stands for “Best Fire Protection”. I guess this would only be funny for those that are familiar with the TTC lingo.