Thursday, 28 June 2012

IUI #2.2 - My Husband is a Rockstar!

I had IUI#2.2 today, and am so happy to report that my husband's sperm finally came to the party! :) His motility shot up to 60% (progressive)!! Yesterday it was only 4%, so that is a huge difference! His concentration was decent (28 million per ml), and his volume was the best it has been yet (2ml). Overall, awesome result! We had 13 million motile post wash! :)) I am so so relieved. Even if this doesn't work this cycle, I have a little more hope now, as there is evidence that his boys can put on a good showing. :)

I think the difference might actually be the lack of abstaining this time. His motility has been consistently higher when he doesn't abstain for more than 24 hours, and substantially lower when he does (for example, he abstained for 3 days before the 4% motility yesterday). His count is higher when he abstains, but frankly, who gives a fuck if we have 100 million immotile sperm? So, no more abstaining for us. It's more fun this way anyway! ;)

As for me, the jury is out on whether I had already ovulated. The ultrasound technician said definitely not, but the nurse said maybe/probably based on my bloodwork (progesterone went up, estrogen fell slightly). The doctor was adamant that I would not ovulate until 36 hours after the trigger, and that my bloodwork was normal for right before ovulation. Dr. Google is, of course, inconsistent - some sources say progesterone starts to rise immediately before ovulation, and some say it only rises after (and no, I am not consulting Yahoo answers!). I did get one positive OPK the night before trigger, but I got a negative within hours, and my bloodwork has not shown an LH surge. Perhaps it was a short surge, and maybe it was a false positive. Who knows. Either way, it was at least close. With multiple follies and 13 million swimmers, I can't help but hope!

Wednesday, 27 June 2012

IUI #2.1 - 4% Motility, WTF??

I had IUI #2.1 today (ie. the first of two back-to-back IUIs this cycle). It did not go very well. There is good news and bad news. The good news is, the collection condoms really did do the trick - my husband's sample volume trippled to 1.5 ml! His concentration was great, at 70 million per ml. The problem, and the bad news, is his motility. It was a whopping 4%! :(. We knew it was low, but we were not anticipating a number like that (it has previously been 26% and 17%). The extremely low motility made a big difference. Notwithstanding that we had upwards of 100 total sperm, only 3 million survived the wash, with 85% of them being motile. Dammit!. If it's not one thing, it's a-fucking-nother. Of course the doctor also could not get the catheter past my stupid cervix again either, and so she had to use the foley balloon method again.

This is so frustrating.

On the plus side, to the extent that it even matters at this point, I had an awesome response to the Gonal-f! Even at the low dose of 87.5, I had three perfect mature follies, with two that were very close (1.6 cm each), and another three at 1.5 cm! The odds of any more than the three most mature follies containing an egg are about 50/50, according to my RE. Of course, none of that matters if we don't have enough good sperm to work with. *sigh*

I guess we will try again tomorrow. My bloodwork and ultrasound today showed that I had not yet ovulated, so there is still hope. We really need to get to the bottom of this motility bullshit though. My husband has an initial appointment with a urologist in July, which can't come soon enough.

Sunday, 24 June 2012

CD8, & The Baby Shower

I had my CD8 monitoring appointment today.  My follies seem to be doing great!  I have two good follies (1.8 & 1.6), and one more that might catch up (1.3).  Not bad for CD8!  :)  I will be taking Gonal-f again today, and then hopefully, triggering tomorrow!  IUIs on Tuesday and Wednesday.  I am so excited and nervous!  Excited because well, I always am - I am a perpetual optimist, and having two to three good follies just makes me that much more hopeful.  Nervous, because no matter how well my body responds and how many follies I have, none of that will matter if MH's numbers are too low.  Eek!  Please, please cross your fingers for us. 

I am happy that I had a good appointment today, as it might make this afternoon a bit more bearable.  I have to go to THE baby shower today.  "THE" because it is for the one person whose pregnancy makes me very sad - I found out that this woman was pregnant within an hour of starting to miscarry in January.  :(  She was just a little further along than I was at the time.  While I do okay with pregnant people and baby showers in general, her pregnancy is a different story.  It reminds me of what I (almost) had, and lost, and of how far along I would be right now (7 months!) had my body not failed me.  She is a great person, and I am honestly, truly very happy for her - but I can't help but be sad for me at the same time.  As I said, she is the only person whose pregnancy really draws out these emotions in me, and I feel terrible about it.  I'm sure it's because of how/when I found out. Thankfully, she has no idea, as I am very good at hiding my emotions and putting on a good face.  I'm sure that I will be able to do it again today.  It will be hard though. 

Friday, 22 June 2012

Collection Conundrum

I had my day 6 monitoring appointment today, and am happy to say that all seems to be progressing well as far as my follies are concerned!  I have one measuring 1.3 cm on the left, and one at 1.1 cm on the right.  I also have one .9 cm on each side. The Gonal-f seems to be doing the trick!  I stim for 2 more days, then go back in for monitoring again. Hopefully that will be all that is required before I can trigger - I do NOT do well with hormones! They seem to make me ├╝ber emotional.  I'm aware of it as it is happening though, so that knowledge seems to at least keep me from descending into actual craziness.  :) When I cry, I also laugh about how stupid it is that I am crying! Lol. My husband thinks it is hilarious.

And the best news - I think that my husband and I *may* have finally solved the collection conundrum!  I think and hope.  See, he has thus far had issues producing a, um, representative sample for testing and IUI purposes.  He finishes, but for some reason only produces about a drop of semen - .25 and .5 ml respectively, to be exact.  We used the withdrawal method of TTA for years and so, I am very familiar with his norm and trust me, this is NOT it! My RE's office offered zilch by way of suggestions of ways to get around the issue and so, I did my own research. I discovered and purchased sterile collection condoms.  I figured it might address his "it's too hard to get it in the cup" issue.  The awesome news is, I think it did!! :). He tried it today, and while it still wasn't enormous volume, it was probably at least twice what it was with cup alone. :). Yay!  I am somewhat concerned with the possibility of losing some boys when they are transferred from condom to cup, but hopefully the survivors will still outnumber last month's swimmers, such that it will be worth it. We'll see what his numbers are like when we do our IUI next week.  Fingers crossed!!!!

Tuesday, 19 June 2012

CD3 - Gonal-f is a Go

I had my CD3 appointment today, and left in high spirits.  Everything looks great for this cycle!  My antral follicle count was 22, with the largest follicles on each side both being 0.9 cm.  Take that, low ovarian reserve!!  No cysts, good FSH (3.74, should be <10) and estradiol (150, should be <200). 

So now I start taking Gonal-f!  I honestly never imagined that I would be sticking myself in the stomach with a needle that looks like this:


...or at all, ever.

But I did it, and honestly, it's no big deal.  It looks scary, but the anticipation is far worse than the actual experience.  It hurt just a tiny bit, that's all.  And then it was done.  :)

I am so hopeful this cycle!  As I always am, I guess. The way I see it, I will be crushed when if I get a BFN no matter what - there is no way that I can actually keep my hope in check enough to avoid that.  So, I figure that I might as well indulge in a little positive energy, and enjoy the fantasy of "maybe."  The end result will be what it is. 

So, here's to this cycle!  I hope it's the one! 

Sunday, 17 June 2012

Moving On (Soon, I Hope!)

So, IUI#1 was a bust.  I'm not surprised, really, given our low numbers this cycle and the difficulty the doctor encountered in performing the IUI itself.  Still, there was a chance, especially given the fact that we also had well-timed sex in addition to the IUI.  Oh well.  Time to move on, and focus on the next cycle! 

Which I would love to do, if only my stupid period would show up already!

Another reason to hate prometrium.  Not only did it turn me into a crazy person for two weeks, and not only did it mimick pregnancy symptoms and thereby fuck with my head, but now, it is preventing me from moving on to my next cycle by keeping my period at bay.  I took my last dose Thursday morning and still, no sign of my period.  *sigh*  I want to get this show on the road already! 

The delay is particularly annoying right now because it is threatening to mess up a trip that I have been looking forward to for months.  We have an amazing waterfront campsite booked at one of the most beautiful parks in the province for Canada Day weekend.  I booked the site almost six months ago, and have been looking forward to it ever since.  Camping is one of my very favorite things - especially the first trip of the year (which this will be).  We have friends coming with us as well.  I am honestly SO excited.  The problem of course is the timing.  Depending on when my stupid period shows, we may need to cancel the trip, because I may need to be in the city to be monitored / triggered / inseminated. 

That's the thing about fertility problems, they're never exactly convenient, are they?!

 I will be taking Gonal-f for the first time this month.  I am hoping that it will cause me to be ready to trigger earlier than usual, in which case we may still be able to go on our trip, albeit with timed intercourse rather than IUI - which frankly, might not be a bad thing.  If I am not ready to trigger before we would otherwise leave for the weekend, I am not sure that they will "let" me go.  Can I skip the trigger when using Gonal-f, and just wait to ovulate on my own?  I have never had issues ovulating, so I would think that it might be okay.  That said, I have also never used this drug before, and I do not yet know much about it.  Is it necessary to trigger when using it, to avoid over-stimulation? 

Lots of questions for my doctor at my day 3 appointment I guess.  For now, I wait...and drink!  There is always a silver lining, right?  ;)

Sunday, 10 June 2012

Prometrium, I Hate You.

I will start this post by saying that I am grateful that I have finally been prescribed a progesterone supplement, which I have suspected was in order since I began charting my temperature in September 2011 and realized that my LP was 7-8 days (9 days in March 2012, yay!).  It was so frustrating to repeatedly get my period before an embryo would have been able implant and begin producing enough HCG to tell my body that it was pregnant (if it was).   I also suspect that my January miscarriage may have been related to my low progesterone that cycle (10nmol/L @ 7DPO; should have been >25nmol/L, or >10ng/mL).  So, while I am about to complain about prometrium, I am very thankful that I am taking it.

Now that that disclaimer is out of the way....

Prometrium is such a mind fuck! 

Prometrium is known to have side effects that are similar to early pregnancy symptoms, and I can certainly atttest to that.  My breasts literally feel like they are going to fall off!  They are not just tender, as they would normally be during the two week wait (2WW) - they are extremely sore.  The only other time that they have felt like this was, of course, when I was pregnant. 

I am also extremely emotional and moody.  I am crying (or at least, my eyes are watering) at least 4 or 5 times a day.  It sucks.  This is also a symptom that I very clearly remember experiencing when I was pregnant.

Other annoying symptoms side effects include backache, bloating, cramps and occasional nausea.  And of course, my temperature has remained elevated.

I am not naive.  I am well aware that all of this is more than likely being caused by the progesterone, and has no bearing whatsoever on whether or not I am knocked up.  I get that.  Several of these side effects actually started several days before implantation would even have occured.  Still.... I have to admit that it is a total mind fuck. 

I am not optimistic about this cycle, because MH's numbers were terrible for our IUI (he apparently has issues producing a representative sample when under pressure).  Still, it is hard to stay realistic and grounded during this 2WW when my body (or rather, the prometrium) is fucking with my head like this. 

Prometrium, I hate you.



Saturday, 9 June 2012

Someday...

I have never had a blog before.  I have certainly thought about it, and in fact kept a journal for many years (hardcopy - yes, I am old).  I have always enjoyed writing. Frankly, I don't know what has held me back... but in any event, here I am. I have finally decided to give this blogging business a chance. 

So, what will I write about?  I'm not sure yet.  For now, I think I think it makes sense to start with what has become the major focus of my thoughts and attention as of late - trying to conceive with diagnosed fertility issues. 

I won't go so far as to say that I am struggling with infertility - I frankly don't think that I am there yet, and I believe that to adopt that label at this point would be insulting to the many women who have been trying for far longer than myself, and whose strength and spirit are both humbling, and inspiring.  My husband (MH) and I have however been diagnosed with a number of fertility issues - low progesterone, low ovarian reserve, low motility, and a varicocele (further testing pending).  All but one of those diagnoses came as a shock to both of us.  We are still reeling from, and trying to come to terms with, this new reality.

MH and I have been trying to start our family since September 1, 2011.  By that time, we had been together for more than 8 years.  My husband was 35, and I was 31.  We had finally decided that it was time.  We were both excited, and nervous.  It never occured to either of us that we might encounter any difficulty in starting this new chapter in our lives.  We both (very naively) assumed that if we had unprotected sex, then I would be pregnant within a month or two (at the most).  After all, wasn't that we had always been told?

We have always known that we wanted children, but we were never in any hurry to get there.  I was in university until I was 24, and then at the beginning of a very demanding career in a male-dominated profession.  I wanted "prove myself" and establish my career before turning my mind to children.

We thought we had all the time in the world.

Whenever someone asked when or if we were going to have children, our response was always to say that of course we wanted to start a family "someday", but "not just yet." 

Fast-forward to September 2011.  We finally decided to take the plunge and so, I began charting my temperatures and tracking my other fertility signs.  I quickly discovered that I had a painfully short luteal phase (LP).  My concerns were dismissed by everyone, including my family doctor, who did not know what a luteal phase was (!).  I finally convinced him to refer me to a specialist.  My goal of course was to simply have my progesterone tested at 7 days past ovulation (DPO), in order to determine whether I needed to be taking progesterone supplements in order to stave off my period and sustain a pregnancy, if one were to occur.  This process took several months. 

In the meantime, I became pregnant in December 2011.  I actually did not know that I was pregnant until mid-January 2012, when we were in the midst of trying to time our sex during what we thought was a new cycle.  I had begun bleeding at 8DPO in December, right on time.  I bled for 7 days, as usual.  I also had a negative pregnancy test that day (way too early to test, I know!).  I therefore assumed that I had my period, and went on with my life.  It was only after I had positive ovulation tests four days in a row in January, nausea and extremely sore breasts that I thought "okay, I know this is crazy, but I am going to take a test."  Lo and behold, I was knocked up.  We were so excited!

Unfortunately, our excitement turned to apprehension within hours as I realized that what I thought was mid-cycle spotting in January could in fact be indicative of a problem given that I was pregnant.  Our fears were confirmed via numerous betas and ultrasounds (in which I heard the heartbeat, twice) and ultimately, I miscarried naturally at home over the course of several days.  I was 8 weeks, 3 days pregnant.

Around the same time, I began a new job with a great company.  We decided that we would take a short break.

We started trying again in April, and finally met with a specialist and had testing done in May 2012.  My only concern was my progesterone, but my RE insisted that I have full testing done before she would treat me.  I anticipated that I had low progesterone so I was prepared for some bad news, but I frankly did not expect there to be any other issues.  Unfortunately, I was wrong.  In addition to low progesterone, I was diagnosed with low ovarian reserve (!).  My husband was diagnosed with low motility at 26% (should be at least >40%).  He has also now been diagnosed with a vericocele.  He will be doing further testing, and is scheduled to see a urologist soon.

Because of MH's low motility, we have been told that our chances of conceiving with timed intercourse alone are not great.  We are therefore proceeding with IUIs.  Our first cycle will be natural.  I will thereafter be taking increasing doses of Gonal-F.

So, there you have it.  We are continuing on our journey to start our family via the world of fertility treatments and procedures. 

While I am still confident that we will have children someday, I now realize that "someday" may just be a little farther off on the horizon than I had anticipated, and our path might not be as straight and flat as I had hoped.    Hopefully though, we will still get there soon.