Happy New Year!

I’m now officially 3 dpo according to fertilityfriend. So I’m officially in the 2WW. I will use that date to help me decide when to call for a blood pregnancy test if necessary.

We’re about to head to Mississippi to spend time with my parents for the weekend. This will be our Christmas with them! I’m all packed and ready to go. Just have to wait on Rick to get off of work. I took the day off!

I hope that everyone has a very Happy New Year! I’ll be back next week and will hopefully have plenty to post about! Feel free to leave topic suggestions for me in the comments, if you have questions on any one thing.

CD15 Update

I went in today for the mid-month ultrasound and bloodwork.  Normally I would have done this a few days earlier, but I was out of town, and I’m sure the doctor’s office wasn’t open. In any case, today I went for this.  There were lots of follicles, one big one that they thought had already ruptured (meaning I’d already ovulated).  They wouldn’t know until the bloodwork came back though.  If the bloodwork showed I haven’t ovulated yet, then I would need an HCG trigger.

After a tedious day sitting by the phone, they finally called, and the bloodwork showed… that I’ve probably already ovulated!  I guess I will call in a couple of weeks for a beta if no period has started yet.  She didn’t give me a hard time limit on that.  I’ve got the new nurse, so it seems she’s still learning or something.  Thank God I don’t need the trigger shot.  I’m so needle-phobic I don’t know how I’d deal with giving on to myself, or receiving one from Rick (this is the option I’d choose, btw).  If we’re not successful this month, there is always the possibility that I’ll need the trigger in the future.  I’m sure I’ll hold my breath on that decision every time!

I don’t know exactly when I ovulated.  I chart my temperatures, even though I don’t have to.  I may write more on that another day.  I thought that I had a temperature rise a couple of days ago indicating possible ovulation, but then it dropped again yesterday morning.  It’s on its way back up today, so I don’t know?  Maybe I didn’t ovulate til yesterday.  I guess we’ll see.  My sleeping patterns have been awful (see previous post), so that kind of skews the temperature readings a bit.  This makes it a bit harder to decide when to do a blood pregnancy test.  I guess I’ll cross that bridge when/if I get there.

All that being said, I hope everyone’s Christmas went well!    Ours was great!  It’s not quite over though.  We’re going to my parents this weekend, so more Christmas-family-time to go!

Hormonally Induced Sleep Deficiency?

For the most part, I’ve felt much better the past couple of days. My headaches have gone away, and my energy levels are back up. But, I’ve woken up before the alarm all week! I probably should just get up, but I don’t want to get up. But yet, I don’t really go back to sleep. I don’t know if this is residual from the medication or not. I took my last dosage Tuesday night, so it should have had enough time to leave my system by now. Femara has a short half life, so it doesn’t stick around too long. However, I suppose it is possible that my hormones are still out of whack, due to what is hopefully multiple follicles growing, and possibly causing my sleep ailments. I have no problems getting to sleep, it is just staying that way!

That being said, we’re going out of town tomorrow for Christmas. We’ll be back Tuesday night. I will still have net access, but don’t know if I’ll take the time to post or not. So just in case, I hope that everyone has a wonderful Christmas!

Planning

Recently someone new learned of our infertility.  I got the response that at least we have the luxury of planning, that not everyone gets that.  Of course, that sort of made me think she did not have that luxury, which is fine, I suppose.  But I thought, if things went according to my “plan” I would have had a baby by now!  I don’t consider infertility as a luxury of being able to plan.  Clearly things are not going according to plan.  Which is the opposite of what this person most likely experienced, the unplanned pregnancy.  I have the unplanned non-pregnancy.  That being said, I did not talk with this person about how long this is taking for us, so she didn’t have that information.  I also won’t say that I was hurt by this comment, but it definitely led me to think.

Another strange thing I think about is that my dad, me, and my brother all have birthyears ending in “0.”  My mom’s birthyear ends in “5.”  We started this journey late 2004.  Of course, I thought that maybe, just maybe I’d have a late 2005 baby to keep up with the easy to remember birthyears.  Of course, things did not go as planned.   Maybe I’ll have a late 2007 baby, maybe a 2008 baby.  To keep up with my tradition I’d have to wait until 2010.  I honestly hope that I’m not having my first child in 2010, but I suppose that is possible.

Hysterosalpingogram (HSG)

Rick thought it might be good to post about the HSG test. I had this test way back in September. An HSG is a common diagnostic test used to see if the fallopian tubes are open, and it also will possibly show any uterine defects. It also has a slight theraputic affect too. No one is 100% sure why, but one theory is that the contrast dye will push any slight tube blockages out of the way.

It is considered outpatient surgery. Why surgery as opposed to outpatient diagnostic lab or x-ray, I don’t know, but as far as the insurance was concerned, that’s what it was considered to be.

So what’s involved? A catheter is inserted into the uterus (this was described as a “little pinch”, but I tell you that was more than a pinch to me!) and a contrast dye is pushed through the catheter. While this is happening, an X-ray is being used to visualize where the dye is going. A normal HSG should show the contrast dye fill up the uterus (should be triangular or martini glass shaped), then flow through both tubes, and spill into the abdomen. The spillage will be reabsorbed by the body. This site has some photos of what normal and some abnormal HSG results should show. Afterwards, you can usually return to normal activities. I felt pretty yucky after mine, so I went home and watched Desparate Housewives in bed for the remainder of the afternoon.

They will tell you that the during the procedure you will feel period-like cramping, or they will tell you that it is “uncomfortable.” I will use the uncomfortable descriptor. It was pretty painful during, but the pain subsided afterwards. Fortunately, it wasn’t that long of a procedure. I did take 3 ibuprofen two hours before the procedure as instructed, so maybe that helped some with the pain. When I got home, I took some prescription Naproxen, and I was mostly uncrampy the rest of the night. The remainder of the day was very similar to period cramps, but I definitely would not describe during the procedure that way. I have heard that it is much more painful if you have blocked tubes. Fortunately, my HSG came back all clear.

Some doctors (mine included) will prescribe an antibiotic before the procedure. This is to fight off the very slim chance of infection from the procedure.

Oh and expect a lot of people in the room. Rick was thankfully allowed in there with me. Additionally there was a nurse, my RE, a radiologist, and a student. The student was positioned in a way she could just see the X-ray, and I had to consent to her being in there. I was ok with that though. I have heard of many places that won’t allow husbands in the room. I’m so glad he could come in there with me. Even though he was on the other side of the room, it was helpful knowing he was there.

tired

The femara leaves me exhausted. At least this cycle. I realize I’m perpetually tired, but this is different. There isn’t enough coffee in the world to keep me awake! But yet, I have to work anyway. Such is life.

On an unrelated note, how about the layout of the site? I’ve played around with the sidebar widgets and I think I have it set up how I like, but I was wondering what others thought? I can’t customize the look of the theme unless I upgrade with wordpress.com. Right now I’m just using what they freely offer. I can play around with the sidebar though. Also, I love some of the dashboard functionality that comes with a wordpress.com blog. One of my favorites is the blog statistics I can access through the dashboard. We use webalizer for our other blog, and I don’t like that nearly as well as this.

Anyway, not much to update today. I’m too tired to write in depth on anything.

Inside my head

Today’s will be somewhat depressing, so feel free to skip. As much as I’d like to keep everything scientific, the fact is that it’s not. There are tons of emotions involved. Plus, I’m still in the middle of my femara regimen, so feel free to blame that for today’s post.

10 weeks. That’s how far along I should be. Or, I should have a 10 month old ready to celebrate his/her first Christmas. Or, I should have a 3 month old, ready to celebrate their first Christmas. Usually, I don’t let these things get to me, but sometimes they come back up, and I have no control over when or how they do. There are a couple of triggers this time. The first, I learned someone at church is 9 weeks along. That’s really close to how far along I should be. When that baby is born, will I be reminded that I’m missing out? Maybe I’ll be pregnant by then. But then again, maybe not. There are no guarantees. I have no idea where in this journey I’ll be by then.

The other trigger: We’re sending out Christmas cards this week. I had thought about announcing our pregnancy using the Christmas cards. It would have been a couple of weeks earlier than I’d like, but the timing was too perfect. Another option was to forgo Christmas cards and send New Years’ cards. But instead, I’m sending cards out that just say “Merry Christmas.” I still like the letter idea for announcing. Maybe I’ll do that anyway, even if it is not at Christmas time when I get to make my grand announcement.

IUI Explained

Ok, I’ll let out my frustrated teacher, as requested. But, I’ll leave the diagrams at home for this one. First, some resources (I do have these):

IUI Facts

Stirrup Queens and Sperm Palace Jesters IUI writeup

IUI stands for intrauterine insemination. It is often used to boost the chances of conception. For unexplained infertility it is often combined with superovulation. The process would be similar to what I’m doing now, except instead of going in mid-month to be told when the right times are, I would go in mid-month and figure out when to go back for the IUI. Some advantages to IUI is that before the procedure, the sperm is washed. Washing the sperm gets rid of any of the sub-optimal sperm. I just read here that the seminal fluid is replaced with a nutrient bath. After the washing you’re left with a small amount of fluid with lots of good sperm. In IUI, this fluid will bypass the cervix and be placed directly into the uterus by way of a catheter. This is a second advantage. Sometimes the cervical environment may be hostile to sperm, so this method would get rid of that component, plus they have less distance to go to the fallopian tubes, causing more sperm possibly available to fertilize the egg when it is released.

IUI is a pretty common procedure. It is used to treat unexplained fertility, as well as several cases of explained. One such case would be a couple with slight male factor infertility. Washing the sperm and placing it close to the tubes would increase these couples’ odds. I think typically this procedure is used before proceeding to IVF. Sometimes though, as in the case of a severe male factor, this step would be bypassed. A sperm count needs to be typically at least 5 million (some doctors may go down to 1 million, from the IUI FAQ above) to do IUI because a certain percentage of sperm is lost in the washing process. If the count is too low, there may not be enough sperm after the washing to perform the IUI. I think they decide this using statistics and such.

In summary, for IUI + superovulation you have more eggs and more good sperm available = increased odds of conception. It is very commonly used to treat unexplained infertility.

Next question?

CD3 update and more on Aspirin

Everything today appears to be back at the baseline. I will be on Femara for the next 5 days. I’ll go back for a follow-up on the 27th. Normally I’d probably go in sooner, but, um, Christmas is in there and not only are they probably not open, but I will not even be in town.

I actually did get to see the Dr. today. Normally I just see the nurse. I pointed out a bit more family history I recently thought of. He did not seem as alarmed about that family history as some of my others I’ve told him previously. I also asked if it would be ok to take the low-dose aspirin for the entire cycle. He seemed to think it wouldn’t really help, but it could, and if that’s what I wanted to do.. kinda attitude.

So why do I want to try the aspirin? Aspirin therapy can possibly help with the clotting problems, assuming I may have some sort of clotting problem, which we don’t know if I do or not. There are also some other studies that say that the aspirin, working as a blood thinning agent, could cause more blood flow to the reproductive organs, which would overall improve their function. There are other studies that say that it doesn’t do anything to help with reproductive function. So it is all still very blurry right now. But, because I’ve had three very early losses, I wanted to try *something* different than I have been. If it helps, great! If not.. then I don’t know. I’ll cross that bridge when I come to it.

Oh, we talked about the path ahead too. Right now it seems that we’re going to try three more cycles of Femara. After that then we’ll start talking about Femara combined with IUI. At least right now I’ve seen that I can get pregnant on the Femara without IUI, so maybe IUI will be unneccessary. The only way to know though is to see what may come of these cycles before then!

Some of my non-infertile friends may not know what the femara is doing. Often as a treatment for unexplained infertility, a doctor will prescribe a medication that will cause superovulation. In a normal cycle, a woman will have one dominant follicle between her two ovaries. The follicle sort of holds the egg before it is released. In superovulation, several follicles are allowed to grow, allowing for mulitple eggs to be released. This is why the odds of twins is increased on these medications. However, my doctor does not seem worried about me producing twins. For some reason, the femara has a lesser chance of twinning than the other common fertility drug, Clomid. So why does superovulation help in unexplained infertility? Well part of the problem with unexplained is they don’t know what’s causing it, so various treatment options are tried. The idea here is that maybe if we throw more eggs into the equation, there’s higher odds that one will implant and be healthy. I’m sure there are scientific papers behind all of this, but I don’t have any handy.

So, now that I’ve bored everybody to death, I am very excited to be able to do another treatment cycle. These doctor ordered breaks just about kill me!

Again, if anyone wants me to maybe go into more detail about these things, holler at me and I will try to explain if I know. If I don’t know, well then that gives me something to research that I hadn’t thought of! I could probably come up with resources for many of the things as well. Most of it is in my head, but I got all of it either from Dr. Google, or my RE at one point in time or another.

Now that I’ve talked about femara and aspirin in one post… I don’t know what I’ll post about later after this!

More on Unexplained Infertility

I wrote yesterday that it is frustrating to find nothing is wrong with you. That is somewhat misleading though. Sure, the specialist couldn’t find anything out of the ordinary from the diagnostic tests. I read recently that it just means that the science and diagnostic tests are not yet advanced enough to give me the answer. Statistically, I should be getting pregnant about twice the rate I am, even if none of them stuck. The reason I keep losing them so early could also be the reason I am not getting pregnant as often. But whatever that reason is, we don’t know. All we can do right now is try a few different treatment methods, and see if that helps. I may go into those later. The writeup I linked above does go into some of them though.

 

Tomorrow I go in for CD3 bloodwork and ultrasound. This is to check that everything is back to the baseline before we begin a new treatment cycle. I will also ask if maybe aspirin therapy could help if taken before conception occurs. I’ll write more on that later as well. I’m going to try to write here often, so I’ll be careful not to use up all of my material all at once!