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.

road signs?

part of my pushing for natural cycles right now has been my treatment at the RE clinic, and feeling like nothing but a cog in their wheel. my infertility should be simply situational, but they see things in numbers, so that "40" stamped across my forehead means i'm in the hopeless range.

of course i'd searched for other fertility clinics, but being a smaller state, nothing came up but the one clinic i was going to, linked to notorious hospital, part of huge massive soul-eating medical group. there wouldn't be other options, unless i opted to travel out of state, which i was kind of toying with. i know the RE i've seen is excellent, and very much a realist, but she feels very much to be lacking a soul. the whole place does. this is a painful and frustrating journey -- you'd expect those in it day to day to have compassion and humanity. it must just get dragged out of them with all they see...

giving my musings this week about how i want a road sign telling me which way to go, tonight's experience has me going hmmm.... there was a huge new billboard up on the highway, saying something along the lines of "need help having a baby? bear left" with a big arrow. it was pointing towards huge massive soul-eating medical groups shiny hospitals and my clinic, so i figured it was their ad. but it wasn't their signature colors, so i searched for a name.

oh, hello huge fertility specialist from neighboring state. i had no idea you now had a office around the corner from my REs group. i'm up on their website now and fining it a wealth of information, unlike my clinic which is simply, read our name! we are linked with hospital! this is all you need to know!

looking for some metaphorical road sign and i find a literal one. i may have a back-up plan for my back-up plan.