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!

::headdesk::

I have an entry on this past Friday's new RE visit half drafted (damn you work for blocking blogger and keeping me from running my personal life on work hours!) but small little blip on the radar for today.

Hello, surprise CD1!! While on campus. And waiting for a CD3 testing (blood and antral follicle count) for my cycle start after two weeks of estrogen.

Only problem being I'm only been on the estrogen 4 days, so do we test?

Cue me trying to get hold of the doctors office (note to self, please put office number in phone ASAP) as I'm running back to my car for "supplies" between lab and class. In the miserable heat and humidity that we are having. Ick. Very sweaty now.

All this will make much more sense once I get that other entry finished. And this will be a good kick in my butt to go ahead and get it finished!

i finally ordered a pee cup

the old mug that has been pressed into to pee-service for me has been dropped on the bathroom floor for the last time. there is only so much i can do with the Gorilla Glue these days. so i finally ordered this cute, specially designated pee cup as a treat for myself.

13dpo today and a BFN. i'll test again tomorrow and Tuesday morning just in case before i stop the prometirum. i remain strangely detached from it all. i think i'm trying very hard to protect myself. after seeing all kinds of signs and promise these past 2 weeks, i knew it was going to be hard.

my mom called this morning to tell me that the Today Show was running a piece on choice moms, and i put down my book and quickly tumbled out of bed to catch it. i thought it was a wonderfully positive piece (finally!). my mom commented tonight that my dad had watched it with interest, and though he always has been supportive of me, he now really "gets it" as to why i'm making this choice, and hat maybe i do know what i'm getting myself into.

things that make you go hmmm....

great, just gave myself an earworm for the rest of the day with that post title.

this cycle seems to be off to a good start, except for a few hiccups at the moment. most interesting was that my fertility monitor started the month (CD7) with giving me a "high" fertility reading. wow, have never gotten that prior to ovulation before! looking at the test strips (event though they say not to) it was clear it was because my estrogen was high.

of course the monitor did completely miss my LH surge yesterday. this is why i double test with OPKs, folks. had a nice strong surge yesterday at noon that held steady until 10 pm. by this morning it passed, so the clueless fertility monitor just kept reading high, even though estrogen was starting to lighten up.

the only question i have right now is whether i actually ovulated last night. temp jumped from 97.3. to 97.7 this morning, which is below my "usual" coverline, but last month, i wondered if my coverline hadn't dropped a couple points thanks to the winter temps. also, a pretty pathetic ovulation jump for me, and given the last couple cycles as far as LH surge and timing to O, it was a wee bit quick. way to make me worry madly about timing the IUI next month, silly body.

cervix is still high and soft this morning, with lovely EWCM. day three of amazing EWCM. i'm so proud of my old cervix finally getting into the grove of things here.

i suppose tomorrow will tell me what happened, and i'll just have to figure out things from there for next month. just makes me crazy nuts if i'm switching to a single IUI for the cycle. though trust me, my checkbook loves the idea.

::sigh::

BFN.

i knew it was coming since i hadn't had a secondary temp spike, but what is most likely allergies had me thinking i'd won the lottery with being utterly knackered, food tasting off, constant upset stomach, and low grade headache. of course at 5:15 am yesterday, you probably all heard my frustrated yell of "F&*^!!" as my temp dropped from it's 5 day streak of 98.4 to 98.2, despite me bundling myself in multiple layers before heading to bed.

so i'm a faced with a decision right now. the nurse who called yesterday told me to call back on CD1 to schedule my baseline scan for the next cycle. bwuh? i asked was this DC3 bloodwork or a sonogram. she said a sonogram since after medicated cycles they need to check for any cysts and see if you need to take a break. i explained that, hi, i'm single and thus uninsured for such things, and no, had not had one done previously. she seemed highly confused and read through my chart, but still insisted it was SOP to do a scan, but she'd put a note on my file, so when i called they could let me know if it was actually necessary.

of course part of me would love to have the scan done because i'd like to know just what shape my right ovary is in, and if half of it is missing (or it's just shriveled up like some forlorn raisin) as my RE said the bloodwork had her thinking.

my checkbook on the other hand is hiding in the corner whimpering at this point at the mere thought of one more fertility related bill to pay. doesn't help that i smacked it around earlier this morning with an OMG, i need more fertility help spending spree for FertileCM support, FertilityBlend and FertiliTea (because obviously the 6 million supplements and teas i'm already taking have not done anything for me).

i'm also toying with the idea of one last IUI at the clinic, and if that doesn't work, switching to ICI on my own. of course, that may be completely insane given my age and fertility workup. which is where a scan revealing antral follicle count and all the rest could really be enlightening and help decide if i would be throwing my money away on sperm or not. and then there is the question of doing the ICI unmedicated, or talking the RE into clomid while i do this.

because, hey, i do obviously respond and ovulate with the clomid. but then i went and read this article on our amazing ovaries and how they really work.

i followed it up with this article on how thinking too much and overanalyzing everything in this journey does not help. well, duh. i then made myself try and focus on actual work. for about a whole 15 minutes before staring into space and slowly sliding back to the internets.

anyway, i'd love to hear opinions of those who are, ahem, more mature and facing some challenges with conceiving, but managed to do it at home. is it worth saving the $850+ in clinic fees a month? am i looking at better or worse odds?

day 3 testing

my lunch today was heading over to the ART center at W&I and having about 16 vials of blood drawn for my cycle day 3 testing. i did decide to go ahead and have the genetic testing run for cystic fibrosis, just so i know my stats, and can be extra diligent from shopping for swimmers if i need be.

of course this means i'm 2 days away from starting the reported fun of mood swings and all hell breaking loose that is the Clomid challenge. oh joy!

next tuesday's lunch will also be back visiting the vampires, i mean nice ladies in the blood lab, but for fewer vials. i hope.