598 and 1069 Mean Nothing to Me

So after the tactless voicemail I received from the RE’s nurse last week which included both: abnormal cortisol levels and cancelled IVF cycle, the nurses did not return my emails nor voicemails for a week! Normally, they reply within a 24 hour period, but this time it took me writing an angry email to coerce a reply.

I had asked to see a scanned copy of my lab results, but instead, she just gave me two values for my cortisol levels which mean nothing to me without reference levels or even UNITS! Sometimes the results are given in mcg/dL and other times it is in nmol/dL, and the conversion factor is somewhere around 27.59 to go from the former to the latter.

The upper range of normal is from 5 to 23 mcg/dL, which converts to an upper limit of 635 nmol/dL. This puts me within the normal range for my first result (pre-Marvelon).

My second result, was taken after I had started Marvelon, which can significantly increase serum cortisol levels anyway, so I’m skeptical of how they feel my second cortisol level is data they can even consider to be reliable.

I asked two other questions in my email, which she didn’t address at all.

For partially privately paid health care in Canada, and for a treatment cycle that costs 11 000 not including the cost of fertility drugs, I was expecting better care.

I’ve been shopping around for different RE clinics, but the reality is that they’re all the same: one doctor, 5 clinics, and a bunch of nurses who have been trained not to think for themselves.

My beef is not with the nursing profession- but rather with how these clinics are run- and how it makes me and other patients feel like we are nothing but a file number with a dollar sign.

Oh- and I’m STILL waiting to hear from the endocrinologist. Argh.

Plan B Derailed

Missed a call today from our RE’s clinic. They left a voicemail that make me want to cry and call them back, both at the same time.

Last week, my blood test revealed some abnormally elevated cortisol levels. The RE was concerned, so he had me come in this week to have my blood tested again. They called to let me know the following things:

1. My cortisol levels were still really high.
2. They’ve sent an urgent referral to an endocrinologist to have it investigated further.
3. Our IVF treatment cycle has been cancelled until further notice.

I am on the brink of crying, not just because this Marvelon is seriously fucking with my emotions (extremely irritable and anxious lately possibly because of it), but also because I’m:

A. So disappointed that we can’t proceed with the egg retrieval.
B. Actually worried about what might be causing the elevated cortisol.

All of my blood work has been normal up until now, and I doubt that the teenage brats at school are driving me nutz enough to cause a sustained elevation of cortisol!

Anyway, all I can do is keep my fingers crossed that I get in to see the endocrinologist soon, and we figure out what this nonsense is about.

Why I Didn’t Get Pregnant

At our appointment yesterday with the RE, he discussed how it was unusual that I didn’t get pregnant via the IUI’s that we did. He reviewed my blood work, my sonohysterogram, my ultrasound results for each treatment cycle, and could not find any reason why it didn’t take. I ovulate on my own, there were no structural challenges (e.g. fibroids), and there were a good number of follicles present each cycle. The only thing he could conclude was that either: there was some kind of adhesion or endometriosis near the opening to the fallopian tube that they couldn’t see, or that there is an autoimmune disorder that is making my uterus an inhospitable environment for implantation. DW and I pondered for a while, and wondered if maybe it could be due to a) the massive ovarian mass that I had in 2010 that was 1.5 x 2.5 cm, which was so unusual that it caused my physician and specialists to suspect that I might have ovarian cancer. It ruptured on its own, but could have left scar tissue behind. Or b) my Celiac Disease, which is being treated with my strict gluten-free diet. Who knows.

DW’s bloodwork has come back normal, and apparently she has “very young looking ovaries”, according to the Russian ultrasound technician. Her sonohysterogram revealed a possible blocked left fallopian tube, which we wonder if resulted from her abdominal hernia a few years ago, as it happened on the same side. It might have affected her ovulation, if we were to try natural cycles with her eggs.

Either way, going the route of Plan B is the best plan of action given our stats.

Welcome to Plan B, Where B is for Baby

Aloha Blogsphere! It’s been a while since I’ve posted anything meaty, and I think it’s time to update you on how things are going.

Well, I’ve seem to come out of my subfertility depression, and entered into a whole different sort of emotional disorder- anxiety. September finds both the wife and I back in the classroom, stressed as fuck, as transitioning from relaxing on a beach in Maui to dealing with rebellious teenagers is a shock to the system. We both also worked part of the summer teaching summer school, and doing some renovations on our home, so it really didn’t feel like we had much time off.

I’m at a new school this year, and am teaching what is arguably the worst grade and courses this semester. The blood work from my most recent draw (last week) came back and apparently my cortisol level is alarmingly high. High enough that they want to retest me tomorrow and do a full blood panel to investigate further. I blame it on the stress of TTC-ing concurrent to the start of a new school year. I know I am stressed because I’ve been biting my cuticles again, craving sugary comfort foods, and can’t sleep unless I’ve gotten out all of my aggression at the gym or a muay thai class. I am finding that I’m having mini anxiety attacks daily now, and the only thing helping me is the exercise and leaving my work at school.

Darling Wife is super stressed as well, which has exacerbated my anxiety levels. She’s taken on a position of responsibility at school and it is like working 2 jobs.

But despite all of this, these are exciting times.

We both started our periods within 24 hours of each other, and went in for day 3 blood work and ultrasounds. We’ve been put on Marvelon for ease of IVF timing, since we will be doing reciprocal IVF- my buns, her oven.

So far, this is how it’s gonna work:

Pre-treatment Cycle:

CD1: Sept 15/16- we got our periods- called to make day 2/3 blood work and ultrasound appointments

CD2/3: BW and U/S- my cortisol was high

CD3: We both start Marvelon

CD7: Wife has a sonohysterogram, which revealed possible blockage of her left fallopian tube (doesn’t matter because she’s the oven); Review appointment with RE

CD9: I have my blood redrawn to check cortisol levels again, and do a full blood work-up

CD18: October 2- Start Lupron, 20 units, daily in the morning- continue until told to stop

CD 24: October 8- take last BCP

CD 27- 31: October 11 to 15- sometime within this time-frame we should get a period. Call to book CD3 appointment for BW and U/S

Treatment Cycle: Me

CD3- go in for BW and U/S, start Gonal-F daily for 8-12 days (in addition to Lupron); Regular monitoring of hormone levels and follicles until they are mature enough

CD unknown- HCG shot

CD unknown- Egg retrieval

Treatment Cycle: Wife

CD3- go in for BW and U/S, start Estrace for unknown number of days

CD unknown- 5 days after egg retrieval, embryo transfer

We’re pretty excited, and when we work out the timing of it all, Darling Wife may be going in for the embryo transfer close to Halloween. We’ve got awesome costumes all set for this year, and I think she should go to the appointment dressed as a fairy princess (DW is pretty butch, which is why her costume is so hilarious to both of us).

I’ve been reading a lot about egg retrievals, which, to be honest freaks the shit out of me. I too, am considering going to the appointment with fake blood on my face, wearing super long incisors- dressed as a ovary-bloated Dracula.

Waiting to Bleed

20130915-222014.jpg

10 am: Today will be the 10th day of my luteal phase. In all of my previous non-medicated cycles, I have started shedding my uterine lining on or before this day. The wife too, feels a bleed coming on soon. I hope that we are right. We had been very patient during this in-between time. I think that the numerous agonizing two-week-waits have served as some sort of training.

In the meantime we’ve been busy with work, doing summer-closing chores around the house and in the garden, cooking up heaps of homemade lunches for the week, and getting our sleep schedule back on track.

11 am: I found this beautiful art painted in menstrual blood:
http://www.vanessatiegs.com/creations/menstrala/

12 pm: Wife starts bleeding, then cramps begin.

9 pm: I feel cramps, then start spotting.

Within 12 hours? I’d say we’ve synced!

This is a first for us!! I’m hoping it’s a good sign.