Everything is on track

So far, everything is on track for me.  I have been on the Follistim and Menopur for the last few days, and I went in for my first blood draw since starting the stims.  My Estradiol level was just fine, so she wants me to continue with my current dosage.  I go in for my first follicle check (by ultrasound) on Wednesday.  I am really excited (and nervous) about that first ultrasound.  Hopefully, they will see lots of follicles growing.

I have to say that the meds are making me feel awful.  Migraine headaches, bloating (and noticeable weight gain..ugh!), cramps.  Friday night I had bad nausea and vomiting, too, although I am not entirely sure that I didn't have a virus.  Also, I am so irritable that I have been avoiding being around people as much as possible.

One thing I have found really helps a lot when doing the shots is icing the heck out of the area prior to giving myself the shot.  Then, I can't feel the needle going in at all.  I can still feel the medicine going in, but if I can get the needle in without feeling it, that's a big improvement in my mind. The gel packs that came with the shipment of medications have been serving that purpose really well.  I just keep a couple of them in the freezer, and they are big enough that I can numb a fairly large area on my lower abdomen prior to giving myself the shot.  I generally leave it there for about a 45 seconds to a minute, and that does the trick.

On a brighter note, I was exceptionally motivated to do cooking and baking this weekend.  Satuday I made french toast for breakfast, and Sunday I made homemade yogurt, guacamole, and chocolate chip cookies.  The chocolate chip cookies didn't turn out that well for some reason (I think I may have let the butter soften too long, because they turned out overly flat!), but everything else was great.  I also baked an apple pie for the first time, and it wasn't half bad, despite a few small mistakes on my part.  I forgot to dot the filling with butter and only remembered after I had already put the top crust on, and had sealed it.  So, I cut vents in the top crust, and tried to shove little chunks of butter through the vents.  It didn't look very pretty after I was done, but it actually tasted really good!  My husband ate three pieces, so he must have thought it was okay, too.

Starting stims....Other complicating factors

Tonight I start the stims!  By stims, I mean follicle stimulating agents, specifically in my case Follistim and Menopur.  More shots.......yay?

I am also having a hard time with another aspect of this whole fertility treatment/possible pregnancy thing:  I just accepted a job in Omaha, and my husband has yet to find a job in the same city.  Truth be told, he is not very stoked about leaving Colorado.  He has grudgingly agreed to go (because I have made an awful lot of career sacrifices for him along the way in order to accommodate his very restrictive geographic preferences) but he has still been kind of dragging his feet about finding a job in Nebraska.  However, this was a one-in-a-million, dream job for me, and I am in a very subspecialized field of medicine where such opportunities come up really only once in a lifetime.  

I was absolutely miserable in my current position, and had tried in vain to find something that was more suitable for me here in Colorado.  It was so bad, in fact, that I was considering leaving medicine.  The only reason I had taken this job in the first place was because I was trying to make my husband happy by taking a job in Colorado (he loves it here because he is at a practice he likes, and there is a lot of opportunity for him to ride his bike in the mountains here).  I tried so hard to be happy where I am at, but it was just a total dead-end for me.

When I got a call from this hospital in Omaha asking me to interview for the position (they had someone leave unexpectedly),  I thought, "Hey! Maybe I don't have to give up on all my years of education after all!"  I interviewed there, and it looks to be an ideal fit for me.  It also doesn't hurt that they offered me a very significant increase in salary versus I am currently making.  While Nebraska is not exactly a mecca for outdoor enthusiasts, it's where both of us grew up and both sets of parents are still there.  Being near family is important to me.

So here's the real issue....if S doesn't find a job in Omaha right away, and if our IVF is successful (we were sort of already committed to going through with it prior to my taking the job), then I could be stuck by myself while I am pregnant, and possibly with an infant.

I am very nervous about going through with the IVF.  I am scheduled to start my new job in April, and move out to Nebraska at the end of March.  However, I was told that because I have a low ovarian reserve, it's basically now or never.  I thought about waiting a few months to see if my husband's job issue would work itself out (or that he would at least stop dragging his feet), but he has also given me an ultimatum that "We do this in February like we planned, or I'm not doing it at all.  I am tired of waiting."  This is really eating at me.  My career is too important to me to let an opportunity like this go by,  but it's really complicating things because the timing is so crappy.

Officially on my way!

So, the crisis was averted for the most part.   I was able to get some backup Lupron doses from a local pharmacy to tide me over for a couple of days (which I started yesterday), and the rest of my medications arrived today.  I am ready to get this show on the road.

I have been noticing a lot of side effects already from the Lupron, including nausea, cramps, and some serious irritability.  My husband has wisely taken a few extra overnight calls this week (requiring him to stay at the hospital).  I suspect the purpose of doing so was to get the heck away from me.  He even texted me today to ask:  How is your tummy feeling, and what is the "b*****ness meter" reading right now?  My response was: Crampy and high!  I also told him that the only cure for my b-ness was to buy me a pair of Gucci shoes.  Wonder if he'll take the bait?

Starting the protocol tomorrow......well, maybe??

My RE is planning for a Microdose flare protocol and I am supposed to start my Lupron injections tomorrow. The problem is that my meds were supposed to arrive today, but the shipment was delayed because of weather, and now the earliest it will arrive is tomorrow. This means that even if they do arrive tomorrow, I will be at least 12 hours late for my 1st shot (I don’t get done with work until 6 or so, and I am supposed to give my first shot at 7 am tomorrow).


I called the office and spoke with the IVF coordinating nurse, and she said it would probably be okay to get my first dose late. However, she wants me to let her know if they don’t arrive tomorrow, because we will need to try to get the Lupron from a local pharmacy. I probably would have needed to order them already today in order to get them by tomorrow, though.


I have been attempting to track my medication package through FedEx, but all it says on their website is that it arrived yesterday morning at the Dallas-Fort Worth FedEx location. It’s 11pm, and as far as I can tell, it’s still there……but by now it should have gotten at least a little closer, because I thought the airports at DFW opened back up this morning. I called FedEx earlier today, and the person I talked to was utterly clueless.


Here was my conversation with the (overseas call center) representative:


Me: “Is any way to find out if the package will arrive tomorrow, because it contains medications I was supposed to get today, and which I am supposed to start tomorrow. I need to know as soon as I can if there will be any additional delay so that I can order the meds from a local pharmacy.”
Fed Ex: “Okay, I will place the request to have the package delivered first thing tomorrow.”
Me: “No, that’s not what I am asking. I am asking if you think it’s likely to be delivered tomorrow! Because there is some pretty bad weather throughout the whole country, and I can’t tell exactly if my medications are still sitting in Fort Worth, or if they are on their way. If you can tell me where they are, and whether they are expected to ship tonight, that will help me decide whether I need to order them from a local pharmacy or not.”
Fed Ex :“ Oh, they’re not in Fort Worth. They’re in Texas!”
Me: “Yes, Fort Worth is in Texas. Do you think they will be here by tomorrow or not?”
Fed Ex:“Oh, yes. They will definitely be there tomorrow. I put in a request for them to be delivered tomorrow first thing.”
Me: “It’s 4 pm and you are telling me they are still in Texas. If they are still in Texas right now, do you think they will be shipped in time to get here tomorrow? You know there’s a huge snowstorm happening here, right?”
Fed Ex:“I guess I didn’t know about the storm. But you can always call back tomorrow morning after 8 am to see if they have been shipped.”


I know I can’t ask miracles of people, and no one can predict the weather, but I felt like this lady was just saying whatever she could to get me to go away as quickly as possible. She didn’t even know about the huge snowstorm that’s been sweeping across the US! I seriously doubt that her "putting in a request" to have the package delivered quickly will make an ounce of difference. I just needed to know if the plan is to get it on a plane tonight or not! Tomorrow morning may be too late to get the medications ordered from a local pharamacy, though. I am worried that I may not be able to do my IVF cycle this month after all!!!!

I think this may be a prime opportunity for me to use those mind-body relaxation tracks I talked about in the last post.  Deep breaths....calm yourself......

IVF Schedule

Today I got my schedule for the IVF.  Apparently, my RE has decided that I am likely to respond poorly to a regular luteal phase Lupron protocol, and so she wants to start me on a Microflare protocol, which is more aggressive.  I guess this is her normal approach to patients with low AMH.

I was told not to be alarmed when I get an enormous box full of medications.  All those shots!  Yikes!  Did I mention before that I really dislike getting stuck with needles?  The single Ovidrel shot for the IUI was bad enough, but now it looks like I will be giving myself up to 4 shots per day.  This whole infertility business is a real drag....

The egg retrieval is tentatively scheduled for between February 14th-16th.  The embryo transfer will happen between 2-5 days after that, so we are looking at anywhere from the 16th to the 21st for the transfer.

It's really exciting to have a plan, but at the same time I am so nervous about it not working.  Of course, I fully realize that stress is detrimental to a cycle.  So, rather than letting the stress consume my thoughts, I got some fertility mind-body meditation recordings (from Circle+Bloom) to try to help me relax.  I really like them so far, although my husband has been making fun of me for listening to them on our speakers in the bedroom.  He keeps joking that they might make him ovulate or something.  Honey, if that happens, we have a more complex situation than the RE ever realized......

Moving on to IVF

Well, after discussion with Dr. S. on the phone the other day, I think I am going to move on to IVF after all.  My husband and I are having a formal consultation with her tomorrow to go over our plan for the cycle.  In the meantime, she has prescribed birth control pills for this month in order to allow my ovaries to rest.  It seems ironic to be taking birth control pills at a time when I want to become pregnant!

I am a little nervous about jumping right to the "big guns"(with the associated BIG price tag), but at the same time, I am happy to be moving to something that has a higher likelihood of success.

IUI was a bust

Well, I am officially not pregnant this month.  I had some spotting on the 25th (yeah...Merry Christmas to me!) and my period started for real today.

I am really undecided about where to go from here.  There has been some recent literature in the reproductive medicine journals suggesting that IVF may actually be the most cost effective first line therapy (from a population-based perspective) for unexplained infertility, because it has a significantly higher success rate per cycle than IUI.  It makes sense when you think of it....with an overall success rate of 25-30% of IUI per cycle, and a cost of 800-1000 dollars per cycle (if you include meds and ultrasounds), many people who have to do several cycles before getting pregnant can come pretty close to the cost of an IVF cycle.

I feel like a gambler trying to size up the odds and place my bet accordingly.   The question is...do I pony up the (rather significant) funds for the "money shot", or do I keep trying the thing with lower odds of hitting the jackpot, but with significantly lower "risk of ruin" per try? BTW, I hope the gambling analogy doesn't come across as flippant.  My fertility is not a game to me, but the parallels with using statistical odds to make a decision about the next step are striking.  There is, for many people, more to it than statistical odds, like willingness to undergo a much more invasive process, personal/spiritual reservations about the IVF, etc.  But for me, I think I am of the frame of mind that I just want to do whatever will get us to our goal as quickly as possible without ruining us financially.

I wish my RE had a shared risk program.  It would make me feel better about IVF.