IUI #5

So instead of IVF we decided to go ahead and do the IUI this cycle. The blood tests did not show a natural LH surge so I had one more scan on Wednesday (follicle measured at 19mm and lining at 10mm). We got the Ovidrel trigger to do at 10pm. On Friday my husband had to be there at 8am, then I was supposed to show up at 10am (36 hours post-trigger). Of course there was insane traffic which caused me to be about 20 minutes late. I tried not to totally freak out, but definitely not the most stress free of mornings! The IUI itself went smoothly, no problems and took about 5 minutes.

I decided to get some extra progesterone suppositories (or pessaries as they call them here), since I already had most of the box left from our previous IVF attempt. I teeter on the edge of feeling like it’s a waste of time and effort vs. trying not to totally give up and at least go through the motions of trying to help facilitate success.

But instead of taking the day easy, we had decided to pack up and go away for a ski weekend, so shortly after I got back home, we headed out again for a ~4.5 hour drive to the mountains. It was good to get out, but the temptation of the apres-ski hot tub was great. The person who did my IUI (I’m not sure if she was a Dr or nurse) had said not to apply direct heat to any part of my body, which I thought was a little strange as a lot of people emphasize keeping feet warm, encouraging blood flow etc. I did put my legs in and even dipped in briefly, because it really wasn’t that hot, but then instantly felt like I’d sabotaged it all! Of course, the night before we had cranked up the heat in the hotel and I’d woken up boiling hot in the middle of the night, which was probably worse… but really, neither are great. Ugh, what can ya do.

I started using the progesterone Sunday night, doing it in the morning and at night (2x Utrogestan each time). It is what it is. Next steps are a blood test to check progesterone Friday and a blood pregnancy test Monday a week after. Implantation should have been yesterday/today. I did an acupuncture appointment the day before the IUI and today (Wednesday). I hope there’s some tiny glimmer of a chance that things worked out how they should, but I don’t have a lot of confidence in IUIs.

Trying to send some love to my body, and love to all of you reading. I leave you with a photo from our snowy weekend! I’m one of those little person dots riding up the Tbar ๐Ÿ™‚

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The IVF That Wasn’t…

Our second scan was last Friday, and as expected, there was just 1 follicle still. They measured it at 11mm. We decided to stop doing the Menopur and switch to IUI. They also mentioned that they measured my LH level on the day 7 blood test (I guess accidentally? As they don’t usually measure it apparently…) and it was quite high (over 19- I need to check the units, but it should be under 10). It went down on the day 10 test and they asked me to do another blood test Sunday (day 12) and come in for another scan on Monday (day 13). The estrogen was also a bit low, but increasing (185 to 338).

At the follicle scan this morning they measured it at 15mm, so growing, but not big enough yet. They told me I’d need to do blood tests every day to see when my LH surge starts to schedule the IUI. My arm is already bruised from the latest rounds of tests and I’m so frustrated that this cycle has been such a let down… I’m feeling so angry that our last IVF attempt was ruined just because of the bad retrieval timing. I mean it is not unlikely that it wouldn’t have worked anyway, but it sucks feeling like we didn’t get our solid last try.

I’ve done some reading about elevated LH during the follicular phase of the cycle, and it’s not good. This article reviews several studies and cites one where ‘A higher likelihood of pregnancy was observed when the LH level was <10 IU/L and the miscarriage rate was significantly higher in women with LH levels >10 IU/L’. So generally, higher LH at the beginning of the cycle leads to less chance of pregnancy and if you do somehow get pregnant your more likely to loose it. Not encouraging for even continuing with the IUI at all…

We debated just throwing in the towel on this cycle altogether and saving the $ for the IUI and possibly trying IVF one more time IF (and that’s a very big IF) our Dr. thinks there’s something different we can do that might actually make a difference. I’m not sure there is at this point. From reading, it sounds like there are things we could do if the high LH is part of what caused this cycle to be so bad. This article mentioned some potential treatments in the last paragraph. I’m not sure what we’d do differently for the stim medications though… go back to only letrozole? Do letrozole alone, then menopure? Increase doses? A different priming protocol? I don’t know. And unfortunately we can’t talk to our Dr. about it because I found out today that she’s gone on vacation for 2 weeks.

So, we’ve somewhat settled on continuing for now, in case there isn’t anything worth trying for another IVF. We’d rather end with the IUI than with nothing. Ugh. Not feeling hopeful. I was/am ready to be done, just hate going out without a good-feeling effort. But starting to wonder if we’ll even get that at this point.

As always, thanks for reading. Here’s a lovely view from our NZ adventures over the weekend.IMG_20200719_145546.jpg

First Scan, Last IVF

So, first, the protocol. My Dr. suggested we alternate Letrozole (3×2.5mg), with Menopur (1 vial, 75mg), for 5 days starting on cycle day 2. This meant 3 nights of Letrozole, 2 of Menopur before the first blood test and scan. We decided it felt strange not taking the Letrozole on the Menopur nights, and since I have plenty of extra we figured we’d go for it and I took 2 Letrozole tablets on those nights. Even with all of this, and feeling rather positive going in to the appointment, the scan was disappointing. They found just one follicle to measure (8mm). In all of the cycles we’ve done with Letrozole, (I’ve lost count how many now), we’ve always had more than one, so this is definitely a let down for our last try ever, especially with the addition of the shots. On top of that unfortunate news I got a headache and felt pretty crappy for the rest of the day.

While I attempted to process the unexpected news, I was a little tempted to throw in the towel then and there, but they proposed taking Menopur every night for 3 more nights and check again on Friday. If there is still just one follicle on Friday we’ll cancel the IVF and maybe do an IUI- just to do something. I certainly didn’t go into this without preparing for either outcome, so I’m not feeling blindsided by the bad news. Just disappointed that we won’t really get a real last try. I keep thinking about how we should have pushed harder to do an earlier retrieval last time… Alas, the past cannot be changed.

I am interpreting this response as my body just being done with this s%*#! So this will, no matter what happens, really be our last IVF attempt, and we’ll have to say goodbye to our hope for another little one. I’m not optimistic about Friday’s scan, but we’ll finish up the shots as planned. They’re pretty much the same as what we’ve done before, with the exception of the liquid to mix with the Menopur powder. Here it comes in a little glass narrow tipped bottle that has a special tool to break off the top to get the liquid out. It seems kind of crazy, but I guess it works! Hopefully no little shards of glass will get in there! Side effects so far are headaches and hot flashes.

Here are all of the shot items, the yellow thing is the glass breaking tool. They aren’t big on the alcohol to sterilize things here, but out of habit (and the fact that I have a box of them still), I’m using it on the top of the Menopur vial and on my skin before the injection.

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Thanks for following along. Best of luck wherever you are as you read this.

 

The World Has Changed…

And left me here (almost a lyric from one of my fave songs (any Weezer fans out there?).

We have weathered COVID-19 remarkably well here in NZ and are feeling extremely lucky that we are here, that we came here when we did, that we were locked down in the best place we could have been under pretty much the best circumstances we could have hoped for. And so far our families and loved ones in the US and abroad are safe. Needless to say, we did not jump into another cycle before all of the sh*t hit the fan.

Aside from the shutdown, my thyroid insisted otherwise, and we weren’t really ready anyway. My TSH was a bit elevated (at 3uIU/ml), so they suggested I add 25mcg to my usual 50mcg dose on the weekends (so add 1/2 a pill 2x a week). It took a while to get down below 2.5 so this is the first month we got the go ahead (latest test 1.8).

Now that life has pretty much returned to normal here, as the novel coronavirus has been eliminated from the country (with the exception of people returning to NZ from abroad, who are strictly quarantined and tested at the border), we are on the brink of our absolutely last attempt. I can’t keep doing this, I know that. I’m ready to move on if this does not work. I’m almost having a harder time convincing myself that I am ready if by some miracle it does work… but I feel like we are invested enough for one more go.

I’m currently in the last day (hopefully- of 7) of ‘priming’ with progynova (2x2mg per day, estrogen) pills and DHEA (25mg per day). Day one should be tomorrow, and then I’ll start letrozole. To spice things up a bit this time we’ll also plan to add our old friend Menopur into the mix, but not nearly as heavily as last time so this will still be considered a ‘natural’ IVF cycle. I’m still waiting on the specifics of how it will look when we get started.

I’m not sure yet how I’m going to psych myself up for this. Maybe it’s the headache creeping in- a sign that my period is on its way- but I am feeling pretty blah. It’s also school holiday for the next two weeks so my little one is home. I know, I know, I’m lucky she’s been back to school at all compared to friends elsewhere, but it is still a lot. A little like lockdown but we can go places and see people if we want. My husband is still mostly working from home though, and we all stayed in today as it was quite rainy, so it did feel quite similar! We’ll be out and about tomorrow though.

I am definitely starting to feel like the sacrifices for doing this (again) are feeling very heavy. Financially, mentally, physically, I’m really starting to question if it’s worth it. Of course, if it works it would be… but I know how small the chances are. I guess we could still back out before the retrieval if things don’t go well, but that’s not easy. And I don’t want to drag things out and start over again.

Our theme today has been rainbows, so here’s one to share. Hopefully, ours is on it’s way…IMG_20200510_163157c

‘Natural’ IVF: The Outcome

I’m surprised and not surprised at the outcome, I’m not surprised it didn’t work but I am a little surprised we didn’t even have anything to transfer.

So what happened? One egg ‘did not survive’ the PICSI procedure, and the other did not start dividing, so therefore didn’t show signs of fertilization. So, tomorrow will not be a transfer day for us.

What now? I’m not sure. I was thinking we’d jump back in either this next cycle or the following one to try one last time with an earlier trigger. I don’t think I want this to be our last attempt. My parents weren’t ready to commit to an amount of $ to help us with yet, so if they don’t come through, that may be it. We certainly can’t afford to plunge in again on our own right now. I don’t really like the idea of taking another cycle off but I also am not sure I’m really ready to start right away, as the priming would have to start really soon.

In the meantime, I will give my little girl some extra hugs and kisses and reflect on how very lucky we are to have her.

On that note… Me and my sweetie, someplace beautiful in New Zealand

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‘Natural’ IVF: Retrieval?

It was a bit of a whirlwind of a weekend going back and forth about whether or not to go through with the egg collection. I found another study that reflects my situation pretty closely, focused on older women and those with DOR issues. The study found dramatically higher pregnancy rates when the trigger shot was done with lead follicles in the 16-18mm range instead of 19-20.5mm. The pregnancy rates were almost 5 times higher (42% vs 8%), for women below 43 with similar DOR issues (such as high FSH and low AMH). The interesting part is that both groups had a similar percentage of ‘high quality’ blastocysts that resulted in such different pregnancy rates.

Of course this completely freaked me out because my lead follicle was even larger than the higher category in this comparison by the time we triggered. We kept going back and forth, one minute it felt like we were in so deep we should keep going, the next we were ready to pull the plug, get back whatever refund we could and try again with an earlier trigger. It was exhausting, and I yet I barely got any sleep! Talk about being stressed about being stressed! I feel like I also began to disconnect from my body and sending positive thoughts to my follicles/eggs.

We also talked to my parents. They were encouraging us not to give up now and even offered to help us pay for another round if this doesn’t work. At first I wasn’t sure how much this would change how we felt, but for me, it definitely made it easier to lean towards seeing it through. The financial side is so major. After I thought about it a bit more it felt like a huge weight off my shoulders. So we decided we would most likely go for it.

I had barely even thought about the reality of the egg collection. Last time it was pretty traumatic. I knew it would be different, because I wouldn’t be completely knocked out and paralyzed but I didn’t really know what else to expect. Obviously we would be going into it with very different expectations, knowing the most we would get would be 2 eggs. So I had my last snack (I was told not to eat past midnight- don’t worry I didn’t stay up that late!). I decided to take the first prednisone, which my Dr had said I could start the day of trigger, but we were not ready for that, plus there were only 5 pills instead of 6. I looked at my old schedules and I took them 6 days with the last day on transfer day. I always took them at night in preparation for my previous transfers, but looking at the bottle here it said to take it in the morning and that it could cause insomnia. Though I really wanted a good night of sleep, I went ahead and took it. At 5am I started to regret that choice!

During the couple of hours I tried to get back to sleep, I started going back and forth again.ย  I thought about what we could do when we arrived: ask about the exact refund we would get if we didn’t continue, and if they could do a scan to check the follicle sizes one more time, and talking to my Dr. about the article linked above (that I emailed her in the middle of the night before!). Then I asked myself if any of the above would actually change our minds again and swing us back to cancelling. The answer was probably not?

I was told to drink only water sips until 7:30, then nothing except for 2 panadol (I only had tylenol, which I thought were the same but I guess are different), then we were meant to arrive at 9 for the egg collection at 9:30am, exactly 36 hours after the trigger shot. So, we quickly dropped off my daughter at kindy and headed over to the clinic. We were running a few minutes behind so I ran in while my husband parked. When I got up there after the slowest elevator ride ever, I asked about the financial side, but they couldn’t really give me an answer and by then the nurse was getting anxious to get things started! My Dr. came in and she hadn’t seen the paper yet, but we talked a bit about the results. She even offered to do a scan to see how the follicles looked without me asking! She measured them at 23-24 for the largest and 20mm for the other. She still thought it was worth going forward. At this point we didn’t have much time to delay things! Overall, I felt a lot less nervous, less naive, probably less hopeful and more realistic. Honestly, I didn’t have that much time to really think about everything.

My Dr. put in the IV line herself (much better job than for the intralipids!), then got ready for the collection. We went across the hall to the same room I’d done my scans in wearing a lovely hospital gown and they quickly got me set up on the bed, made sure I was comfortable, began draping me with various things and then they injected a pain killer, then the drugs to make me feel ‘different!’ The first dose didn’t do it, but the second definitely did! I was somewhat aware of what was going on and I was listening but I was mostly just laying there with my eyes closed! And my husband got to watch it all! I don’t actually remember how we got back into the recovery room but they brought me water and cookies (not gluten free but my husband enjoyed them!). I think I started feeling normal more quickly than I expected, or maybe it was a time warp from the drugs! At any rate, I felt about a million times better than waking up from the retrieval last time. No crying at all!

To sum up, she got both eggs! They will call in the morning to let us know about fertilization and some instructions for a transfer (if they think we’ll make it that far). Lets hope so, trying to stay positive! I’ve been feeling pretty good, just tired. Definitely a bit sensitive and some bleeding, but ok. I was starving when we left the hospital so we went out to lunch, then home where I put on my favorite movie and napped through most of it on the couch! Then had a relaxing afternoon playing with our daughter, well I mostly relaxed in our new hammock :-). Depending on how the call goes I’ll start to think more about the transfer. Now I just have to decide about taking the prednisone again tonight…

This is the only photo that’s not me looking like a total zombie! Here are my shark socks again! Yes I washed them :-).

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‘Natural’ IVF: Trigger Night

It’s been a bumpy 24 hours since my last post. I hardly slept last night, partly from my own uncertainty about how to proceed, and partly from my daughter, who spent most of the night in our bed and also did not sleep well. Somehow she managed to get several bug bites yesterday and she really has a strong reaction- they get quite swollen and red and they were really bothering her last night.

Anyway, in my mind was playback of the article I read saying that the sizes of my 2 growing follicles are too large for a good chance of getting mature eggs. This sucks. I was feeling pretty positive after we decided to keep going once we reconciled with just two follicles, and now I don’t know how to get myself back to a positive place. And I do really believe that it makes a difference. I ended up getting up and emailing my Dr. in the middle of the night and sending her the link to the article to see what she thought. I didn’t really get a chance to talk to my husband about things aside from a kind of rushed conversation amidst many other things going on around lunchtime. I did go ahead and do the last Orgalutran injection in the morning. My Dr. called me a bit later, which was really nice of her. She ultimately said that knowing what she knows, she would probably keep going if she were in this situation. She did, however, say that if it wasn’t the weekend we could have triggered yesterday. I have been feeling very lost.

If we go through with the collection and the eggs are post-mature, and don’t fertilize, of course I’ll regret it. On the other hand, if we stop now, we’ll get a partial refund and have to go through everything again plus another couple (?) thousand dollars (not to mention the $1K we spent yesterday for the intralipids), and if we still end up failing I will also regret it. I don’t know, maybe I’d feel a little more in control of things, but frankly, I’m not sure we can afford it right now. I wish things were different, that the follicles had taken their time a little bit more, that we could have done the trigger earlier and it wouldn’t have fallen on the weekend, that the weekend didn’t matter and we could just do things on the days that are most optimal for our bodies… so many things.

My husband wants to continue. He feels like we’ve already invested so much, he wants to see it through. Part of me agrees, it’s hard to pull the plug when you’ve spent so much time (and $) building up momentum. Part of me just feels detached and not up to making a decision, and there is probably part of me that thinks we should walk away and do things more on our terms. But we’re in so deep, it’s hard.

So, we went ahead and did the trigger shot as directed tonight at 9:30pm for a 9:30am collection time on Monday. I was instructed not to eat anything past midnight the night before and only water sips until 7:30, then nothing except panadol (tylenol) with a small bit of water at 8:30. The nurse said I shouldn’t even take my thyroid med, but I don’t see any reason for that, and it seems like other people have gone ahead with their meds.

The trigger was Ovidrel (250mcg in 0.5mL), which I’ve done before, but for some reason this shot was far more complicated than other ones I’ve used. For starters it came with two detached needles, individually sealed. One of these had to be attached onto the unnecessarily large syringe pen. Then I had to turn the dial to see some fluid at the tip, then rotate it to 250 before injecting. Then do the shot, hold for 5 seconds and remove. I was so busy thinking about all of the details, hoping I did everything right that I forgot to keep the end held down before pulling it out (ugh!). I hope I didn’t accidentally withdraw some of the medication… (uuuuuuggggghhhhh!)

I just looked at the cost breakdown again, it looks like we could potentially get back everything but $1000 plus the meds ~$700 if we cancel the egg collection, although it’s not entirely clear. That makes cancelling slightly more appealing… but it feels so late in the game right now. And it would be a total waste of everything we’ve done if we just give up now. I have no idea if they’d let us switch to IUI at this point, but even if we did it would set us back another whole month so we could do the estrogen priming again. Man these decisions suck!

Here’s a photo of the ridiculous Ovidrel pen. Thanks for reading and good night, I hope I can get some sleep!

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‘Natural’ IVF: Scan #4

My 4th, and possibly last, blood test/scan combo day- I did the same routine as last week- minus the forgetting to set an alarm part (which turned out to be irrelevant anyway as I woke up well before). Also, unlike last time, the Labtests was busy!! I was not the only one there breezing in for my quick blood draw, it was crowded I actually had to wait a bit! I still made it to my appointment on time, it helped that it was 10 min later at 8:35am!

For the scan I had my main Dr., she measured the right side first at 20 (up 4 from the last appointment Tuesday). Then she measured the left, and surprisingly also said 20! We were both surprised, so she remeasured- then she got 18. Just another example of how imprecise these measurements are!! So this follicle grew between 5 and 7 mm to practically catch up to the right side. I kind of wish she had said we should do the trigger tonight and collection Sunday, but she said to stick with the plan and do the trigger tomorrow and collection Monday. I’m a little concerned that the eggs could be post-mature… I found a study showing the highest level of mature eggs from follicles 12-19mm on the day of trigger. I’m already over that and not even triggering today. Sigh, I really don’t want this all to be for nothing because of the damn weekend! This one is a slightly more encouraging as it states ‘the optimal follicular volume for a high yield of good quality blastocysts with good potential to lead to a live birth is 13โ€“23โ€‰mm/1โ€“6โ€‰mL,’ at collection.

Anyway, back to today… She measured my lining at 8.1mm and I got my estradiol levels from Tuesday (666) and today, Friday (1771). I brought my last Orgalutran shot with me to do at the clinic (good call as it was 9am before I finished with the nurse). They ordered me one more to do tomorrow (Saturday) in the am, and my trigger shot, to do in the pm, they’ll have to call me tomorrow with the exact time. As I mentioned before, I discovered that Orgalutran is Ganirelix, as it says so right on the syringe.

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I also picked up the prednisone so I have that if I’m going to take it as well. The trigger shot needs to be refrigerated so thankfully the pharmacist gave me an ice pack as I was not going back home before my intralipids. I had a relaxed breakfast at the cafe and then headed over to the other fertility clinic. Side note, somehow most of the Drs at one clinic also work at the other one, so I saw several of the same people over there! Thankfully they put my shot in the fridge for me during the infusion.

For $800NZD you would think things would run like a super professional luxury experience, but no. They were nice and all, but it seemed like one of the nurses was doing some on the job training, and he completely missed my ‘big juicy vein’ the first try. Luckily the more experienced nurse stepped in and got it set. My poor arm is ready for a break from all of these needles! Hopefully there weren’t any more significant errors, but I’m not entirely sure! I don’t know if what I found in CA exists here (the home IV service), but I do wish I’d done a little more research into other options to get this done. Anyway, I was well equipped with my tablet, hopped on their internet and watched a movie on netflix to keep myself entertained for the 2 hour or so duration of the IV.

I feel somewhat on the verge of a headache, but it seems to be holding off at the moment, I really hope that lasts! Otherwise I feel a little bloated, but otherwise just a bit tired again. And now a little depressed that we should be triggering tonight or even last night… Once again I dropped the ball and didn’t take any photos today. Here’s a photo of some lovely NZ scenery instead…

Thanks for reading!

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‘Natural’ IVF: Scan #3

Two more days, two more measurements: Both follicles jumped up by 3mm to 13 and 16, L and R respectively. Today was a bit more rushed as our live little alarm clock decided to sleep in and I forgot to set one on my phone, I woke up at 7:15am and decided to drive straight across the bridge and go to the Labtest facility closest to the scan appointment, it worked out pretty well, I managed to still score a free parking spot and was only a couple of minutes late, mostly due to a slow elevator, for my 8:25am appointment. Most importantly, I decided not to let any of it stress me out.

Again with a different nurse, but the same Dr. who did the measurements on Sunday (2 days ago). I didn’t catch the number, but she also said the lining was looking good, getting thicker and trilaminar. So, we decided to keep going, and hope that these two follicles will each give us a good quality egg that will fertilize, grow, have the right amount of DNA, etc., etc., and bring us to a happy family of 4.

Continuing meant my first injection for the cycle, Orgalutran (turns out Orgalutran is Ganirelix, more on this next time). These come pre-loaded, so are pretty easy, though they tend to burn a bit. She showed me to leave the air bubble in the bottom so that all of the medication gets pushed out and then to count to 5 before pulling it out, and she gave me the first shot there in the office. Another interesting thing is that I’ve noticed a lack ofย  wiping skin with alcohol here for anything but blood draws, not for shots or acupuncture, whereas in the US this is by far the norm. I asked my nurse today about that and she said it was because there was a study done that showed that it didn’t matter. One thing about this clinic, is that they are very research focused, everything they do or don’t do is because of a research publication. Anyway, Orgalutran is tasked with preventing ovulation by preventing an LH (Leuteinizing Hormone) surge. I will now need to do this every day around 9am including the day of the trigger shot.

I will go in for the next appointment on Friday morning, which is easier because it’s a school day so I can head over, my husband can go with her to school and then head to work without such a late start as he had today. The projected retrieval, or egg collection, is Monday, but it seems to me that if they keep growing at this rate they may be too big by then. So we shall see what happens on Friday. In the meantime, I’m trying to fit in some more yoga, (although I may not do my usual aerial class Thursday night), and heat pack on the belly (1-2 times per day). I am doing low dose aspirin at night as well, I started that during the letrozole, and kind of wished I had started earlier, but will continue. I am also trying to sort out the intralipids (we figured, if we’re doing this, we might as well DO it) and have been given a prescription for prednisone, which I still need to fill if I’m going to take that again. They don’t do antibiotics here before collection or transfer, which is good news for my gut. I’m still doing probiotics every day as well. I started a new prenatal/multivitamin because my others ran out, I’m not thrilled with it so I may look into other options. Otherwise I’m taking CoQ10 (ubiquinol- I took MitoQ for a month leading up to this, which is an NZ thing that’s supposed to be better absorbed), Algae omegas, Vitamin C, Vitamin B12, Vitamin D, Vitamin E, Calcium, Iron (occasionally), and I think that’s it?! And of course, snythroid for my thyroid.

Once again I didn’t take any photos at the appointment, but here are my socks, one shark for each follicle- we are going after it! I wore shark socks for our successful transfer, and I’ll wear those again if we make it to transfer this time, until then I’ll keep these ready for the collection, maybe also for Friday, we’ll see how things go with the laundry ๐Ÿ˜‰

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‘Natural’ IVF: Scan #2

All 3 of us ventured out to my various appointments today, we just barely made it in to one of the only 2 Labtest facilities open on Sunday morning before the 9am cutoff for same day results- and it’s a good thing that we did because it ended up being an important one. Luckily there was no one waiting and they took me right away and the whole thing was done in less than 3 minutes! We then had about an hour to relax and found a beautiful park right next to the other hospital where I needed to go for the scan. We had a lovely morning tea and walked around the park filled with gorgeous old trees and even big fields of sheep and cows! We even ended up just walking over to my appointment from there, which was nice- only had to climb over one stone fence ;-).

I saw a different nurse and Dr. than I had previously, which was ok, although I liked the other nurse a bit more, they had offered to call the other Dr. for me to check in with her before making any decisions, which was nice of them. The follicles are growing, but only 2 of them. The two small ones on the right seem to have dropped off and so we are down to the one on the left, which went from 8 to 10mm, and the one on the right, which has gone from 12-13mm. So it seems like they are both in the game, which is good, I would have loved to see one or both of those 5s to have stepped it up, but no such luck. The lining is a little thicker, but they seemed a bit concerned that it’s still somewhat thin, and I’m actually still having some blood from my period, which is really odd that it hasn’t finished off by now, it’s been 8 days! Just get outa here already!

Anyway, they were also concerned about my estrogen levels, they said my level from the day of the first scan (Friday- 2 days ago), was less than 50, so they wanted to see if it is going up today before deciding if we should continue, if it’s not going up it would indicate that they are actually not really growing. So we left things that they would call us back when they had the level and went ahead and scheduled an appointment for Tuesday (another 2 days) for another scan and blood test to see where things stand then, or cancel if the level doesn’t look good.

They texted around lunchtime saying that the estrogen level is at 232, so they are happy with that for me to continue. Now it’s up to us to decide if 2 chances is enough for us to keep going, knowing full well that they may not actually get 2 eggs, and any egg they get may either not fertilize or not make it until day 3 to transfer or day 5 to freeze, and even if we do make it that far, there’s certainly no guarantee of it ‘sticking’. I also know that with the protocol we did, 1 or 2 follicles is pretty much what was expected, so we shouldn’t really be too disappointed. It just means so much is riding on so little… part of me is wondering if we should have just done a higher stim protocol and tried to give ourselves more chances or if this is the right choice hoping for better quality over quantity.

I realized yesterday, because I felt more normal, how really floored I was on Friday. I was so exhausted, it seemed like any movement or task required a huge, almost insurmountable amount of effort. I’m not sure if it was just the sum of all of that letrozole (last dose the night before), or the lack of iron pills, which I usually take when I’m on my period but decided not to with the letrozole at night. I did take one Friday night and last night to help get back up to speed. I think they have unfortunately also contributed to a little constipation that the Dr. commented made my right ovary harder to see today… oops! Hopefully that clears up quickly!

We have some thinking to do about these two follicles, but likely won’t make any dramatic decisions until our next appointment on Tuesday. Until then I’ll keep doing some heat pack on the belly, and resting, and work on scheduling another acupuncture appointment next week, and possibly line up the intralipids as well. I found out I can do them at the other clinic, but will have to pay $185 for a consult and then $800 per intralipid treatment!! So far this is the first thing we’ve come across, fertility related, that costs more here than in the US… a lot more! They also recommend 3 treatments if positive instead of 2 like I did before, but I’m hoping I could negotiate that… if we get to that point. I also got a prescription for prednisone so we could also do that like last time as well.

I also got my TSH results, but the Dr. said I should ignore them because it’s not accurate while doing stim medications, so the level was 3.6- super high, I guess I’ll have to do it again with a different blood draw to find out what it actually is.

Thanks for reading!

A photo from our walk in the park…IMG_7495.JPG