.3rd times a charm?.

so, call us crazy, but cameron and i are gearing up to try ivf #3. this time we were a little smarter about it. first, we have changed drs, we'll be seeing dr. fisch in las vegas..who deals specifically with egg quality problems. he thinks the protocol i've been on is "ruining" my eggs from the beginning so they don't stand a chance to make it past day 3. with our first cycle, i had 9 eggs retrieved, 6 mature, 0 fertilized. with ivf #2 i had 14 eggs retrieved, only 9 mature, 5 fertilized with icsi, only 2 made it to day 3. we did a day 3 transfer of 2 8-cell embies, grade 1. but still bfn. second change is that dr fisch is going to put me on their a/acp protocol, an antangonist protocol, which he thinks will give me better eggs, with better fertilization rates. third change that we've made to maximize our results is that we've purchased a buy 3 cycles and if you don't take home a live baby, you get a portion of your money back. good deal if you ask me, because that includes everything except meds. it even includes all associated fet cycles if we have frozens to use.

as for this cycle, we're looking forward to having much better results on the antagonist protocol

so here's my schedule...
12/30 bcp (yaz) starts
1/20 add dexamethasone and lupron
1/24 stop bcp
1/27 stop lupron, add 0.25 ganirelix, continue this thru to hcg trigger
2/2 start follistim 375 for 2 days then drop to 225
2/4 first luveris dose 1 vial
2/6 second luveris dose 1 vial
2/10-2/11 possible hcg trigger
2/12-2/13 possible egg retrieval
2/15-2/17 possible embryo transfer

once again, this is mostly for journaling purposes, since i don't write this all down. if you're interested, then that's just a bonus.

ash

.i think explains it.

From an article by Dr Aniruddha Malpani, MD:
"The third group is perhaps the most difficult. These are women who grow a sufficient quantity of follicles in response to superovulation ; and have high estradiol levels as well. Egg collection is usually uneventful ; and the doctor often retrieves 8 to 16 eggs for them. If IVF is done, when the fertilization check is performed the following day, much to the embryologist’s surprise and the patient’s dismay , it is found that the fertilization is very poor even though the sperm are fine and actively motile. If ICSI is being done, the embryologist often finds that the eggs are morphologically normal ; or are very fragile. For example, these eggs have granular cytoplasm ; or vacuoles in their cytoplasm ; or dark areas within the cytoplasm. Since normal eggs are simple spherical formless blobs, these subtle cytoplasmic abnormalities are often missed or overlooked. The embryologist may also noticed that the eggs are fragile, and the cell membrane offers little resistance to the injection pipette. Many of these eggs may die during the ICSI process.
Unfortunately , because egg morphology has not been adequately studied , we still do not have good descriptive terms , when talking about these abnormalities. Since the eye only sees what the mind knows, often these abnormalities are not picked up. The patient is often subjected to repeated IVF or ICSI cycles , with the same poor results each time."


we're just a "hard egg case."

.ivf report.

unfortunately i didn't have the computer in cali so i've had to wait til now to update my blogs. first off i wanted to write down everything that happened in california regarding our ivf cycle.

thursday nov 12 i had my first ultrasound at dr. marrs office in LA. i had about 10-12 follicles, but some were pretty small. they were predicting that i'd be ready sat for trigger, and that we should have about 10 eggs to retrieve. i was happy about that. they did lower my fsh and upped my lh to help the smaller eggs "catch up." my e2 this day was 1158

saturday nov 14 i had my second ultrasound and it looked about the same. about 12 mature follicles, and my e2 was 2710, getting a little too high. i was given the go ahead to trigger that night at 1030 pm.

monday nov 16 we arrived for our egg retrieval. this time was WAY different. it was an actual OR, not some scary 1930's exam room. i got my WONDERFUL anesthesia and woke up to the news that they had retrieved 14 eggs. i was thrilled. cam gave his "sample" and we went back to the hotel to relax..our work was over.

tueday nov 17 got a call from dr. bronte stone, the embryonologist, and gave us the report that only 9 of my eggs were mature and of those only 6 fertilized with icsi. we were kinda crushed..but happy that we at least had that many.

wednesday nov 18 took a break from worrying about it and went to disneyland!

thursday nov 19 went back in to get knocked up. they gave us an update of the little embies. we had 2 that had stopped growing, but the 4 remaining were going strong. finally, they brought the little embryos in, in their little incubator and we got to look at them in the microscope. we got to see our little babies first photo shoot, as seen below. anyway, i have two perfect, 8 cell embryos inside my little uterus. the remaining 2 will be frozen tomorrow if they make it to blastocyst stage. we're praying for them too, in case this doesn't work, we could have a frozen embryo transfer in a few months.

.our babies.

i'm feeling so much more hopeful this time around and i feel like it's our turn. we've been patient. it would be an added reason to celebrate this holiday season.

.off we go.

we're off to los angeles today. my mom and i are driving out, with a small stop in st. george and then cameron and my dad will be flying out friday after work. i'm super excited to go to disneyland and price is right and hopefully all the ivf stuff will go as planned.

as for my appt yesterday with lindsey (who i absolutely love).. everything looks a lot better this time, than at this point in the game last cycle. i have 15 follicles and about 12 are the same size.. so we can hope to expect about 10-12 follicles. my e2 was 261, at this time last cycle it was only 123. so i'm happy.

i just want to tell cameron i'll miss him til friday. can't wait to make some babies this weekend.

.all clear.

well bloodwork and ultrascan both indicated that we're all clear to start stimulation injections tomorrow night. it's great news. you can never predict whether your body will respond appropriately to all the "over-riding" that ivf protocols do to you. i'm grateful that my little ovaries are perfect and so is my little old uterus. last cycle i had 9 antral follicles and we retrieved 9 mature eggs. this time i had 11 antral follicles, so we're hoping for 10 or more mature eggs in LA. as for the protocol we're using this time...it's the same as last cycle.. 75 menopur, 225 bravelle, and 5 units lupron. it's so exciting and a little nerve racking. so far, so good. hopefully icsi will work and we'll get good fert rates.

.phase I.

i think that i am lucky. i'm sure most girls that try ivf go on mad horomone mood swings. i'm blessed, i really don't have much of that (well, i guess you could ask cameron if that's true). i think the worst part is the birth control. so i'm happy to report that i finished that on thursday. i should be expecting a wonderful red flow here tomorrow. it should be right on time. if so, i'll be having my baseline scan (love the wand) and bloodwork. i'm getting really anxious to see how this cycle will pan out. i think i'm definately more hopeful and more calm about this one. it feels good. so maybe in 3 weeks we can have some of these:

and an update on what i think is wrong with us: this has not been diagnosed, but from my research i believe that cameron's swimmers have anti-sperm antibodies on them (mostly on the heads), thus preventing the sperm from binding to an egg. when the dr explained that we have a "receptor" problem, i think he meant this. i'm not going to push for an actual diagnosis, because at least we know that whatever the problem is, we have found it and have a way around it. thank goodness.

.let's talk about shots.

so with ivf you have to do tons of shots..big surprise, right? well, i have yet again, began doing these shots and after a whole cycle last month of doing this you would think i'd be "used" to it... nope. last night (my first one) i sat with the needle facing my belly for about 3 minutes before i got up the courage to stab it in. i can't believe how easy it is to do to other people..like my patients, but when it comes to me..i'm a baby. i'm not complaining at all, and don't need sympathy, it's just a realization to me, that maybe my patients hate it too. i'm excited to go to my baseline ultrasound next week...hopefully i'll have lots of follicles!

.here we go again.

okay, so since everyone kinda knows that we had one failed ivf cycle...i thought i'd be a little more open about this one and can document how things go. so we're going to los angeles to have our 2nd attempt at ivf with dr. marrs. i just really love him and didn't want to go to another dr here in salt lake, and i know his office is SO successful and he already knows why the 1st one didn't work. anyway, we're leaving on November 10th and will be coming home November 19th. i think i'm going to post a tentative cycle schedule here, just to keep track for myself...and if you're reading this and having ivf struggles, we can talk about it...

10/13 start birth control
10/23 start lupron injections 10 units
10/29 stop birth control
11/1 begin period (hopefully)
11/2 baseline ultrasound and bloodwork (i only had 9 antral follicles for our last failed
cycle, this time i have 12+..so that's promising)
11/4 start stimulation injections.. Bravell 225 units :: Menopur 75 units; drop lupron to 5
11/9 ultrasound and bloodwork monitoring
11/12 first appt with dr. marrs in california, ultrasound and bloodwork
11/16 tentative egg retrieval
11/18 tentative embryo transfer
11/30 first beta

.the 5 stages of finding out you're not pregnant..again.

This is just about the truest and funniest blog entry I've ever read and it truly is like the 5 stages of grieving.: http://999reasonstolaughatinfertility.blogspot.com/2009/09/885-five-stages-of-finding-out-youre.html

Similar to the five stages of death/grieving, when you find out you're not pregnant you find yourself going through a similar state of mind.

Stage one: Denial. No, this can't be my period. It looks too light. It could still be implantation bleeding. The blood on the tampon looks too brown. I'll just wait until the end of the day to take a pregnancy test. If the pregnancy test is negative, it could mean that I tested too early. I don't have cramps this month and it doesn't "feel" like my period. I could still be pregnant.

Stage two: Anger. Well, I'm not pregnant again! Why does this keep happening to me? Will I ever get pregnant? I hate all those pregnant women on Facebook. Why do they keep posting pictures of their belly's? Who wants to see pictures of their babies anyways? There are pregnant women everywhere. How do they get pregnant so easily? Must be nice to be so fertile.

Stage three: Bargaining. Please God. Give me a child. I will do anything. I promise I will lose weight and eat healthy if I can just get pregnant next month. Sperms - please implant. Just swim upstream as fast as you can. Follicles - please grow and multiply. I promise not to drink coke tomorrow and I'll be the best mother ever. Doctor - please don't cancel my cycle, I'm okay with having 8 babies.

Stage four: Depression. WHY ME??? I feel like my heart is going to ache forever and my eyes hurt from crying so much. There is a lump in my chest. I am going to sleep all day in bed because what's the point of getting up anyway? Why is the pregnancy test always negative? How come everyone else can get pregnant but me? I feel so alone. My husband doesn't understand how awful it feels. (even though my hubby does, he's been great)

Stage five: Acceptance. Well. I guess it's really my period. I guess that negative pregnancy test really is correct. I'm not pregnant this month. I know it seemed like it was implantation spotting but it's really my period. Time to tell my spouse that I'm not pregnant.You might think finding out you're not pregnant again is bad but don't expect sympathy from the dying man beside you. He's got his own problems.

is anyone else out there laughing... i am, only because its all TOO true..

.why.

ok, i hope not a lot of people read this, but i need to put down a few thoughts before i forget (or go crazy). first of all, i'm angry. i don't know why i have to be so punished. doing ivf was my last hope and now that's all thrown away. i'm angry with the people that always said to me, "relax, it will happen when it's supposed to." what do they know? i'm sad for dr. richards. i could tell he feels like he failed me. i wish more people could understand. no one will ever understand. i'm alone. i am lucky in one aspect...my husband is amazing. he has not, for one day, not been on my side. he understands. and i love him for that. this trial has not been nearly as hard just because he is there. i cannot seem to wrap my head around the fact that we will never, in a million years, be able to conceive a baby by ourselves. why? didn't heavenly father create our bodies to do this? isn't this my divine calling on earth? isn't this what the proclamation to the family is all about? i'm so confused. as much as i know about science and advanced medicine, why on earth can't they KNOW, with certainty, what the problem is? where do we go from here?

for those that do want to know what's going on:
cameron and i did ivf this month and we just found out today (after many ups and downs during the cycle) that NONE of our nine eggs fertilized. yes, cameron's sperm is perfect.. yes, my eggs were all mature, yet we have NOTHING. it seems that the drs are somewhat baffled, although, they have seen this before, it is VERY rare. we have a receptor/enzyme deficiency that may or may not be treatable with icsi. i'm emotionally drained and do not know if we can even pursue another ivf cycle, not to mention that we don't have any more money for one?

.joy.

these past few months have been the months of confusion for cameron and i. we have been dealing with the infamous decision of ivf vs. adoption vs. just waiting. needless to say, it has been torture. it's such a hard choice because it involves so much emotion and obviously money. we have had a hard time feeling like there is ONE right choice and we are lost as to what heavenly father wants us to do. as we fast and pray for answers, we are empowered by the fact that heavenly father doesn't want us to be sad. i had a eye-opening lesson in RS today, it was on joy. the lesson focused on having joy despite our trials and tribulations. as it seems SO hard to find joy in anything when you've been faced with the ugliness of infertility, i'm stregthened by the fact that i have so much to be thankful for, such as, my husband (he is my rock), the best family, great friends, and most importantly my heavenly father, who truly has a plan of happiness tailored just for me. i may find it hard to feel happy every day, but i know that i am so blessed to have what i do have. i know i will be a mother. i just don't know how or when. but i will. thanks for the thoughts and prayers.

.nothin' better.

well, as y'all know, we are taking a break from the stress of trying to get me knocked up. not that we're not "trying," we're just not as scheduled as we were when i was taking all those meds. i feel a little weird since my body was used to those, but i'm getting back to normal. we are off to go backpacking this weekend and i'm excited to get away and spend some quality time with the hubs. all i can say, is there is nothin' better than a break.

.plan b.

well, i know it has been awhile since i posted, but i think we have finally made a decision to go with a "plan b." maybe i'm "untraditional" but i did not like the way my dr was going about our treatment, so i asked around and got some great advice. so i called a new dr..his name is dr. richards and he works with a guy named dr. marrs. together, these two have the BEST success rates for ivf in the nation. they solve some of the toughest infertility problems around the country. i thought, well, i'll call and see if they do less aggressive tx other than ivf. i left a message for dr. richards (who is actually a PhD reproductive scientist, not an md) and he returned my call in less than 4 hours. now, his office is in american fork, so going to an appt down there before i knew what our plans were was out of the question. oh, no big deal. dr richards spent an hour and half with me on the phone answering ALL my hard questions..and at the end, even gave me his cell phone number in case i thought of more questions after he hung up. basically, he told me that the success rates of couples trying for over one year have a less than 5% chance each month of conceiving on their own.. not impossible, but definately, not fabulous odds. secondly, he said i could possibly have a problem with horomone receptors at the end of my tubes (fimbria) that may not even pick up my egg, even though i ovulate one (or 4, ha ha) each cycle. meaning, we'd never conceive without ivf. obviously this cannot be diagnosed with any test, so you just trouble-shoot til you've had it and resort to ivf anyway.
so you're wondering what the plan is. since we did not plan to pay $15,000 to conceive a baby, we are not going to jump on the ivf wagon just yet, but we are planning on doing that at the first of 2010. until then, i'm going off all my medication (except parlodel) and if it happens before then, great. if not, we have a great dr who i know can help us. he said our chances are fabulous considering our ages and our health.
just to give you a look into their success rates. for the 11 april ivf cycles they performed, 8 of those got pregnant. the three that did not, were over age 35. so that's way over 50%. i'm feeling relieved that there is hope. i'm not devastated in waiting til january like i thought i'd be. i just keep thinking how much better that + pregnancy test will be after waiting so long.
thanks everyone, for being concerned. i'm finally realizing that this is part of who i am, and not what i am, a broken human.

.so sad.

well, went to the dr monday...and lo and behold...he wants to continue on the path that we've started and not change anything up. he does not feel my ridiculous spotting is any sort of a problem. what planet is he from? its not normal. anyway, the parlodel (bromocriptine) lengthened my luteal phase a whopping 4 days! i guess that's one thing to be thankful for. so just to sum up last cycle...i started spotting on april 26..my period didn't start til may 4...and now i'm done. started clomid last night...100 mg. let's just add up what i'm taking to make everyone out there feel better because they don't have to take 27 pills a day.
1- pre-natal side effect: nausea
2- clomid side effect: mood swings and hot flashes
3- parlodel side effect: whoa, dizzy (i even fell on my butt the other day)
4- vitamin b6
5- baby aspirin

and that's why i've felt so crappy lately. i think the dizziness is the worst. even as i type now, the room is going in a counter-clockwise circle and the letters are smearing together. oh, the things you do to get to those sleepless nights with a baby.

other thoughts. i have finally given into the idea that i do not have ANY control over our infertility issue. when i first started this blog, i felt like i had all the keys to fix this...knowledge, a good dr, meds that i respond to, and a fab hubby. little did i know, that even when everything is "timed perfectly" you still might not get pregnant. the last few months (mostly april) were spent in my bed feeling sorry for myself.

those days are over (well, i'm sure i'll feel that way some days...like when i start my period). i have realized that i have NO control and all i can do is what the dr tells me to and the rest is up to my heavenly father. i'm going to enjoy my summer doing things that you can't do pregnant..and not worry too much about it. its SO much harder to do than to say, but i'm so sick of being depressed about something i can't change. i'm so sad...and i'll still have that sadness deep down, but i need to be there for cameron to make our summer fun. this is such a sob-fest. anyway. i never thought i'd have to survive such heart ache...and most people can't relate, but i'm ok. really. i'm looking up.

.spotting, wonderful spotting.

yesterday i went in to have the wonderful lab-lady poke a lovely 14 guage needle into my very sensitive little anticub... gotta love blood work. anyway, my progesterone was 18, suggesting that i had a "great" ovulation...and my prolactin is down to 22...within normal range, from what the nurse said. good news, i guess..but i'm still spotting...just like i always do 7 days after i ovulate...i swear that's NOT NORMAL.

let me just discuss why i hate that i always spot...not because its annoying and abnormal...but EVERY time i get that call from the nurse with the progesterone results she says, "yeah, looks like this month could be it!" then i proceed to tell her....but i'm spotting...like i always do, looks the same, feels the same. and she ALWAYS comes back with.. "yeah, spotting can be a sign of implantation at 7 dpo." ha. lady, NOT with me..it's always the precursor to my more dreaded red-cloaked friend. i don't say that...i just laugh it off like she knows what she is talking about. i mean who really gets implantation spotting? like 2% of women? most people just "miss their periods," why not me?

at least this time the nurse said that we may need to discuss this further with the dr. wahoo, finally we're getting somewhere. the dr finally asked me and cam to come in for another consultation to discuss further testing to find answers as to why i always spot, but continue to have high temperatures and high progesterone. one reason (one that i feel has already been ruled out) is uterine polyps, and the other is endometriosis...the dreadful diagnosis. i love my body...it is such a wonderland of mystery.

so next monday..maybe we'll have a better game plan. i'm about done with clomid...it's just not changing anything!

.thoughts.

first off.
the side effects from the parlodel are pretty ridiculous. i started taking it last saturday and i'm just now "getting used" to it. mostly i just get really nauseated at night and have dizzy spells throughout the day. not fun, but tolerable. they say the side effects will subside as my body acclimates to the drug. we'll see.
second.
i went back to my dr to have a follicle scan (ultrasound) and, man, i just love when they shove that long stick up places it just shouldn't go. ha ha. anyway. news to me, i had ZERO follicles on the left...and 4 huge ones on the right. dr instructed us to go home now and have some fun..as if you can even call it that anymore. i hate this timing thing...miss the spontaneity. i guess that's good news. he also said my uterine lining was "great," whatever that means. so everything seems to be in proper working order. we are now officially in the 2 week waiting period. i go back to have my progesterone and prolactin drawn next week. and the saga continues.
thanks for listening.

.yup, on to parlodel.

i finally had a chance to talk to my nurse at the fertility clinic and she talked to the dr about starting parlodel (bromocriptine) to help bring down my prolactin levels. no wonder i haven't been able to get pregnant...prolactin is about 90% effective in preventing pregnancy while a woman is breastfeeding. i've read that this med will hopefully stabilize my levels within 2-4 weeks. in conjunction with the 100 mg of clomid i should be set..? right? at this point, i'm a little hesitant to think this is actually the problem because i'm not willing to overlook other problems that will prolong our journey, but it's a start. i'm hopeful.

.the results are in.

well, as i hoped, my prolactin level has gone up! i'm grateful because now maybe we have a "diagnosis." i'm waiting for the MD to call to see if he thinks this is high enough to treat. stay tuned.

.prolactin.

as my list to the right says, i found out yesterday that i have elevated prolactin levels. yes, this is the hormone that is so abundant in those breastfeeding women out there. but how, in my unpregnant, and even less lactating body can this be high. well, perhaps stress, perhaps a tumor on my pituitary gland. believe it or not, i'm pretty ecstatic about having something "wrong" so that we can fix it. now, not to get my hopes up, this level could have been slightly inaccurate, therefore, i'm going back to get it re-drawn next week. i'm secretly hoping it will still be high so i can get on anti-prolactin meds and on to getting pregnant. if it comes back normal, we'll just proceed with my 100 mg of clomid and an ultrasound at ovulation to assess follicle maturation. blah, blah, blah.

anyway, in limbo, yet again.

.welcome.

well, here we are. i hope that this blog will keep our family and friends informed of our "struggle" (i hate using the word struggle, but is there a better word??) with infertility. i'm sure that most of you know, because i'm hardly a private person. i seek no pity. fortunately, this has strengthened our marriage rather than strain it, and we both know that we will become parents when the time is right. we understand that the way we get our babies may not be how most people get them.. and we're ok with that. mostly, we want people to feel comfortable commenting and asking questions even if you don't have problems with infertility, but this blog is mostly a way to help us document what we've done so far. i'm excited for what the next few months bring as we have moved on to a reproductive endocrinologist to help us on our journey. i laugh a lot because cameron and i took our time to become "ready" to start a family..and now, we can't. really? it's a fabulous lesson in patience and faith. welcome to our infertility rollercoaster.