ha ha, faked you out!

That would be my left ovary mocking me in the subject line. After 2 days of tightness, fullness and pain over my left ovary, I got up this morning (conveniently forgetting to take my temp) and it was ... gone. I headed off to my early morning sono and bloodwork with my emotions around my toenails.

Uber-cheerful Wandi (what I have dubbed the sonogram tech) tried to happily talk me down from my cliff ,asking if the sperm was in, and I ducked behind the curtain to jump into a sheet. She then talked to me through the reading, saying I had a big 20mm and another 14mm follie on my right ovary. Left ovary came into view ... with nothing. No follies, no fluid, no cysts.

Um, guys, what was all that commotion down there about?

And bugger, 2 follicles, only one of which useful. (but as Wandi reminded me with a big smile, but it only takes one!! ::grumble -- I don't want to hear it right now) I headed home to sulk and wait for the call from the RN on my lab results. I could tell with a 20mm one sitting there I was going to trigger tonight.

And so I did. My estrodiol was in the high 300s, and my LH was already at 18. Surging on Day 10. Great. Nice way to bake a healthy egg there, body. < / sarcasm > So I'll be heading over to the back-up location of the urology office that has the lab with my sperm tomorrow, and one of their RNs will do the IUI at 9:00am.

I'm not thrilled, with the IUI so soon after the trigger. Then again, I could be popping that follie at anytime, so who knows.

I'm going to get back to surfing for potential donor embryos to console myself.

crap

As I was sitting on a plane today, waiting to take off to Charleston for the weekend, my phone rang. I had a feeling when the number popped up as "blocked" that is was the new Dr.'s office.

In fact it was the new Dr. herself.

She didn't sound as enthusiastic with my numbers as I had been. That's because that missing AMH number came in.

0.22

I have no eggs left. The low FSH may indicate that they can get me to respond to meds, but the AMH means they will only get at most, 1 or 2. The chances of those 1 or 2 being healthy eggs? Really, really low.

I knew this was hanging out there. But after several hours, it is finally starting to sink in. adjectives like "barren" keep popping into my head out of nowhere.

From the get go, this was never about a biological child for me. But somehow getting diverted onto the TTC path has made me think more and more about the possibility of a biological child and how amazing that would be. We are a cute family with some really strong genes (my siblings and I and all my nieces and nephews look *exactly* alike). Picturing that has started to play in my mind.

I think it has also been playing in my mind to think of that with the added "as if" I had managed to get married. That happy little family unit, the great combination of our genes. My way of tormenting myself.

Now I'm thinking what that would all be in the context of the truth of my physicality. Barren. Infertile. How that can have additional impact when you are part of a couple. I think of what a failure I would be. Gosh, maybe it was better things worked out the way they did and The One That Got Away got someone who was fertile (even in her 40s). One more dig to that gaping hole in my heart.

Instead I have to fight this and start thinking donor embryos. Start doing research. Start finding a donor. Focus on the positive and what can be, and not what is not and never will be, right?

Right.

Still, I think copious amounts of wine and some tears are on the to do list this weekend.

now for the rest of the story

[originally saved as a draft under the title "my gut says ... this feels right"]

Wow, didn't realize it had been so long since I posted. The new schedule of juggling work and school has me busier and more sleep deprived than I've been in that last two years of the From Hell work project, but I am so much happier. At least when I'm in lab/class or studying. Work I have a hard time giving a fig about. Except when I remind myself that a lack of income is looming fast on the horizon.

Friday (okay, now last Friday) I had my appointment with the new RE, Dr. W. I like her. The office was quiet, low key. but very friendly, and not at all the rushed, you are just a mouse in the lab feeling that I had from the other REs office. I was an actual human being here. It could be because this is a satellite office for a big city clinic with lots of smaller offices, and only one doctor on staff here.

Or it could just be because they are awesome and have a different approach to it all.

First thing was it was the doctor who came to the waiting area (right on time) and called me back with a huge smile on her face. She is cheerful, bright and enthusiastic. And realistic. She also gave me the usual, "You are here on your own? Where are the men? Look at you, you are beautiful, professional, why no partner?" If you could figure that one out as well as my fertility....

We sat in her office and reviewed my history and medical file, and finally got to those pesky numbers. Mind, they only have the CD3 testing that had been run last March (09) as part of my clomid challenge. I was not about to offer up, "Oh, hey, my midwife ran CD3 tests last month too, and just to let you know, my FSH was up to nearly 40 now!"

And this is where the doctor was realistic: my numbers suck. They are basically saying that someone who should not be facing diminished ovarian reserve yet is. It's a fact. But where she differed from my prior RE is she mentioned donor eggs or donor embryos with enthusiasm, and asked very gently, "How important to you is it that this be genetic child of yours?" I know my answer, but the power of the emotion still caught me off guard, so I was more than a bit choked up as I answered. I've been on this road a long time. Sometime in college I decided "I'm adopting a baby" and having a husband never entered my mind as part of that picture. I've fought the adoption fight for close to four years, and came out feeling beat up and worthless, and basically like there was no hope as a single woman. I know, it does happen, but it is few and far between. Being turned away from agencies, nearly scammed by others, all the rest I won't even get into right now. I'll go back if I have to, but I want to give the chance to carry and birth a child one hell of a fight first.

When my prior RE had given me the "It's hopeless with your own eggs" speech, she rambled right into, "You'd have to consider donor eggs, and that's just so expensive, you really don't want to go down that road when in the end it wouldn't end up being your child."

Yeah, she said that. SHE. A woman. In the reproductive field. I think that is pretty much when my heart said "Bitch! I'm done with you!"

Is donor egg/donor embryo easy or inexpensive? Hell, no. But I'm sorry, when you take a cell or a small handful of cells and nestle it into your womb and feed and nourish and grow those cells through the miracle of it all with every bit of life force from you, how can you dare say it's not your child? How can you say to a child that you adopt, and look at the first time and know instantly that this is the child that has been waiting for you and meant to be and give that first hug that forms the start of that bond and say it's not your child? Anyway, I don't want to get sidetracked with this, but it really struck me the difference in how the two female doctors approached this.

So I said I was certainly open to donor eggs/donor embryo provided we are not talking about a $40K egg. But I wanted to give my body one last shot. One good kick in the pants to see if there was a good egg that could be shaken out. The RE smiled and said, "Good. We're going to get you your baby." And that was a phrase she said a couple of times. In her words, it takes three things for a pregnancy: a womb, sperm, and an egg; but people often mistake that a womb is just 1/3 of the equation -- it is much more.

In reading through the land of IF in the last year plus, you find there are two types of REs -- those who look at FSH, see one high number and say, "Nope, that is what your body is saying, and it's over" and those who read FSH month to month, and look for a low FSH month to try an IUI or IVF. Happily, new RE is in the latter camp, believing fully that FSH varies from month to month, and that doctors and acupuncturists can lower it and get a good egg. She agreed that my scarred and stunted right ovary may very well be affecting the FSH number since all others numbers looked good. But she also cautioned that endometriosis is very strongly connected to DOR. Research suggests that inflammation in the abdomen and the stimulation of the body's immune defense to that probably has a lot to do with destroying the primordial ovarian reserve.

So the protocol we decided on was to see if my body would respond to FSH suppression with estrogen (Estrace). This would help my pituitary relax since it was thinking the ovaries were busy doing their job, help to down-regulate my FSH receptors (which are most likely shot and exhausted after be yelled at so loudly month to month), and it would also give my follies a nice vacation to sit around in a pool of happy estrogen, and fat and strong. Sound like a win to me! So two weeks of Estrace, stop, I'd get my period and then we would do CD3 testing and go from there. If it could be lowered to 15 or under, IUI was possible. If it got to 12 or below, oh, we're talking IVF.

I left feeling good, but also realistic. I really don't think estrogen is necessarily going to do anything. After all, haven't I had a history of estrogen dominance? I tried to not let my logical brain take over, and started the Estrace on Saturday. It was about then, too, that I just seemed to let out one last held breath and said "whatever". It is what it is, I can't control it and change it. But I can move on to contingency plans and just not be so wound up in it all.

Which means I felt really good this week. Well, at least until class on Wednesday and the surprise period explosion after only 4 days of Estrace. (is it really a surprise if your cycle was 30 days long? Yeah, I didn't think so...)

~.~.~.~

And so we come to today and CD3 testing. I had/have a migraine to beat the band today, but stumbled out to the REs office for blood work and a scan. Nurse H who was driving the dildo cam today was excessively cheerful for 7:45am, but I'll take it. I didn't get to see the screen, so was a wreck over what my terrible antral count would be. Until she reminded me that I was on a suppression cycle, and they weren't expecting to see much. As expect, old Righty is a dud, still tiny, and absolutely void of follies. But Leftie apparently had 4 nice ones sitting out on pool floats, soaking up the rays. Nurse H chirped that this was an excellent reading for a FSH suppression cycle and sent me off with a huge smile.

I managed to keep from barfing at work (migraine) until noon and then packed it in. As I got home, my cell rang, and Nurse P was calling with my blood work. The AMH wasn't back yet, but she had the rest. My jaw hit the floor:

TSH - 2.87

Prolactin - 11.9

LH - 5.6

E2 - 36.7

FSH - ....... 14.2

Say what?!? I made her repeat the FSH a couple of times. She said she was quite pleased with the response and though the doctor is on vacation and I have to schedule a follow up with her to confirm anything as far as how we are proceeding, she said hopping back on the Estrace for a couple weeks would not be a bad idea.

So I should really go and call the office to schedule that follow up, and take a nap to chase of this migraine, but good golly, it looks like we may be on to something here!

pulling myself back together

this past week has been hard, to put it mildly. in a way i was lucky to have the distraction of classes started and being caught in the whirlwind of 5 hours a day of a summer accelerated organic chemistry lab and lecture to keep my mind occupied. but once i was at work in the afternoons and bored with the document monkey work (which takes about 0.35 seconds), i would spiral down into sudden tears, fits of rage, and searching the internet.

luckily for my sanity, firewall problems at work have meant nearly every site has not been blocked as of mid-week. instead i'm sending myself emails reminders at home for things to look up and investigate.

first order of business was making an appointment with the other RE clinic in town. i have a friend (also single) who has been seeing that doctor and has great things to say about the doctor and practice. I had a follow up with the mid-wife on CD3 for labs, and mentioned the potential of seeing the new Dr. W, and she also added her high recommendation, noting that she had worked with Dr. W and Dr. W was "in the trenches" as a normal OBGYN.

the RE clinic (which is huge, and actually headquartered in a neighboring state) called me back promptly Thursday morning after my Wednesday evening internet appointment request. they are sharp and on the ball, and not at all phased with working with a single woman. in fact that were well versed in the area, knew the issues with my health insurance (they refuse to cover fertility treatments if you are single) and it was explained to me how they would work with that limitation to be able to circumvent restrictions and keep my costs down as much as possible. So i have an appointment of 6/18. fingers are crossed.

i think i mentioned that after my one and only FSH test back in March of 2009, i had kept an eye on those level with the "at home" urine tests. they show positive for a number of 25 or higher. once i started acupuncture, the test line was becoming fainter and fainter, and a couple months ago, there was no second line at all. hurrah, or so it seemed, i had beaten the high FSH.

maybe it was just this past cycle, or maybe those tests are crap, because the CD3 bloodwork we did on this cycle came back with an FSH of 37. on top of it, my estrogen was low. basically, my pituitary is screaming like a drill sergeant and the ovaries are doing nothing. i'm back to remembering my original RE's question of whether i was missing part of an ovary.

certainly these numbers are looking like i'm missing an ovary, or part of one. we know the right one is pretty much kaput, but how can i be testing over the course of the cycle with estrogen dominance and yet on day 3 be completely deficient. add into my tendency to surge/ovulate early (CD11 surge is the norm for me) and all signs point to crappy, crappy eggs. i guess this will be a mystery for the new RE.

my plan at this point is to push for two aggressive medicated IUI cycles. I keep hearing good things about Femara and its ability to produce high quality eggs. if that doesn't work, i'll do one round of IVF -- possibly low-stim if i again am showing signs of being a "poor responder". i think that is probably the limit of what my body can handle as far as influx of meds. the step beyond that will be looking into frozen embryo donation.

i started a 3 week purification program today (from Standard Process this time). not too bad, but i definitely feel like crap today. i think there is going to be a lot of lounging around and hot baths to pull out the toxins this weekend.

for as much as this post is spilling out of me in a very business and cut and dry fashion, the anger and frustration is still there. i'm just having to shove it to the side to get on with the mission of making this need become a reality. it also hit me that if i am going to go through my doula certification, i need to build up some stronger emotional barriers. it's weird enough to be doing the readings and get defensive and hurt at the mention of the partner; seeing things play out in reality is going to be even harder.

yep. i've pulled up my big girl panties and i'm ready to fight for this once again. i can't keep bemoaning the card i've been dealt when all it does is pull me down.

wow, look at that, a whole month and then some went missing up here. i've been a bit holed up in my head of late, struggling with finding time and energy to write. things have been both a whirlwind, and yet the same old boring things. work has mostly taken all my time, and i've been doing some soul-searching on that front and am contemplating a career change.

but that's not why you're breezing by to see if i'm still here.

let's see, long story wrap up from when we last left our intrepid heroine:

• i checked in with my gyn to discuss if endo was hiding and if another surgery should be undertaken. his conclusion is that no, no signs on sonograms or symptoms, and that the risk of surgery for me outweighed any possible benefit.
• i sent off saliva test for my full December cycle to get a full hormone analysis. came back with classic estrogen dominance, to the point that i should not be ovulating as regularly and nicely as i do. but it explains why i was not able to hold onto the egg that fertilized in December -- my progesterone levels are good, but the estrogen is still higher.
• did testing for my adrenals which came back showing major burn-out. classic signs of long term high stress. shocking. absolutely shocking. < /sarcasm > am now on some herbs for adrenal support. my reaction (or rather, my lack there of) to high stress moments now is just amazing.
• did a full herbal cleanse from Blessed Herbs. wow. that was amazing, and felt incredible. i feel like i've completely reset my body, and last month's BBT chart was one of the best i've had this past year.
• was supposed to try another IUI this cycle, but the bank didn't have any IUI sampled ready until *this* month for both my #1 and #2 choices. argh!
• not trying this month may have worked out for the best. at the very end of my cleanse and the start of this cycle, i got hit with a nasty cold. i'm still rather miffed by that -- i haven't had a cold in probably 15 years. i get the flu, i have allergies, but i simply don't get colds.
• i broke down and bought the circle+bloom meditation series. this is another wow. absolutely love it. have never had such a powerful and effective guided meditation experience. the relaxation i'm able to achieve in my body is just amazing.
• started this cycle trying an herbal protocol for the estrogen dominance. unfortunately, i don't think it agreed with my body. i got tossed into a chronic daily migraine cycle, anxiety, depression, mood swings, and just feeling sick and unhappy. i decided to listen to my gut this week and stopped it. 48 hours later, and i am beginning to feel like myself again.

so, that's about where we are. i went ahead and purchased 4 vials of #1 donor in IUI, so i won't get caught not being able to try again. CD20 right now, so should probably drop the midwives a note to let them know i'll be back in circulation next month.

now, to see if i can accomplish the new mission of keeping this spot actually updated in a timely manner...

crap

well, post an entry, get a phone call.

CMV is negative, so that's fine and know i know what i'm looking for in swimmers.

on the not so good side, my clomid challenge results "were not in the normal range." Day 3 FSH was 10+. Day 10 FSH is 10+.

::insert expletive::

this is going to be a fun and stressful follow-up visit i schedule.

it's the little things that make you stop and say...

... WTF am i thinking?

well, no, not really. but today is one of those hectic days of family-making stuff scrambled in with the usual chaos of work. and much of the stuff if of the deep though provoking kind.

much like my contemplation of caffeine this weekend. i have, successfully, broken the diet coke with lunch habit that crept back in a month or so ago. i hate the stuff, but i love the brain power it gives me. but what is worrying me more is the new cup o' coffee-coffee-coffee at 6 am. i was thinking last week that i really need to not continue to use the yummy soy creamer i discovered that made coffee drinkable since soy is not a friend of conception. trust me to avoid thinking of the much larger (as in a whole mug full larger) fact that i'm going to have to give up this form of caffeine. just because it happens when i am fresh out of the shower and barely conscious as i check email does not mean it is a free pass.

then i start thinking of what this means -- falling asleep while driving to work. huh. caffeine that is bad for me, or, dying in a messy wreck on I-95. i wonder which i can talk the doctor in to.

when you start thinking of all that crazy things that were considered perfectly normal and "safe" around the time i was born, a cup of caffeine a day does not seem that big a deal. wisdom of the late 60s and 70s suggested women gain no more than 5 lbs when pregnant. alcohol while pregnant wasn't that big a worry, nor was smoking. heck, my first 4 months of formation in the womb were accompanied with a steady dose of birth control pills since mom was in such denial she could actually be pregnant. and cars were on the highway without seat belts, never mind child restraints. for goodness sake, you went home from the hospital, held in the arms of your mother sitting in the front seat of a car with no seat belts! surely, when viewed against this, one cup of coffee? please?

but the other bigger thoughts of the day are courtesy of:

Day 10 bloodwork. will need to see if they call me back or if i give up and call to schedule followup appointment with RE. i'm still in happy denial that anything will be wrong with my hormone levels. it keeps away the massive panic i felt when thinking about "what if..."

Estate Planning. the SMC yahoo group recently brought home the importance of planning ahead and having everything lined up when a SMC recently died of pregnancy complications this past December. her son did survive, and thankfully, she was one of those planner who had everything, including life insurance, in place for her child. seeing as life insurance will not be written for a woman who is pregnant, that is my first piece to get into place.

i also had a meeting today with the attorney (K.) who handles my will. i did already have one in place because of some family estate issues, but that was drafted 12 years ago and needed to be updated. also, i knew K. would be able to handle all my questions and the best way to arrange everything now for the little wild child before daddy sperm is even chosen. sure enough, we have a plan, and now it is up to me to do the hard part of thinking and talking with some special people in my life.

roles needed to fill:

1. Guardian
2. Trustee of Estate (a guardian will most likely also be a co-trustee, but a more money manager is best in this role as well)
3. Trustee for Power of Attorney
4. Trustee for Medical decisions.

oh, and i really should figure out my own thoughts/feelings/wishes on funeral and burial for myself. cheerful stuff, and certainly something i need to explore and settle my own thoughts on. (note to self: there will be no archaeological digs in cemeteries once you bite it so after-death fame of your skeleton is a moot point; go for the modern version of the Viking funeral pyre.)

i also need to reconsider life insurance amount i'm shopping for. 10 times my annual salary is the normal starting point, but that is also taking into consideration there is another parent there to supplement that income. not the case in this situation also, my salary in years past has climbed steadily. granted, not looking for that this year, but still, where will i be 7 to 10 years into a term policy? so i'm thinking i'm going to have to bump that amount up a bit higher and see how loudly my budget yells.

Required Counseling with Social Services. tonight i get to meet with the counseling that is required for anyone using donor sperm or eggs. happily, my thoughts on this have been knocking around for 15 year. my biggest problem i've ever worried about was omg, what will people think of me, single and knocked up? and what will they think when i tell them i've been knocked up by a test tube? because yes, it's all about me. explaining to a child the vast amount of love and desire that brought them into being through this still somewhat unconventional route, not so scary.

of course the doctor hinted that this session was more to decide and discuss what if anything the child should be told.

::blink::

okay, but i tend to be of the belief that there should never be a moment in their life that the child cannot remember knowing how they came to be. maybe it's different for a couple facing infertility. for me, i'm intent on building rock-solid confidence in my child, and first and foremost in that is comfort and understanding of how they came to be. i just have too much love for them already to let a little something like no partner get in my way of bringing them into being.