Frustrations, Nervous Anxiety and Happiness!!

Work has been incredibly busy lately, which I guess can be a blessing because it keeps my mind off of TTC.  On Wednesday as I was leaving work I was checking my phone for messages from through out the day (I don't carry my phone on me while I work because the only place I have to put it is in my front scrubs pocket and I am trying to eliminate any extra radiation to my pelvis).  I noticed that I had a voice mail from my RE's office so I listened to it and then I cried tears of anger.  The receptionist had called me that morning and left a voicemail saying she was wanting to confirm my appointment for Friday and that I had until 4:30 Wednesday afternoon to confirm or they would cancel my appointment.  I did not get the voicemail until 8:15 Wednesday night....  See why the tears came in..... :(  On my drive home I called my husband and vented my frustration to him about the voicemail.  We talked it out on the phone and then I hung up and cried some more.  By the time I walked through the door of our house tears were just rolling down my face.  My husband grabbed me in a warm embrace and just assured me that all would be OK.  I let him listen to the voice mail, because he was certain that I just misunderstood what the girl was saying, but sure enough it was clear as day that at this time on Wednesday night I probably no longer had my appointment for Friday.

First chance I had to steal away at work Thursday morning I went and called the office.  (Trust me if I could have called them as soon as they opened I would have however my little patient was critically ill and I had to put her needs in front of my own).  I spoke with the "nice" receptionist and she informed me that my appointment had not yet been cancelled and that usually those phone calls are made the day before not 2 days before.  Talk about sigh of relief!  I would have cried happy tears but I had to get back to my patient!

Friday comes and I see my RE.  He is just such a positive person and is very forth coming with all information!  I asked him questions that I had about our chances with IUI and he was honest.  We are not the couple with the best scenario for IUI.  My thought process was this:  If I have a high antral follicle count and DH has a sperm count of 104.6 million (I think I may have posted before that it was 95 but I read the paper wrong, it was even better than that) then our odds must be good, right?  Nope, not necessarily.  The theory is that since all of our numbers are great than our chance of success actually decreases (slightly than someone else) with IUI because the rational is that we shouldnt have had a problem getting pregnant in the first place.  IUI works better when there is a known factor like low count or low motility because your helping to make sure the healthy swimmers are right there in front of the egg.  That being said he said our chance of success is 8-10% each cycle instead of 10-12%.  He said that still puts around the 30% success rate after 3 cycles, which equals about 1:3 odds, not bad!!  So we are going to move on with IUI.  He said he still recommended IUI for us to start with because for 1. it is so much cheaper than IVF and 2. we wont know until we try anyway.

So....  I will start Clomid on CD 3-CD 7.  I will have a folli scan and lining measurement on CD 12 and if all looks good we will trigger.  Followed by our first IUI.  I asked questions about our risk of multiples and he informed me that it was low risk with clomid.  Although I must tell you a side story on multiples: When DH and I were dating and we discussed having children one day I jokingly said "what if we end up with triplets"  DH did not really find that funny, although at the time I did!  He said at the time that he would  be okay with twins but more than that would be so much work (not that twins wouldn't be).  So recently my family was in town and we briefly talked about our infertility and what our next step would probably be.  My sister said "oh my gosh you are going to end up with triplets"  I had never mentioned before what I had told DH once upon a time!! It was something I found amusing and I truly wouldn't mind triplets as long as everyone was safe and healthy even being a high risk pregnancy.  So back to the RE.  He said with clomid our chances of twins was about 15%, triplets <3%.  So more than likely we will end up with a singleton which and we will just be happy and ecstatic about welcoming a baby into our lives!

So here comes the irony of this whole Clomid IUI scenario.  If all plays out the way it is scheduled at this point and I start AF on time like I normally do than there is a very real chance that my first IUI could end up being the day that was my original due date from my miscarriage....  If it all works out that way it will be a bitter sweet day, but a hopeful day that my IUI landing on my due date is a sign from God of all the possibilities that our future as parents hold.

Hey St. Jude

I know this post has absolutely nothing to do with fertility however I couldn't help but share!  These kids hold a special place in my heart!  We all have our own daily struggles, but most of these kids act as if they are not even sick! 

Please watch the video because it is so stinking cute and brought tears to my eyes!!

MIA for a few days!

I have been MIA from the Internet world for nearly a week now.  Work has been crazy busy and my family came into town this weekend.  So its been a nice busy break!

I should be around 4-5 DPO at this point of my last cycle before we officially start fertility treatment.  We have been on our own with this for far to long, and I am ready to move on to the next step.  The nice thing about this past week though as I have thought very little about me and my journey, I guess because I am at peace with moving forward.  I have thought a lot about the ladies I follow on here and over at the ovagraph world who have been trying for a long time and/or are on similar journeys.  We all deserve this and one day our wishes will come trued! 

I know that I O monthly, that has been confirmed, however I rarely feel O pain.  I seem to only be able to feel it a couple of times a year.  Well this was one of those cycles where I am pretty sure what I was feeling on CD 13 was O pain.  The last time I felt it was with my January cycle, which was also the cycle we conceived.  Of course that leaves me hopeful for this month just like all of the other past months but I am also going to be realistic since our chances of conceiving on our own are a mere 1-2%.  The other weird thing about this cycle is that on Saturday I was woken up in the middle of the night with cramps, which also happened with the January cycle, however I am way to early as far as DPO for any type of implantation cramps.  On a very rare cycle will I have any type of breast pain and so far since the day of ovulation they have definitely been sore.  So my assumption is that maybe this month my progesterone is just surging higher than my norm.  Gosh you have to hate the side effects of that hormone sometimes!  Playing tricks with my mind!!

I have officially had all of my testing now for infertility!  My RE has personally called me 3 times with results!  I have really been shocked by that.  I could see his nurse calling me but not him personally.  Of course this makes me happy!  He also does not rush off of the phone.  First he called when my FSH came back (it was 6. something), left a voice mail and said it was normal.  Since he called with that lab result I just assumed that all of my labs must have been back and with in normal limits also.  I was wrong.  A mere three days later he calls me again (while I am in the waiting room for my HSG) and tells me that all of my labs were back at that time and all perfectly normal.  I do not know physical numbers yet but I will when I go back this Friday for my next appointment.  He then called me again this past Thursday to let me know he received the report from the radiologist that my HSG was normal.  I let him know that since I am an inpatient person I had already had my husband print my report while he was at work! HA!  RE got a good laugh at that.  While I had him on the phone I asked him about my right sided uterus and he said normally that is a perfectly normal finding, however once I bring him the disc on Friday that shows the physical HSG he will know more if mine still looks normal. 

I asked him if at this point we would be in the category of "unexplained infertility" and he said yes.  He said since all lab work looks good, as far as he knows HSG is normal and DH's SA was (in his words) phenomenal, we are left unexplained. 

So be that as it may we will work out an official plan this Friday.  It should be a medicated IUI as we discussed before.  At my last appointment we discussed Clomid + IUI, I just overall need more information about the whole process as far as will we trigger, how often will we follow my follicles with ultrasound, etc.  DH is leaving to go out of town this Friday so he wont be able to make it to this appointment so I asked him to give me a few questions that he wants me to ask the RE.  Next week I will be leaving for a presentation that I have to do at a conference in Pittsburgh.  I am sure it might not be a bad thing if I have to start Clomid while I am out of town, in case it causes me to be grumpy!

Always remember that I am praying for you that are also on this stinking infertility journey.  It will definitely make us stronger parents once we all receive our gift!!

The Big HSG Day!

Today was full of pictures.  About a year and a half ago I found out that my left vocal cord is paralyzed.  I had an unexplained hoarse for about 6 weeks when I saw my fabulous ENT for the first time.  He scoped me (camera up the nose and partially down the throat) to visualize by vocal cords and what he found surprised us both.  My left vocal cord was not moving.  Every other month I went back to my ENT and he would re scope me to see if function had returned but it never did so we moved onto a surgery to place an implant in my neck that would move my vocal cord over to the center, in essence strengthening my voice which at that point had been hoarse for 9 months.  Surgery was a success and I had a "new normal" voice. 

Well about 3 weeks ago my voice started to become hoarse again.  So I went back to the ENT today.  The took 3 x-rays of my sinuses.  My x-ray showed that my sinuses were cloudy so they are now treating me for a sinus infection.  The nurse practitioner told me that since I only have one functioning vocal cord that my thresh hold for hoarseness is just going to be much less than any one who has 2 normal cords.  So this is what we try for now.  Thankfully I did not have to have a scope because I already new what types of "tubes" my afternoon would bring.

In between my appointments I had just enough time to grab some lunch, get gas in my car and pick up my prescriptions for my sinuses.  I felt good about the day, fairly calm considering I was going for my HSG in a bit.

I went to the hospital, registered and sat in the waiting room for a short period of time while still remaining calm, however I was starting to get just a little bit anxious!  I was fortunate enough to have a great X-Ray tech who explained the procedure and reassured me that it shouldn't be to bad.  Once I went and changed into my hospital gown and sat on the table my anxiety hit the ceiling.  Now I have been told by the families that I take care of at work that I always remain so calm during "code blue" situations, even though I feel like a basket case inside.  So my guess is that the Radiology Tech and Radiologist had no idea just how nervous I was!!

All that anxiety and the test really was not that bad.  Really it just felt weird to feel somebody cleaning my cervix and inserting the catheter.  When they inserted the dye I only felt pressure, a pressure that I really can not explain and a crazy urge to pee!!  My radiologist told me everything he was doing prior to doing it and after the procedure was over took the time to show me my slides and give me some info.  He told me that from what he could tell on quick glance was that my HSG was normal.  Tubes are patent, uterus is shaped like normal and the dye spilled out the end by the ovaries just as it should. 

Here is my uterus (they gave me a CD to take to my doc!)

 

 

My husband who is also a radiology tech of course wanted to see my slides and his only concern with the pictures is that my uterus is not in the center, its off to the side (the darkest black blob), so this is something that I will ask my doc about when I go back in a couple of weeks.  The thin lines that are on both left and right side are my fallopian tubes.  The line in the center is the catheter going into my uterus and at the end of my fallopian tubes where the color becomes darker again is where the dye is fawning out around my ovaries.

 

I asked the lady that was in with me today when my official report would be ready and she told me that it should be in a couple of days.  I could either pick it up or just see it when I go back to the RE.  Well I am a little impatient so I am sure that I will pick it up from the hospital as soon as I can!!

 

I also received a phone call from my RE today telling me that all of my labs are normal.  Being me I need more info than that so I asked him to mail me a copy so I can physically see the numbers!!

 

Can you sense my impatience?

 

This is what I know so far.

So far I know that I started my next cycle yesterday 9/6/12 however since it was after 4pm my RE office is counting today (9/7/12) as CD 1.  My CD 3 labs will actually be CD 4 labs on Monday because I am teaching nursing students this weekend and really wont have a chance to break away.  And my RE office was not fond of my idea of having somebody in my hospital draw my labs.  So be that as it may I am OK with this plan.

Then I have will have my HSG next Friday.  I am already excited and nervous about this all in one!!  I am hoping I am lucky enough to have a radiologist who will talk to me as this is happening and will explain a little bit about it as we go.  I remember in nursing school going through a rotation and watching this happen.  Its funny the things that stick in your brain.  I always thought I would end up doing something with obstetrics, however that is not where God lead me. 

I also did some research about CD 1- CD 3 follicle counts and found some very interesting information that I did not know!!  What I found out yesterday is that this early it is considered an antral follicle count.  This plays into perspective with your chance of conceiving with IVF in particular and when you will go into menopause.  I found out that my antral follicle count is on the high side of normal so according to some websites if I had to use IVF I "should" have a higher probability of conceiving then someone else.  But this is not without risk.  Some one with a higher than normal antral follicle count could easily be over stimulated with drugs leading to some severe problems.

Here is a link that I will leave you with tonight that goes into detail about antral follicle count:

http://www.advancedfertility.com/antralfollicles.htm

And the story unfolds....

Well today was my first RE appointment and all in all I think it went well.  The appointment was definitely a little different than what I was expecting considering we met with the doctor the entire time.  The office was also much quieter than I was expecting. 

On my first appointment I am pretty sure I saw someone that I know also but not to sure because I was reading some papers and happened to look up as she was leaving the office.

Ok so on to the appointment.  My DH and I sat and talked with the doctor and told him our history.  He said that even though we have been ttc for 2 years he is labeling us as 5 years infertile since we have never used any form of protection in preventing a pregnancy, fair enough.  Then we talked about our one BFP that we had in February, how it lasted 6 weeks and when my blood was drawn my hcg and progesterone were very low and how on exam that day I had a lot of rebound right sided tenderness.  I told him how my regular doctor was initially concerned about ectopic, repeated my hcg and p4 two days later and determined it was just a miscarriage.  My RE asked me if my OBGYN ever did an ultrasound during that time and I told him no.  He was not happy about that and feels that it probably was an ectopic pregnancy.

We also discussed my menstrual cramps and how I hoard drugs from previous procedures in order to have pain medication for when I really need it, my period.  He saw that I take lortab and/or ultram to get through the really bad days of cramps, which is usually only one or two a month.  I explained to him that after my surgery for my vocal cord that I saved my lortab for a time I needed it more since the pain in my neck was no where near as bad as the pain I experience most months.  So he figures I very well may have endometriosis, however he doesn't think I need to have surgery to get rid of it.

I told him about how ever since the miscarriage I have had a lot of right sided pain (during my period) and that it feels like tugging, and twisting.  He said well lets go do an ultrasound.  There ultrasound room had a nice big screen tv so we could watch everything as it was happening.  The doctor was the one who performed the ultrasound and he had an LPN in there with him.  He could see an old corpus luteum so we know that I did in fact ovulate last month, which is always good to know.  Then since today has become just like I expected he counted the follicles that I already have brewing for this cycle.  This seriously made my jaw drop.  In my right ovary on CD 1 I have at least 20 follicles and in my left the counted 16.  Are you F***ing kidding me!!!  Prior to the ultrasound we had discussed medicated IUI's and IVF.  He was telling me that for the first round of IVF they give lots of stim meds in order to increase follicle counts so they can harvest more eggs and freeze them for future cycles.  He said when they do that they hope for 15-20 follicles in each ovary.  I already have that and its only CD1!  What would happen if they did stim me???

So at this point I will have CD 3 labs, however he said after seeing my ovaries today he expects them all to come back perfectly normal.  Then after my period is over I will have an HSG.  He is not concerned about getting another P4 level because he already saw an old corpus luteum so he knows I ovulated and I have had a P4 level before and it was normal.  He said we could start fertility treatments this month but DH and I decided to wait until all the test results come back and then move forward next cycle.  I don't want to feel rushed to get all of these things done and move into fertility treatments at the same time.

So the plan is that once we get labs and an HSG then next month I will start clomid and have an IUI barring that there is nothing terribly wrong with my tests that would move us straight towards IVF, like nearly blocked tubes. 

I do have to say the clomid discussion happened before we saw 36 Folli's so I don't know if that would change the plan at all.  I did read up on clomid with IUI's a little while ago and it did say that when clomid was used with an IUI it increased the chance of conception with someone with endometriosis.  So I may still want to try it that way even if I end up with a gazillion follicles.... 

Now we wait and see.... as the story unfolds...

Just when you think its safe to be hopeful.... Pre AF spotting commences :(

Over the past 6 or 7 years I have had intermittent pre AF spotting, ranging from 5 days before down to 1 day before.  It seems as time goes on however it has become more of a problem.  Over the past year I would have to say that it has definitely occurred every cycle (minus the cycle I had a BFP).  Ever since my miscarriage it has been more consistently there 5 days before AF starts.  It really is annoying for me to think about because if I spot for 5 days before AF, have AF which is usually 5-6 days and then spot for another 3-4 days then I am actually bleeding for about 2 weeks in a 28 day cycle.  Something is wrong with that.

I was supposed to start my pre AF spotting yesterday, and nothing happened.  In the back of my mind that brought some extra hope however I do not have the feeling that I had in February where I just new I was pregnant.  I put it at the back of my mind knowing that I would wake up and spotting would be there.  Heck I even had a dream last night that I went to the restroom and spotting was clearly evident.  (Yup TTC has officially invaded my dreams).  So today nothing happened.  And this afternoon nothing happened.  And then I noticed my BB's were sore and I was incredibly hopeful!  Only to use the restroom tonight and have my hopes smashed in my face.

I hate my period!  It really tortures me every month.  I dread the thought of having it and not because it means it was another BFN month but because they are crazy painful.  I usually start to feel nauseated about a week before AF.  I hoard drugs from previous surgeries of drugs for my husbands herniated discs that did not work for him in order to ensure I have some relief from AF.  I had surgery in December to help my paralyzed vocal cord and instead of truly managing that pain I took the least amount of pain medicine as possible because I new I needed it more for AF. 

The more and more I think about it the more and more I know that my cramps have to be part of our TTC problem.  And now ever since our MC I always have right sided ovarian pain that feels like some one is reaching in body and twisting my ovary and Fallopian tube as hard as then can.

I have self diagnosed my self with an endometrioma.....  I am hopeful that I will have some answers about this on Thursday at my first RE appointment!!