Thursday, August 30, 2007

May I Scream Now?


Our third consult was today. Though it wasn't very uplifting. I never knew just how scared I would be of three little letters...IVF. She went over our "options." Basically there are two options she would like us to do.

Option #1: She seems to think that they need total control of my cycles to make things happen as they normally should. This being done by giving myself injectibles of a medication called Lupron everyday of for the first two weeks of my cycle and when all the hormone levels line up where they need to be, they will force my body to ovulate and then do IUI. She informed me that the pregnancy rate for this is 15-25%, which sounds good. However, those numbers aren't "take home baby" numbers. Those are strictly how many people got pregnant in doing 3-4 cycles of this process. Some, inevitably, ended in miscarriage. This procedure will cost us around $2,500 a pop. Another downside is that if I produce more than three eggs in a cycle, she will not do the IUI for fear of multiples, which means that $2,500 is wasted for nothing. So, if we had to do the four cycles she wants us to do then that would add up to over $10,000!

Option #2: Dreaded In Vetro Fertilization, otherwise known as IVF. Just hearing it come from her mouth made me want to belt out an ear-shattering scream! Never, in a million years did I see our situation coming to this. For those of you not informed of this drawn out procedure, now's the time to learn. I would again have to inject myself with the Lupron medication as well as Follicle Stimulating Hormone and Lutenizing Hormone until all hormone levels indicated my eggs are mature. Then I would go in for a procedure where they insert a rather LARGE needle to draw out all the eggs produced. Luckily, I would be asleep for this. Chris gets off easy (pun intended). After doing his duty, my eggs and his sperm are placed in a petri dish to be fertilized. Three to five days later, 1-2 embryos are inserted into my unterus. Then they either implant to grow or die and I miscarry. Any extra fertilized eggs are frozen for later use. Isn't that nice...frozen baby pops!?!? The upside to this procedure is that the statistical pregnancy/take home baby rate is 50-60% for those under 35 years old. The downside, you ask? Just ONE of these procedures is around $13,000! Not exactly pocket change, eh?

We, unfortunately, cannot do either of those two options. It would be a different ballgame if the insurance we are paying out the ass for would lend a hand, but oh no!! So, I brought up a 3rd Option...really, the only option:

Option #3: Chris and I try on our own with the aid of medications, Clomid or Femara to make me ovulate and Progesterone for after Ovulation. We'll just do things the old fashioned way...I have to admit, that way is much preferable anyhow. She said she would be okay with that but she really doesn't want me on Clomid too much longer because she thinks it's starting to reduce my uterine lining month to month. There's not much evidence of that, but whatever.

Chris and I will have to discuss these options but by process of elimination, I can see that #3 is going to be the best for now. I think it would be awesome to be able to get pregnant as similar as a normal couple...not to mention, much more pleasurable!

Monday, August 27, 2007

Timing is Everything!


My Dr. never called me back to discuss what effect the lack of Estradiol (E2) would have on an early pregnancy. Therefore, we decided that it would be best not to trigger ovulation. I did internet research on my own seeing as how I cannot depend on my medical team to get back to me. *rolls eyes*

I found that E2 is responsible for giving the "go ahead" to other hormones. It cues FSH and LH. FSH or follicle stimulating hormone is what makes follicles/eggs grow and mature. LH or Luetenizing Hormone is what forces ovulation. So, with my E2 levels being dramatically low one would think that my follicles wouldn't be growing/maturing and that I would just not ovulate this cycle. Something just didn't add up to me. I clearly saw that my follicles were in fact growing. Now, maturing is another issue all together. I can't see that. But growing they were. E2 is also responsible for the production of CM or Cervical Mucus which allows sperm to travel with ease. This I also have.

Hoping for the best and preparing for the worst, with this information under my belt, I continued to test with my Ovulation Predictor Kits (OPKs). To my surprise upon testing just last night I got my very fist positive that has occurred naturally, without the hCG Trigger Shot. I again called my Dr's office this morning to inform them and to ask of my chance of miscarriage if becoming pregnant and if it would be wise to proceed with the IUI. I spoke to the nurse, of whom I really wish was my Dr because at least she calls me back! She asked me to take another test this morning. I did. It was negative. She said "Well, it seems you caught the end of your LH Surge" (as I had already assumed). She continued, "I'll put another call into your Dr. to have her call you but I don't think we'll move forward with the IUI because we do those the day after a natural LH Surge. We can't do it on such short notice. Aren't you late into your cycle anyway?" I told her that I was only on Cycle Day 18 (the first IUI was on CD18). She told me that she hoped my Dr would return my call this time. Fat chance of that, I thought. I do really need her to call me back though because we are going to try this the "old way" for a change but I still need Progesterone for my Luetal Phase Defect. I'll need to start it in a few days and don't have any refills.

With all of this, I have to ask myself if they've always been wrong? I mean, they've always done my tests on CD11-12 and then told me to trigger myself that same night. What if they've always told me to take the shot too early and all my eggs thus far weren't ready to ovulate. That and the fact that they've just accepted that I have a Lueteal Phase Defect...or at least accepted it to appease me. They can't argue with facts though. All of this would inevitably lead to several early miscarriages. I'm almost certain I've been pregnant before and simply lost all babies due to faulty timing.

Tuesday, August 21, 2007

Am I Even Female?


It's been a very busy past few days! Today is Tuesday. I went to the Dr. for my consult last Thursday. I brought in all my charts to show her proof of why I think my main issue is lack of Progesterone after ovulation. Let's go over some vocabulary first. Progesterone sustains a pregnancy through it's first tri-mester. A Lueteal Phase is the time period between ovulation and the day a woman starts her next mensus. The average woman has a lueteal phase of about 14 days. This is the length of time a fertilized egg needs to make the journey to the womb and implant securely into the lining, or endometrium, of the uterus. My lueteal phase is normally nine days. So, I have a lueteal phase defect or LPD. This last cycle, I was put on Progesterone to lenghten my lueteal phase. It worked and our fertilized egg implanted 11 days into the lueteal phase. For some unknown reason, however, the baby died.

Back to the charts and the consult. Even with all the proof in front of her, she wouldn't see my point or validate it. She said, "Well, how did you know it (the baby) implanted on day 11?" I had implantation spotting as many women do. She said, "Many women spot all throughout their cycles." Maybe, but I don't and it's not normal for me. I know my own freakin' body. In any event, she said she would give me the progesterone as it won't affect anything in a negative way but that she doesn't really see the point. Idiot.

A friend of mine mentioned to me that I am a Dr's worst nightmare. Though he was jokingly serious, that shouldn't matter. I'm not a wallflower. I can't just sit idley by and let Dr's decide what they want to do to my body just because they have a degree. I wouldn't understand a person not wanting to be educated about what is happening to them. Grant you, I don't go into these appointments and tell her what she is going to do. I do, however, ask plenty of questions, demand answers, and suggest alternative routes to take. At this point, I really don't feel that my opinions are taken seriously, which may eventually lead me to another clinic and Dr.

In any event, afer going over all the options:

1. Exploratory Surgery
2. 4th Clomid/IUI
3. Femara instead of Clomid
4. Injectibles/IUI
5. Clomid/2 Injectibles/IUI

We decided to go with #5. This is called a Hybrid Cycle. It's more expensive than what we've been doing because shots cost more than just pills. So, this is what I did after the miscarriage: Took 50mg of Clomid on Cycle Days 3-7. Took my first shot of FSH on Cycle Day 7 and the second shot on Day 9. I went in for my ultra sound and blood work on day 11 (Yesterday). I have two good follicles, one on the right measuring 22mm and one on the left measruing 19mm. My uterine lining was ok at 6.7mm. I left the Dr. and headed into work thinking I'd probably take the hCG shot that night and that the IUI would be on Wednesday. I got a call yesterday afternoon and it was the nurse telling me there was some bad news. My Estradiol Level (Estrogen) was only at 85. It wasn't corresponding with the size of the eggs on the ultra sound. It should have been in the 200-300 range. They ordered me to come back in today to do the exact same thing. Right egg was the same size (22mm), left egg grew to 20.5mm, and my uterine lining thickened more to 7mm.

Here is the picture of my left ovary and egg follicle. The biggest black circle is the follicle that is 20.5mm. The egg is inside.

I just got the call from the nurse about my blood work. Again with the bad news! Is there ever any good news? She said that my blood from today had an estradiol level of 50 and they re-ran yesterday's blood and it came back at 32! I'm not producing Estrogen. So, there's no estrogen and no progesterone. Am I even female? Geesh! She said they wouldn't do the IUI becuase there is no point in wasting the money when they don't think it will work anyhow. She said that since I already have a trigger shot, that I could use it to go ahead and ovulate and just have "timed intercourse." I asked her if by chance it worked and I became pregnant, what my chance of miscarriage would be if they already know these eggs aren't quite "right"? She of course said she doesn't know but doesn't think it would effect that. I don't know what to do. Chris and I have to talk about this tonight and we'll decide then.

In the meantime, I've written a Memorial Poem for our early loss:

Our Angel

Early morning breath and hair,
Racing to the test.
Good news I was hoping to share,
Praying for the best.

Trembling hands awaiting the time.
Pacing the floor, not wanting to look
As the clock chimes.
So much courage it took.

My emotions much too raw,
Glancing toward the table.
Finally, two pink lines I saw.
I could now have the label,

We’ve wanted for so long.
Hitting my knees I cried,
“I’m so glad I was wrong!”
It really isn’t a lie.

Blood they wanted to take.
Forcing my veins to bite the bait,
To make sure it wasn’t a mistake.
I would just have to wait.

A new day dawns,
Feelings of despair.
My husband smiles and yawns,
He doesn’t know what’s in the air.

My anxious mind racing,
Wanting the phone to ring.
Again with the pacing,
Really hoping I’d be able to sing.

The Doctor’s voice ever so clear,
“Hun, I have some bad news.”
It was my worst fear.
The baby I would soon lose.

Unable to speak,
Dropping the phone to the floor.
Knees feeling weak,
I felt it in my core.

Tears flowed like rain,
As I tried to tell him
Our efforts had been in vein.
He drove to me on that whim.

Sobbing at my desk,
Red face and eyes closed tight.
He held me to his chest
And told me it would all be alright.

His heart had to be breaking,
But he held strong for me.
As I was aching,
He could surely see

In my womb our miracle died.
It was two days
Before our baby would fly
Into Heaven’s bright rays.

Returning to Sender
I can understand.
For if this Lender
Was holding my hand,

My life in His eyes,
My soul in His heart,
I couldn’t be shy.
I surely wouldn’t want to part.

I now think I’ve long enough mourned.
With this new title,
I can’t be that scorned.
Devil, toss your dagger, reins and bridle!

For now, I’m a mother of an angel
That will never fall
And likes to dangle
High above us all.

Wednesday, August 8, 2007

Third Time...


Was a charm. I finally got the long-awaited + yesterday morning!!! I was so thrilled! I was crying with joy and shaking because I was so enthused. I couldn't believe it. I kept looking at the result window all day just to make sure the + was still there! I called my nurse to let her know; she ordered a blood pregnancy test.

I woke up this morning to an aweful, gut-wrenching feeling. Something was wrong. I had one more HPT left and I took it. Negative. It seemed my worst fear was coming true. I tired calming myself thiking that maybe it was wrong.

I still needed to hear the blood test results from my Dr. I headed into work, trying to be optimistic. I called at 9am...results not in. 12 noon...called again and they put me on the phone with the Dr. herself. I knew this couldn't be good. Sure enough, first words out of her mouth were, "I'm afraid I have some bad news, hun." She began to explain, "There's actually some good news from this though." "What?" I insisted. "Well, you were pregnant, which means you can achieve conception. However, you have had a chemical pregancny, which means an early miscarriage." "W...w..why?" I manged to stutter. "There's really no explanation. It could be any number of things. Set up another consult when you are ready and we'll discuss your otpions." Choked up and tears already flowing, I managed to say, "O...o...k, bye." I lost it. I'm still losing it.

Just yesterday there was a live and growing baby in my womb. Today, that same baby is dead. I'm very angry and frustrated. I don't understand why people should have to go through this!?!? It hurts more than I could ever put into words. 18 months to finally achieve a pregnancy and all for nothing, for death. I feel the greatest sense of loss at the moment. Emptiness.

Chris didn't know about the pregnancy at all. I was going to tell him today. Tell him finally that he would be a Daddy in a few short months. Instead, I called him from work. I couldn't even speak I was crying so hard. He said, "I'll be right there." Ten minutes later he walked into my office and I was still sobbing. "What? What is it, I'm here." He desparately asked. I told him everything, everything that had happened. He's just as crushed as I am but I believe he's holding it all in for my sake. He's trying so hard to be strong for me. I don't know how he does it. He's the most amazing man I've ever met.

We both took the remainder of today off and did manage to inform our parents of what happened. I'm still aching all over. I haven't miscarried yet, which means the baby is still inside me. That hurts even more. I wish it would just come out. For the first time in a long time, I just wish my period would come. It's killing me to know our dead baby is just there.

I don't know what we are going to do at this point. My Dr. insisted that we come in for another consult. We'll see her this coming Monday, 8/16.

Please pray for our angel in Heaven and for our sanity.