Saturday, October 30, 2010

Here's to a Change in the Weather

I think Fall is gearing up to give way to Winter here. I love Fall - it's my absolute favorite time of year. The colors, the cooler temperatures, the wardrobe options, the distant promise of the Holiday Season.

It's a time of transition. Our second opinion is scheduled for 11.9.10, so I put on my Big Girl Pants and called my RE to request my records be transferred. I talked to my favorite desk girl, and told her what I needed and why. I told her I didn't want my RE to take it the wrong way, but we feel that it's only wise to hear it from two separate clinics before we go further into debt to move on to uninsured IVF treatments. You just don't drop that kind of cash without being certain that it is the best plan. She was very understanding and very helpful. She even called to let me know when the records had been sent. 

That's about all the news I've got from this week. I've been feeling like I don't have much to say and feeling bad for not being more supportive of you all. I go through these stretches sometimes when the words just aren't there. I'm still reading my Twitter feed and I'm caught up on my blog reader. My heart hurts for you all, but I don't really know what to say. So many of you have had bad news and mishaps this last week. It's like there's a black cloud hovering over my IF crew, and we're all waiting for a change in the wind.

More waiting.

Monday, October 25, 2010

Happy 101 Blog Award

Big thanks to Holly over at Life As a Navy Wife & Everything Else for passing this along to me! This one is super easy! Here are the rules:

1 - Post who gave you this award (done)
2 - List 10 things that make you happy:
  • My husband
  • My cats
  • The beautiful Fall colors in the park today
  • Roasting marshmallows over a campfire
  • Rediscovering the brand new sweaters I bought at the end of last winter
  • Pumpkin Spice lattes
  • Long weekends
  • Having enough money to pay the bills
  • A good BBC mystery
  • A new book released from a favorite series
3 - Pass the award on to 10 Bloggie Friends:

Happy Reading!

Friday, October 22, 2010

Oh Doc, Just One More Thing...

After our last WTF consult with the RE, we were a little bit in shock. The change in diagnosis and the possibility of uninsured IVF in our future were a kick in the ovaries to be sure. It actually took a few days for all of the information we'd been given to sink in, and of course once it had, we just had more questions. I called the insurance company and my HR department (several times each) and eventually managed to get confirmation of what the RE had told us:

No IVF coverage under any of the health care plans offered by my employer. Period.

Then I set about booking the second opinion with the fertility center recommended by my acupuncturist (and approved by my midwife), only to be told by my insurance company that they weren't a contracted provider so none of their services would be covered. Which after 3 days, many phone calls and much gnashing of teeth was proved untrue. So after a little more Google-mining, I put in a call to our RE with our follow up questions (answers are my paraphrase):

  • If the theory is that the recent 9 day luteal phases were really early miscarriages, then do we have a concern about egg quality or chromosomal issues? Not really
  • My acupuncturist and I were discussing my periods and it sounds like mine are clot-heavy, is this a concern? Not really (my last acupuncture treatment seems to have helped with this)
  • Can you prescribe the PIO during my next injectible IUI cycle so I can hoard it for a possible future uninsured IVF? Yes, though the cost is minimal anyways
  • Can I go ahead and get the AMH tested even though you aren't worried about it? Yes, but it may not be covered by insurance. (I am checking this out today)
  • What can you tell me about state funded grants for uninsured IVFs? Funding has run out and is not currently expected to be renewed (damn).
  • Is it OK to take melatonin to help me sleep (any contraindications)? Go ahead - it's fine.

There are a few other questions that I will pose if/when we reach the point of IVF. The melatonin question was actually a little sneaky. I read an article recently about a new study that reported improved egg/embryo quality in IVF patients who were given 3 mg melatonin. There was no information on timing/frequency of dosages, but I figured if it helps me sleep through the night AND has the potential to improve our chances it would be worth a shot.  After a week on it, I have slept through the night twice in a row, so that's good at least!

Ultimately, I chickened out of mentioning the second opinion. The Professor feels strongly that we should be upfront about it to minimize awkwardness. I will do it when I request the records, but I just caved in the moment and couldn't broach the subject.

Monday, October 18, 2010

Unexpected Words of Wisdom

I may not like her family and their politics and this makes me wish she had done something to further the cause while she was in spotlight, but credit where credit is due, she nailed this one:

The English language lacks the words to mourn an absence. For the loss of a parent, grandparent, spouse, child or friend, we have all manner of words and phrases, some helpful some not. Still we are conditioned to say something, even if it is only “I’m sorry for your loss.”

But for an absence, for someone who was never there at all, we are wordless to capture that particular emptiness. For those who deeply want children and are denied them, those missing babies hover like silent ephemeral shadows over their lives.

-from Spoken from the Heart by Laura Bush

Sunday, October 17, 2010

Cycle #22 Report Card

This report card details progress made by Miss Leftie in the 22nd cycle TTC.

7dpo Progesterone: 14
(A+) Excellent number and much improved over past results. Congratulations Leftie!

Luteal Phase: 14 days
(A+) Exemplary behavior, again much improved over past cycles.

Pregnancy Achieved: Negative
(F) This is an area that needs significantly more work on Leftie's part in order to achieve a satisfactory grade. Must try harder.


Recommendations for improvement:

Thursday, October 14, 2010

Room to Breathe

Well, CD1 is just around the corner. I've got the cramps and headache, and light spotting started this morning. With my work schedule for the next four days (including the weekend) being packed solid with meetings and events from 6:30AM - 10PM daily, there is simply no time for a baseline appointment.

AND, the Professor and I have been wanting to hit the KOA the next weekend before they close for the season. That's not a deal breaker, but it would complicate things what with trying to manage injections and monitoring appointments.

AND, I haven't had a chance to call the RE to discuss the questions and concerns* that have come to mind since our consult last week.

PLUS, I'm still trying to find/schedule a second opinion and sort out insurance options.

Which is all to say that I'm feeling more than a bit rushed and this cycle hasn't even gotten started. So I'm calling it off. One more benched cycle won't be the end of the world, and the extra time will undoubtedly mean that I will be in a better place (both mentally and physically) to gear up for a Last-Chance-IUI when the next CD1 rolls around.

*Questions & Concerns that still need addressing:

  • If the theory is that the 9 day LPs are really early miscarriages, then do we have any concern about egg quality? Chromosomal issues?
  • Is there anything I can do to optimize egg quality?
  • Should we be concerned about clotting issues? My periods are very clot heavy, though I didn’t realize this until discussing it with my acu last week.
  • Can we check if my insurance will cover PIO for a 4th IUI?
  • I want my AMH tested before dropping $10K cash on IVF. Period.

Tuesday, October 12, 2010

THIS Is the Thing That Breaks Me Down?

You've met BFF(H). There hasn't been a single moment of her recent pregnancy/delivery that bothered me. Not her pregnancy announcement, not the ultrasound pictures, not seeing her seven months pregnant belly or sleeping in the nursery when I went to visit her over the summer.

I was perfectly fine and happy when the baby was born and the photos of her and her husband with the baby started arriving in my inbox. So, when I saw that I had a new email with a new photo album from her, I was nothing but excited to see how the baby was changing.

Right up until the photo of her mother holding the baby. At which point I burst into tears. Not just a few tears trickling down the cheek, but full body gasping sobs. My damned eyes are filling up again just remembering. Somehow, I hadn't realized just how much it meant to me to have a chance to see my Mom holding my child. I don't understand why this should be so much harder than seeing BFF(H) or her husband holding their child?

Is it because this disappointment feels so fresh and new, whereas I have already had so many months to adjust to the disappointment of perhaps never seeing my husband holding our child? Is it because of the recent change of our diagnosis to "unexplained" and the appearance of IVF on our horizon (and thus my new-found fears for my egg quality)?

I'm serious... if you have any ideas, I'd love to hear them.

Saturday, October 9, 2010

Answers, In a Way

FYI: This is gonna be a long post and possibly interesting only to me.

I got my 7dpo progesterone levels (unmedicated cycle): 14 (YAY!)

So by way of an update on our re-visit with the RE... all in all we left the appointment feeling fairly upbeat, which is quite a feat as you will soon see. We reviewed the last 11 months of treatments and discussed positives, negatives and possibilities. He even apologized profusely (unprompted) for our experience with Dr. Hate. It was pretty clear that we weren't the first patients to have such an encounter with her, and that she is on her way OUT.

To review the questions we took in with us:

What's with the regression to the 9 day luteal phase?

The big surprise for me was that he feels like the last two cycles with the 9 day luteal phase were actually early miscarriages rather than failed LPs. Non-viable embryos that implanted for a day or so and then fell apart. This is based on the statistics for success for my protocol, my response to it, the bloodwork, the ultrasounds and the fact that a similar ovarian response with the Clomid DID result in a full 14 day luteal phase.

Why did Clomid fix the LPD, but injectibles + progesterone supplements NOT (even with multiple follies)?

This is related to the above. He explained that Clomid would result in the desired amount of progesterone and length of luteal phase, but can negatively impact the quality of the uterine lining, whereas the injectibles would improve both, making it more likely that with injectibles we got implantation (with subsequent failure).

Is it possible that my body simply isn't making use of the available progesterone for some reason?

He doesn't think this is realistic in my case, as I did carry that blighted ovum to more than eight weeks even without progesterone supplementation.

Has the diagnosis shifted from LPD to "Unexplained"?


What is the plan to get better response from Rightie this time? Should we just wait for Leftie's month instead?

He doesn't feel like there is good evidence to support waiting for a Leftie month. In reviewing my previous cycles, there were months that Rightie was noticeably more responsive and there is no guarantee that my ovaries are on a strict rotation. The plan is for increased GonalF dosage and progesterone (both oral AND suppositories).

Has my AMH been tested? If so: what was it, and if not: why?

No. All evidence from my other blood levels, tests and ultrasounds show that I respond well and can produce plenty of eggs. He says he does order the AMH test for some of his patients, but doesn't see indicators that it would be valuable in my case.

If this doesn't work, what is the next step?

This brings the total to three suspected early miscarriages and one blighted ovum miscarriage. Which now that I've had some time to consider it,  makes me wonder about my egg quality. Question for the next visit.

We discussed the statistics for success with the injectibles/IUI protocol, and our RE feels like after three failed cycles on this plan, there isn't much point to continuing it. So we're doing one more injectibles/IUI cycle with adjusted dosages and tweaked progesterone delivery. After that, he suggests switching to IVF.

Deep breaths.

He also informed us that our insurance won't cover it (not even meds).

Deeper breaths.

The "good" news is he estimates the total cost, including meds, will be about $10K per cycle (including the cost of meds). From what I've seen on Twitter and in BlogWorld, this is downright cheap for an out-of-pocket IVF. Not that we have $10K laying around. It will probably mean coming out of the IF closet to our families and begging for funds.

More deep breaths.

It will be worth it if we get a baby out of it.

Thursday, October 7, 2010

Happy-Hopeful Blog Award

Yet another TAG - You're IT out of BlogWorld! Big thanks to SoCalled(TTC)Life and thisispersonal who both tagged me for the Happy-Hopeful Blog. I suspect this award is intended to be bestowed upon someone who is perhaps in need of a reason to focus on Happy and Hopeful thoughts. That would certainly be me.


I'm going to refrain from using the most obvious (if accurate) answers: my darling Professor, my adorable furbabies, my recently paid off car. Instead it's something much more momentary and fleeting. I get the most amazing sense of lightness and peace on crisp Fall days with weather like today. There is something awe inspiring about the quality of the light as the sun strikes the changing colors of the leaves on the trees against the backdrop of dark storm clouds on the horizon. The sight never fails to stop me in my tracks and make me think "I am alive and THIS is beautiful".


I have to admit, moments of happiness are somewhat easier to come by than moments of hopefulness. Oddly enough, that is exactly what is giving me hope right now. Hope, and dare I say confidence, that however our IF journey plays out, the Professor and I will still have an abundance of reasons to be happy. I don't really have much hope at the moment that we will be able to successfully bring our own offspring into our lives. But I have every hope that we will be able to live happily either way.

I'm tagging the following players for Team #Hope:

The Fertilely-Challenged Black Sheep
Gurlee at Infertility Musings

Tuesday, October 5, 2010

Making My List (Checking It Twice)

We have our fourth (fifth?) consult with our RE on Thursday. I have been compiling a list of questions I would like answered. I fear that a great many of them will be answered with, "We're just not sure".

  • What's with the regression to the 9 day luteal phase?
  • Why did Clomid fix the LPD, but injectibles + progesterone supplements NOT (even with multiple follies)?
  • Is it a coincidence that the only two cycles using Ovidrel were the only two medicated cycles with a shortened LP?
  • Is it possible that my body simply isn't making use of the available progesterone for some reason? 
  • Has the diagnosis shifted from LPD to "Unexplained"?
  • What is the plan to get better response from Rightie this time?
  • Should we just wait for Leftie's month instead?
  • Why do you expect this new progesterone plan is going to help?
  • Has my AMH been tested? If so: what was it, and if not: why?
  • If this doesn't work, what is the next step?

Can you think of any other questions I should be taking along?

Saturday, October 2, 2010

I've Been Tagged!

There's this "getting-to-know-you" game that's been making the rounds through BlogWorld in recent weeks, and I just got tagged - I'm IT! NoBabyRuth tagged me since we were Cycle of Fail Buddies last month. If you haven't checked out her story yet, you should. Her life as an expat totally fascinates me, as does her European IF Journey. The game goes like this: answer the series of questions and tag three bloggers who you'd like to see answer them as well. Pretty simple!

1) What is your dream occupation?

Archeologist. I think this is an outgrowth of my career as a potter. Ceramics is a field in which you can't help but be aware of the immense and intriguing history of the craft, of all of the people who went before you and the objects they left behind. I think it would be terribly exciting to be the one who actually gets to find, excavate and identify those artifacts, to extrapolate their histories and the stories of the people who made and used them.

2) What is the best dish that you can cook?

White Chili - check it out.

3) Have you ever been mentioned in the newspaper? What for?

Yes. A few years ago, I was featured in a short article about the non-profit art center where I was working. Nothing particularly special, they wanted a photo and I was the only one doing anything "artsy" when the photographer arrived. I was probably mentioned in high school as well, but can't remember specifics.

4) What’s the worst and/or most memorable job you’ve ever had?


WORST: dishwasher or buffet waitress in Florida. The dishwasher job was just plain gross. Other people's partially eaten meals and garbage, and everything all steamy, wet and mushy. YUCK. And I'm sure you can just imagine how rewarding it would be to wait tables at an all-you-can-eat buffet in a retirement community in Florida.

MOST MEMORABLE: teaching pottery. That would be the thing I am best at, the thing I enjoy most, the thing I promise myself that I will get to do again. It is so rewarding to show/tell another person how to do something they've never done before and don't really believe they CAN do, and then see their excitement when they get it right for the first time! Nothing like it.

5) When you were a teenager, at what age did you envision yourself getting married? How old were you in reality when you got married?

When I was a teenager, I was certain without a doubt that I would be dead by age 24. I couldn't tell you why. It was just something I believed. I never dreamed I would live long enough to get married. Needless to say this strange belief evaporated after my 24th birthday. Professor and I got married when I was 36 years old (though I still feel like I'm in my early 20's).

6) What’s your most hated household chore? What’s your favorite?

I can't honestly say that I have a favorite household chore. I don't like ANY of them. I am a terrible housewife. The relative squalor in which I exist would probably appall you (it appalls me, just not enough to motivate me very often), although I suppose things aren't really dirty so much as dusty and cluttered. My most hated chore would probably be cleaning/changing the catbox. My least hated would probably be loading/unloading the dishwasher.

7) What’s your earliest memory?

My earliest memory is not really of a specific event, but more a collection images in my mind. They are from the house my grandma lived in when I was a toddler, the pallet she made up on the floor for my bed, the kitchen with an old metal highchair that I sat in to eat, the prickly holly bushes with bright red berries by the front door. I've asked my mom about these rememberings, and she says I would have been a little more than 2 years old. I know they are actual memories because we don't have any photos taken in that house.


TAG - you're IT!