Swim

Today's magical moment has nothing to do with Christmas and everything to do with the fact that I just had all of this to myself for an hour after a long day of meetings. No, it isn't a tropical paradise, but I'd say it's not too shabby. For Buffalo. On November 29. (wouldn't you agree M?)




- Posted using BlogPress from my iPhone

Finding the Magic

I am bound and determined to enjoy Christmas this year. As I'm sure most of my readers know, this is an extremely difficult time in the life on an Infertile. It will be the third Christmas since we started trying that I will still be empty inside. 
The difference this year, is that instead of waking up on Christmas morning wondering if I am or if I'm not pregnant, this year, I know for sure I will not be. We've had to "abstain" this cycle for my endometrial biopsy coming up on Thursday, and will have to again the following cycle when I will be starting Lupron for IVF #3. 
Somehow, I hope that not having to wonder, but yet, being able to focus on the cycle that is to come shortly after, will help me to be able to focus on the magic of the holidays, and not on the what ifs. 
So, my plan over the next few weeks, in addition to trying to be as creative as possible, it to focus on the magic, and share as much of it as I can with all of you. 
Today, the magic began when we set up our new tree (yes, artificial - we travel a lot at Christmas - with the lights built in!) after we got home from visiting my mom. I won't decorate it until next weekend, but I did put one new ornament on that I picked up this weekend. It's a peacock, which fits right into our living room color scheme. There really is nothing quite as magical as lights on a tree!

Another thing that is pretty darn magical is to be recognized by other amazing bloggers. I am thrilled to have been given the Liebster Blog award by Miss Conception and Miss Mac from Mac and PC. It means a lot to get this award from these two ladies. Miss Conception is one of the first blogs I started reading, we went through our first IVF cycles together, and will likely be cycling together again after Christmas. Miss Mac got her BFP shortly before my first IVF, and was an incredible source of what to expect in the process, not to mention the fact that I have been on a Mac since they first existed, and am constantly fighting with Hubby who is much more of a PC, so I can totally relate! So, thank you both, very much. 
*Updated later to also thank JJ from A Journey of My Emotions who also awarded me. 

This Award is given to bloggers who have less than 200 followers, all in the spirit of fostering new connections. Leibster is German & means ‘dearest’ or ‘beloved’ but it can also mean ‘favorite’. The idea of the Leibster award is to bring attention to blogs with less than 200 followers.

Here are the rules:

1. Thank the giver and link back to the blogger who gave it to you.

2. Reveal your top five picks and let them know by leaving a comment on their blog.

3. Copy and paste the award on your blog.

4. Hope that the people you’ve sent the award to forward it to their five favorite bloggers and keep it going!

OK, so onto my nominees. I have a feeling that some of you will have probably already received this, but I figure, it doesn't hurt to know that a lot of people love reading your blog, right? And these ladies definitely fit into the category of beloved to me. 

1. Mr. Thompson and Me from Viva la Vida!

2. M from A Miracle 4 Us

3. Michele from Greetings from Nowhere, NM

4. Chon from My Path to Insanity & Beyond

5. Jill at Dear Infertility,

Filling Empty Walls

I have a few posts in my mind right now, one of which includes accepting an award of received from two lovely ladies! (Thanks Miss C and Miss Mac!) But, it has also been on my list to reignite my creative mojo which I worked so hard to get going again leading into IVF #2, and has suffered a bit since. I think I mentioned back then, that at some point, I would tell you about the cool ceramic dot vases I got during our trip to P Town at the end of the summer. I just wrote this post for my house blog I write under my real life identity, so I thought I would share it to kick off the creativity again. 


I have been staring at the empty walls in our dining room for over a year now...granted, it's only been about six months since we painted them gray. The weekend before Thanksgiving, we finally had time to hang up a few things! I am so excited to finally be activating this formerly blank space.

Below, you can see two framed photos that we had in our old dining room. One is of the magnolia tree at our old place. The other is of some umbrellas hanging in a glass dome at the Venetian in Vegas. To the left of the window, are three ceramic "dot" vases that we found this summer in P-town.

On the opposite wall, that backs up to the kitchen, we hung Hubby's beer labels that I framed for him as a gift for our anniversary one year. He likes to home brew, although he hasn't done it in awhile. When he does, I design the labels for him. We hung them high on purpose, with the intention of adding more objects below at some point. 

Here's how things are looking from the living room. (Please pardon the half chewed chenille blanket in the front left corner. Roy has been slowly devouring it, and I have yet to get rid of it...it's on my list, but anyway....!) We were really excited when we found those dots, for a few reasons. One, because the colors tie in with what's going on in the living room. 

And two, because the dishes we got for our wedding strongly feature dots! You can see why we couldn't resist picking up a few of these. At some point, I plan on making some flowers, either of paper or beads, to put in them. I would like to add a touch more green to the dining room, to tie in with the living room, and this seems like a perfect opportunity. 

I'm pretty happy with this way this turned out, for now. I tend to stress out a bit about silly decisions like this, so Hubby just encouraged me to get it done. I'm sure you iffers can relate. I have zero ability to make decisions these days. But, it's only a few holes in the wall after all. I'm sure it will evolve with time. But for now, like I said, I'm thrilled to no longer be staring at empty walls!

Why I am Thankful

Thanksgiving seems like the perfect day to reflect on all the wonderful things I do have in my life, rather than that one thing which I do not (yet...optimism!)

For starters, have I told you what a wonderful husband I have? He works so hard for our family and our home. He loves to surprise me with little things like cleaning up the garage and sneaking my car back in so I would see it on my way out to work in the morning. He is wise, and kind, and strong and silly. I'm a lucky lady.

I also have a pretty great family.

My mom is awesome. Low key, helpful, silly and joyful. When she came to visit recently, she did all of the laundry, and cleaned the house until it sparkled because she wanted me to see how beautiful it actually is instead of getting caught up in all the things I still haven't done yet.

My brother and I are close. Well, as close as you can be when you a separated by an ocean. I have a great sister-in-law, who actually turned out to be a really great listener when if comes to that thing which I do not have yet. And of course, there is the ever adorable Lady C. Have I mentioned that I am incredibly thankful for Sk.ype, which allows me to spend time waving and sticking my tongue out at her, and watch her do it back? This is considered to be an incredibly intellectual conversation with a 17 month old.

My in-laws are not to shabby either. Hubby and his brother spend every other Monday visiting their 91 year old grandfather. And BIL finally has a serious girlfriend, so for the time being, I actually have an ally at family gatherings! My MIL is silly, fun loving, and thoughtful. And she works at Low.es. What girl with a new house could complain about having a discount connection at a home improvement store?

And then there is that house, which we have owned for just over a year now. It has a garage, and a half bath, and a finished basement, and a (nearly) fenced in yard. It has an open plan living area, three big bedrooms with (mostly) big closets. It has incredible light. And it's transforming little by little to reflect our style and personality.

My friends, who are there for me, even if not here for me. We're always able to pick up where we left off. And the ones that are here for me are always willing to help out, participate in wacky parties and activities, and are in general quite a bit of fun.

I suppose I am even thankful for my job. It is less than 20 minutes away from my house. As long as I get my work done, and get in 40 hours a week, nobody cares if I came in at 9:15 or left at 4:30. The flexibility is pretty incredible, and hard to find. And, even though the advancements in my career are not exactly at the forefront of my goals as of late, I am still making advancements in my career. Each new project is offering me opportunities that I haven't had before. I am learning new things all the time.

And how about a random list of things like kitties who sleep on my feet and keep them warm, a fresh bottle of nail polish that goes on like nothing else, sun streaming through my windows, a hammock in which to nap in the breezy shade, living close enough to the ocean to have summer beach days, a car that I will own entirely after three more payments, a house that is clean and picked up and ready to be decked out for christmas as soon as we get back from our thanksgiving trip, friends at work who join me for sushi lunches, silly singing competition shows, blogs about design and decorating, a box of hair dye waiting to take my grey away, sleeping in on weekends snuggled up to Hubby. I could go on and on.

Then, there is this blog, and the amazing friends I have made whom I will (most likely) never meet. You have made all the difference for my this year. For all of you who are still here fighting with me, my wish for you today is that you will soon cross over to the other side, but I also wish you the ability to take some time today to take a break, and think about all of the wonderful things you do have.

Happy Thanksgiving everyone!

How to deal with nosy people

Another funny little tidbit from my girls weekend. KD, the one who is sure she doesn't want to have kids, is a bit of a rough around the edges tough girl from Brooklyn. L and I were seriously scared of her when we first met her as freshman.

Anyway, brought up how she hates when people ask her if she's planning have children, when she's going to be pregnant, etc. So what does she like to do when faced with these questions...with a completely straight face and sad tone, she will say "I can't have children." (which isn't true, that she knows of anyway.) People will react with shock and sadness. And then she will say..."Actually, I'm lying, but how do you think you would have just made me feel if that was true?"

As mean as that is to pull on someone, I just wanted to hug her. I did tell her thank you on behalf of all of us. That's the kind of awareness you just don't expect from people, especially not scary girls from Brooklyn.

On another note, I'm feeling really behind in life. I'm getting busier at work, I'll be going back to Buffalo two more times before Christmas. We're traveling to see my mom for Thanksgiving, Hubby has been working literally non-stop. So between my travel and his work, I feel like I've barely seen him in weeks. And, I've been fighting a stupid sinus headache all week. It's the kind that's so deep in your head that your nose isn't actually stuffy, but you feel sort of loopy and dizzy and headachy. I really want to get my crafty mojo back on, and get some stuff done around my house so it will look nice for the holidays, but It's hard to motivate to do much when I get home from work. I do have to give myself credit though, because I have managed to get on the elliptical for a half hour for the last two nights. So, I guess I'm getting something productive done. It's just that I'm starting to feel like Christmas is already over, and it's not even Thanksgiving yet. Does anyone else ever feel like time move way too fast with not enough to show for it?

Perspective

This past Saturday, I headed down to Duchess County, NY for a little reunion with some of my college girlfriends. 5 of us gathered at the home of my friend A. Of the five of us, L, one of my best friends who was in my wedding has two kids, 5 and 2. KD got married on the same day I did and never wants to have kids. KC has a 14 month old son, and A is divorced, just broke off an engagement, and seems to consistently date men with teenage kids. Seems like a fairly safe weekend on the pregnancy announcement front, right?

As well all arrived, A offered us a glass of sangria. KC was the last to arrive. She was still standing on the entrance mat when A offered up the sangria. "I can't," she said, with a dramatic wave of her arm "I'm four months pregnant..." she uttered, sounding a wee bit dismayed. "We hadn't planned on having two under two."

Of the crowd there, only L knows what I have been through. There was a lot of excitement, some labor stories. I'm not even sure. I managed a congratulatory hug, and was able to sneak off to the bathroom for a few deep breaths.

Later in the evening, the conversation turned to KC again. She again talked about her stress about having two under two. Finally, I couldn't take it any longer. I blurted out "I'm actually hoping for twins." I just couldn't sit there and listen to her pity herself for being given such an amazing gift, twice, when there are so many of us who long for just one. Just one.

With the help of L, I managed to fill them in on what has been going on. KD said she had wondered. A didn't seem surprised either. And then, KC started in on the stories. I'm sure she felt awkward being that she was just complaining about something I admitted to wanting so desperately. But really, I don't need to hear about how your aunt was told to abort her twins because they might have been conjoined (they weren't) and then later went on to have at least two more children, all naturally, even after the age of forty. Can someone tell me how that is supposed to help? Someone brought up the age old adoption makes you get pregnant anecdote (yes Baby Hopes, we all know, you made it come true!) I had to shoot that one down by telling them that adoption has absolutely no statistical impact on pregnancy rates. I can't stand it!

Mostly, they didn't ask me too much. A expressed concern for the fact that she is 37 and is still undecided as to whether or not she wants children. He current boyfriend of 3 months has an 11 and a 16 year old. He's in his mid/late 40s. I was proud that I was able to tell them, and that I was able to shoot down a few obnoxiouss oblivious fertile comments.

The interesting thing was that there I was, feeling incredibly jealous of KC, when later in the evening, she admitted that not only is she alcohol free because she's pregnant, but also because her husband has an alcohol problem. He will buy a six pack, and then not stop until it's gone, and ends up drunk. She found him this way once at home alone with their baby. He hasn't "messed up" as she put it, since March.

Anyway, it was a good reminder that everyone has shit going on in their lives. I might be all consumed with IF, and jealous of anyone who doesn't have to suffer, but just because they don't suffer that, doesn't mean their lives are perfect. A is divorced, called of an engagement, has a bipolar sister, and a mom recovering from cancer - among other things. KD mom also had cancer, her grandmother died, and her drug addict sister-in-law was living with her for awhile, stealing her pain killers. L on the other hand, well, her life is pretty damn idyllic with the exception of the 22 inches of water she got in her basement during the hurricane earlier this year. Everyone has something, right? I wish for us all that the biggest pain in our lives would come from a wet basement.

Dr. Anatomy Download

Whew, first of all, thanks for all the support yesterday. I needed it. I feel like all I do lately is write really long posts filled with technical information. And yes, here I go, yet again.

First, let me tell you a little story about having the name Jen.

After being accosted by the wall o'babies, I had a seat in the waiting room. I was early, so I knew I'd be waiting awhile. I had seen Dr. Anatomy come out of a door across the room to take a couple back to meet. A few minutes before my appointment, another doctor came out of a door closer to me, and said "Jennifer?" I was sort of out of it, feeling weepy and distracted, as I mentioned yesterday, so I didn't look around to see if anyone else reacted to the name. I just went with the man who was clearly not the man I was there to see. I mean, who knows how these things work. Maybe Dr. Anatomy had gotten tied up or something.

We get back to his office, and he says "So, Dr. K sent you to me?" Uh, who the hell is Dr. K? So I say "Um, I'm Jennifer I-----?" We realize I'm not the right Jennifer, so we head back to the waiting room and discover that one of the other two women in the room is also Jennifer. Big surprise.

A few minutes later, I hear yet another Jennifer check in at reception. Seriously? By then, I am now distracted because my friend from Resolve so my blog post, and we are texting back and forth. Have I mentioned that her name happens to be Jen?

Then, a nurse comes out of the door where I had previously seen Dr. Anatomy, and says "Jennifer?" The new woman gets up and goes with her. They seem to recognize each other, so I don think anything of it, until about a minute later when Dr. Anatomy finally reappears and says "Um, Jennifer I-----?"

Honestly people, have you not picked up yet on the fact that there are more women between the ages of 30 - 40 with that name than any other, and that we are the prime age group for your clientele? Initials, people, please! I don't need to end up with some other Jennifer's baby. Wow, that kind of sounds like a name for a bad lifetime movie. "Some Other Jennifer's Baby." Starring Jennifer Lopez, Jennifer Aniston and Jennifer Hudson.

Anyway!

OK, on to the details. I'm feeling a bit confused about it all. I tried to take notes since I was there by myself, so we'll see if this helps me sort things out.

He reviewed my history, and immediately realized that I am more than halfway up the ladder of treatment that he was lobbying against in his presentation at the conference. It's frustrating to think that I wasted nearly a year on IUIs without a good reason for why I wasn't getting pregnant. The one real lesson to me in all of this is for anyone with an unexplained diagnosis, keep pushing for answers. Don't keep repeating the same kinds of treatment endlessly. If I had to do it all again knowing what I know know, I would have gone for second opinions when I first heard the words "unexplained" instead of over  a year later.

One of his first assessments is that he thinks it's a sperm issue. Although he didn't really make it clear why he thought that. He said the labs looked good when we first looked at them, but then referenced his presentation about how what they consider to be normal not being the right parameters, and that far fewer men actually fall into that category, or something. I apologize, this is the part I am having trouble understanding.

I think, though, the fact that the first IVF with 13 mature eggs, only 4 fertilizing, and the fact that there were virtually no unsuccessful sperm actually hanging out in the dish around the embryos, is leading him to this assessment. He did say, however, that since our second IVF was with ICSI, we are already treating a sperm issue, and there there is not much point in further testing if it is not going to change the treatment plan.

Protocol wise, he was not happy with my second IVF with the antagonist protocol. He basically thinks the protocol was right the first time, but since we didn't have ICSI, we didn't have a chance. And when we got to ICSI, we had the wrong protocol. He is not a fan on bcps before a cycle. He said that the eggs start developing long before the bcps are given, and when you interrupt that process, they get confused, and end up staggered. That is something I have read about the antagonist protocol, but some seem to think it is the right way to go for some people. I think Dr. Stats agrees that it's not right for me, since she is going back to a lupron based suppression. Dr. Anatmoy would go back to full Lupron, though, not the diluted version that Dr. Stats is suggesting. He is afraid that I will ovulate through it. However, I think I see her reasoning for it. I think I was over suppressed on the first cycle, based on the fact that I didn't start to bleed by the time they thought I would, and that they had to increase my stims halfway through the process. From what I understand, it's better for the eggs to grow evenly, rather than slow at the start, and faster at the end. So to me, the very-low-dose lurpon makes sense. I'm not sure Dr. Anatomy had enough time to absorb those details. He was looking for very specific facts and figures, and not necessarily diving in deep to the data. OK, so the conclusion of that, is that I think I am comfortable with Dr. Stats's recommended stimulation protocol for IVF 3.

Dr. Anatomy would also prefer that I be on PIO until a pregnancy is confirmed. I can't remember if he said a chemical (positive beta) or a clinical (positive u/s), and then switch to crinone. He mentioned this in relation to two chemical pregnancies. So, my veteran friends out there, thoughts on PIO vs. crinone? I may push for PIO for peace of mind (and pain of ass) if I stick with Dr. Stats. They do seem to prescribe it in some cases.

In terms of further testing, I asked if he thought any laporoscopic investigation was recommended. He said, "What do you think? I told you I think it's a sperm issue. Do you think poking around in your stomach is going to tell me anything helpful?" So, I guess that's a relief! If we were to go with him, he would like to repeat Day 3 and Day 10 bloodwork, do his own hysterocopy with a biopsy, and also have a look for himself at Hubby's sperm. Which sort of contradicted his earlier statement of if we're already doing ICSI, what's the point. But, I guess he wants to be thorough and get his own eyes on everything. The other interesting thing that we are going ahead with is some genetic testing through a service called Counsyl. Basically, he gave me a code to go to their website and order a kit for me and Hubby. They send you a tube, you spit in it, send it back, and they test for literally hundreds of genetic diseases based on your ethnic background. This would determine if PGD was necessary in the future to ensure healthy embryos. He says its covered by insurance. I'm waiting for my confirmation email on that right now, so I will keep you all posted. But it seems like an easy and harmless way to be prepared and/or gain some peace of mind about the health of our future children.

I almost forgot to mention that when I mentioned that Dr. Stats said there was a 1% chance the biopsy would show anything, he said it's more like 15%. He feels that the pathologists are too focused on finding cancer, and that the endometrial inflammation is actually really hard for the them to find, so he stressed the importance of a thorough screening. He also wants Hubby to stop drinking, or at least keep it to just weekends. And he needs to start now because sperm takes 74 days to develop. Hubby seems willing to do this. I hate to ask him, because he's been super stressed and busy at work, and his nightly bourbon has been part of his winding down routine after work. But we'll do anything to make this next cycle work. I think though, that a free pass for Christmas and Thanksgiving days might be ok.

In regards to the small world or reproductive endocrinology that lives inside the expansive Boston medical community, he said the he knows Dr. Stats. He, and some of his partners came from her hospital. One of his partners used to run the department. They left for private practice so they could do things without the red tape (ie. not get stuck on the ladder of treatments that is clomid, injectables, IVF, etc.) but also, lets me real, to make a lot more money I am sure. He remembers interviewing Dr. Stats. He had all positive things to say except for that "She's young," which could be left up to interpretation. But he was extremely positive about the medical care in general there, except for the red tape issue. But, this does bring some clarity to the reactions of Dr. Stats and her nurse. Everyone has feelings about coworkers that may or may not apply to their actual professional expertise, so I am just going to try to sweep all of that under the rug.

The last interesting thing that happened, which I'm not quite sure how to judge, was that Dr. Anatomy showed me some charts, which he is not allowed to post on his web site. One was comparing live births across all the hospitals and clinics in the area. His clinic ranked first, of course (or why would he be showing me that). Dr. Stats's was second I think. The second chart was in regards to how many cycles it takes to achieve that live birth. Again, he was the lowest, 2.1 something. But again, the Dr. Stats's came in second place, on the higher end of 2 cycles.

So, in conclusion, he gave me some things to think about. I'm excited about the genetic testing. He does think my prognosis is good (cause I'm still young after all, wish I could believe that!) He seemed to confirm that Dr. Stats's is essentially doing what he would do, with a few minor variations. Now, I need to decide if we think it's worth uprooting ourselves before IVF 3, or give it one more go and hope that the third time is the charm and we don't need to switch. The process where I am already in terms of monitoring fits into my life much better than with Dr. Anatomy's office which is not nearly as conveniently located. And let's face it, that's a huge part of remaining calm through the process. One of the RE's at the conference said that when people switch, it's really more for their own peace of mind, to feel like they are doing something to help the process, but sticking with a clinic who knows you and your history simplifies the process. I would add, as long as they keep trying new things, and are not stuck endlessly in the same process. If we were to switch, we would be able to get in one more cycle this year, because they don't close for the holidays. However, I would need to go for days 3s tomorrow to get the process started, and I am heading out of town for the night. I also have two more trips to Buffalo coming up in late Nov and mid Dec, so it seems to me that it's just not the right time. Hubby and I can relax and enjoy the holidays, and kick of the new year with another go.

As of last night, I think we were leaning toward one more cycle with Dr. Stats. But, since we have some downtime, we may seek out another opinion or two so we're more prepared if we end up needing to switch. But we won't, right? Cause the third time is the charm...right?

Feeling weepy

I'm sitting in the waiting room in Dr. Anatomy's office by myself. Hubby is so unbelievably slammed at work he's barely taking time to eat meals, so I told him I would come alone to take some pressure off. At the reception window, I was created by a wall filled with baby announcements and christmas cards with photos. Yes, this is sweet, they have successes, but I don't think it's what I needed to see. Could be because my period came this morning meaning officially that I will not be pregnant in 2011. I never imagined I would be in this place. So yeah, baby pictures, mixed with hormones and a back ache, added to the fact that I've seen hubby for all of two hours in nearly a week, yup, I'm a little weepy.

I'll update later on what Dr. Anatomy has to say.


- Posted using BlogPress from my iPhone

Information Overload

Hubby and I spent the day yesterday at the Resolve conference. It was quite a day jam packed with information. I was exhausted by the time we got home. I think it's a good thing that I am shuffling off to Buffalo later tonight for work, and won't be back until the wee hours of Thursday morning. We both need a break from IF!

But, of course, I wanted to summarize some of the things that we learned so that I don't have to carry them around in my head while I am away.

The morning started with a keynote speech by Dr. Ali Domar. She rattled off a lot of stats about her studies, and seemed to directly quote phrases out of her book Conquering Infertility, which I am currently reading. She mostly talked about does stress cause IF, and does IF cause stress. Her answer was yes. One of the interesting things she mentioned, was that in some newer studies, she has some evidence to show that stress at the beginning of a cycle might actually be beneficial, as long as during the stimulation process, the level of stress drops significantly along the way. So, I guess the lesson is to not freak out if we're anxious at the beginning, but to make sure we have the proper coping mechanisms and relaxation strategies in place.

Someone asked her about exercise, and she was reluctant to answer because her belief is that too much exercise is indeed harmful. She often recommends to heavy exercisers who can't conceive that they cut back from three months to see what happens. I am no where near a heavy exerciser. I stick to walks and the elliptical, but you can bet that I use this evidence to when Hubby suggests I join him running. There is not much I hate more on this earth that running!

We also ran into her at her center's booth in between sessions. Hubby asked her about exercise in relation to Dr. A's suggestion that I lower my BMI. (By the way, I think I need better names for my doctors. Some of you have fun nicknames, and I've decided it's time, so from now on, Dr. A will be known as Dr. Stats.) Dr. Domar said that her understanding of the effects of BMI on pregnancy and miscarriage come into play at a BMI of 35 to 40. She looked at me and said, you're probably a 30. I don't think you need to worry. (She's right by the way!) She suggested that eating as heathfully as possible would be a good route for me, and that I could make an appointment with their nutritionist. I might consider it, but I do think a lot of a healthy diet is just common sense, and the will power to stick with it. And of course, I will keep up my 30 minutes on the elliptical in front of my Tivoed General Hospital as often as I can.

OK, so the first actual session we went to was an overview of Donor Egg and Adoption, with a panel of parents. We decided to take advantage of this conference to do some exploring into what our plan B might be. It was very emotional to hear the parents talk about their joy at finally achieving parenthood. Right now, we don't think donor egg is for us. If we have to loose one set of DNA, we'd rather loose both. I would love to be pregnant, but it's nine months out of the lifetime of a child, so it's something I think I could give up if it comes to that. In addition, we're so lucky to not have to spend exorbitant amounts of money on IVF, but I feel like if it comes to having to spend $40k to build our family, I'd want to spend on something that's a 100% chance instead of only 60%.

Our second session was on why infertility should not be unexplained, with Dr. H who we are scheduled to see on Friday. I'm feeling much better about that appointment, after one of my lovely readers reached out to me with a good experience with him. And, he looks much less like a car salesman in person that he does in his picture. I'm struggling to come up with a good name for him, but I think we will call him Dr. Anatomy. One of the main topics he focused on was on anatomical issues, like problems with tubes being adhered and not being able to swing to the ovary and receive the egg, or similar issues with the uterus. He seems to do a lot of laporoscopies to check for these things. He also stressed the importance of a trained eye looking that the films of the HSG, not just the report, to identify subtle issues with the tubes, or potentially these adhesions he talked about. I'm a little bit bummed that when I requested my medical records to be sent to him, I didn't think about the fact that I needed to request the HSG film separately, so I'm not sure I can get that for Friday.

One of the other things he brought up were the success rates of Clomid IUIs. 7%. Hubby asked him why we still bother if the rates are so low. His answer was that his practice does not use clomid. It was hard not to feel like we wasted 6 months of this journey on our 3 clomid IUIs. For scheduling reasons, we were never able to do them back to back, so it took awhile. But, it's in the past now. I really just need to let it go, and consider it part of the process to prepare one's mind for IVF.

Another point he made was about the various progressions of treatment that we often end up on because insurance requires it. Clomid IUIs, Injectable IUIs, then IVF. He said that insurance doesn't really require clomid IUIs, and it's up to us and our doctor to advocate. If our doctor has a medical reason to do something, insurance should approve it. I think the problem is with the diagnosis of unexplained infertility, insurance doesn't want to approve procedures without knowing that simpler and less expensive ones didn't work first. It's ridiculous that insurance gets to dictate medical care at all.

I was a little disappointed that his investigations were so anatomically focused. You guys know I'm interested in immune and clotting issues. He didn't bring those things up at all.

Our third session was on what to do after a failed IVF. It was way overfilled with charts and graphs and data that were hard to understand. But, one of the more interesting graphs showed pregnancy rates compared to age from 22 to 44. It's frightening to see that line take a nose dive. I'm on the downward slope already, and it only gets steeper with every minute that passes. The interesting part was that they also showed pregnancy rates with donor eggs across all of these age groups. the line stayed level, meaning that age has virtually no affect on a woman's ability to get pregnant with god, young eggs. This information does reinforce Dr. Stats's opinion that we are dealing with an egg issue. This presentation did also say that egg issues are the number one reason why IVFs don't work. And it's not that it means my eggs are bad, just that unfortunately, I'm getting older, and there are just fewer normal ones left. Dr. Stats told us that 1 in 15 are normal in a 40 year old woman. Terrifying!

After the session, I did go up to one of the presenters to ask about natural killer cells. She said that basically, the topic is being researched, and there is not enough data to suggest what to do with the diagnosis yet, so most doctors are not testing for this right now. She said that there are a few (Dr. Sher being one, from what I understand) and if her patients push for it, she sends them to those doctors. For me, that means going out of state, and not being able to use my benefits. I'm not sure if I'm ready to do that quite yet. Later in the day, I asked another doctor about natural killer cells. He said that testing/treatment is not endorsed by the American Board of Obstetrics and Gynecology. This third opinion of the topic definitely left me feeling like this topic is not one that will be looked at in the great state of Massachusetts.

Our fourth session was basically an overview of domestic adoption. If we were to adopt, we would prefer an infant, so we would not be going international. There was a lot of talk about the decrease in international adoption as well. I'm not sure why, but there seems to have been a significant decline. Anyway, it's a plan B that's off in the distance, so I won't spend too much time on it now, but it was good to get a better understanding of steps, timing, and those god damned costs! Hubby went to the hotel bar for a Bourbon after the session ended, while I went to a Q&A session.

Lastly, at a question and answer session with an RE at the end of the day, the one who told me about the nk cells not being endorsed, I also asked him about clotting and immune issues. He said those things are tested in relation to repeated loss late in the first trimester or later, so they don't apply to my two chemical pregnancies. People also asked him about supplements. He said CoQ10 doesn't do anything, but it can't hurt you, so if there is a placebo effect, he's fine with is. He also suggested omega 3, but he said he was not a fan of DHEA. He said that baby aspirin was a placebo effect too, and that it should not be taken until a few days after retrieval because it could cause bleeding issues in the retrieval process.

Whew, I think that about sums up most of what I absorbed yesterday. The day made me feel more confident in Dr. Stat's assessment, although I still plan to keep the appointment with Dr. Anatomy. I looked at my calendar, and I think it's unlikely that we will be able to get in our next cycle before the lab closes for the holiday, so I'm debating whether to pursue a third opinion now, or to wait until after IVF #3. I think I have until about the second week in December until I would have to give Dr. Stat the go ahead to get insurance approval to start lupron at the end of December. And since we won't be able to try for two cycles to to the endometrial biopsy and the lurpon cycle, getting more opinions might make me feel like I am actually doing something instead of sitting around waiting. But, since I'm off to Buffalo later today, I think I will have to sort that all out when I get back.

I'll be reading while I'm away, but commenting will probably be hard, since I'll only have my phone with me. See you later!

WTF Brain Dump

OK, where to begin. There is so much information, I want to get it all down so I don't have to keep it in my head.

First of all, Dr. A says we're making progress, which is good I guess. Our embryos this time around were WAY better than with IVF #1. She said id she gave grades, she would have considered the 8 cell to be an A-/B+, and the two seven cells to be Bs. But yet, it still didn't work.

She says all signs point to an egg quality issue. It really is a numbers game, and you just have to try to get as many eggs as possible so that your chances of having a good one in the bunch are greater.

We asked a ton of questions...

- Autoimmune issues - She says there are a few autoimmune issues, Lupus being one of them that can cause issues. But didn't seem to think there is a need for any testing. Damn, I really should have taken more notes while she was talking. I always think I'm going to remember more than I do. But she basically has a study to quote for every question that says it doesn't make a difference.

- Thyroid antibodies - I've never actually been treated for them, but since I have hypothyroidism and it's not because I don't have a thyroid, I have antibodies. But, they should not have an impact on pregnancy because I am being treated for it.

- Natural Killer Cells - She's a doctor who falls clearly "in the middle" as hubby puts it. She's extremely evidence based, and doesn't buy into the natural killer cells having an impact because when you look at the data that has been gathered collectively, instead of an isolated study, there is no real proof.

- Endometrial Biopsy - I haven't had one yet. We asked if I should. She said it couldn't hurt (except, well, that it does) and therefore she would leave it up to me. There is a 1% chance of it showing anything. I am planning to do it. I would much rather check that box off the list that have another cycle fail first.

- Vitamin/Mineral deficiencies - I had some electrolytes checked by my primary care right before this last cycle. I showed as anemic, and low calcium. When my calcium was rechecked two weeks later, it was fine. She said I would have to be anemic to the point of needing a blood transfusion before it would matter.

- Karotyping - She brought up doing it before we did.

- Luteal Phase Defect - Hubby has been obsessing over this one for awhile because my luteal phase always seemed to be border line on the short end. Her answer was that I'm getting progesterone, so it's not an issue with IVF cycles.

- Lab chemistry - We had heard that you shouldn't do more than two cycles with one lab because of the way that particular culture medium might react to our unique DNA in the embryos. She said there are only 3-4 culture manufactured, so that all the labs are really using the same thing.

- Clotting - She quoted a study that said clotting issues were shown to have no impact in miscarriage rates.

- BMI - She brought this one up. I hover right between overweight and obese, which is kind of amazing to me, because, while I know I'm a little bit Rubenesque, I just don't see myself as fat. I'm hovering between a size 14 and a 16, and have manage not to put on any weight (or at least get rid of it all) from these two cycles. She doesn't think it's the reason I'm not pregnant, but it's proven that with a normal BMI, pregnancy rates go up, and miscarriage rates go down. I think I need to loose 30 pounds to get to normal. Geesh. Not easy with the holidays coming.

Then we got to what the new protocol will be. I'm going back to Lupron, no BCPs. But it will be "Very Low Dose Lupron." Which is basically the same as the Long Lupron, but it's a diluted version. (I hope that doesn't mean I have to mix it myself!" I will only stim with Gonal F 225 at night only. (Wow, just realized that this means only two injections a day, one morning, and one night, not bad!) So, because we had a higher fertilization rate this time, it seems that my eggs do better with just FSH, as opposed to FSH and LH, which is what you get when Menopur is in the mix. But, I didn't have as many eggs this time, so think that's why they are changing up the suppression method again. They are also lowering my dose of stims, because I stimmed a little fast the last time, but had only one follicle that was 18 at trigger. But, they had to go with it or risk ovulation through the suppression. I am a little confused by this, because with my first cycle, I had a few over 20 at trigger, and they even stretched it out over another day.

OK, so I'm happy with the protocol. But, what about second opinions. We had promised to get one after the second cycle. She said she recommends it after the third with her for sure. She asked where we were going, and when we told her, she made a face, and said please don't let that be your only second opinion. Our nurse had a similar reaction when she recommended two other possibilities, and then said "and that's all I'm going to say."

Admittedly, when I look at the picture of Dr. H who we're scheduled to see next Friday, I do get a bit of an oily used-car salesman feeling. I just don't know what to make of it. Dr. A did rattle off a few other names of people she would recommend. I'm so torn. I like her, and I like that she has stats for everything, but I'm also not opposed to out of the box, not necessarily proven yet, thinking. We chose this doctor not based on reviews, or SART data, but just based on the fact that he gives an IF should not be unexplained talk at the conference. I don't know, though, is egg quality enough of an answer to explain my IF? Ugh, what to do?

Hubby and I chatted briefly before dashing off to work, three hours late. He thinks we should keep the Dr. H appointment, possibly go ahead with Dr. A's new protocol and try to get it in before Christmas and the lab closure, and then seek out additional second opinions after that. I did a quick calendar when I go to work though, and it looks like if I have normal 28 days cycles, we'd be aiming directly for a xmas week retrieval, which is a no go. It looks like we'll have to wait until the new year, or at least the week after xmas to start lupron. So, maybe I will go ahead with another opinion or two in December. We can do the biopsy next cycle, but we can't try that month, and we also can't try with lupron, so we're now looking at two wasted cycles in terms of trying naturally. That's a little bit frustrating. I'd like to push the biopsy off to the start of the IVF cycle maybe, so as not to waste one, but then we'd have to schedule that to a specific cycle day right after christmas, which might be hard to do. It's not looking like I have much choice other than to bide my time and try to stay calm and get skinny.

OK, that's enough of a brain dump. It's 1:30. I really should start some work for the day! Three cheers to anyone who got this far.

WTF on Thursday

First things first, we have power!! (and heat and hit water!!)

Ok, now before I forget, I wanted to poll the troops to see what you think I should ask the doctor about. I have a list in mind, but I don't want to share to sway what you would tell me. Looking for things that go with two failed ivf cycles and two chemical pregnancies.

More soon once I dig myself out from being behind after the storm!


- Posted using BlogPress from my iPhone