IVF#2: After 11 Days of Stims… Almost There!

I must confess that I’ve been napping lately. After lunch, I fall into some sort of food coma, and nap on the couch with the dog, or retreat to the comfort of our bedroom. I just feel so tired. I’m not sure how much energy goes into growing and developing 32 follicles, but hot damn it’s draining me. And I’m doing pretty much no exercise right now because of the wobbly wobbly going on in my abdomen. I needed assistance from my wife last night to get my underwear on after a shower. I’m sure she loved the view, but when you can’t lift your knee up and balance on one leg because it squishes your ovaries, well, it just sucks.

My breasts and nipples are super sore, and have been for three days now. Looking at my bloodwork, it seems that my LH and progesterone have increased a bit, probably because of all the mature follicles. I have read that increased progesterone levels near trigger can yield a poor prognosis for implantation in a fresh cycle, but if a woman has high follicle counts, these levels are to be expected. I am trying not to think about this too much, lest my anxiety start to soar again.

I have also lost my appetite. I’m hungry, yes, but nothing appeals to me. Our local Costco sells organic free-range whole chickens, so I bought some last week and have been eating them for almost 5 days straight, and am so sick of chicken right now. Everything tastes bland and flavourless to me. Yesterday, I polished off a bag of HardBite chips because I needed to eat, wanted the salt, but didn’t enjoy them that much. Being a person very much ruled by my stomach (and on a whole whack of injectable hormones), you can imagine the kind of existential crisis I am experiencing right now.

Today’s monitoring went well. My favourite phlebotomy nurse took my blood, I joked around lots with the reception ladies, and my favourite ultrasound technician dildo-wanded me. She even printed off a photo of my right ovary because it was pretty:

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I’ve actually begun to find the dildo-wanding rooms to be relaxing. The lights are low, it’s always warm, there’s a place to take off your clothes and lie down. There’s someone else there, but they don’t talk to you. You just lay there in silence. It’s almost meditative. I just focus on breathing in, and breathing out.

Anyways, apparently lazing around all day yesterday was good for my follicle growth. Here are today’s stats:

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As you can see, I have a total of 32 follicles (last year was 36). Of those, 17 are 15mm or larger (last year at trigger there were 18). My estrogen levels from yesterday are higher than those on a comparable day last IVF. I think trigger may be tonight, but I’m waiting to hear from the nurse. If we trigger tonight, egg retrieval will be on Thursday, which will mean a very early appointment (like 4 or 5am), because my RE has a standing OR day on Thursdays at the Hospital (he’s actually an OB-GYN so he does operations every Thursday).

So by the phone I will wait, all day. I will post again if we trigger tonight!

IVF#2: After 9 Days of Stims

DW and I had a nice date night yesterday. We started off the evening at Whole Foods (always a delight), and then headed to my favourite Thai place. This restaurant is 100% authentic Thai. The women who own it are sisters, and actually purchase most of their spices from Thailand themselves because for some reason, a lot of Thai products aren’t approved for import into Canada. My favourite dishes are their made-from-scratch (and not from a powder) tom yum soup:

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And their tilapia keang som, which is a non-coconut milk based curry. It has a base of tamarind paste:

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DW tried a new dish, called Pad Ped Pla:

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The dishes were served with jasmine rice, and were sooo delicious. We saved some for the next day’s lunch, but by 10pm the same night, we inhaled the leftovers.

After dinner, we hit the movie theatre to watch the new Johnny Depp movie, Mortdecai. We enjoy Depp’s silly humour, and kind of picked this movie without knowing much else about it. However, we were quite pleasantly surprised by how enjoyable it was. Several times I found myself literally laughing out loud. We got home in time for my nighttime Gonal-f injection, and a couple of episodes of the Walking Dead, which we are catching up on on our PVR.

Today, I had monitoring this morning.
Here are today’s stats:

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The ultrasound tech was funny today, saying, “uh oh, Dr. ______ isn’t going to like this- so many follicles!”. Ahh such is my life.

She was right. This afternoon one of the nurses called, and I’m supposed to lower my dose of Gonal-f again tonight, down to 200 units.

Monitoring again tomorrow!

IVF#2: After 7 Days of Stims

So I’m at that point of bloatedness now where it hurts to pee and poop. My ovaries are each packing in 10 follicles that are on average, a centimetre in diameter each. In the morning, the bloat isn’t so bad, but by the night time, I feel like someone has pumped my belly full of air, creating a very high-pressure system. It hurts to twist or turn too quickly, and rolling over in bed has to be done very carefully. It takes me forever to empty my bladder, because bearing down feels like I’m squishing my ovaries. Pooping, well, you can imagine how difficult pooping is too.

I had monitoring again today, and have a lead follicle at 14mm, so I start coming in daily now for blood work and ultrasound. I hope things progress fast, because my cervix is getting very sensitive to the poking around, I’m running out of veins, and just had to buy another 900IU of Gonal-f and vial of Lupron. These drugs aren’t cheap!

Plus, stimming for 14 days last time nearly killed me- both the wait, but also the amount of monitoring and the OHSS. 36 follicles was just crazy!

So here are today’s stats:

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Those follicles are growing, and more importantly, they are growing all within the same range of sizes. I hope all 20 make it to a good diameter so that they’re all mature. Last time, even though I had 36 follicles, only 19 were mature enough.

What I’m really enjoying right now is comparing my stats from this IVF to those from last year: after 13 days of stims, and after 14 days of stims.

Judging from how things progressed last year, I predict that I’ll be triggering on Tuesday, and retrieving on Thursday. That seems so far away, and a long time feeling so bloated, so of course I’d be thrilled if things progressed quicker this time around.

Another update tomorrow!

IVF#2: After 3 Days of Stims

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(Clementine, keeping the eggs warm)

Things have been busy over here at the mamaetmaman household. My in-laws visited for the weekend, which is normally very nice, but I was feeling kind of hormonal (literally), and would’ve preferred some time alone with my wife. It’s weird, I have been feeling this internal restlessness, which has been making me yearn to travel more than I already do. It feels like a passion burning inside of me. Except that I’m kind of in the middle of an IVF stimulation cycle, and the only things even remotely interesting inside of me are these ovaries, which I am starting to feel.

Today’s Stats: (after 3 days of 225 units of Gonal-F)

Uterine lining: 6 mm
Follicles: 5 on L, 6 on R, all very small

They’re bumping up my meds tonight to 250 units of Gonal-F, and I go in on Wednesday for more monitoring. Tomorrow, I have an intralipid infusion. Fun times.

Grow grow grow little follicles!

IVF#2: CD2: Baseline Ultrasound and Bloodwork

So the clinic called me yesterday and pushed my baseline appointment to today, cycle day 2.

Here are today’s stats:
Endometrial lining: 5mm
Antral follicles: 5 on R, 6 on L (funny how it is different than two days ago- technician variability!)

I start stims tonight!
Stay on 10 units of Lupron in the morning, and start 225 units of Gonal-F tonight!

I go in again on Sunday (stim day 4) to see how things are responding (blood work and ultrasound).

Investigation into the Case of the Missing AF

Well folks, it has been quite the day!
DW and I both seem to have some kind of mild flu. I never get the flu. And this year, I actually got the flu shot!! Wtf? The last time I can remember having it was sometime in 2005, and it was complete with bedsheet-soaking fever and chills, loss of appetite, and diarrhea. It lasted about 3 days, and cost me about 7lbs of my already emaciated frame. Luckily, I am no longer this skinny, and this round has not come close to being that bad. For me, it’s still a mild fever and chills, body aches, and my favourite: the runs. Seriously, I tore into a new package of toilet paper recently, and stocked the bathroom with two extra rolls. Just in case.

Now, feeling like shit would be a whole lot nicer if I knew where the fuck AF has been hiding out. Yes, it has come to this. I know I’m starting to sound like a broken record, or like your significant other nagging you about why it’s necessary to keep 13 bottles of supplements on the kitchen counter permanently, but I am seriously frustrated.

Let me put this into perspective for you.

This is what the Long Lupron Protocol for IVF is supposed to look like:
Day 21 Precycle: start Lupron and stay on it until near the end of IVF stims
Day 28 Precycle: get period –> this becomes Day 1 of Treatment Cycle
Day 3 Treatment Cycle: start stims (Gonal-F for me), lower Lupron dose
Day 13-15: HCG trigger
Day 15-17: egg retrieval

This is what it looks like so far for me:
Day 21 Precycle: start Lupron (and Provera because not yet ovulated)
Day 28: no period
Day 29: still no period
Day 30: still no period
Day 31: still no period
Day 32: still no period
Day 33: still no period
Day 34: still no period
Day 35: still no period
Day 36 (today): STILL NO PERIOD!!!

Notice how in an ideal cycle, you’re on the high dose Lupron for 7 days before your period, but I‘ve been on Lupron for over 15 days now. Lupron causes weight gain, headaches, and major irritability. So yeah. I’m kind of losing my mind.

Early this morning, I went to the fertility clinic for bloodwork, a full bladder pelvic ultrasound, and a transvaginal ultrasound to figure out what the hell is going on. This appointment went well.

The ultrasounds revealed that:
– my endometrial lining is 8.4mm thick
– I have no cysts (hallelujah! I was so worried about this)
– I have 14 antral follicles (6 on the R, 8 on the L) just chillin’, waiting to be stimmed

Last year, during our baseline for IVF#1, I had 16 antral follicles, so time does seem to be showing an influence here. I was reading a research paper on antral follicle numbers, and apparently they are grouped into three ranges: less than 3 (poor ovarian reserve) , less than 6 (average ovarian reserve), greater than 9 (high ovarian reserve). So with 14, I’m still looking really good.

I still had to wait for the bloodwork results, which would be available this afternoon.

By the early afternoon, I got a call from the head nurse.
Apparently, my blood results were in, and they were abnormal:
Estrogen 360 (way too high, should be less than 250)
Progesterone close to zero
She wanted me to keep on the 10 units of Lupron for another week, and then we would recheck my levels.

I thought this was really weird. It didn’t make sense because I was definitely feeling my classic progesterone signs- sore breasts, back ache, dairy cravings. So before she could hang up, I asked more questions, really nit-picking about the values, which required her to go back to her computer and consult my bloodwork results.

There was a pause. An extended silence.

And then she spoke.

She had planned my next steps based on the WRONG results!! Those results were from my pre-Lupron scan, not today!! My results from today had not yet be logged, so more waiting…

I took the dogs shopping, as Clementine needed a new winter coat. Then I took the dogs to the conservation lands for a hike. The paths were all iced over, and I was glad to have my grippy strap-ons (for my boots). When we got back to the car, I noticed that I had a voicemail from the fertility nurse (no missed call- she sent it straight to voicemail):

My levels for today were actually:
Estrogen 74 (nice and low- they want it to be less than 250 to be cleared to start)
Progesterone 1.71 (nice and low- period should be here soon)
My period looks to be due any day now, with my progesterone being so low, so they want me to just call when my period shows up, and then I guess I go in again for my baseline (I actually hope I don’t have to, since everything looks good today).

I found this online, and really liked how it presents estrogen and progesterone levels throughout a typical cycle:

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Also, my BBT temp went down a bit today:

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So all signs- blood, temperature, and ultrasound- point to AF coming soon. But I’m checking every chance I get, and soon can’t seem to come soon enough.

Honestly! Still Waiting for AF!

I consistently have 31-32 day cycles. Today is day 35. I finished a round of Provera about 8/9 days ago, which was supposed to bring on AF last week. My temps remain high, my nipples are super tender, my back hurts, and I’m super emotional.

This needs to end.
AF where are you??

I emailed the nurse on Friday, to ask how long we should be waiting for AF, and she said if I don’t get it by Monday January 19th (today), to call her and we will have to investigate. She also told me that they don’t need AF to show before starting stims. This kind of scared me, and delighted me at the same time. So of course, I scoured Google for examples of this, and sure enough, IVF stim cycles are commonly started with or without preceding periods. Now, since we plan on doing a fresh transfer, wouldn’t this be like sleeping in bedding that hasn’t been washed since last month? Okay, bad analogy, but you know what I mean.

Anyway, I called the nursing line and left a voicemail about not yet having a period, and I’m waiting to hear back from them. What I’m anticipating is that they will have me in for blood work and ultrasound, and then one of the following outcomes will happen:
– my hormones look great, and we go ahead and start stimming
– my hormones look not great, and they make me wait or take Provera again
– ultrasound reveals a functional cyst and they either aspirate it, or cancel the cycle

I certainly feel the effects of progesterone, so my gut feeling is that AF will happen eventually, but that I am just experiencing a very long luteal phase (Lupron can delay AF too). I do worry about being on Lupron for so long, as it can cause oversuppression, and then I’d need higher doses or longer stimulating with the Gonal-F.

Here’s my BBT for those of you who enjoy these types of things (I know I do):

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Anyone have experience with starting stims without a period beforehand? I going nutz over this. Please send sanity vibes. This waiting is seriously killing me. Merci beaucoup!

Still Waiting for AF

So I’m 5 days post Provera cessation, and there is no sign of AF are mixed signs that have been driving me nuts for days now. Normally, I have a bleed 3 days after stopping any progesterone, but this time, the time that timing really counts, nada. Perhaps all my talk of diarrhea scared her away. Maybe me pointing my finger at her and blaming her for the cramps made her self-conscious. Either way, I am super PMSy (which, is actually quite rare), my boobs hurt, my back is sore despite being recently sedentary (couch potato is the name of my new IVF workout plan), and I have no patience for this anymore!

I have been needling some choice acupuncture points the past two days as well.

Every time I use the toilet, I’m inspecting the toilet paper for any trace of red or pink tinge.

The only thing that I can conclude is that despite the Provera, my body must have insisted on ovulating sometime during the middle of last week, and that remnant corpus luteum is what is keeping my progesterone naturally high. My BBT experienced a mild dip a few days ago, but went back up, and has stayed high. Argh.

So I’m frustrated. I need this IVF stim cycle to start to feel like I’m moving forward… Forward towards a hopeful outcome. I am sick of how consistently depressed and anxious I feel. I know part of this is the Lupron, but the primary source is the more than two years spent living with our lives frozen on pause. It’s the multiple miscarriages, the false hope, the awkward social exchanges. It’s the over forty thousand that went down the drain, only to end up back here again. I’m tired of waiting. I feel like I can’t handle much more of this, and right now, I feel like a barren wasteland, full of hurt and pain, where embryos come to die.

AF, wheeeerrrrre arrrrre yooooooooou!?!?!!!!!!!!

Provera, Diarrhea, and Waiting for AF

What a title eh?

Well, I finished my last dose of Provera on Saturday night. I was on a 10mg daily dose for 7 days, overlapping with Lupron. The Provera didn’t make me sleepy like the oral Prometrium usually does, which was disappointing (especially for the insomnia).

Some side effects that I did notice from the Provera were:
– constant back ache
– sore breasts toward the latter end of the week
– cramps roughly 12 hours after each dose, with the worst cramps from days 3-5, lasting 1-2 hours
– frequent urination at night- 3-4 times a night
– major constipation!

It’s hard to tease out what side effects were from the Lupron, but after consulting with the information sheet that came with my medication, as well as some IVF blogs, I think the following side effects are care of Lupron:
– super hungry (increases cell uptake of blood sugar and causes hypoglycaemia)
– insomnia
– mild headaches

For two days now, I’ve only been on the Lupron, and I’ve had the headaches. They aren’t bad, but have me retreating into the depths of a dark bedroom for a while.

As the Provera wears off, so has the constipation. Today, I have had frequent episodes of the runs. Fun times. Notice that I didn’t give you a TMI warning? (People who want babies should become desensitized to poop issues.) Diarrhea is a good thing though, as I would like my meals from three days ago to finally vacate my body. Diarrhea also means that my period is coming… Soon! *Fingers crossed* I can’t wait for CD1 and to start my stimulation drugs!

I have been tracking my BBT the past two days, so that I can get an idea of when to expect AF. Many women report not getting their period for up to two weeks after stopping Provera, so I’m a bit anxious about it. I’m super OCD about scheduling, so waiting for AF is pure torture for me. But my BBT has been hopeful, as this morning, my temperature dropped almost to half of the overall spike temperature. So I might start to bleed any day now. My withdrawal bleeds after Endometrin came three days later, so if I am consistent with that, I should get my period late tonight, or tomorrow.

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For now, we wait.

Ugh.. Where Can I Buy Some Sleep?

It’s 4:44am right now, and I have been trying to fall back asleep since 2. We went to bed at 11:30 tonight last night, and I think I may have finally fallen asleep at midnight.

I have been having problems sleeping on and off ever since July, and it has progressively gotten worse since then. I think that all of these treatments have my hormone balance all out of whack and it is affecting my sleep cycles… Oh and my anxiety levels! I’ve talked about my recent struggles with anxiety here, and how my family doctor encouraged me to take Cipralex (Lexapro), an SSRI. I wavered in my decision several times, got desperate after 13 days without a good sleep and filled the prescription, and then our last FET failed, and the potential of doing another full IVF had me reconsidering starting the Cipralex.

Here’s why:
Cipralex is an SSRI, a serotonin re uptake inhibitor. Normally, when serotonin is released between your neutrons (nerve cells), there is a sort of pump-like mechanism that gobbles it all up (re uptake). The Cipralex turns off this re uptake mechanism (inhibits it) and allows the serotonin to linger a little longer for your body to benefit from it. This happens in many places in your body- of interest to those with mental health issues, there are receptors in the brain. But there are also receptors in the ovaries, which is why I’m hesitant to start it right before an IVF cycle. The IVF stim cycle is such a crapshoot on a good day, and seeing as how my first IVF went so well, I kinda don’t want to add any new factors to the mix.

Last IVF:
On lupron (20IU–>10IU)
On Gonal-F (200IU)

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Part of me feels like once I get pregnant, and I mean safe zone pregnant, the anxiety and sleeplessness will go away. But following some of your journeys, I have come to realize that the worrying doesn’t really stop, and the sleep issues might get worse. Another part of me feels like if things are still super shitty, it wouldn’t be a big deal if I waited out the minor heart defect risk of the first trimester, and started the Cipralex during the second. I am willing to deal with the temporary risk of infant withdrawal symptoms.

So yeah, this is the shit that I am worrying about at what’s now 5:17am! Totally getting ahead of myself, over planning, trying to control shit that is unreasonable for me to control, feeding my anxiety with more anxiety… I suppose this is what my life has become. Sadly, seeing my therapist on a weekly to biweekly basis hasn’t helped much beyond that first visit. I know that therapy is so patient/therapist specific, but I feel like my anxiety is beyond the mending capabilities of talk therapy. I also feel like the only thing other than being pharmaceutically altered that will help me feel better is finally getting pregnant and staying pregnant. I know this is a tall order, and I am still working on not getting super upset that everyone on my Facebook is pregnant or has children already.

Anyway, it is amazing that I have lived 32 sweet years not knowing what anxiety feels like. I have empathy for those who suffer from mental illness. It is a struggle wrought with a lack of understanding or compassion. For many people, there isn’t a “solution” that helps them cope with life or even affords them the simple enjoyment of a day. And while there is a lot of encouragement to “talk about it”, the stigma remains, and people are forced to stay in the closet about it. Being a gay woman, I’ve already spent too much time in the closet.

Now, where does a gal go to buy some sleep at this time of night? (It’s now 5:40am. Faaack!)