Pregnancy after Infertility

It's been quite awhile since I posted here but I've had a few comments as well as a hike in visitors.  I thought that those visiting here would be interested to hear that even though I continue to have PCOS and its symptoms, that I was able to have a second child on my own.

We tried a couple rounds of IUI at Carolina Conceptions with Dr. Meyer back in 2010 with the last one being in November.  After the last failure, we decided to take a break for the holidays.  I'd been very stressed through the IUI and holidays and had laser eye surgery scheduled for January 2011.  In early March I struggled with shingles and later was just not feeling better.  I got the crazy idea in my head that I might be pregnant so I took a test.  And then hubby had me take another test!  Sure enough, baby girl was on the way!

Sweet Inara was born in December last year and just turned a year old!  I hope everyone had a wonderful holiday and a Happy New Year!

Video Parade

Almost there.. just a few more days til HPT...

Here a lady gives herself antagon. These are easy b/c they are prefilled & in a nice glass syringe. But the meds sting. And I just noticed she didn't push the air out first. You're supposed to hold it up and push out the air bubbles. This one comes with a giant airbubble at the top and it's easy in this glass syringe to accidently push it too far. I've squirted a little of the medicine out before when I did it too fast. I've taken this in both IUI & IVF cycles. This cycle I took this the two nights before trigger shot.

IUI graphics

from http://www.fertility-docs.com/glossary.phtml

Shooting up

Here's a chic giving herself a Follistim injection using a Follistim pen. This is the drug I used in both IUI & IVF. I never could hold the pen the way she is (which is how they taught us to). Just seemed too much like a jabbing motion, I hold the pen closer to the needle. I love how excited she is at the end that she did it. Superquick.



Ok so I really want to show two videos today. But this lady in the second one has a pretty foul mouth on her so I'm only going to link to it, instead of embeding, and it's up to you if you want to watch it or not. The reason I like it though is because she gets herself all 'siked out'. I've done this so many times! Over the last year I've taken dozens of these little shots, but every now & then you freak yourself out. Karla shoots up!

Dr. Lovely

The only funny thing about this video is that this chic's name is really Dr. Lovely. But it's a good, quick overview of IUI (about a minute).

IUI #5

DH & I got up bright & early (5AM for a 6:30 appt) for our IUI this morning. We were the first patients to arrive at the clinic, the doors to the building were even still locked when we first got there. Everything went really smooth, other than the doc couldn't find my cervix at first. But there was no pain or discomfort at all which is unusual. I've had some cramping this afternoon though. But that's it, this is always the anticlimactic part. Now we wait. Again.

Multiple Risk

My scan today showed still 4 follies that were mature. On my right ovary, had some big ones, I think the two were between 18-20mm, the large one may have even been bigger. I've already forgotten the exact measurements. The left had smaller ones, one larger than the other. RE thought the smallest one of the left was a 'maybe' on whether it had a mature egg or not.

Because of all those follicles, my RE & I had a nice little chat about the risk of multiples that he had mentioned on Wednesday. He wanted me to be aware that I'd likely have to go for 'reduction' if I got pregnant with trips or quads. So we discussed the possibilities and there was a way to reduce the risk. Instead of doing an IUI, we could finish the cycle by trying at home. If this had been only my 2nd or 3rd try, he would have strongly recommended that option. However, being my 5th IUI and already having done IVF once, he left it up to us. DH & I decided to stick with IUI as it has the best chance of a pregnancy. Even though trying at home limits the risk of multiples, it also reduces the chances of a pregnancy at all. Right now we just want the best chances we can get, and can worry about multiples & reduction if we get there. You know, cross that bridge when we come to it. He didn't bother taking my e2 as it would not change either option. If this doesn't work, it will be the last IUI. RE said IVF would be the next step. That was another deciding factor but not a surprise.

So with all that in mind, we scheduled an IUI for Sunday. (Going to have to get up at the crack of dawn! Our appts are at 6:30 & 7:30 in Raleigh). So I'll take my trigger shot tonight at 6 which will have me ready for Sunday morning. Really the timing worked out well. I'm co-hosting a bridal shower tomorrow and need to shop tonight. So I'm glad we don't have the IUI until Sunday.

4 Follies

My RE said I was close to ready. He found four follicles that were almost the right size. My right ovary had a 15mm & 13mm, the left had two 10s. So, he's upped my follistim to 75IUs (from 50) and added a shot of antagon (ganirelix acetate) tonight & tomorrow night. Then return on Friday for another scan with expectation that IUI will be Sunday. Of course he did say I'm at risk for multiples due to the number of follicles. But I'm not too concerned about that right now, since my body has not been in a hurry for just a single.

Big box of meds

It's odd getting a big box of medicine delivered to the door (yes I just ordered yesterday after my appt, but these specialist pharmacies understand the urgency & schedules of IUI/IVF). And it was over a 100 degrees today again so I'm glad I was here to bring it in right away. (Most of mine has to be refrigerated). They pack it pretty good with icepacks & special bags, but at these temps it's better not to take the chance.

Up through today, I'd been using leftover meds from IVF (besides a few Rxs I had to fill here & there). But when RE said to up the dose, I knew I didn't have enough left to get through this round. I had to order more from the IVF pharmacy and man is it expensive. After insurance, it was still $200. I was glad to see when I opened it that it was way more than I'd need for this one cycle. So that helped a little with the 'sticker shock'. It's more than enough to get me through at least one more cycle if need be. (Hopefully not necessary though!). I was disappointed I didn't get a sharps container like with my last shipment. Mine is full, so next time I'll have to remember to ask them about that.

Here we go again... (aka IUI #5)

Yep it's already time for another go. Thats one thing with infertility, you barely get time to let the last negative test (hpt or beta) sink in before it's time to move on (unless it's IVF, they make you wait after that).

This morning, after my scan, Dr Meyer suggested we change my protocol for this cycle. So, no more Femara. Instead, I'll start the Follistim earlier (day 3 instead of 7) and up the dose. Taking 75IUs tonight and then 50 until I go back next Wed (15th). I had been taking only 37.5IUs. This is a more agreesive schedule, but not too much. After 2 previous cycles with the same doses, he didn't think it made any sense to try another without making changes. He said I could try another if I wanted to, but I'm in agreement we shouldn't keep trying the exact same thing over & over.

IUI #4 today

This morning we went in for our 4th try at IUI. Everything looked good and the IUI went pretty easily (less discomfort this time). Not much more to say about it .. now we start the two week wait.

IUI on Monday

My IUI is scheduled for Monday morning. I was not expecting it to be so soon. I went in this morning for my Day 10 ultrasound and they said everything was looking good and that my follicles were at the right size & number. I had guess-timated that it would have been the later half of the week. So I take my HcG trigger shot (Ovidrel) tonight at six and that should make me ovulate just in time for IUI on Monday. My uterine lining was a bit thin, so I do have to start taking estrogen (estradiol) three times a day. With my old doctor, I was given an estring when the lining was thin, but either way the point is that I needed more estrogen. I don't know which works better, but the estring was easier. I'm not used to taking pills 3x a day.

IUI cycle #4

My cysts from last IUI (May) have cleared up so I've got the green light for another IUI cycle. Today is day 2 and my baseline scan looked good this morning. The medication on this cycle will be just like in May. I'll take Femara for 5 days (start tomorrow & finish on Wed). Then I'll start Follistim injections on Wed night and keep that up until doc says stop. I'll have another scan next Sat (7/21). Each cycle can vary a bit, but last time I had my IUI on day 16. So I expect IUI to be around 7/27.

Reproductive Immunology

Today a friend in the UK (whom I "met" via fertility message boards), posted a link to an article in a UK newspaper about a treatment she is starting. I wanted to pass this article along, because I plan to pursue immune testing as a possibility if we have to resort to IVF again.

Dr. Beer was a pioneer in the field of Reproductive Immunology and I talked a little about his book (Is your Body Baby Friendly?) in a previous post. His book is very new, actually published after I started my fertility journey. This was one of the first books on IVF that I found to provide real explanations for couples who continue to have infertility & IVF failures. (You should see all the post-it notes & highlighting in my copy). Most of the patients who go to Dr. Beer's facility (Dr Beer has passed away but the center he founded still provides these treatments) have usually already had 3 or more IVF failures or miscarriages. The article explains in fairly simple terms what the theories & treatments are to prevent another failure so I won't try to explain it myself. I hope to have the testing done before we make another IVF attempt (if IUI does not work within the next two tries, then we will have to move on to IVF again). Unfortunately, Dr. Beers ideas are not accepted by the entire medical community.. so I do not know how feasible it will be. But in my opinion, it would be better to have the tests done than keep trying if something is wrong. Even if all the tests come back all negative, at least you know that is not the cause of your failed attempts. One of the biggest frustrations with infertility is not knowing (at least for me anyway).

The woman in this article wrote about an 8 page introduction in Dr. Beer's book..
Daily Mail - My body tried to kill my baby

I also listed a few quotes from the book.

"Pregnancy risk assessment is advocated in many areas of medicine. We must now add 'immune risk assessment' to find the unfortunate people who end up spending a fortune in money, time and emotion, and get nothing in return. I strongly believe that we can identify these couples even before a first IVF failure."

"Unfortunately, if you mention these ideas to your doctor you must still be prepared for them to laugh at you and not take you seriously. Yet these same doctors would take autoimmunity seriously if it affected your thyroid gland, insulin-producing cells and joints. It's only infertility and recurrent losses that they consider have no biological causes outside of those that can be treated with fertility drugs."

"Studies have reported that many couples consider infertility to be at least as, or more stressful than divorce or the death of a loved one, with up to half of infertile women feeling depressed and anxious" (I've also heard it compared to the stress of dealing with cancer).

Tatooine

May the force be with you.

I'm not really going to write about Star Wars on my fertilty blog, but thought Tatooine was a good title for this entry. Tatooine is the home planet of Anakin & Luke Skywalker (and Princess Leia) and I've always thought it was a funny name for a planet. You'd think everyone on the planet would be covered in tattoos. (Yes I'm a dork, and I'm ok with that).

Which brings me to my subject, my new tattoo. Yep, for those of you that didn't know, I got a tattoo. I've had a lot of people ask me why. Why now (at 28 years old)? Why that? Why there? (Esp. family) I don't promise to answer all of those questions now (maybe not ever), but I will talk about it a little.

It is my first & only. It's a small tattoo but readily visible. It's about an inch wide decorative eternity symbol in all black. (And I'm going to go back to get it touched up a little). I got it on June 16th at Monkey Ink in Garner and Jack went with me. Yes, it hurt, but not that bad. After all the needles & pain with IUI/IVF, this was not a big deal plus it only took about 2 minutes.

Some may think that both the timing & the design are random. But they'd be wrong. I've wanted a tattoo for many years but various things stopped me (money, design, not wanting it to show in my wedding dress one day, etc). I saw this design several months ago and thought it would make a good tattoo so I kept it in mind. The cysts that I had on my ovaries made this month a good time (can't get a tattoo while you are pregnant or think you are). The more I thought about the design, the more I thought the symbol could mean a lot to me. (Plus it looks cool). I'm not going to go into what it means to me, but I will say it's related to where I am in my life and in my illness (yes infertility is an illness). So it very much is not random.

I don't expect everyone to understand, approve, or like it. And that's ok. I got the tattoo for me. And I put it on my wrist because that is where I liked it.

HPT negative

What a week... it's been one thing after another! My hard drive at work crashed while I was supposed to be doing my job plus being a backup for someone else, had tons of family events all week including a graduation to attend and another negative home preg. test. Yesterday was 14 days after IUI so I had taken a test first thing in the morning. RN said to stop taking the progesterone and that would allow me to start a cycle.

Before the day was out, I started another cycle. Unfortunately, when I got to the doctor today, he found a few large cysts. They are nothing to worry about, just remnants from the IUI cycle. Actually, with PCOS, I have cysts all the time, but these were particularly large (he measured them .. but I wasn't paying attention to what size they were). The problem is that with these large cysts, he would be unable to monitor me through another cycle as there would be no way to tell if I was developing mature follicles or still just had the cysts.

So we have to take a month off again. You'd think I'd be happy for a break.. with all we've been doing, it doesn't seem like we've had many breaks. But in the last 6 months, we've only had the two cycles of medicine, one IVF and one IUI. So I really am not thrilled with yet another delay. But, it is what it is. Of course, just like my previous two doctors, he said that it's still possible to get pregnant while off the medicine. But, it is not very likely. So, again this blog will be quiet for a few weeks.

IUI today

I was surprised that the nurse did my IUI this morning. My other clinic did not do that. But it seemed to go well. She said everything looked good and then gave me a progesterone suppository Rx to start this weekend (always fun). So now we start the two week wait.

IUI will be Thursday

Yep, my IUI has been scheduled for Thursday. (Well technically I've got to call back tomorrow to actually schedule the time, but it's planned for Thursday).

My scan this morning looked good with a few follicles that were almost the right size. RE did want me back for another scan tomorrow to check on those follicles but before the day was out that plan changed. You really have to learn to be flexible when it comes to fertility treatment. Apparently after getting my e2 result (260) the doc didn't need to see me back. They made me laugh though, they said I could still come in for a scan if I wanted to. Hmm.. come in and pay 25% of roughly $200-300 when doc doesn't think its necessary. Nah, I don't think so.

So now the plan is to take another dose of FSH tonight, then take hCG shot tomorrow night. Then IUI on Thursday.

IUI progressing nicely

I'm on day 10 of my cycle today (IUI try #3) and had an US & e2. The US looked good, I had a couple of 12-13mm follicles and the others were smaller. RE is trying to get just one or two to develop ahead of the others (this would limit my chances of high order multiples. With IUI, we don't want to see as many follicles as we did in IVF). The nurse just called me back with the e2 results. My estradiol was 55.9 which shocked me. In IVF, my level was never anywhere near that low, but that is a good thing! So they want me to continue on the low dose of follistim (37.5) through Sunday night. My next appt is Monday morning.

IUI #3 finally getting started

Once I returned from Minnesota, I started taking prometrium to force a cycle to start. Today is day 3 and I had a baseline US (doc said everything looked good). So tonight I start the IUI meds. Plan is to take Femara (letrozole) on CD 3, 5, 6 & 7. Then I'll take 37.5 IUs of Follistim (same drug from my IVF cycle) on CD 7, 8 & 9. Then back next Fri for another US.