IUI Day

There is only one doctor in my clinic's practice that I don't care for. Well, actually there's another one that I don't like at all, but I never have to see him, because he works in the middle-of-nowhere-in-Virginia most of the time. Anywho, there's only one doctor I don't care for at the Rockville Office (out of 6). There's nothing particularly wrong with him, he just rubbed me the wrong way once, and I've been holding an unreasonable grudge ever since. Guess who was covering IUI appointments this morning? Bleh.

Undeterred by the thick layer of ice on our cars and on our roads, since ovulation waits for no one, S left early this morning to head to the clinic. He returned home just as I was leaving for my appointment (he had to get to work) and told me that the roads were not pretty, but they were better than they had been at 7am. Fair enough.

The roads, in fact, were terrible. The Beltway wasn't bad, but my neighborhood streets, 270, and the roads near the clinic were absolutely dreadful. Ah well. At least I made it on time. Only to discover that Dr. Annoying would be doing the IUI. Bleh.

I don't know how to put it delicately, so I won't bother. But... it's the first time that I've heard a slurping sound at the end of the IUI. Seems a little off to me. Plus, and I really meant it when I said I don't know how to put this delicately... usually after the IUI I lay there for five minutes, and then get up. It's not uncommon for me to feel... um, a dripping feeling as I stand up. What has never happened until today, however, is feeling that dripping feeling as he pulled the catheter and speculum out. It felt like all of those little swimmers came pouring out of me. Now, I recognize that there probably wasn't much spillage, and it probably doesn't matter, but it still seems off to me.

Plus, there were only 5 million swimmers today. The only other time the count has been that low was last month, which we attributed to Seth having a pretty high fever that day. Every other time the count's been between 20 and 40 million. Anything over 5 is acceptable to the clinic, which is fine and dandy, but still. I'm not upset about it, because even with 20 million the odds are really low and I don't have a lot of faith in this IUI anyway. But S said he felt like an underachiever. I told him it served him right for getting such a puffed up ego about the counts for the first four IUIs. Hah!

Also, I'm incredibly crampy and nauseated now, which never happens. I'm certain the nausea is from the cramping (yes, the cramping really is that bad). but the only reasonable explanation for the cramping is the IUI. While I've experienced mild cramping while the catheter is being inserted, I've never had severe cramping and certainly not for this long after the procedure. I mean, it may be me projecting my dislike of Dr. Annoying on this whole experience and maybe nothing was off or wrong or anything and I'm overreacting. But I'm still annoyed.

Oh, while I was there, I snooped around in my record (what? It's not MY fault they leave my record up on the screen after they leave the room!) to see what my E2 and LH were on Monday. My E2 had risen from 302 to 427, but the LH had gone down from 4.38 to 3.18. So now I'm even more confused about why they triggered when they did, even though I know that ultimatey the reason was because they were concerned that going one more day might mean I had too many mature follicles. But Still!

Anywhozit. Dr. Annoying has no sense of humour, which is funny, because the administrative staff swears that he's very funny, but he's always very deadpan and serious around me. Bleh. When we were talking about the fact that the IUI was on Valentine's Day, I remarked: "Who said romance is dead?" and not only didn't he think I was being funny, he gave me a rather horrified/offended look. whatever.

Followup Appointment with Dr. Amazing on Friday. We'll be signing IVF consents that day as well as finalizing my protocol and timing for an upcoming IVF cycle, pending a negative beta on March 1st. The fun just keeps on coming! :)

IUI tomorrow (aka My Life As a Cliche)

It's snowing/sleeting/whatever here right now. Schools will probably be cancelled tomorrow. And of course this is on IUI day. Which leads to the mad scramble to figure out how to handle having to be at Shady Hell, but still having early morning coverage for J, given that we can't just take him to school as per usual.

So my mother, grandmother extraordinaire, is coming over tonight and spending the night so that she can be with J in the morning (we are assuming that school will, indeed, be cancelled) and we'll have to figure out the rest of the day after the appointment. This leads to the rather uncomfortable situation in which I had to (yet again) disclose to my mother that we had appointments at Shady Hell tomorrow. Non-reschedulable appointments. So she's not stupid, so she knows exactly why we're going. And I find this supremely annoying. I do try to minimize the number of people in real-life who know when exactly my IUIs are scheduled and when I'm in the two week wait. I hate that she can't help but give me meaningful glances and all that garbage. It's not her fault, but I am still irritated. Nevertheless, I'm extraordinarily grateful that she's willing to come over in the middle of nasty weather to take care of J for us on absolutely no notice.

Another fine reason I wish I didn't have a full-time job. I hate working. But that's another story.

In other news, I can't find my IVF info packet ANYWHERE, which is not good because it contains the consents that S and I need to sign. I was planning to bring them with me to Friday's followup appointment with Dr. Amazing. The consents are very annoying because they must be signed in front of a witness at Shady Hell or notarized. S and I are almost never at Shady Hell at the same time, so it's been impossible to get the consents signed. We never have time during business hours to get to a notary at the same time. And I really, really, really don't want our friend/neighbor who does all of our notarizing for us to be witnessing this particular set of signatures. It's just a bit too personal. (yet somehow, I don't have a problem with him seeing our financial documents, which I'm usually pretty closed-mouthed about)

Obviously, my nurse can provide me new copies of the consents, but I really wanted to go over them ahead of time, because we never really settled on how we were going to deal with some of the things we have to address in the consents (e.g. what happens to frozen embryos, if there are any, in the event that, chas v'shalom, one of us dies? Discard, transfer to the sole custody of the surviving spouse, donate, etc?) Those just aren't questions I wanted to have to address without initial review together. Oh well. I guess we'll figure it out.

Bleh.

Well, there's nothing more cheesy than having an IUI on Valentine's Day. My life isn't cliche enough to be the cycle that works, so we'll just count on a negative beta on March 1st, CD1 around the 4th, and BCPs around March 7th until after Passover, when I will re-start Follistim. Yippee.

Trigger Time

Trigger tonight (CD20).

IUI on Wednesday (Valentine's Day, which I find somewhat irrelevant since we don't celebrate Valentine's day, but it's still an interesting coincidence).

I am ambivalent about triggering tonight. I think it's too early, to be honest. I forgot to ask what my E2/LH was, which might have made the difference. If my LH was surging, there may not have been a choice. If my E2 hadn't gone up much, it might have indicated that I did, indeed have only one lead follicle. But I was in the middle of a meeting when my nurse called, so I didn't run through my normal list of questions. Anyway, on the one hand, I fear that it is too early to trigger and that it's a waste of time. But on the other hand, who cares if it's a waste of time? I'm done with IUIs as of Wednesday.

I have scheduled a followup appointment with Dr. Amazing, at his request, to review the IVF protocol going forward. Follow up is this Friday, Feb. 16th. It's sooner than I would have expected, but my only other option was to wait until March 8th, which is after I would have started BCPs, so may as well meet with him sooner rather than later.

Beta will be March 1st. I should start BCPs around March 7th at the latest, assuming I even make it that far (remember that CD3 of this cycle fell on the day that my original Beta for last cycle was scheduled, so it could be I start BCPs earlier.

Oh, I mean, I suppose it's possible I won't start BCPs at all, since, well, this IUI could theoretically work, but that's crazy-talk. So there you have it.

This feels like deja vu all over again

Last night I took a Flexiril (muscle relaxant) and codeine along with my nightly medications. The good news is that I woke up without much of a headache, but the bad news is I'm not entirely convinced that I'm even awake yet. Flexiril always does this to me, and yet I never learn my lesson. All I really want to do right now is curl up into a little tiny ball and sleep for a few more hours. Hard to do in a desk chair at the office. Bah.

Something about my monitoring appointment this morning felt "off"... like I'd already done this before. Oh wait, I had... just yesterday! Same bat room, same bat channel. Today's ultrasound was promising, but troubling. I've got a lot of good growth, which is great, but unfortunately, there may be too much. The doctor covering monitoring today said that they'll have to balance their options after getting my bloodwork results back, but that right now it's a choice between triggering tonight, possibly a little too early or going in for one day of monitoring, risking too much growth and having to cancel due to too many follicles. Here's where things are right now:

Right Ovary: 15.4, 14.2, 13.4
Left Ovary: 16.4, 14.2, 14.0
Lining: 15.23mm (huhwha? I've never had a lining that thick. Is that good or bad?? I know in theory the thicker the better, but isn't that getting a little ridiculous?)

There are some other follicles, but I'm not so worried about them. I suppose I'll know more after today's phone call with my E2 level. I expect it's likely that I'll trigger tonight and have an IUI on Wednesday. I'm hoping the weather cooperates with these plans. If that is indeed the case, it won't interfere with us going to Florida on Sunday, which is good news.

An IUI on Wednesday would put Beta day on March 1st. According to the normal timeline, I'd then be on BCPs for 3 weeks and start stims. However, that would possibly conflict with Passover, which can't happen, which means I'd have to be on BCPs through April 11th or so before starting back up with the Follistim. I am not loving this timing, but I don't think the solution is to squeeze one more IUI in, even though that would still end up around the same timing. I think I'm best off trying to stick as closely to the original plan as possible. So on March 1st, I expect to start taking BCPs, which is going to mean a lot of migraines for all of March and much of April. Especially when you factor in the Lupron, which tends to cause headaches as a side effect. Yay!

Well, hopefully I'll get some definitive news this afternoon. Here's hoping.

Maybe not so useless after all?

Is it possible that my formerly-useless left ovary might actually be the producer this cycle? That might, indeed, be a first. Well, a first in the last 6 IUI cycles, anyway. Probably not the first time in my life, though I suppose that's possible. Anywhozit, I had an early-morning monitoring appointment today. It would probably have been more pleasant had I not been babysitting for a friend (I know, I'm a saint) until 1am. I got to sleep around two and was NOT happy when the alarm went off at 6. Oh well. I figured I'd better, you know, shower and all, since I was pretty sure Margaret would be there today (I was right!). Gotta look nice for Margaret.

I got called back for my scan first (No! Throwing off my whole routine! I always get bloodwork drawn first! No fair confusing me!) and after I'd undressed and climbed up on the table (seriously, have they never considered that their patients might be short and fat? Why are those tables so frickin' high?), I briefly considered turning the stirrup covers inside out a la Julie, but changed my mind when I heard the door opening. (I swear, Margaret is desperate to see me in all my glory... she keeps giving me less and less time to get undressed and has walked in a couple times before I've done so successfully. Sheesh! Like she doesn't see enough of me??)

Ahem. Back en pointe. Focus, people! Margaret breezed in all cheery and happy, as always. Dear heavens how does that woman manage cheery at 7 in the morning on a Sunday? Sheesh! She said "We're going to get you pregnant this cycle, gosh darnit." Meh. I shrugged. I'm not counting on it, gave my usual shpiel about how I never count on any individual cycle. And besides, IUI is so last year, don't you think? I'm so not into this cycle, no matter how hard I try to pretend that it's got any chance of success. I mean, it DOES have 20% odds, and that's better than zero, right? Margaret said she likes to tell people she's not a pessimist, she's just an optimist who's been disappointed a lot. Heh.

And so, all pleasantries aside, on to the show! My ovaries, as per usual, were perky and eager to please. Today we saw a dramatic shift in dominance. The useless left ovary seems to be a little insulted at all the nasty things I've been saying about her (her? it? Certainly not him...), and she is rebelling by actually showing some positive growth. In fact, it seems that she is racing against the formerly useful right ovary in a fight for dominance. Observe:

Right Ovary: 13.8, 13.1, 12.2, 12.2
Left Ovary: 15.3, 14.4, 12.9, 8.5, 8.0
Lining: A beautiful 13.77mm today!

Now, I know you're all aquiver with excitement, just like I am, but lest you forget who we're talking about, my E2 and LH levels aren't back yet. For all I know they've plummeted into the depths of despair again. But odds are good that they haven't plummeted, but are rather on the rise, so I might just hold my breath for my next phone call. (though I really would do well to remember that I'm rarely on the GOOD side of fertility odds)

Since I know you'll all be refreshing your screen madly awaiting the E2/LH update, I promise, you'll be the first, er-second, er-third? to know after I receive my daily phone call. I expect to return to Shady Hell tomorrow, but I suppose we'll see. I'm a little irritated at having to return tomorrow, actually, because the earliest appointment they had available was 7:45. I'm normally at work by 7:30, so a 7:45 appointment is REALLY FREAKING ANNOYING. Plus, traffic's a lot worse then. But I'm not bitter.

Edit! Holy Shmoly! Could it be? Could this cycle be turning itself around? at 10:30 my home phone rang and it was Shady Hell. Slightly annoying since the contact number I supplied today was my cell phone number in case I was out when they called. But I'm just happy I was home to get the call. Either way, the numbers are in and they're looking good!

E2: 302 (!!)
LH: 4.38 (up from 2.54)

Holy Cow! I've never, ever had an E2 that high. Seriously. The cycle that worked (sort of) my E2 only got to 113 before I triggered. I'm still not expecting this cycle to work, but the good thing about my levels going up is that it suggests an end in sight. This is a phenomenally good thing, because I'm hoping this means trigger and IUI before Sunday, since that's when we're supposed to be leaving for Florida. Yippee!! End of Edit

Dragging Along Part II

Lest you think that today's E2/LH levels will shed any more light on my peculiar puzzle, I should update you on my call from my nurse this afternoon.

Three more days, two more clicks of the pen. I'm up to 108 IUs for the next three nights. Apparently Dr. Amazing is bored and ready to move on to IVF, which is good, because I'm ready to move on also. I return on Sunday for more ultrasound fun! Whahoo! I asked Mary (my nurse) what my E2/LH levels were and she said she didn't want to tell me because it was only going to irritate me. I promised her I could take it.

E2: 110 (down from 113, but that's really just a plateau)
LH: 2.5 (it went from 2.5 on Sunday, to 2.2 on Tuesday, back to 2.5 today)

Mary is pleased with my LH because she doesn't want it spiking yet because that would mean I was about to ovulate on my own and that would be bad, since apparently my eggs are too immature. They're like teenagers trying to break out into maturity, but still stuck with some rather childish behaviours and development. Curses!

I forgot to tell you all the funniest part of my ultrasound this morning. After Dr. S. left the room I was talking to Margaret, sonographer extraordinaire, and she said (JOKINGLY), "gosh what IS going on with those ovaries of yours? Whatever they tell you to take, you should take double and see what happens." I told her I'd considered it, but that would be wrong. Wrong, I say! Do I sound convincing? I reminded her that doubling my meds was probably the easiest way to land myself with a canceled cycle from overstimulation. "True," she said, "but they can't stop you from having lots of sex!"

Of course, sex has never helped us have a baby before, but if I had four perfectly mature, ripe, beautiful follicles ovulating all at once, you can be damned sure this would be the one time I'd end up pregnant. With quadruplets. And I gotta tell you... I really don't want quadruplets. Not even a little bit. Seriously!

Anywhozit. The point is my ovaries are doing absolutely nothing. I think I ought to have S provide a "sample" for cryopreservation, because I suspect what's going to end up happening is that I'll end up needing an IUI when I'm supposed to be in Florida. At least if we had some swimmers on ice, I'd be able to stay here while S and J go to Florida without me (or maybe just have me catch up with them later or something). And anyway, if I plan for that contingency, I won't end up needing it, and all this worrying will be for nothing, right??

Edited to Add: Anonymous makes a good point in the comments that I could always go for the well-timed intercourse in Florida idea in lieu of the IUI. The IUI itself doesn't really increase our odds, since our whole problem appears to be me not ovulating naturally, so well-timed intercourse COULD do it, except for a couple things:

1. We'll be staying at my dad's ... and well, GAH!
2. Timing has never worked out particularly well for us, but we could still give it a shot.
3. I need to find out whether my RE would count this as one of my 2 last IUI cycles before moving on to IVF if I skipped the IUI part. I suspect he would, but I'm not entirely certain. But I am NOT doing another one of these cycles if I don't have to. It's time to move on. My insurance coverage for IVF runs out in September or October. After that, I start fighting an uphill battle. Bleh.

Still, I haven't entirely ruled out the possibility of just resorting to "the old fashioned way" if necessary
End of Edit

Dragging along

Last March I had the longest IUI cycle in recorded history. Or at least in MY recorded history. And since it was only my second IUI cycle, my recorded history wasn't very extensive. That cycle went on forever. hCG trigger was on CD 31. Thirty One! IUI on CD 33! Dr. S. called me a "two-pager" meaning that in the old days of paper charts, I would have been one of those patients whose cycle notes went on to the second page.

Not to worry, he assured me. Because historically, two pagers had a remarkably high pregnancy rate compared to shorter cycles (you know, the cycles where trigger happens on Day 12 and IUI is on Day 14 like a textbook?). I remember I really appreciated his reassurance (actually, I still do), but the long cycle was slightly problemmatic because I had a one-day trip scheduled to go to Florida (to see my father and a friend from Scotland) when I figured I'd be in the two week wait, but was actually not even close to IUI day. Dr. S. said no problem and let me push off my next monitoring appointment an extra day, figuring it wouldn't be too big a deal. It wasn't, and the cycle dragged on another week or two after I got back before I triggered.

That cycle ended horribly and dramatically while I was away for Passover. It was probably the worst bleeding I'd ever had until that point, and that's saying something. It was unbelievable amounts of pain, componded by the fact that I was away from home, living in a hotel for a week, not able to start a new cycle because I was nowhere near my fertility clinic (a 10 hour drive each way seemed extreme just for CD3 monitoring). I snapped a lot at my husband that week, had very little energy most of the time, suffered from migraines throughout the trip, and cried a lot. (Believe it or not, I still had a tremendously good time on that trip, especially considering the circumstances)

Do I have a point? Not really, actually. But fast forward to today's CD16 monitoring appointment. Last cycle I triggered on Day 14 and had an IUI on Day 16. This cycle I am not anticipating triggering anytime soon. Dr. S. was covering monitoring today, so I needled him about the fact that Room 1 doesn't have a mobile. He said they were waiting for a donation and I said that for what I'm paying this place... he chuckled. On to the ultrasound, the funnest part of the day!

Follicle growth is weird. The follicles on the Right Ovary seem to have stalled, while the follicles on the Left Ovary (previously known as the completely, utterly, evil, underperforming, useless ovary) made a little bit of progress.

Right Ovary: 12.3 (down from 12.6), 9.6, 9.4, 9.0
Left Ovary: 12.0 (up from 10.7), 11.0 (up from 10.0), 9.4
Lining: 11.41 (down from 11.75, should I be worried?)

No word yet on my E2/LH, but Dr. S. was not worried about the lack of growth of my follicles. He said that I had a beautiful jump in E2 on Tuesday (67.5 to 113!) and that we should expect to start seeing some more growth soon, based on that estrogen jump. I trust him, I believe him. I mentioned that I thought this was going to be another two-pager cycle and he laughed that I remembered that, but reminded me that historically two-pagers have relatively high success rates. When I told him that my last two-pager cycle was a resounding disaster he said, "and that's my cue to exit stage left!" (except he was wrong, it was stage right)

Anywhozit, the bottom line is that there is very little progress happening in Ovary-Land, perky or otherwise, so I'm sorry to give you such a boring update. Not to worry, I'm sure I'll have some dramarama for you soon!

(You know, for example, the fact that I have a trip scheduled to go to Florida for three days Feb. 18th-20th...Since I figured this cycle would be similar to last month's I figured this IUI would already be over, at the end of the 2ww, and failing by Feb. 20th. Now I'm wondering if my IUI is going to end up being scheduled right smack in the middle of that trip, meaning I have to cancel either the cycle or the trip. I haven't seen my father in almost a year and my father hasn't seen J in a year and a half so I really, really, really don't want to cancel this trip, but I also don't want to skip this IUI. DRAT, DRAT, DRAT!)

Too Tired for Eloquence

It's 8:10 pm and if the three year old weren't WIDE AWAKE, I would have been in bed 2 hours ago. Ugh. I have a cold, but also the Follistim makes me exhausted. Bleh.

Anyway, I'm too tired for an expansive post, but the bottom line was that there was decent news this morning. It appears that one follicle has decided to be dominant and the others are shrinking away. So much for quadruplets...

As always, the details are in my Google Spreadsheet for IUI #6.

Oh, and good news: While it is still quite low compared to what a normal human would expect, my estrogen finally went up! It was 113 today. Whoo hoo. Dr. Amazing was covering monitoring today and he reminded me that this is my last IUI cycle. I'm glad he hasn't forgotten, because I sure haven't.

That's really all I have energy for. I hope you all are well. I've been reading, but have been so swamped, I haven't been able to comment much. Sorry!

And the Fun Just Keeps On Coming

Another monitoring appointment this morning. I have 3 follicles on the Right Ovary measuring 11.8 and one measuring 11.6. If I end up with four mature follicles at trigger time, my doctor will cancel the cycle. My completely useless Left Ovary has one follicle measuring 8.8. Not impressive, but that's fine since I've got four contenders on the Left.

I'm not too worried about this cycle being cancelled because of over-responding. I've certainly never had that problem, even in the cycles when it looked worrisome at this point. I'm more concerned about my wonky estradiol levels and the fact that these follicles are only at 11.8 on CD12, which is quite a bit smaller than in my last cycle at this point (on the same dosages). It almost seems as if my response has gotten worse with each successive cyle, but it might be me overreacting. In fact, it probably IS me over reacting, since I know they've been fine-tuning my protocol with each cycle, so I wouldn't necessarily have the same response as previous cycles. For example, my 2nd IUI cycle went on FOREVER, in part because of the teeney weeney dosages. But now I'm on slightly higher dosages which means faster, but different response. I get that in theory, it's just frustrating right now. I'm sure I'll feel better once I get my E2 and LH levels back. I'm somewhat annoyed right now.

Actually, the reason I'm annoyed is because I had a sonographer and not a doctor today. It really irritates me that I haven't been getting an actual doctor on the weekends. It's one thing when it's my beloved Margaret running the ultrasound. But no offense to Julie (the person covering today), but she's just not Margaret. She didn't let me look at the ultrasound display at all, so I couldn't see anything for myself. And I also know that when there are different people measuring each time, it's not necessarily great for comparison, since some people measure differently. Plus, I know I could have asked Margaret to send in Dr. O (the doctor theoretically covering monitoring today, even though I never saw her). I really wanted to ask if there was any possibility that my wacky estrogen response this cycle and last could be fallout from the miscarriage. I know it probably isn't related, and it won't make a difference even if it is, but I wanted to ask. It's very rare that I have questions for my doctor because honestly, I'm pretty well-read on this stuff, and I trust the care I'm getting. But it would have been nice to have the option to speak with Dr. O today. I think I'll call Dr. Amazing this week.

I'm to return on Tuesday unless I hear otherwise after my bloodwork comes back. I think it's possible that they'll ask me to return tomorrow, but not necessarily likely. My guess is I'll stay at the same dosage (which was bumped to 83 IUs as of Friday), but I suppose it doesn't much matter. If I go back tomorrow, I won't call Dr. Amazing, since I'll be speaking to my nurse in the afternoon. I love my nurse... she knows me very well, and while we had a bit of a rocky start (she used to have a hard time remembering specifics about me), I've been around long enough at this point that she knows me really well, remembers the important things, and we have an incredibly good relationship. When she called me with my results and protocol on Friday she said that I should increase to 83 IUs and return on Sunday. I said that was fine and that I'd already set up an appointment for Sunday and she said, "I don't know what I'm going to do when you get pregnant! I'm going to have to find another patient who always knows exactly what to do." I told her I was pretty sure I could do this without all the doctors and she agreed. She's been there, done that, and has twins via IVF, so she gets it.

One final note: Thalia mentioned in a comment to my questions post that in the UK I'd be required to take a couple months off between IUI cycles because any kind of ovarian stimulation is regarded as needing a break between cycles. I can understand this to a point, but it still confuses me a bit. I do understand that you don't want to muck too much with your body's natural processes. But on the other hand, is it not reasonable to believe that there's an enormous difference between trying to stimulate ovaries to produce one egg and trying to stimulate ovaries to produce 20 eggs. So while I could see taking a month or two off after every two or three IUI cycles, I find it odd that there would need to be a blanket policy of taking 2-3 months off after EVERY IUI cycle. I would think one would want to look at that on a case by case basis. Probably none of my readers know that I'm a dual citizen of the US and UK and it is my goal to move to the UK eventually, but the timing has never been right. We can't move out of the State we live in, much less the country given the status of our foster son at this point. And beyond that, I'm not certain I would want to move while in the middle of all this fertility stuff, particularly since protocols between the US and UK seem to differ widely. I don't think one protocol is better than the other, but moving to something completely different seems overwhelming, at best. Ah well, I hope it will happen eventually.

UPDATE: Shit! (pardon my language) Not so much with feeling better now that my levels are back. E2: 67.5, LH: 2.5. This means my E2 levels have dropped. In fact, I snuck a look at my record after my monitoring appointment (they left it up on the computer monitor, so I couldn't resist a peak) and my E2: level had actually be 71.8 on Wednesday, not 71.5 as it was on Friday. So it's dropped twice in a row now. DRAT! Why in heaven's name is my body doing this? This is utterly ridiculous. Anywho, increase dosage to 91 IUs tonight and tomorrow night and return on Tuesday. Joy of freaking Joys.END OF UPDATE

Craptastic!

Let's Review!

Me: 31 years old.
Diagnosis & History: Anovulation due to PCOS; Four (+) year history of infertility. 5 IUIs. 1 pregancy, resulting in 1 miscarriage at 12 weeks. No male factor.
Usual response to Gonadotropins: Super-responder. No problems whatsoever. Go me.
This cycle and last? SERIOUSLY MESSED UP.

Okay, so here's the deal. If you don't remember, last cycle, I had a little plateau problem... my E2 level went up, went back down, went up a little bit, and hung out for a couple days without doing anything interesting prior to IUI. Follicles were all wonky (splitting, disappearing, whatever). It kind of freaked me out a little bit, but it had to be a fluke, right? Yeah...No.

And now we find ourselves caught up to date for everything prior to this cycle. Now just to refresh your memory....

CD8 (Wednesday)
Right Ovary: 9.6 & 10.2. Another 10 follicles smaller than that
Left Ovary (hereafter referred to as the useless ovary: a bunch of small, meaningless, boring, uninteresting ones.
Lining: 9.2
E2: 71.5
LH: Unknown (they didn't tell me)

CD 10 (Today)
Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Useless Ovary: 7.0, 7.1, 9.0 and 6 smaller ones
Lining: 9.6
E2: 71.5
LH: 1.85

Follicles are expected to grow at a rate of about 1-2 mm per day (I'm nearly always on the low end of the growth chart... averaging a little over 1mm per day... most normal humans are closer to 2mm per day). My biggest follicle on Wednesday was 10.2, so they would have hoped for it to be 12-14 (preferably closer to 14) today. Instead, it was 11.9. Not quite 1mm per day. And did you notice that lovely E2 level? I didn't either. I only see the craptastic one. That is, the craptastic 71.5 that has not changed at all in the two days since the last level was checked. So again, I'm facing a plateau which might possibly mean this is all useless.

Now, the truth is, I never ever put much faith in any individual cycle. I have complete faith that eventually something will work, but I never believe any individual cycle will work. However, I'm not normally so ridiculously negative as to believe any given cycle is a waste of time. I'm beginning to feel that way now.

And by the way, should I be worried that my right ovary (hereafter lovingly referred to as the "Not-As-Bad-As-The-Left Ovary", or NABATLO for short) is always the producer? Is my Useless Ovary really and truly useless? Is it just there for looks? Did God just want me to have a matched set, even if they don't work? Or is it purely coincidental? I get that none of you actually know the real answer to that question, but I'm asking anyway, even if I'm not sure what kind of answers I'm hoping for.

BLEH.

Ruh-Ro!

This morning's monitoring appointment was a little less happy than it could have been. I've got too many follicles trying to peak out all at once. Not so fabulous. I owned up to the fact that I'd accidentally (again) increased my dosage by 8 IUs, but also noted that I'd accidentally done the same thing last month. The doctor didn't think that the 8 IUs were really signficant, particularly in light of the fact that I didn't have the same response last month to the same dosage. I think my second cycle (could have been the third, I can't remember) I had a similar response (super-perky ovaries, that is) with only 33 IUs but I still only ended up with 1 mature follicle at trigger time, so I'm not too worried. But look take a look for yourself:

Right Ovary: 8.5, 8.9, 9.2, 10.3, 11.9 (and about 7 smaller ones)
Left Ovary: 7.0, 7.1, 9.0
Lining: 9.6

Maybe I'll have quintuplets! JUST KIDDING! Seriously!

Even my beloved Margaret (sonographer extraordinaire) asked if I could please tell my ovaries to tone it down. I told her it was all her fault since she's the one who dubbed my ovaries "perky" oh so long ago. She has promised never to refer to my ovaries as perky again. Until, you know, the next time she does. At any rate, I'll be going back on Sunday. No dosage change unless my bloodwork comes back all wonky. It's all good. I mean, after all, why would I want to be anywhere but the clinic at 7am on a Sunday morning?

While I'm disappointed at my ovaries' blatant disregard for my wishes, my biggest disappointment wasn't seeing them rebel most annoyingly... Rather, it was that I was put into Room 1 for my ultrasound (I'm not actually serious). The problem with Room 1 is that it doesn't have a mobile hanging from the ceiling. All the other rooms do. Dr. S. (hereafter known as Dr. Can't-Follow-Through-With-Mobile-Hanging) once told me that he personally hung the mobiles in the exam rooms and I was quite impressed. I mean, really, what else is a girl supposed to look at during an ultrasound? But Room 1 has no mobile, so every time I'm there I harass the staff about the fact that I'm stuck in the boring room. Margaret offered up a Garfield poster, but refused to accept my suggestion of putting comics on the ceiling above the table. "In a fertility clinic? Nah!" Why not? There are bound to be some funny infertility comics, right? Now I must scour the internet for funny infertility comics and I'm asking you, my faithful readers, to help me. I have made it my mission to bring a collection of infertility comics to Margaret before this cycle is done for. So give it your best shot!

Edited to Add: Okay, sure, I COULD be looking at my ovaries during the ultrasound, but really, they're kinda boring after a while. Plus, what about the 2 IUIs I've had in that room? Laying there bored for five minutes afterward with nothing to do but count the ceiling tiles isn't so fun. Fortunately, the other 3 IUIs I've had were in rooms with mobiles! End of Edit

Anywhozit, Dr. Can't-Follow-Through-With-Mobile-Hanging (Dr. CFTWMH) wasn't the doctor covering monitoring today, so I didn't get to harass him directly. Instead, Dr. C. was covering monitoring. He's an extremely good doctor and very well-respected in the Washington Area (named one of Washington's Top Doctors), but he makes me edgy. He's very nice and personable, so that isn't it. It's that I tend to see him when things aren't going QUITE as expected in my cycle and he gets this worried look on his face every time. I mean, he didn't freak out or anything, but he sort of gave this worried sigh-like sound and that worried look flashed across his face briefly. Maybe I'm reading too much into it.

In other news, the Follistim is really getting to me this cycle. I'm moodier than I've ever been on Follistim (though maybe it's just me and I can't blame the drug) and I'm having a tremendous amount of nausea. If I didn't know better, I'd be wondering if I was pregnant. But I do know better, and I'm definitely not pregnant. Last cycle I didn't have nearly as much moodiness, nor nearly as much nausea. But last cycle the Follistim REALLY STUNG every time I used it, and this time I've barely felt the injections, so I guess I should count my blessings.

That's all for now. I'll keep you posted if anything changes (since I know you're all just on the edge of your seats waiting to hear my E2 and LH levels!).

Perky!

I am so smart. Seriously, I don't need no stinking doctors! I can practically predict my treatment plan for just about every cycle at this point. Right. So stay on the same dosage and come back on Saturday, which means Friday, since I can't go in on Saturday (I'm Jewish, if some of the newer readers here didn't realize that). So I'll go back in on Friday. If things work the same way as last cycle, I'll be back there again on Sunday as well, but it could be Monday. Maybe I should start a betting pool. :-D

By the way, I again screwed up and have been taking 75 IUs instead of 66, but I finally figured out why... I was reading the numbers on the pen incorrectly. I've decided that it hasn't messed anything up so severely and I'm not going to disclose my mistake to my doctor, I'm just going to keep at it. 8 IUs really doesn't make a huge difference at this point, as my nurse once pointed out to me, so it shouldn't be a big deal. At any rate, I didn't realize the mistake (or the reason) until tonight, so it's a bit late to rectify anyway. *shrug*

CD 8

I've never been good at coming up with snappy or witty titles for my posts. So there you have it. Today is CD 8, which meant a return visit to Shady Hell. I didn't get a doctor today, just the sonographer. I find this far preferable to the times that I get a doctor and no sonographer, because frankly... Margaret's better at this than they are. She's been wanding patients for 17 years. Seriously!

Anywhozit, nothing terribly exciting today, except Dracula managed to draw blood with only one stick. Hooray for her! Still early, so nothing terribly interesting. Two follicles on the right ovary measuring 9.6 and 10.2. Another 10 or 12 follicles smaller than that. 14 on the left ovary, all under 10mm. Lining was 9.6, so at least I know there's some estrogen floating around somewhere.

They'll call me later today after they review my bloodwork to let me know when to schedule my next appointment (and whether my dosage needs to change). I'm anticipating a Friday appointment, but who knows. I suspect Saturday would be preferable, which is why I'm betting on Friday, but I suppose it could be Sunday. Either way, I've made an appointment for Friday morning just in case. Gotta snag that 6:45am slot!

the beta that wasn't

Today was supposed to be Beta Day. My google calendar agenda (emailed to me every morning at 5am) even told me so because I'd forgotten to change it. Anyway, CD3 marks a new beginning, of course (vs. CD1 which marks another end). Every new cycle has the potential to work, even though I know it won't. Still, in the interest of new beginnings, my new google spreadsheet is up and running for IUI #6 (it's really just a new tab in the same old spreadsheet).

I got to see my beloved Margaret, sonographer extraordinaire, this morning. "Gosh it's been a while," she said. Yep, a whole two weeks. But you know, if I'd made it all the way to beta day, it would have been even longer before I got to see Margaret again, so at least I have that going for me, right? This morning she declared that not only are my ovaries "perky" as per usual (Margaret is the person who inadvertently named my blog) but that I am the poster child for PCOS. Er, I'm not sure that's something to be proud of. Apparently in the two weeks I was twiddling my thumbs at home intead of having thrice-weekly dates with an ultrasound wand, I missed the Shady Hell Holiday Party. Margaret, apparently, wore a stunning black pants suit and looked very skinny (she IS very skinny, so that isn't a shock). I'm curious what Dr. T. wore, but I didn't ask.

I realized, when I noticed that the same doctor I had for Day 3 monitoring last cycle was the doctor doing monitoring today for my Day 3 appointment, that I had exactly a 28 day cycle. No wonder the time seemed to fly right by. My last period started December 27th, this one started January 24th. How's that for perfect timing? I've never had a cycle last exactly 28 days. EVER.

The good news is that if I have a similar cycle to IUI #5, it won't interfere with my plans to be in Florida visiting my father in February (18th-20th). I'll be at the tail end of the 2ww. I thought that could be a problem, because if my period came earlier, I'd miss my CD3 monitoring appointment, but NO! I forgot! This is my very last IUI cycle! So I'll just make sure to fill my script for BCPs before I leave for Florida so that I can start taking them in preparation for IVF#1 if I need to. I mean, not that I'll need them. Because, after all, the 6th time's a charm, right? Or, um, not?

Anyway, this is it, folks! Last IUI. The very last one. Soon it's on to the fun of, um, injections? Oh wait, I've already done that. Dates with an ultrasound wand? Nope, been there, done that one, too. Um. Oh! right! Egg Retrieval! Haven't done that one before, and boy am I looking forward to that one... oh, wait. No I'm not! Well, at least I don't have to keep taking my temperature every morning. There was no greater torture, in my opinion, than taking basal temperatures every day.

By the way, you'd think having two periods so close together (yes, 28 days is a short cycle for me these days), I'd be in less pain ... but HOLY COW THIS FREAKING HURTS! I think I almost prefer when my period was a twice a year event. Except in as much as it interferes with baby-making.

Well, let the games begin! (hah! I had to create a new label for this post. IUI #6. Sheesh. You'd think I'd have learned my lesson by now, wouldn't you?)