Onward

I’ll save the suspense, letrozole cycle #4 + IUI was not the one for us. I’m not surprised. The timing ended up being less than ideal with spending most of the day trapped on a freezing cold plane flying to the East coast on what should have been implantation day, followed by a far more exhausting and stressful week of going through everything from my childhood/life at my parents house, packing it up and sending it off to meet our shipping container back here on the West coast to get it all to NZ. It’s go time now, less than 2 weeks until we move out!

So, that’s it for us here, we shall see what surprises NZ holds for us 🙂

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A photo from our trip there a decade ago!

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Letrozole Cycle 4/IUI Update- Luteal Support

I had blood tests done to check my estrogen and progesterone levels 2 days after the IUI to gauge how much of either/both I should supplement with during the TWW. My estradiol turned out to be super high, 764.5 pg/ml (for reference: luteal phase range given: 43.8-211, pregnancy 1st trimester range given 215-over 4300pg/ml). My progesterone was a little more within range at 26.3ng/ml (luteal phase range given: 1.8-23.9, pregnancy 1st trimester range given 11-44.3ng/ml). This test was done in the afternoon after after one evening (post IUI) and 2 mornings of the suppository containing both 3mg estrogen and 25mg progesterone and one night with a 100mg progesterone suppository. My naturopathic Dr. suggested I stay on both of those supplements even though the estrogen seemed pretty high (combo in the morning and 100 progesterone at night). So, that is what I shall do! We’ll see how things go flying to the east coast in 2 days with one of the suppositories needing to stay refrigerated…! I must say, though, that these suppositories have been way less crappy to deal with than the ones I had back in 2013/2014… I still make sure I have a pantyliner on, but overall much smaller, less messy and uncomfortable, and so nice that the 100 mg progesterone doesn’t even need to be refrigerated (the little white balls in the photo). I try to lay down for at least 15 min after putting them in (either kind), which I think helps. And let me just say- overall, way better than the daily shots to the backside!!

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So, with that, happy 4th of July, I’ll be back on the day our 2ww ends, I’ll probably bring along a couple of tests because with the extra progesterone my period probably won’t just start on its own.

Fingers & toes crossed! Thanks for reading 🙂

Letrozole Cycle #4 (double dose) plus IUI

I’ve been meaning to write a post for a while now, but things have been busy to say the least! We decided to take last month off as the timing was just not going to be good. This cycle, though, is our last hurrah, stateside at least. We are moving out of our place in officially less than 1 month (OMG!!!), and will be on our way to New Zealand soon after (still waiting for the visas to get the dates nailed down).

Anyway, we decided to throw what we could into the ring this time by doubling up on the letrozole (2 tablets per day for 5 days), and got our act together for the IUI. Fortunately most of the blood work was also required for NZ immigration so we just had to do one more test to satisfy the IUI requirements (infectious disease panel), and figure out the timing and trigger etc. For some reason, that is still unclear to me, my OBGYN prescribed a lupron instead of HCG trigger this time, which was almost twice the cost at $198, and there’s just a lot less information I’ve been able to find about doing an IUI with that kind of trigger.

We had a monitoring appointment last Friday (day 9), so a little early because of the weekend timing, and there were 2 follicles on the right around 15-16mm. The ones on the left were smaller and he didn’t measure any. If I were doing this with an RE, I’m fairly certain we should have checked again Monday or Tuesday, but since I’m not, he didn’t offer and I didn’t ask… so we had to kind of guess when to do the trigger. I wanted to give them time to get to the larger size range, though I’m not sure how fast my follicles were growing and I don’t know exactly how thick my lining was, other than that he said it looked great during the ultrasound.

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One of the follicles below, not a great photo!

I monitored ovulation instead and planned to do the trigger before the LH surge. Of course, that didn’t work, because it was low all day/evening Monday, and then of course positive first thing Tuesday morning! After the whole ‘do I trigger or not trigger’ dilemma, I went ahead and did the trigger in the morning, I had been planning to do it at 1pm, 24 hours before we had scheduled our IUI. So it ended up being about 9:30am which put us around 28 hours before the IUI yesterday, but at least a few hours earlier for my natural LH surge starting. Hopefully we hit a good window for his washed sperm (which don’t ‘live’ as long) to be in the right place at the right time, and hopefully the natural surge + trigger worked, but there was definitely a lot of guess work involved!

The actual IUI went pretty smoothly, although it was sandwiched in between two ocean science workshops I gave- busy day. My husbands sample was processed and injected about 1 hour from collection time (and looked great, 162 million sperm). My daughter ended up coming with us, which turned out to be pretty sweet. I went to an acupuncture appointment that evening (I had also gone on day 8).

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Right after the IUI, my hopefully lucky shark socks!

The next question became whether or not to do any luteal support- using progesterone or progesterone and estrogen. With my FET when I got pregnant I used both estrogen (patches) and progesterone (injections), with IUIs in the past I had done progesterone suppositories. I got my hands on some suppositories just in case and I’m still not exactly sure what my plan is. I asked my OBGYN about it and he prescribed 200mg of progesterone once per day. Most of the studies I’ve seen have used 200 to 400mg per day with the suppositories. I also read some interesting things about estrogen and lupron and estrogen levels during an IUI dropping more in women who don’t get pregnant, so I thought it might be good to do a little of that as well, but as I said I’m still figuring out exactly what I’ll do. I emailed my naturopathic Dr today and she may order estrogen and progesterone blood tests for tomorrow to check levels and decide from there. We are traveling next week as well, which means the kind that have to be refrigerated are not going to work. As far as I can tell in the literature, there’s not a lot of evidence that it will matter, but again, the combination of drugs I’ve used this cycle is really rare to find anything on. Most information is about clomid rather than letrozole, and HCG rather than lupron trigger, and of course I’m sure there’s a lot of individual variation in natural hormone levels as well. With that said, I do plan to do something, I’m just not sure how much. I’ll post again once we figure it out.

So many questions that come up with these things, it’s never easy to just try something different! At least if you want to try to maximize chances for success anyway.

So I’m officially back in the TWW. Thanks for reading and send some baby dust my way if you can 🙂

Quick update, letrozole cycle #3

So we did another cycle, same deal- letrozole once a day for 5 days- but instead of 4 decent looking follicles, we only had one. Ugh. So we decided to forego the IUI (we also hadn’t gotten the blood work done anyway), but we still tried on our own. And…. surprise, surprise, it didn’t work. Things have been so busy with finishing up the semester teaching and trying to figure things out for moving to New Zealand(!!!), that this stuff is falling by the wayside a little bit. I’m still open to trying an IUI, but just not sure if it will happen in the midst of everything else. It’s not happening this cycle either because of travel timing issues. We held off on the blood work because several of the tests seem to overlap with ones required for the visas, so we’ll hopefully get those results soon and then we can get any others we need and hopefully that will be ok! So, this will be another ‘wasted’ cycle, as we decided not to do anything and we’ll go up to a double dose of letrozole, possibly with an IUI if we can get things together next time. We shall see!

This is a card from my yoga class, definitely big changes on the horizon!

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And so it goes…

Our 4 year anniversary cycle was not to be. I do feel like it’s the best shot we’ve had, but alas, letrozole cycle #2 has failed. I got my period yesterday and went in today for a follicle check to be cleared to start letrozole again this cycle. Things looked ok, although it seems there is still a little bit of a cyst on the right side, but he said I was ok to take the meds again starting tomorrow.

Ach. Yesterday was disappointing, but sadly, not surprising. Despite knowing that we can make a viable embryo, and that I can carry a baby successfully, it just doesn’t work for us. My OB thinks it’s probably the eggs and sperm just not getting together for whatever reason. We can do an IUI, but honestly it just feels like a waste of $600+. I decided not to this cycle because the timing seems like it could be too tricky with teaching, but told him we might do it next cycle. I need to call the place where they do it to find out details, but the nurse today mentioned STD testing- we have of course, done it all, but I’m not sure if it’s been too long since then…

My disappointment pales in comparison to my friend who just learned that their trip to transfer their last two donor egg embryos didn’t work. I’m really shocked. She did everything, and I mean everything to try for another successful FET. Intralipids, a D&C instead of just endometrial scratching, infrared saunas, acupuncture, massage, chiropractor, and I’m sure I’m forgetting more… not to mention traveling from CA to Eastern Europe and many expensive medications and supplements.

This journey is not for the faint of heart. It is hard, it is heartbreaking, it is unfair, it is painful, and it is costly in many ways.

Speaking of cost, I just found out my HSG is likely going to cost us another $600+ for a total of $851. I spent a few hours on the phone with the OBGYN office, the Imaging office, and the insurance office to try to straighten things out yesterday (on my day off from teaching), but it seems unlikely they will cover any of it. Since the HSG is associated with infertility, it is automatically on the ‘not covered’ list, even though my OBGYN tried to code it for the abnormal bleeding issues etc. and it initially looked like they would cover part of it.

On a happier note, my husband was offered a job in New Zealand! We are pretty amazed and bewildered as it’s something we’ve been talking about for literally years. And it has just sort of happened really quickly over the last couple of months, and now it’s ours for the taking! It feels very daunting thinking about all of the logistics of moving there- what will we take, what will we not take, what will we do with things we don’t take, will we be there for a few years or forever? So many questions! And crazy to think our lives could be completely different in just a few months.

Of course we looked in to fertility related things, and it seems like I might be able to qualify for covered IVF there, but I would have to be referred before my 40th birthday, which gives us until October. My low ovarian reserve and the fact that we have a living child could count against us, but if we did qualify, I would probably give it another shot. I just really don’t know if lightning could strike twice for us. Even if it’s not covered, it seems like it would be less expensive there if we did pay for it, but I’m not sure how the options and details compare.

Anyway, lots of big decisions in the weeks to come!

Thanks for reading. Leaving you with some wild flowers because that’s better than a photo of my empty uterus, am I right?

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Sick Day at the Beach & Anniversary Eve

What is that they say about best laid plans? Oh yeah… so school and soccer and everything else that could have happened today fell by the wayside when the little one woke up with a low fever. She wasn’t acting like herself. Of course after I notified the school that we wouldn’t be coming I second guessed myself a bit because she seemed to perk up, and the fever was still quite low… We headed to the beach to enjoy the beautiful day for a bit because she wanted to do ‘something fun’ and after about 5 minutes of playing in the sand this happened! IMG_4190.jpg

Now when she was a wee munchkin she used to nap at the beach fairly often, but these days, unless she’s sick, it’s pretty unheard of. So this solidified for me that I made the right call! So much for getting a full day of work done! Although, she did take about 2 more naps after this one, so I did manage to grade 2 papers (and should be grading another one now, which I will shortly… sigh).

Though it’s been little more than an occasional ‘oh yeah’ moment over the past few weeks (I did mention things have been busy!), our 8th wedding anniversary is tomorrow! I was just reflecting back a little bit on my past posts and realized that 4 years ago, on our 4th anniversary we were about 5 days away from finding out I was finally pregnant with our sweet little babe. Hard to believe! Though the timing is a little different and the processes are pretty drastically different, I find myself back in the TWW all these years later. It would be pretty amazing if this turned out to be a lucky one for us…

Anyway, I just wanted to write a quick note to mark the occasion as tomorrow I’ll be working late and my husband will be jet lagged- he’s STILL making his way back from his 1/2 way round the world whorl wind job interview- and my daughter will probably still be a little out of sorts. So, not sure when or if we’ll do much celebrating, but it is a big deal. We’ve had our highs and lows, but I think we still make a pretty great team. And we may soon be taking on some big new adventures… we shall see!

Thanks for reading!

And so the wait begins… again

Friday and Saturday went pretty amazingly well. On Friday, the little one napped before my husband left, so we got in our last try, and I got my stitches out and all was well. On Saturday we made it to acupuncture and she was thoroughly entertained with the toys that she and I had picked out so I got in somewhere around 30 min of acupuncture time- she definitely could have played there longer too! Then we went off to see a ballet with some friends so it was a pretty special day (she’s currently in love with ballet- mostly the Nutcracker, but this one was exciting too!), and good way to keep busy with daddy gone. I’m still flying solo in the parenting department but he’ll be back tomorrow night.

After all this time, I’m not really sure what I should be doing now to try to maximize chances of hopefully fertilized eggs dividing and traveling down toward my uterus. Is there anything I can do? Other than keep taking aspirin and try to focus on things that could help implantation? Should I still take the mucinex stuff? I haven’t been… I should review my FET #2 protocol too, except the things I feel like probably mattered most (if anything we did mattered), were the endometrial injury and the intralipids. It’s too late to do the former and seems a bit extreme to do the latter at this point in time… but maybe I should think more about that one.

As far as side effects, I feel like there are some hot flashes I get on on the letrozole, and sometimes headaches. The Ovidrel seemed to cause some uncomfortable bloating/constipation, which was most uncomfortable Friday, then better by Saturday.

I’m a bit stressed about work, so the plan is to take my daughter in for an extra school day tomorrow so I can hopefully finish these lab reports that have been hanging over my head for over a week now (and I’m only half way done). She started coughing today though, so I’m really hoping that will blow over and she’ll be ok for school. Fingers crossed we both get sleep tonight and she feels good in the am!

I’ll sign off with a picture she drew this morning- it looks to me like a cell, although she said it’s a stage. I just had a thought that maybe, just maybe, it could represent a little zygote that could become her sibling! Now that would be cool!

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And now we wait… Thanks for reading!