BFN

As soon as AF comes (probably tomorrow night or Sunday), we'll be on to our 6th and last IUI cycle with this doctor.

He'd better keep his word about being more aggressive this time.
Or I will punch him in the nose.

Upcoming beta

Beta on Friday. It was supposed to be Saturday but I changed it because we have out of town plans. Besides, it will be nice to know whether or not I should pack stuff for impending AF.

I'm pretty positive it will be negative given the grim cycle, but I'm holding out a little hope to be pleasantly surprised.

We're not testing ahead of time. I don't see the point.

Bottom of the 5th

Well, we did what the doctor said and triggered on Thursday night for IUIs on Friday and Saturday mornings. In true "this cycle is doomed" fashion, I woke up on Friday morning feeling like I got hit by a bus - all over body aches, low-grade fever, sore joints, fatigue. I am feeling a little better now but I am of course concerned that the illness will be yet another thing that messes with this cycle's chances.

Our frozen donor, however, was a total superstar again. We got 20million total motile on Friday (62million/59% motile) and 19million total motile on Saturday (70million/54% motile)... so from the swimmer end the cycle was a good one. We used up our last two vials of this dude, though, so if this cycle doesn't work we need to choose someone else for our last IUI. I hoe it doesn't come to that because I've become quite attached to this dude's numbers and don't know if I can find another as good!

So now we sit and wait for the next two weeks while we overanalyze everything. I decided not to temp this cycle because I was always going ridiculously crazy over every little fluctuation in temperature... so I'm hoping by NOT temping I will be able to chill a little. We'll see how that goes.

We're hoping not to test before beta this time around. We've never done that. Ask me again in about 10 days. ;)

Frustrated Incorporated

I have really gone off the deep end. So much so that I called my doctor's secretary and made her have him call me back personally, because I had already pissed off all of the nurses.

Today is CD10. For those of you Not In The Know, that means Cycle Day 10, which means I'm 10 days in. CD1 is always the first real day of menses. Today was my second monitoring appointment, which means ovarian ultrasound and bloodwork.

I went for my first monitoring appointment on Monday, which was CD8, after 5 days of injecting 75iu of Follistim. That's basically injecting FSH (Follicle Stimulating Hormone... think back to 9th grade bio) straight into your gut. (Some background: Follistim works by stimulating the ovaries directly to produce follicles (which contain eggs), rather than Clomid (the drug I did before, it's oral) which tricks your brain into blocking cessation of estrogen production so you might make more eggs. Anyway, the point of shooting yourself up with FSH is supposed to be more eggs (and better quality). An average woman has one mature follicle per cycle. An average Clomid cycle is 2 follicles.) So where was I? CD8. On CD8, I had a bunch of little follicles that were all under 10-12mm... with one on my left ovary taking the lead at 13.5mm. My E2 (estradiol, a beta form of estrogen that is released by maturing follicles) was 82, which is pretty low. General consensus is that a mature follicle has an E2 of 200-600pg. I thought they would raise the amount of FSH I was injecting, but they didn't. They told me to stick to 75iu for the next two days (CD8-9) and come in on CD10. That's today.

I came in this morning and was shocked to find that my 13.5mm little guy had grown to 17mm in two days! But the thing that SUCKED was that NOTHING ELSE GREW. So I had this 17mm and the same bunch that were all 12mm and under. I was so upset by this that I called the nurse's line and said something like, "Hey, I thought that the point of injectables was to have MORE follicles, and I am getting ONE. I want to know if you know why this is, especially when I have a good ovarian reserve." I got a message back from a nurse that said, "Oh, everything looks GREAT, you have a ton that are around 11-12mm and I'm sure the doctor will be pleased." She seemed to miss my entire point that I already had one at 17mm and I didn't have much time.

I got the call about my E2 in the afternoon, and it was, oh my god shoot me now, 131. (Guys, that's low. Not only does it show that my 17mm dude isn't mature yet, it definitely proves that there is nothing else really maturing in the pipes.) And in the same breath, the nurse says that I am to take one more dose of 75iu Follistim tonight and then do Ovidrel tomorrow night (Ovidrel is an injection of straight hCG - human Chorionic Gonadotropin - that forces the follicles to release their eggs in about 24-48 hours.) for inseminations on Friday and Saturday!

!!!

So let me spell this out a little bit. An injectables cycle hopes for 2-4 mature eggs. There is usually an E2 level of 200pg for EACH mature egg. You trigger ovulation with Ovidrel when the eggs are mature. For a little comparison, last cycle I triggered when I had 2 follicles (19mm and 15.5mm) and an E2 of 398. This is WAY lower than that.

I was so upset about the idea of triggering tomorrow and having ONE follicle that I really pissed the nurse off. She was getting really short with me and didn't seem to like the idea that I "knew stuff." When I brought up things about E2 levels and mature follicles and stuff she just started saying, "Well, what the doctor wants..." and then I knew that a) I had more information than she did and b) she was getting irritated. So I told her I was sorry, that she was the messenger, and that I was frustrated.

Later, I was still upset and Jen convinced me to call back and demand to speak to the doctor. I had previously tried to do this and the receptionist said the doctor was with patients and sent me back to the nurse line. So this time I called back and asked for the doctor's secretary... and then I told her that I was VERY concerned about my cycle and I really wanted the doctor to call me back TODAY. And she said she would try. And he did call, at 4:45pm when I was in the middle of staff meeting.

He was nice about me wanting a call and told me I probably didn't piss off the nurses (but I know I did), but really didn't have too much to offer me aside from the "party line" of "Oh, this is going to be fine." (I have learned through this process that "fine" means "the minimum of what might possibly work maybe.") He did agree with me that the E2 was low, and WAY lower than last time (dude, you don't need to be a doctor for that) but kept telling me that it was going to be fine because he was sure it would be MUCH higher by tomorrow. (Keep in mind that it went from 82 on Monday to 131 on Wednesday... how high is it going to be tomorrow?) He also said, and I almost spit out water, that the 12mm follicle on my right ovary was going to be mature by the time of trigger. Remember that the time of trigger is TOMORROW and that mature follicles are a MINIMUM of 15mm. He basically told me I didn't know what I was talking about, and that a good E2 level for a mature follicle is 120pg. Whatever.

So basically I can't say I don't have a chance this month because I /do/ have one mature follicle, BUT I really don't have a heck of a lot of optimism (I've had 2 follicles every other cycle and am certainly not pregnant yet) and I don't really have a lot of faith in my doctor's office if I am getting this sort of result from an aggressively medicated cycle.

My main frustration is that I feel like my doctor is not taking these injectable cycles very seriously and is just thinking of them as a stepping stone to IVF. He is always talking about what goes in on IVF cycles and how that is my next step, and today he went as far as to tell me with some happiness that after my third injectable cycle, my insurance will automatically cover IVF. HELLO, CAN WE LIVE IN THIS CYCLE RIGHT NOW? I seriously think he gets a big stiffy in his office thinking about jumping to IVF and raising his stats.

I was pushy enough that he agreed that if this cycle didn't work, he would be a little more aggressive with the meds next time. I think this occurred because I told him quite forcefully, "Look. I am trying to move away. My wife is taking a job across the state and I will be LIVING HERE BY MYSELF to do these cycles and this is my LAST CHANCE." I'm hoping that by telling him under no uncertain terms that even if I ever pursue IVF it will not be with him will let him realize that he has to actually TRY. Or maybe not. I don't know.

So basically I have given myself track marks in the gut and have a major pizza face (FSH causes skin breakouts) for one ridiculous follicle and the lowest E2 ever. I am ready to punch someone in the face.

~//~

That said, yes, I know that people get pregnant with one follicle. All the time. In fact, most people get pregnant with one follicle. But most people aren't spending a billion dollars and shooting themselves in the gut with hormones with one follicle. I feel like I am paying these people for results and am playing by their rules to a T, and I'm getting the same odds that I would be getting if I wasn't doing anything with them at all! (I do still ovulate, without them, and it's probably one lonely follicle.)

~//~

It's times like this when I really REALLY get it when people say, "I am just waiting for this cycle to be over so I can move on to IVF." Because it seems like the doctors only really care about IVF and that's what they spend their efforts on.

A little update

Ultrasound and bloodwork today, after 5 days of 75 units of Follistim. Estradiol was 82. I had a 13.5mm follicle on the left and a whole bunch that were under 12. Not too much going on with Righty - some stuff under 10mm. (Last month, the two good follicles I had were on the right. I guess they're taking turns.) Nurse seemed to think that things were rising nicely, though I would REALLY like to see a couple more lead follicles, please.

75 units of Follistim again tonight and tomorrow, and then a repeat of the ultrasound and bloodwork on Wednesday morning.

Jen is getting offered a job in Amherst, and our Western Mass move is really moving forward. The job is coming way ahead of the babymaking, though, which means she will likely move there a month or more before me. Gosh, that will suck.

Please oh please let us be successful this cycle so that I can move out to be with her sooner. I know I should stay where I am until I get my last BFN or until I get a heartbeat detected, but ugh... I don't want to be without my wife!

Hopefully Challenged

I am having a hard time with hope right now. We had so much hope last cycle, so many good feelings and high aspirations, and still got a BFN. I'm in that phase of the cycle where I feel like it doesn't matter what I do, I will get a BFN anyway. It doesn't help when a friend e-mails you and tells you that maybe the reason you aren't getting pregnant is because somewhere out in the world is a baby waiting for you to adopt it. Now I am a big fan of adoption and we plan to pursue adoption channels when we buy our home, but come on, people! How cold and callous can a person possibly be?

Today and yesterday I broke down and got iced coffees. I only drink decaf so it's not that kind of a big deal, but I swore off artificial sweeteners for TTC. And I got the Splenda baby, yeah! I figure lots of my clients get pregnant on steady diets of McDonald's and drugs, so what's a little Splenda? That and I have no confidence that we will be successful.

A quack doctor many many years ago told me I would probably never get pregnant because I never ovulated. I ovulate all the time now, but damn, I wish I'd just kept listening to him and didn't get my hopes up at all. Because who knows? In two cycles I may be right back in that place.

Sigh.

Here we go again!

Started injectibles for our 5th IUI cycle. We'll be doing 75iu of Follistim from tonight through Sunday night. I go in on Monday morning for bloodwork and ultrasound to see how things are cooking. Hopefully there will be some good things happening in there.

I haven't been temping because I'm going to try a cycle without temping to see if it helps me be less neurotic about everything. Because I'm not temping, I haven't been as in touch with my cycle. I totally forgot that I was supposed to start injects tonight, and would have totally missed it if I didn't practically trip over the box from the pharmacy while trying to get in the door. Thank goodness for small favors, I guess.

Insurance approved three cycles with injects. We've got two left. The pressure is ON.

Overachiever

I'm a goal-oriented person. I'm also an overachiever. This is a GREAT combination in life. (I'm successful in my career, in my finances, in my friendships, in my family, etc.) Somehow, though, this makes TTC much, much worse.

I have a goal - to be a parent. And granted, I will take it any way I can get it (we're already planning on adopting in the future, and Jen may want to try on her own), but I got it into my head that I was going to have a baby for us. And when I get something into my head, I do it. I was valedictorian of my high school class. I went to college for free. I went to grad school for free. I keep in touch with people I haven't seen in 10+ years. I keep my promises. I return library books on time. I keep a clean house. I complete all projects. I have the most thorough paperwork in my office at work. That's just the way it is. I set goals for myself and I do not stop until I meet them, on time.

I do this with hard work. If I'm not getting the desired results, I work harder. I step it up. If it's getting closer to crunch time, I buckle down. I schedule breaks and do not extend them. I am a machine.

What's frustrating about TTC is that I am doing everything right. I take my temps at the same time. I take my pills at the same time. I take my shots at the same time. I go in for all of my appointments and I don't make long-term plans during TTC time so I can do everything on their schedules. I do not lift heavy things after IUIs. I switched donors when we were getting low numbers. I cut out all of the "trouble foods": caffeine, alcohol, ibuprofen, artificial sweeteners, too much fish, etc. I organic'ed my diet. I eat less sweets. I lost weight. I check all of my fertility signs.

My body, that didn't work for my entire young adult life, now ovulates on its own. And it works even more efficiently with drugs - more follicles, stronger ovulation. I have a nice, long luteal phase that is very consistent. My ovarian reserve is excellent. I am in good health. I make great EWCM. My cervix opens nice and wide on O day.

SO WHY IS THIS NOT WORKING FOR ME?

That is the frustrating part. I am a goody two shoes and I believe that I am successful in life because I do the right things. I may be fooling myself, and I know that some people become "successful" by chance or by family hand-out or by dumb luck but I DO believe that hard work can take someone a long way. I do believe that working hard helps you achieve your goals. I am not a self-help book, just a girl who grew up in a crap environment and struggled to break free.

TTC kills my confidence and my ability to believe in my own hard work. TTC laughs at you when you do everything right and says, "Everything in my own time." TTC makes you continue to do everything right while at the same time letting you know that it probably won't work anyway. Talk about a mindgame.

My insurance company agreed to cover 3 IUI cycles with injectibles. We've had one. We have two to go. It is crunch time and there is NOTHING I can do to bolster my game. The pressure is on. I feel it, it's tangible, it's in my fingers and my mouth and stinging my eyes. October. October or bust.

The game is still on. But I honestly do not know what I am going to do when I'm told to stop without success. Because it's never happened to me.