Day 21

Okay, so no follicles over 10 mm today, but my estradiol was 106 PG/ML and my lining was 11.5 mm and partially trilaminar.

I was very disappointed after my U/S today. I was almost 100 % sure the doc would cancel my cycle because I hadn't made any measurable follicles yet. I knew my estradiol had risen, but I wasn't sure if that was enough to keep going since it is getting kind of late in my cycle. "Fertile Myrtle ovulates on day 14." (Quotes here indicate sarcasm so imagine this in a snotty sing-song voice).

Imagine my surprise when the nurse told me the doctor wants me to do 100 IU for three days and come in on Saturday for further monitoring. The tone of her message implied that she thinks the doctor is nuts. I don't really care, as long as he thinks there is a chance to save this cycle.

It's my understanding that because my estradiol increased, there is still hope for a follicle. It would be nice for something to happen so that this month does not end up a total waste.

For the record, my lab bruise count is up to 5, and I have one new self inflicted injection bruise, for a total of 6 bruises this cycle. Just a fun fact.

Day 18

Still no follicles over 10 mm at my U/S today. The nurse called me about noon and said they are letting me decide what to do next. I thought to myself, "WHAT!?!" She said I could take 100 IU for three days and monitor on Weds or end my cycle and take provera to induce a new cycle. My estradiol hadn't risen since the last check, but she said it was up to me. Boy did I hate that. Isn't that why I'm paying the doc the big bucks - so he can decide what's best for me?

I'm going to try to get something out of this cycle and continue the meds. There must be a small chance of hope that I could grow a follicle, otherwise they wouldn't let me try, right? That's my theory anyway. The nurse said if I don't have a measurable follicle by Weds, we will quit for this month. That will be a bummer, but it's nothing I haven't been through before.

Now, of course, I am questioning my decision to not do acupuncture this time. I know I said we cannot afford it, and that's true. However, the one month I did it I ovulated and got pregnant. Maybe it was just a coincidence, but what if that's what made it happen? I fear I'm just waisting my time and money by not doing it.

I would like to say that when it's meant to be I'll get pregnant, but that's such an ignorant statement to me. If I had that mentality, I wouldn't have gone through treatments before, and I wouldn't have Hadley. Besides, I just cannot believe that there is some grand scheme where we have to go though hell to be parents and other idiots can reproduce on a whim. If that's true, I'd like to meet the genius who decided that. I would certainly give him a piece of my mind.

Day 15

I had monitoring again today. Still no measurable follicles, and tons under 10 mm. The tech did measure a couple of 8 mms though, so maybe one will grow big. My lining is partially trilaminar and 7.9 mm. My estradiol was 69 PG/ML, so that dropped, and I have no idea what role that plays. I wish I were a doc or nurse in this field so I could get it.

They told me to take 75 IU for three days and come in Sunday for monitoring. That sucks because my mom's flight is Sunday at 10:50 AM, so now I have to get up super early to make it to an appointment before the airport. At least they are both in Mpls and on the same day.

This seems like a never ending cycle - I feel like I've been taking shots forever and had no response. Even though my IUI cycle with Hadley lasted 21 days before HCG, I don't remember it taking this long. I suppose I blocked it out because at the end of it all I found out I was pregnant.

Testing Sunday will be scary because it will be day 18. Last time, day 19 was the day that Hadley's follicle measured over 10 mm, so it will worry me if I don't respond by day 18. I am afraid they will cancel my cycle. That always feels like such a waste after all this work and money. I'll just keep hoping for the best.

Day 13

Still no measurable follicles today. My estradiol is up to 76 though. The doc said 75 IU tonight and tomorrow night and monitor again on Thursday. The lab tech dug around in my arm which was fun and then she drew from my hand which hurt. Lab bruise count this cycle: 3 (so far) Not much else to report.

Detoured

I called the nurses this morning to let them know what happened this weekend. They basically said that the plan they give in the office is a "guess" (my word, not theirs) and that they will call if the doctor has other plans - which he did in my case. So I bet the nurse assumed that I have been their before and should know that, but this was only the second time I monitored down there. Very frustrating!

They called back in the afternoon to tell me to take 75 IU tonight and still come in tomorrow for monitoring. I'll post after that tomorrow.

Stupid Nurses!

I am pretty irritated tonight. After my appt yesterday, we stayed at my in-laws because today we had to be at the airport to pick up my mom. We got home this afternoon around 5 PM and there was a message on my machine from their office telling me to take 75 IU LAST NIGHT! I was pissed off because before I left there yesterday, the nurse said specifically to take 50 IU for three days and then return the 19th for monitoring. So of course being out of town last night, I took 50 IU. Now they are not open until tomorrow.

I have decided to take 75 IU tonight and call them in the morning to tell them I didn't get the message until today. The nurse down there never said they were going to call with different instructions, so I never thought to check my voice mail at home for a message. They did have me in and out of there fast - I had a blood draw then within 5 minutes had my U/S. The nurse sits in the room for the U/S, and she gave me my instructions for meds, gave me an order for Tuesday's monitoring, and told me I could leave.

I know they gave me instructions without estradiol results because they don't get processed that fast. That means when they got the results I was already gone, the doctor was probably called, and then they called me to say that "Dr. ___ wants to change your medications..." That's annoying - they try to act like it was the doctor's fault. I think it's irresponsible for the nurse I saw to give me instructions on medications without first seeing my estradiol and then talking to my doctor.

I just had to vent. That irks me that they leave a message and don't bother to reach me. Hopefully this one day lag in meds won't screw up my cycle. We'll see what they say tomorrow.

Day 10

Just a quick update...I went to Mpls for monitoring today. Still no follicles over 10 mm, and I'm not sure about my estradiol. They didn't wait for the lab results before they gave me instructions. They said three more days of meds at the same dose (50 IU) then monitoring again on day 13.

Yesterday I looked closer at my records, and the follicle that produced Hadley's egg didn't appear on the radar until day 15. So I am not worried, just a little impatient and excited to see what happens. Until then...

Day 7

I had monitoring today. My right ovary had 40 follicles under 10 mm and none over, and my left had 50+ under 10 mm and none over. My endometrium lining was 8.1 mm and homogenous. My estradiol was <28 PG/ML. They look for follicles that are developing to release an egg, and they don't measure them until they are at least 10 mm. My lining has to be trilaminar for an embryo to implant and around 8 or 9 mm in thickness.

To keep it simple, nothing has happened yet after four days of meds, although my lining has thickened some. The doctor said to do three more days of meds and come in on Saturday for monitoring.

The meds are going okay. I've had little things that might be side effects, like headache and lower back pain, but otherwise not much to report. I always feel disappointed when I go in and they don't see what they want yet, but I try to remember that the month I got pregnant with Hadley I had also barely responded by day 7.

I started listening to some guided meditation I downloaded off the Internet. I thought that since I cannot afford to do acupuncture this time (it costs $50+ a week for one session!) I would try some relaxation therapy at home. It probably doesn't do the same thing as acupuncture, but it is free and worth a try.

My mom is coming Sunday for a visit. I am excited to see her, and I know she is looking forward to seeing Hadley. It will be nice to have her here if I have any appointments next week, especially if we get to the IUI while she is here - we would have an automatic babysitter. I'm not sure when that will happen, though. With Hadley, (the one IUI we did) the IUIs weren't until day 22 and 23, so it may be awhile.

Rookie?

I started medication last night - 50 IU of Follistim. It has been nearly two years since I gave myself a shot, and I was nervous. Even though I've done it about a hundred times, I felt like a rookie. It's very easy and doesn't hurt, but it is still nerve racking. I was taught how to inject myself in Sept 05, so I guess the learning part was a long time ago. Tonight will probably feel strange, but I'm sure by tomorrow night it will be routine again.

My next step is to go in on Weds to check a lab and U/S to see how I'm responding to the meds. More then.

Feeling Fine

I talked to a better RE nurse today. She took the time to answer my questions. She said the beta comes back positive even before implantation if your pregnant. Whew! Don't have to worry about that one. Also, light bleed doesn't matter for this cycle so I can go ahead. Too bad I spent a day freaking out. Pretty typical of me. I don't know what I was thinking anyway. My lining was only 5.7 mm and was homogenous, and it would need to be like 8 or 9 and trilaminar for implantation. Boy this stuff makes me crazy!

The Obsession

Okay, a lot has happened since yesterday, so here goes. I'm going to give you a time line of sorts.

Thursday
10:00 AM
See blood while at work. Call ins company to check that referral has gone through. They say they haven't gotten anything. Call RM (reproductive medicine) nurses at my monitoring clinic to check on status of referral and have to leave a message. Call my RE's office to tell them it is cycle day 1. They order an ultrasound (U/S) (aka follicle study) for day 2 to check my status, Follistim on day 3-6 and a lab (Estradiol) and U/S on day 7 (Feb 13) to check my progress. They fax the order to me. Provide fax number to my pharmacy for the meds. Call RM nurses to schedule day 2 U/S and have to leave another message. Between work tasks this takes me until lunch time.

2:00 PM
Receive a call from referral coordinator saying that referral has been "sent" to the RE. Good enough. Start to worry when I hardly notice much blood.

4:45 PM
Still no call back to schedule U/S for next day. About to leave work to go get Hadley and decide to call again. Leave another message.

4:47 PM
Get a call from RM nurse and schedule US for 9 AM the next day.

6:30 PM
Worrying some more about lack of blood. I research implantation bleeding and wonder if it is the right time in my previous cycle to be having that instead. I have no idea. Decide if not much change before 7:30 AM when RE opens, will call them.

7:30 PM
Call my mom to talk about period vs spotting. I decide to stick to my plan to call the RE if no change.

Friday

6:00 AM
Period pretty much non-existent overnight.

7:15 AM
Some more blood, but not a ton. Decide not to call and just go to U/S.

9:00 AM
Go to U/S appt

9:45 AM
Print U/S report and fax it to RE. 25 small follicles on the right ovary and 40 on the left. Fibroid has gotten smaller. Uterine lining is 5.7 mm and homogenous.

12:00 PM
RE nurse calls, they want to do a lab because my uterine lining is thicker than they would like. She faxes me the order, I notice it is for a pregnancy test. Whatever. Call to schedule lab appt. Go to lab appt. Start thinking again about very light period and wonder if they too think it could be blood from implantation. Wishing I hadn't called about this "day 1" at all; things would be easier.

1:15 PM
View lab results, beta HCG is negative. (duh) Call RE nurse and she says I can start meds tomorrow. Obsessing by now...mention the lightness of period and ask if I should hold off on meds just in case (this would only be day 19 of my previous cycle). She was very blunt and rude and said, there is no "just in case" - you're bleeding and your pregnancy test was negative. Felt like I asked a dumb question. Lovely. Ask about meds, she says they faxed prescription to pharmacy yesterday.

2:00 PM
Go down to pharmacy, no prescription received.

2:05 PM
Go back to my desk, call RE nurse and have her fax prescription directly to me.

2:10 PM
Hand carry prescription to pharmacy. The same chick goes, "oh, here's your order" - right in front of her! - "your name was partially cut off." Spend 10 minutes with pharmacist because doc wrote for 2 300 IU cartridges and they only have one 900 IU cartridge in stock. Frustrated because insurance covers at a higher rate at only THIS pharmacy. Pharmacist tells me difference between amount prescribed and amount they have is $70. He crunches some more numbers and finally tells me that he will sell me the 900 IU cartridge for what it would have cost me if they had the smaller one. (one thing goes right)

2:30 PM
Go down to pharmacy again, this time to drop $134.22 for the meds. Ick. Go to employee break room to store medication in lunch fridge until the end of my work day. So fun.

3:30 PM
Have more obsessive thoughts about light period. Still very light but still bright red. The lightness worries me, but I think two days of bright red blood, even if it's not a lot probably isn't implantation. Then I change my mind again.

8:00 PM
Call a friend who will understand. Still very obsessed about period - still not normal, consistent flow. I am worried about a very early pregnancy and starting Follistim and what that might do to an embryo. She isn't sure but helps me decide to call the RE in the AM and see if I can get a more reassuring answer from a nurse. I think I know too much about all this and wish I were ignorant so I could get through it easier.

9:00 PM
The obsession continues. I do some more research, this time about HCG levels and how soon your levels rise in a pregnancy. I find that HCG shows up in the bloodstream around the time of implantation, but then also read that it is produced by the placenta, which isn't fully formed at the moment of implantation. Therefore, I am no more confident than earlier.

11:00 PM
Time to finally blog this leg of my journey. I decide to do the time line to give readers an idea of what just 2 days are like for me (and others going through this process). It takes an enormous amount of time and commitment to get through this. I'll let you know how things go tomorrow.