3 follicles

Good morning! I went in for my Day 11 ultrasound (yay!) and I have 3 follicles. One is a 25, one is a 17, and one is a 15, so it is possible that all 3 will go when I surge (29, 21, 19 in 2 days). So, good-goody, it looks like I will be triggering tonight with Ovidrel and insemination will be Thursday. Yippee!

As an aside, the dissertation is due for the final review/read through tomorrow morning. My summer class starts tomorrow night and I will teach it, defend the dissertation, pack, and paint the house for the next month until I go to Alaska. So, all in all, a chock full month. Fun!

Anyways, stay tuned.

No go

Well, that IUI was a no go. I am genuinely perplexed as to WHY I am having these weird things happen to me. You see, this time I had multiple symptoms of pregnancy (including the odd Montgomery's tubercles) but was not pregnant. I bled something awful. Sheets of blood, 1"x3" sheets, fell out as clots.

But nary a positive urine test. You see, if there had been any positive test, I could understand that I had been pregnant and experienced an early miscarriage. THAT I would understand. What I don't understand is why, all of a sudden, I am experiencing things I have never experienced before.

For instance, my usually light menstrual cycle of 1 day has now become heavy for 3 days. I have breast issues before my cycle begins (my breasts NEVER had issues before). I get hot -- huh? I'm the one freezing in 80 degrees. Basically it's like the doctor is saying these are PMS symptoms when I have never had symptoms before.

So I sit here, taking Femara, genuinely confused, and I am really going to talk with the RE nurse something fierce when I see her next week ... I need answers. I need to know why this is happening.

Zero Itching

I can't believe it, I have no itching yet on this cycle. As directed, I took one Femara on CD1, 2 on CD2, 3 on CD3, and 4 on CD4. I'll go in for my first U/S scan this Wednesday (CD12) but I'm hoping this new protocol yields lots of follicles and a quicker ovulation. I ordered my Ovidrel - it's being delivered Tuesday. I'll be on a campus visit Monday through Tuesday (arriving home Wednesday morning), at home Wednesday, and leave Thursday morning for another interview through Friday, so ...

Let's hope we have good follicles. Let's hope the big O decides to wait until Saturday morning, and let's hope all goes well quickly (since I will be leaving Sunday afternoon for another campus visit).

On other news, I LOVED my first campus (as predicted) and am just hoping this decision process is not difficult.

Looking on the bright side

At least I know my eggs can fertilize. I talked with the RE's nurse today and she answered all my pesky little questions. First, the breast tenderness and nipple issues were all due to progesterone a fertilized egg put out. (Yay!) Next, the cessation of the sensation was the egg passing on through my body without implanting. (Rats!) She expected AF today, so she was a little concerned by just the spotting ... as was I. Where was my cycle?

Well, here it is. Nice solid cramps on the right side of the body at 11:00 at night. OK, so Day 1 of the cycle is tomorrow. What was lost is now found. It's the good side of getting my cycle.

Well, they have changed my Femara protocol and this should be a very interesting month. If you think I used to itch bad ...

I will take 1 pill on CD 1, 2 pills on CD 2, 3 pills on CD 3, and 4 pills on CD 4. (I used to take 2 pills a day on CD 3-7.) Then I will go in on CD 12 or 13 (whichever works with my travel schedule) for my first scan. They decided this route since I ovulated at a much later time (CD 19 with trigger) than she liked. Maybe we can get a nice uterine lining and good size follicles and a body wanting to O by CD 14 or so. Yay! She also OK'd me to take my itch meds through ovulation and that no, they won't hurt the follicles. Perhaps, therefore, my itch won't be a bother while I am in job interviews.

She was a little perturbed she did not know I get hives from Femara. (I told the other nurse I did back in November.) There may be an office blessing-out about writing down what the patient cites as issues with the drug. They like my response to the drug, if I didn't turn into a welt-mobile. I was offered Clomid but I said no, that itching is far preferable to cysts, waiting out cycles, and the hellish mental effects of that drug. She was surprised (I guess she hates to itch), but she has no idea that I like mental and emotional stability as opposed to that hormonal haze. Plus, I have YEARS of allergies, so with YEARS of itching, welts, phantom swellings, and other responses, hey, what's one more itch? Better the known devil than the unknown, in my opinion.

So now I'm going to go pop a couple of Tylenol (the cramps are headed down the right leg) and crawl into bed for the long winter's nap. Tomorrow I must acquire some Femara again.

Do I start worrying today that CD 14 is when I will be in Ohio with no swimmers on a job interview? Nah, let's worry about that tomorrow ... I feel like Scarlet. Oh, right, Scarlet had Rhett in her life and said "Fiddle Dee Dee" when she got upset. No cursing for the lady. Such a shame. Cursing can be such a relieving experience ...

Playing the waiting game ...

It's the end of the two week wait (2WW). I tested and it was negative. Yesterday, I spotted. So it was either premenstrual spotting or implantation bleeding (and because I just had implantation, no hcg, which the test measures, has been made yet in enough quantity to show). SO ... I know they call the 2WW all kids of names, but it is this time, between symptoms of either/or and no menstrual cycle which is a killer. I've had weird "symptoms", which could be or could not be, for a week now. Nipples on full alert at all times since last Friday (we're talking a week of gasping as I take off my pajama top), aching breasts, and now this spotting ... the problem is that since I took Ovidrel, hey, it COULD be that! However, I tested with the nipply sensation, since I wanted to see if the Ovidrel hcg was still in my system and I got a negative, so it looks like my body gets rid of hcg quickly. No false positives to be had.

All right, I dub this time period the three day Hades, or 3DH. I have to wait 3 days for enough hcg to build to test positive or I will have a full cycle.

The good news is that my cycles only last a day or two. :) I know, millions of women would hate me if they knew. My cycles are LIGHT, SHORT, and have only about 4 hours of cramps and very few PMS symptoms (just tiredness the day before). And then I guess it'll be onto the itchy Femara again. I was really getting excited because I hadn't scratched my scalp to pieces in over a week ... no random itches, no flaming hives, it was heaven. Of course, I did have hives a lot this week, but they were weird hives. I got a swollen lip Sunday (hey, I drank lemonade so I was kind of asking for it). Another swollen lip Monday. And another swollen lip Tuesday (each day the swelling was in a different place and it was not bad enough to warrant a Benadryl). Then a swollen top eyelid Thursday night. Last night, on the other eye, that triangle at the center against the nose swelled. I had no idea that part could swell up like a balloon like that. :) I'm thinking there may have been lemon juice on the shrimp I peeled and ate, so then when I rubbed my eye driving, up it went. So, like I said, no flaming hives, but a lot of weird hives.

And that tells me my body is on full alert for imposters. I reacted for months on the Femara, reacted strongly to the sperm this time (all those cramps and then feeling poorly afterwards), and then I swelled close to each day for a week. I'm just sitting here wondering if I am one of those women who have that autoimmune response too much for implantation. How does one find out? Grrrr.... my worries will be over (but a whole host of others will come) if only during this 3DH I get a positive. THEN, I will know.

Of course, I would still worry about a miscarriage. The autoimmune factor is huge with me. And by me having two autoimmune diseases (Grave's and Hashimoto's), allergies to drugs and lemons, and a full alert hive attack brought on by Femara, I'm at awful risk of miscarriage provided I can even get there and the embryo isn't killed upon implantation. Oh the worries ... darned 3DH. Well, I have enough to keep occupied over these 3 days. :)

My TTC trials so far

Saying the word "trials" is just not realistic. I haven't had all that many. I met with the Reproductive Endocrinologist (heretoafter, RE) in August and discussed the process. Yes, I was 39, a troublesome age at which to get pregnant. However, he had hopes. I had my Day 3 blood draw and had an estradiol level of 6, which is "excellent." Then he scheduled me for the Clomiphene Citrate Challenge Test for my next cycle and I took the 5 days' worth of clomid pills religiously. (Funny story about 1 day, which will have to come another time.) I passed that test well. It tells them that I have ovarian reserves sufficient for this task. Without passing either test, I would not be able to TTC. Well, all was set for the next cycle ... all I had to do was call them on Day 1 and we would begin.

Day 1 didn't come. Finally, on like Day 8 or 9 of expecting Day 1 (AF), they called me in for an ultrasound. A cyst. Yes, a nasty little Clomid cyst which was simply preventing my cycle from beginning. Nasty little bugger. I was feeling all sorts of angry thoughts at that water-filled cell in my ovary. Well, a cycle on birth control pills eradicated the cyst and I was ready to try again. In the meantime we did the Hysterosalpingram (HSG) test, which revealed I had nice clear tubes and no pesky little problems that they could see.

So on Day 1 of my next cycle, I called the office, all excited to begin trying. Bad news - the RE would be missing, with his entire staff, from the office when I would ovulate 2 weeks hence, so I could not do the cycle. GGGGrrrrr!!!! Back on BCPs (kind of ironic going on birth control pills to get pregnant) for 2 more weeks and another AF.

Finally, AF arrives and I called in. We did a Day 3 blood test (3 months had elasped since the -first one) and I started on Femara, which is a breast cancer treatment drug used off label by REs for ovulation induction. Basically, it holds back estrogen production so my aging body can produce more follicles and we can grow good, strong eggs. Femara is used in older infertile women instead of Clomid, since it does not have as many nasty side effects as Clomid (I have to tell THAT story sometime), does produce good eggs, and does not impede the growth of the uterine lining like Clomid. So I took Femara 5 days, CD 3-7. No problem. I showed up at the RE's office on Day 12 as instructed for my ultrasound and blood draw. Good blood, low progesterone (so my surge is nowhere near) and nice pretty follicles, but they are so small and my uterine lining needs time. So I was scheduled to come in on Day 13. U/S and bloodwork again, again nothing happening but a steady growth. Day 15, U/S. Larger follicles (2) and uterine lining was now an 8.1, but still doesn't look right. Day 16, did an ovulation preditor kit pee-on-a-stick, nope. Day 17, POAS, nope. Day 18, U/S and blood draw. U/S revealed the last remaining follicle was now of a perfect size, a 24, and the bloodwork said I was on the slow uphill progesterone climb of a surge. So, home I went to have my father inject me with HCG, in the form of an Ovidrel shot (I have a needle phobia, so there was no way I could do it to myself). Insemination in CD 19, did not take.

OK, ready to try my 2nd medicated IUI cycle. I spoke with the RE nurse about the timing. I was supposed to be out of town for CD 12-16, which was of some concern, since I am so regular (regularly) it's scary. She said not to worry -- last cycle I ovulated on CD 19 with help from the HCG shot, so it looked promising. So I flew to Texas for a conference and while walking in the airport, thought I was a mite-bit squishy. Nah, it must be my imagination, not a week early, surely. I ignored it and on CD 13 finally tested with the OPK. Yes, surge. Plain as day. A couple phone conversations later, I was cursing a blue streak. I simply had no options since my swimmers were in North Carolina and I HAD to be in Texas (I had a presentation, a major deal). And there was no way to get my swimmers there and get inseminated. Rats!

Counting out, I discovered that the timing looked like again I would ovulate while out of town over the Christmas holidays. So I called the REs office - anything to do to delay AF or perhaps hurry it up, to work around the out-of-town issue? No. (Even though there WERE options as I learned later, they did not offer any.) So do you know happened? Yes, Christmas Eve, I surged. Ggggrrrr!!!!

Now we're talking frustration. Out of 4 possible cycles, I'd only been able to try once. And that one time had not worked (duh!) so this next cycle, I was ready. No presentations were on the horizon, CD 1 came, I was all set. And the nurse said, "We're going to be out of the office when you ovulate." Pregnant silence from me. Then she said she was just joking. Look lady, NOT something to joke about!!

So, on CD 3 I started taking Femara once again. I should at this point tell you what Femara does to me. Since it is a breast cancer treatment drug, yes, my hair fell out. Not all of it, of course, but enough so that it was very embarassing and really had me worried. Then I had scalp lesions. Oh yes, they are fun. Little pus-filled bumps all within my scalp. All that came the 1st month. The second month the scalp lesions returned but we also added a new flavor to the side-effects - hives. Yes, folks, I have a very active immune system. And my body has decided it simply is not fond of Femara. So I called up my GP after suffering for 3 weeks with intense itching to ask for a prescription for Atarax, a hives wonder drug. He gave it to me but said it's not for pregnancy. My 3rd cycle, hives and scalp lesions again. This was getting old. This 4th cycle, since I knew pregnancy was a possibility, I did not take Atarax to help with the itching. I simply did not want to hurt/impede/misgrow the follicles. So I have been an itch factory since CD1. My breasts itched, my back itched, my legs itched, my hands itched, my scalp itched (and oozed, mind you), my neck itched, I think even my dreams itched.

But I persevered. (This is where we cue in the triumphant music.) Cycle Day 11, I went in for U/S and bloodwork. 7 follicles, of which 4 would grow to a good size, no ovulation in sight. CD 13, same 4 follicles were growing and bloodwork showed no surge. I was VERY worried about 4 follicles, since more follicles means more eggs and as a single mother, I simply could not handle quads or triplets. CD 14, POAS OPK. No surge. They wanted blood anyway, so I shot off for the clinic. Nothing. CD 15, U/S and bloodwork, we were down to 3 follicles and the surge was into the hinterlands (not there). I was relieved. 3 follicles meant much less likelihood of multiples. I had never realized how much triplets scared me until I saw 4 large follicles. But with 3, relief. So Dad gave me my Ovidrel that night at 9:30 and I was in on Saturday for my insemination on CD 19. Weird how we're working with a lot of unpredictability with my cycles - ovulations as such: CD 19, CD 14, Cd 14, CD 19. Weird. It could be an ABB pattern ( teacher humor).

This insemination HURT like the dickens. (The first one was pleasant, well, as pleasant at it can be with someone finagling with a speculum and injecting you with sperm.) She had to hold the cervix with a tool and it was not fun. Folks, we have nerve endings in there too! Anyway, I was so down I needed retail therapy to help me get over the feeling. So I bought 4 baby sleepers at an awesome sale at Belk's. They were, of course, in gender neutral colors. :)

But this cycle has been weird. While waiting, I've had weird things going on. I am absolutely convinced this one did not take (it hurt too much). But these weird things have me wondering. No telling.

Anyways, that's my story for now. I imagine in 7 days I will be reporting CD1 again and we will begin the itch routine with Femara again. Stay tuned!