On Cycle #12 & IUI #4

I had my 4th IUI today - maybe fourth times the charm?

I had to drive to a further office because, due to the fire at my RE's office, they aren't doing procedures there. I definitely needed the "avoid ghetto" button on the GPS today, good lord.

Anyways, I got there and had my ultrasound. It showed the bigger follicle definitely released, but they were unsure if the smaller follicle released, although they think it did. My lining was only 5mm IE. The IUI nurse said that the lining measurement today isn't as important as what it looks like in 3 days. She said that they'll start me on the Endometrin tomorrow and the progesterone injections tomorrow. I go back in a week for bloodwork and ultrasound to see how the lining is doing. At this point, I really have no clue what else we could possibly do to boost up this lining, ya know? I have faith the progesterone injections will do the trick.

I turned my normal Negative Nancy thoughts into positive thoughts today. I refuse to let my lining number affect my thinking. We had 1, possibly 2, good eggs in there, great timing, and 30 million or so strong swimmers to work with. The progesterone injections are going to help my lining, the Lupron is going to help implantation and this is going to be my cycle. While I laid  there for the 20 minutes, I just kept thinking "those little guys are going to find my egg and it's going to be great." That's how I'm thinking today. :)

Edited to add: That was the most uncomfortable IUI I've ever had. I was feeling super crampy all morning, and what normally feels like a Pap felt very uncomfortable, almost painful. The IUI nurse said that sometimes when you release a large follicle, or multiple follicles, the fluid stays in your abdominal cavity and that's the pain/cramping you feel. Here's to hoping that different means good things.

On Cycle #12: IUI Tomorrow!

I went yesterday for my CD12 bloodwork and ultrasound. Ultrasound showed my lining at 5mm (boo!) but the grade was IE/TL - and I think TL is the optimal grade for when you are doing IUI. Also, my follicles grew to 19mm and 14.3mm. I had to do 1 last Menopur shot in the afternoon, and then I triggered last night at 7pm. The awesome part is that we were at a bar, so I brought my trigger shot with me, and my friend injected me in the bathroom of the bar, lol.

Overall, besides some bloating and cramping - no side effects with the Menopur. One thing I noted is that between ultrasounds, my follicles didn't grow as much as I thought they would. I definitely thought I'd see more of a "boost", but besides adding an additional follicle to the mix (which I'm hoping grows a bit more so it releases tomorrow, as well), it seems to have kind of stunted the growth of the original follicle. Plus, I'm not seeing the huge improvement in my lining that I'd hope I'd see.

Something I've learned, as sort of a defense mechanism I guess, is not to get my hopes up. I go into each ultrasound not having high hopes for my lining. I go into each IUI not really thinking it will work. Of course, there is always that devastation when it doesn't work - but it has helped my mental health a bit. I remember how sad I was when that first Clomid/IUI cycle didn't work. I was utterly devastated - I thought for sure it would be IT. And since then, each failing cycle has almost hurt a little less. I hate the idea of having lost hope, but I think I'm kind of at that point. I go through all of the motions and I'll do whatever the doctor and nurses say, but I never really think we'll be successful.

On Being Hopeful & Thankful

After my complete breakdown last night, and my puffy eyes this morning, I felt absolutely desperate about my situation.

I was scheduled to see my favorite nurse at the RE's office to get a progesterone injection at 8:15am. When I went there, I saw the damage that had been done to their building as a result of the fire. They are now working in another, older, building that hadn't really been used in years. They have no phone lines, so they are all using their private cell phones to contact patients. They don't have fax machines, so they are using the fax machine at the pharmacy across the street. The absolute dedication of this staff is amazing to me. My nurse relayed to me that they were able to save all of the embryos from the fire - it truly touched my heart.

My nurse told me that not only is my endometrial lining thin, but it also isn't the best 'grade' to sustain pregnancy. They like it to "switch over" to a certain grade after ovulation and mine doesn't do that, so they are hoping the progesterone injections help with that. I'll do the injections every day after O, in addition to the 300mg Endometrin. I'm going to be a progesterone monster, lol.

After receiving my injection, and progesterone supplies for our vacation, I spoke to my nurse about moving to injectibles. The conversation with her made all the difference in the world. She has a very "kick ass" attitude, and talks to me like I'm her friend. She told me she really studied my chart before asking the RE the best steps, and it made me feel like they are really trying to fix the underlying problem and treating me as an individual patient, not a number. She said if I wasn't pregnant next cycle, I should definitely move to the injectibles. I told her that if I'm not pregnant this cycle (I honestly am not hopeful about it at all), I want to move to them for next cycle.

She is going to have them handle calling my pharmacy to get them all ready for me. I don't know my exact protocol yet, but she said because I already ovulate on my own, and early, I'll probably only need 5 days of low dose injections. She said I'll still do an HCG trigger, IUI, Lupron, and my progesterone. She said the biggest risk with the injections is overstimulation and multiples. Honestly, after this struggle, I would welcome multiples. I don't want to be Octomom, but twins would be more than welcome. Also, because they monitor you so closely, we'd know ahead of time if this is an issue and she said I could cancel the cycle or do emergency IVF. Overall, her attitude was very much "you've got this" and she told me it would be easier, side effect wise, for me versus the oral medications.

Because I've been such a whiny bitch, I want to come up with a short list of things I'm thankful for in this journey.

• A supportive husband who deals with my crazy ass, and comforts me during my crazy and has never, not once, complained about a single thing ever. "Look, in my opinion, the best thing you can do is find a person who loves you for exactly what you are. Good mood, bad mood, ugly, pretty, handsome, what have you, the right person is still going to think the sun shines out your ass. That's the kind of person that's worth sticking with." - that's my husband
• My husband's awesome insurance that covers all of this stuff with very little OOP cost to us.
• Living in an area where we have a few excellent RE practices to choose from.
• Being able to seek treatment before the "1 year of trying" guideline.
• Having the ability to seek a 2nd opinion about this journey, and falling in love with a new RE practice.
• The support that my friends and family who know about our issues have shown me. They, too, deal with my crazy and haven't complained about it, yet.
• Having friends who are also going through the same thing that TRULY understand the emotions associated with it. I don't wish this on anyone, but having friends on the same journey makes a huge difference.
• Thong pantyliners - life on Endometrin would not be the same without them, lol.

On Cycle #11 & IUI #3

The IUI went well. I did my ultrasound beforehand, and the egg definitely released, so the timing should be perfect. BUT, my lining went back down to 4mm. When the ultrasound tech told me that, I started crying. Ugh, it was awful. I just had my hopes so built up that the lining would be great, and it was crap. But, she said not to worry because there are women who get pregnant with 4mm lining and that my Endometrin (which I start tomorrow) should help thicken it up.

Also, the IUI nurse didn't seem super concerned about it, and I'll go back in a week for an ultrasound to see if the Endometrin is helping my lining. They are also having me do a Lupron injection in a week to help with implantation - I've never done that before.

But in great news, DH had 41 million sperm post-wash, which is great! Trying to stay positive.

I had it all in my head to eat healthy today since I've been eating like crap the past few days and not working out, but I figured the stress of the IUI and the tears from the lining warranted me a Wendy's lunch. LOL.

On Cycle #11: CD11 Ultrasound & Bloodwork

I had my bloodwork and follicle scan at the RE's yesterday. I have a 19.6mm follie on my right and my lining is 6mm - which is the thickest it's ever been!!! My E2 was also great at 221! 

So, I triggered last night at 7:30pm with 10000 units HCG and I'll IUI Monday at 11am (after bloodwork and ultrasound). I'm so excited. This is the earliest my body has ever produced a mature follicle and the thickest my lining has ever been and it was without meds! So excited!

The only bad thing is that I had another post coital test and again, it showed no spermies. So either my mucus is still too thick (even with the 2400mg Mucinex daily) or it's too acidic and it's killing DH's boys. Basically, the best solution is to do IUI to bypass the CM.

On the weight loss front, I weighed in on Thursday (because I knew Thanksgiving would be detrimental to my Friday morning weigh-in) and I weighed... the exact same as last week. BUT, I did go to the gym Wednesday, Saturday, Sunday, and Monday. Edited to add: I just logged my weight in the WW system, and actually, I lost 0.3lbs, lol.

I've been totally slacking off of tracking my food since Thanksgiving, which is bad, but I'm getting back on track tomorrow. Today is going to be spent in bed because I'm sick - sinusy, sore throat, muscle aches, just feeling crappy. I'm sad I had to miss my workout, which I desperately needed, but my body needs to rest. I won't be able to hit the gym again until Wednesday after work, so I'll only get 1 workout in before my weigh-in this week. :(

On Cycle #11: Baselines & 1st Weigh-In

I've, unfortunately, let TTC take over my life, and my body (and the scale, yikes!) shows it. I feel very gross and out of shape. I did my first weigh-in for my new mindset this morning and well, it wasn't pretty.

164.5

Now, granted, I feel very bloated and my muscles are very sore from Wednesday's workout, so I'm hoping they are just retaining alot of water? A girl can dream, right? I'm officially up over 10lbs from my April wedding. Yikes.

To keep me gym motivated - I downloaded this iPhone app called GymPact where you pledge to do a certain number of days in the gym, and the phone tracks it by GPS, and if you don't, you pay up! I pledge to go to the gym 3 times a week and will lose $5 for each session I miss. Anyone who goes to the gym as per their pledge also earns money (the money that the people who don't go end up contributing). If anyone is interested in it, I have a promo code where we both earn $5 if you sign up.

TTC wise - had my CD2 baseline bloodwork and ultrasound yesterday. Everything looks good, so I'll go back on Saturday the 24th for more bloodwork, follicle scan/lining check ultrasound, and a post-coital test. I want to make this an IUI cycle either way, but I'm hoping our post-coital turns out better than last time. I started my Mucinex today, and I'm also drinking green tea (I read somewhere that it helps with CM). For those who don't know, last time, our post-coital didn't show any of DH's guys in my CM. So, the doctor has me doing 2400mg of Mucinex each day from CD3 - ovulation. I also plan on getting back into the habit of using Conceive Plus during BDing.

On Cycle #10

I think I can officially call myself as "out" for Cycle #10. I tested again today, at 14DPO, and got a BFN. Tomorrow, I go to the RE's office for my beta and progesterone bloodwork. Usually, they'll call you in the afternoon with the results and instructions for the next cycle. I'm sure it'll be another monitored cycle, with possible IUI, and progesterone after ovulation.

As you can see, I stopped temping after the 2nd BFN. I'm starting to learn that the progesterone gives me absolutely beautiful temperatures and charts, but no pregnancy to go with it. The problem with this is that I get my hopes up based on the temperatures and nothing ever comes from it.

Every month, I start out extremely upset about the preceding month being a failure. A few days after AF starts, I find myself being hopeful again about the cycle. I'm hopeful up until around 8DPO, and then if my chart looks the same or I'm not "feeling" pregnant, I find myself slowly going into a downward spiral. I'm miserable, which also has to do with the Endometrin and the awful side effects, I'm hormonal, and I find myself almost depressed about the entire situation. I feel absolute despair and that dreaded "I'm NEVER going to get pregnant" feeling.

I feel like I cried alot more this cycle than I have in past cycles. Yesterday and today had a lot of time dedicated to absolutely awful crying. As a first, I really just cried and cried in front of DH about things. Usually I try not to get too upset in front of him about it, and just cry on my own. Friday, we were both in bed, he was napping and I was crying. It was pitiful, but it's amazing what some therapeutic crying can do for you. But last night we really discussed things, and my feeling of being a failure and that I'll never be able to get pregnant, which resulted in tears. And then we discussed it some more this morning, which resulted in more tears. I cried throughout my shower today.

I'm just at the point where I'm in complete disbelief that this hasn't happened for us yet. I've already had to let go of the fact I won't be able to get pregnant without the use of the progesterone, that I won't be able to get pregnant like most other couples, by just enjoying my husband and being carefree. I've resigned myself to the fact that to get pregnant, I'll need to visit the RE's office several times a cycle to be poked and prodded. I've taken on charting and temping, and all the stress that goes with it. A little piece of you died each time you have to come to the realization that things aren't going to be easy for you with this and that things aren't going to happen on your timeline or how you pictured. I just feel as if I cannot do much more to make this happen, and yet, it's still not happening.

I spent the past few days racking my brain, trying to figure out what the fuck I did so wrong or so badly for us to be going through this. I know I haven't been a perfect person but there is nothing in my past that I can think of that warrants this type of pain and hurt. I wouldn't wish this on my worst enemy.

On 2nd Opinions

I had an appointment for my beta test after the 2nd IUI on the same day as my "next steps" appointment with the head of the practice, Dr. S. While I was at this appointment, he broke the news to me that I had already known from my obsessive POAS - that I wasn't pregnant. He then went on to tell me that the oral medications had thinned my lining too much (duh, I was the one who brought that up before), and that I NEEDED to move to injectible medications in order to get pregnant. He suggested a "break cycle" and then moving directly to them.

This information shocked me - when did things get so dire? I was always under the impression that I may be able to get pregnant on my own, but that due to my own desire to "be aggressive", that's why we took the medication route. Now he's telling me that I need the injects to get pregnant? This news was beyond devastating for me. I consoled myself with a pizza, a bottle of wine, and my jacuzzi tub that night. I literally cried through the night, and when DH came home from work, I was still sobbing in bed.

The next day, I started some online research and chatting with a friend who I knew had suffered from infertility before (but now had 2 healthy children). She told me of her similar experience at the RE practice, and convinced me to make a "2nd opinion appointment" at another RE practice about an hour away. I called and made the appointment, which was about 3 weeks away.

I went and got a copy of my chart from the old RE's office, and much to my surprise, throughout the chart, there were things indicating that "patient may be able to get pregnant on her own", which was certainly different from what was portrayed to me in that last appointment. Was it possible they were only recommending this treatment because they knew my insurance would cover it?

During this time, I had a "break cycle" with no temping, no OPKs, nothing. This cycle, I'm assuming due to the oral meds still in my body, lasted only 18 days. That frightened me. Had I done irrepairable damage to my body?

I ignored the calls from the fertility pharmacy and the old RE's office about starting injectibles, I needed some sort of indication from an outside source that my situation WAS that dire and I anxiously awaited my appointment with the new RE.

From the moment I met the new RE (Dr. C), I knew things would be different. First of all, the appointment lasted over 3 hours. He spends the majority of that time talking to you (a foreign concept this day and age, it seems), and telling you about research & studies he's done, and papers he's published, relating to your certain issue. He goes over everything, including his recommended "next steps". For me, he said he wanted to give DH a more comprehensive semen analysis to check for antibodies. He also wanted to do an ultrasound and bloodwork that day, and have me come back in a week. His suggestion was to just monitor my cycle, add progesterone after ovulation, and possibly use Menopur to "boost" my follicles if the monitoring showed they weren't maturing fast enough on their own (a common issue for women with luteal phase defect, apparently). He also wants to do a post-coital test (to make sure DH's sperm are able to thrive in my cervical mucus), and then IUI, if I want. He said he doesn't see a need for oral ovulation medications or injectible medications to stimulate my ovaries - exact opposite of what the other doctor said.

I left that office feeling so confident. Not only did he have expertise in my problem (luteal phase defect) but his treatment plans were based upon research and studies that HE conducted. Absolutely amazing.

On My 2nd Medicated Cycle - Tamoxifen/Ovidrel/IUI/Progesterone

My 2nd Medicated Cycle was to be 20mg Tamoxifen CD3-CD7, an ultrasound and bloodwork on CD12, and an Ovidrel trigger to spur ovulation 36 hours prior to IUI, and then IUI.

Tamoxifen, compared to Clomid, was a breeze. I still felt a little moody, but not nearly as bad as when I was on the Clomid.

When I went for my CD12 ultrasound and bloodwork, Dr. VD saw 4mm lining, and a 20mm follice on right. Not exactly a stellar response, and the thin lining was still an issue. He mentioned that next cycle, I should take estrogen after the Tamoxifen to try to thicken up my lining, but again, didn't seem very concerned. I mentioned that I may want to switch to injects if this doesn't work, and he suggested I set up another consult appointment for it.

I got a call from the RE's office later that day stating that my bloodwork showed I was surging on my own, so I needed to do my trigger shot ASAP and come in for IUI the following day. This "shake up" of events really startled me. I was very concerned about timing and about my lining and the follicle size. Neither my lining nor the follicle would have any time to grow before IUI. We went ahead with it, but I did not feel confident at all. However, in looking at my chart after IUI, I thought I was for sure pregnant. Of course, I wasn't.

On My 1st Medicated Cycle - Clomid/Ovidrel/IUI/Progesterone

My 1st Medicated Cycle was to be 50mg Clomid CD3-CD7, an ultrasound and bloodwork on CD12, and an Ovidrel trigger to spur ovulation 36 hours prior to IUI, and then IUI.

Clomid, in and of itself, only added to my crazy lady behavior. I am, by nature, a very passionate and emotional person. If you want an opinion on something, ask me, because I'll always be honest. It may not be what you exactly want to hear, but I'll try to watch my delivery but still give you the truth. Now, take that personality, multiply it by 10, add in headaches and fatigue, and general crankiness and you get me on Clomid. It was a rough few days, and I stand by my statement that R is a saint for dealing with me.

On CD12, I went in for my bloodwork and ultrasound. Dr. VD saw 4mm lining, a 23mm follice on the right ovary, and 14mm & 15mm follicles on left. He said the 2 on the left may not be big enough by IUI, but you never know. I was given instructions to trigger that night at 9:30pm, and then come in for IUI 2 days later. R would drop his sample off at 8:30am and I'd come in at 9:30am.

I was beyond excited that night. We were also told to BD, and I was definitely into it. ;) A friend of mine gave me the trigger because I was scared to do it myself, but it wasn't bad at all.

2 days later, I went in for my IUI. R couldn't come because he had to work. All in all, it was a very simple process. I had to sign a piece of paper that told me all about R's little guys, and confirming I was receiving his sperm. Thank the lord I was the only IUI that day, so there was no real concern, but still, lol. The process felt much less uncomfortable than a Pap, and I had to lay there for 20 minutes afterwards. I tried to practice visualization of the sperm meeting the egg and singing a little song that some friends and I had made up (the sperm will find the egg, the sperm will find the egg, hi ho the dairy-o, the sperm will find the egg).

Something that had concerned me was how thin my lining was at the ultrasound. I brought this up to the doctor who performed my IUI (Dr. S, the head of the practice), and he had me start progesterone vaginal suppositories 3DPIUI. He didn't seem super concerned about my lining and neither did the nurse. I had asked if I could switch to something other than Clomid for my next cycle, if it was unsuccessful, to try to alleviate the lining issue - the doctor agreed.

Now, to wait. I had to wait a week and come back for progesterone bloodwork... and then wait another week to come in for my beta. As you can tell by my chart, I started testing on my own at home, so I wasn't totally shocked when my beta came back negative. It was, by far, the hardest cycle for me when AF came. I had a friend who had similar issues to mine and went this treatment route and got pregnant on her first try with it, so it was devastating to me that I didn't. I also had a baby shower for that same friend that weekend, which only added to my personal pity party.

Something that TTC/infertility constantly brings up for me is this feeling of being happy for someone when they get pregnant, but also incredibly jealous and feeling betrayed by my body.