Cycle 19, CD 40 (22 DPO)

Beta #3 came back with good doubling numbers. At 22dpo I'm sitting at 8712 which actually exceeds the high end of the hcg chart. 

Last week was really hard for me. The shock of finding out I was newly pregnant again brought up all the emotions from my last miscarriage. And they spilled out everywhere. It was something I was wholly unprepared for. But in these last few days I've heeded Cristy's advice and begun to feel things without fighting against them; allowing the pain of missing my last little one to mesh with the excitement of a possible brand new beginning. It has been rolling around together to where sometimes I can't tell where one starts and the other ends. But I think that's ok. 

More than anything I'm sitting here thankful. So thankful it makes my eyes well with tears and my heart scream with hope. 

Cycle 18, CD 43 (33 DPIUI)

I've talked a lot about my thyroid during this process. I've also dwelled a lot on my TSH numbers. But I'm not sure I've ever explained why.

I have Hashimoto's Disease. It is a type of autoimmune disease in which the thyroid gland is attacked by antibodies. There are varying degrees of this illness but once diagnosed, it can usually be taken care of simply by taking a little pill each morning. That is, unless you are trying to get pregnant. For woman that have Hashimoto's, achieving pregnancy can be difficult (really? I hadn't noticed). But also, maintaining pregnancy can be very difficult. There is a 3 to 4 fold increase of miscarriage (on top of the 20% risk that women normally face) if you have this disease. Basically, the antibodies see the embryo as a foreign invader and attack it. Add insult to injury, there are also risks to the baby and mother if the pregnancy is able to maneuver through the aforementioned minefield.

And the kicker? There isn't a damn thing modern medicine can do about it.

Many months ago when I had my full thyroid panel done, my RE looked at me and said, "Wow, I haven't seen antibody numbers this high in years!" She went on to explain that my risk of miscarriage, once I was pregnant, was very high. She added that success was possible though.

Those odds didn't instill a lot of faith that things were going to end well. And this is why I'm so freaked out.

So here I sit at almost 6 weeks. We made it over the first, very big conception hurdle. Next we are faced with an even bigger monster: maintaining the pregnancy.

Did I mention? We have our first u/s scheduled for tomorrow morning. I never thought it possible to be so excited and so scared at the same time.

Cycle 18, CD 21 (11 DPIUI)

Hello?

Hello?

Is anyone there?

Just picture me hanging my head in shame. I didn't mean to abandon this blog. But more importantly, I didn't want to you guys to think I abandoned you. Just so you know though, I never left; I've read each post you've written. I know *exactly* where each and every one of you are: the good, the bad, and the congratulatory. I've just been reading from my phone which likes to leave 13 duplicate posts for each comment so instead of subjecting you guys to that, I've been refraining from commenting. But I'm right by your sides and hopefully within the next few weeks I can get back to my old ways. In the meantime, think of me as your personal stalker.

Where have I been you ask? I wish I could say I've been doing something fun like windsurfing every day or too busy learning the ins and outs of my newly purchased u/s machine. Unfortunately the boring truth of it is I've been working. Hard. I've been working harder than I've ever worked in my life. And all this blood, sweat, and tears I've put into my job over the last 4 months is finally coming to a close. So this last month has kinda been like crunch time. A horrible, bumpy road that has given this perfectionist (points to self) an ulcer the size of a watermelon. Ok, so maybe I don't have an ulcer, but I feel like I should! Be that as it may, I apologize for my disappearing act.

I think I left off mid-2ww last cycle. That was the ugly loooong cycle with crappy follicles, high TSH, a missed IUI, and lots of bitter emotions. It ended with a very glaring negative pregnancy test. But of course it did.

After that debacle, Dr. D felt confident that we could sneak in one last cycle before I had to leave town for a bit. She wanted to try the Follistim again even though I reacted really badly to it the previous cycle. So in the spirit of compromise, I asked that we not do the estrogen supplements because it screwed with my TSH too much. It's like a game of Jenga, you have to be careful where you place each block or the entire tower might come tumbling down.

Long story short, for as bad as cycle 17 was, cycle 18 has been the opposite. I was only on stims for 7 days (hello shortest cycle ever!!), I had multiple big follicles, my TSH behaved beautifully, the IUI was perfectly timed (confirmed by an u/s), my husband's sample was rock-star quality, and I didn't have any bleeding at ovulation.

How's about them apples?

So here I sit at a hotel restaurant somewhere in middle America and I'm teetering on a tight rope. On the one hand I want to let in the hope so, so badly. I haven't had a good cycle in a long time and with this one, the stars finally aligned. If I were to ever allow myself to hope, it should be right now. But on the other hand, I've been at this long enough to know the more hope I allow in, the worse the pain is when it doesn't work. And that, my friends, is why infertility is the ultimate mind-fuck.

Cycle 17, CD 23 (9? DPO)

Just finding the time to write a post has been a challenge lately. We have some pretty big deadlines coming up with work and I feel like I'm the only one that cares. My overall fuck-you-world frame of mind probably doesn't help much either. Whatever, it's where I am at.

The bad: My blood work came back after the cancelled IUI and it showed that I had indeed ovulated a day or two prior. I'm glad my RE suggested that we sit this one out and bank the money because it would have been a futile attempt, but it sucks balls I had to go through all that just to have my body play games on me.

The good: No ovulation bleeding! Wow, right? So maybe Follistim is my drug. That said, it did a pretty crappy job on making my follicles grow. But I'm not so down the rabbit hole that I can't see that this is a move in the right direction.

The bad: My TSH has skyrocketed and no one knows why. I thought it was from the estrogen my doctor put me on, but my Endo just told me that it wouldn't act that fast (apparently it takes several weeks to have any impact). No one can give me a good answer because no one knows why this is happening. So they upped me on my thyroid meds yet again. Not that my theories are ever right, but I feel like my TSH is going to go way in the other direction. I'm feeling 50% lab rat and 50% yo-yo. 

The good: I think I miiiiiight be able to squeeze one more cycle in before I have to go travel. That said, my TSH needs to cooperate which I'm not hopeful of, but at least it's a maybe vs a no-way. 

The bad: Mother's Day sucked the big one. 

The good: I got my hair cut! I know this isn't anything fertility related, but it's been almost 7 months since my last cut (hello-treatments-sucking-up-every-extra-penny) and I was feeling pretty ragged. The new do feels really good. 

As you can see, I'm actively trying to see the good in things and not focus so much on the bad. It's hard though, because the bad is really, really bad: I'm not a mom, I have no baby. The good is nice and all- but how do you compare a good haircut to a child? Regardless, I'm trying. Some days are better than others. 

Cycle 17, CD 4

When my Dr. D walked in the room at my CD2 appointment on Tuesday, I exclaimed, "I missed you! It's like we broke up for a few months, but now we are back together!" I'm glad that: 1) I am comfortable enough with her that I can say stuff like this because, who are we kidding, I see her more than my closest friends and 2) she puts up with my crazy.

A summary of how things went:

• I didn't get the answers I was looking for regarding the miscarriage, but I knew I probably wouldn't. "It was early, it could have been a million things, there is just no way to know..." Moving on. 
• My TSH came back at 1.58 which means that we can proceed with this cycle. That news alone made me break out into a smile big enough to make my cheeks hurt. 
• When I explained that I had no ovulation bleeding this month, Dr. D looked puzzled. And right on cue, she suggested that I switch up my medications slightly:  
• Starting Follistim 50 iu until next follicle check and then we'll see if we need to readjust.
• Adding Estradiol mid-cycle (maybe). I'm a bit nervous about this because estrogen pushes my TSH numbers up (as we saw last time). My Endo instructed me to increase my Synthroid dosage preemptively if I take it again. I hate tinkering with things that make my thyroid numbers go wonky because: 1) it reacts violently to small changes and 2) the window where things are optimal for fertility purposes is exceedingly small. 
• Changing up my progesterone type. I've already been on Crinone and Endometrin but she said there was one other kind she'd like to try some sort of compounded progesterone? This is because when I was pregnant (but didn't know) and stopped the progesterone I immediately began bleeding and so thinks I may be extra sensitive to even small changes.
• I head back on Saturday for a follicle check. 
• IUI is scheduled (tentatively) for a week from next Saturday. 

Guess I'm officially back on the gravy train. 

Cycle 16 (sometime after ovulation)

We've had a little movement on the home-front folks. Perhaps I won't be in a holding pattern for the rest of my life after all. I had a +OPK on April 8 and 9 (along with four days of EWCM) so when I went to Dr. D's office for my first post-beta bloodwork on the 12th, I was fairly positive I knew what the results were going to be.

And indeed, my HCG was sitting pretty at zero. My progesterone and estradoil levels showed that I had ovulated. However, because of where my levels were, the doc thought it had happened much earlier in the week. I'd eat my hat if I found out I'm not 10DPO right now though. The disappointing result was my TSH (no surprise there). It came back at 2.82 which is still far too high for a girl with Hashimotos that is trying to get knocked up. Apparently it can take up to 6 weeks for my TSH to restabilize and since it had only been 3 weeks at that point, I was told to wait and retest in a few weeks. Hrmph. 

Want to know something else that is interesting? No mysterious ovulation bleeding this month. Crazy right? To remind you, the pattern went as follows: 

• Never had any weird bleeding prior to starting injectables
• 1st cycle with Gonal-F: ovulation bleeding
• 2nd cycle with Gonal-F: ovulation bleeding
• Natural cycle: ovulation bleeding (but a little lighter)
• 3rd cycle with Gonal-F: ovulation bleeding & pregnancy
• Natural cycle to recover from miscarriage: no ovulation bleeding

I'm going to venture a guess and say that if I go back on Gonal-F next cycle, the bleeding will reappear. That said, apparently I can still get pregnant if there is bleeding, which my RE didn't think was possible. She also didn't think the Gonal-F was the culprit because she'd never seen or heard of anything like that before. Or maybe she will try a different kind of injectable? It will be really interesting to hear what she thinks about all this during my next visit- which will hopefully be next week sometime. 

In the meantime, Mike and I are headed down to spend the weekend at a secluded getaway. We'll have 10 acres of horse ranch, a steaming hottub, and all the non-diet food we can get our grubby hands on. Though we both have to bring some work with us, I'm hoping that the peace and tranquility will do us both well. 

Cycle 15, CD 40 (27 DPIUI)

I was a bursting ball of nerves when I heard my RE's voice on the other end of the line this afternoon. But as soon as she asked me how I was doing, I knew it wasn't the news I was hoping for. I could hear it in her voice.

At that moment, I felt like my chest imploded.

As much as I tried to wear a brave face and be all one-with-Budda, my hopes were high. I kept qualifying everything good and hopeful with, "but I know this isn't really going to happen". I also blame my boobs. Damn things were so sore that I nearly cried in the shower this morning. Stupid sore boobs. We're not on speaking terms anymore. 

So that's it. My HCG has plummeted to 122. My progesterone is crazy low at 4. And my TSH has skyrocketed to 4.75. Moral of the story, the Guru was right- my hormones are jacked (he said it in a much cooler traditional-Chinese-medicine-y way though). 

Right now I'm sad. Not like a face-down-in-my-pillow-sobbing kind of sad, but just like a quiet sad. I feel like if you looked at me, you could see the events of the last few days written all over my face. I'll be ok though. I'll rebound because I still have hope. And I won't stop until I have that baby in my arms. 

Cycle 13, CD 8

I'm feeling unusually optimistic about this cycle. I don't know why. Maybe it's because my TSH levels are back in check. Or perhaps it's because I don't feel completely and utterly fatigued all the time (a classic symptom of hypothyroidism). I watched a movie with my husband last night... and didn't fall asleep! It's been years since that's happened. Feeling awake and able to participate in life... feels really good.

I'm hoping my positive outlook lasts longer than 30 minutes. Just last night I got a text message from a friend that made the tears spring into action. So, who knows. But it feels good to feel good. I'd like to hold on to this for as long as possible. Here's to lucky number 13. 

I was back for another ultrasound today. Right side has sprung into action and has a 10mm follicle while the 2 on the left are continuing to grow. I think she said they were at 12 and 14mm. So that's really positive as I'm only CD8 and probably won't ovulate until sometime next week. I'll start the OPKs tonight just in case. 

Last month I ovulated later than Dr. D expected. She thought it would happen on Saturday, when in fact, I didn't pop until the following Tuesday or Wednesday. This meant that we had sex for 7 days in a row. I got to thinking that maybe this might reduced Mike's sperm quantity too much. So, my question for the doctor today was: is it ok to have sex daily for many days or I should go with trigger shot so we know precisely the right moment to go for it? She said that yes, it will probably reduce the sample size over that many days, but it was such a minute amount- it wouldn't matter. Sex it is then. Yipee for saving the $130.00 on meds and staying away from that horrible full-ovary feeling it causes. Mike will be happy too :)

My doctor always refers to us as her "sex couple", because she knows that we aren't scared of it. Hell, I'd do it 5 times a day if it meant that it would increase our chances of getting pregnant (lucky for me, it doesn't). She said that the majority of her patients don't have sex at all. And apparently it's not because of fertility stuff (I'm the first to understand how unsexy sex is when TTC) but that they just don't have sex. Like, ever. I found that quite surprising.  

Cycle 13, CD 6

Today I had an ultrasound to see how things were progressing on the Gonal-F.

I have 2 follicles measuring at 10 and 11mm. My lining looked great. Also, my full thyroid panel came back. T3 and T4 were fine. So, that's the good news.

The bad news? My thyroid antibody results were sky high. Thyroglobulin Ab was 485.0 (normal is < 40) and thryoid Paroxidase Ab was >1030 (normal is < 9). That's the Hashimoto's at work. Apparently this isn't a big deal- unless you become pregnant. Then it puts you at very high risk for miscarriage.

Can there be any more black marks against me?

I've never even been pregnant. Not once. I don't even know if I *can* get pregnant. But if by some miracle I am able to make babies- I will have a very hard time carrying them.

And how is it that I'm supposed to stay positive and not get caught up in the biology of it again?

Cycle 13, CD 4

Too much to get into, but after a lot of research and talking to other doctors, it looks like Dr. D isn't the devil or incompetent. Her biggest mistake was missing my clinical signs: fatigue, dry/brittle hair, etc. To her credit though, I didn't tell her that I was having any (because I too thought my TSH was in-check). So for now, my husband and I decided that we're going to wait and see what my new endocrinologist says (appointment next month) and progress as usual until then.

I went to my CD2 appointment on Saturday. The plan was to see what my TSH level was and if it came back between 1 and 2, then we'd do the Gonal-F injections again. And if not, we were going to sit this month out (shoot me now).

And in some weird twisted act of fate, it came back at .9!

Thank goodness for small miracles. What were the chances of it falling perfectly to where we wanted? Especially with something as tricky and specific as thyroid levels.

So for now, I'm trying my best at looking forward and not back. I have been hanging my hopes on 2012 for so long now- wouldn't it be great if it happened right off the bat? I know I shouldn't get my hopes up, but damned if I can help it.

Cycle 12, CD 29 (13 DPO)

Someone got busy. I've been traveling a lot this month which is good because at least I've had other things to think about besides my ovaries. I've still been thinking about them a lot though.

I wasn't sure what the new strategy was going into this cycle. When I saw Dr. D on my CD2 ultrasound appointment, she said she saved one sample of Gonal-F for me. It can cost upwards of $300.00 so not only was my new "path" revealed to me but I was exceedingly thankful for my doctor's generosity.

I had to travel for business the next day so quickly had to learn how to inject myself in my stomach. For a girl with a paralyzing fear of needles, I think I did ok. I certainly will never get used to giving myself shots, and thank god it was a thin needle- but I managed. For 11 full days.

Then I went on vacation with my husband for the holiday. I got a positive OPK the night before we left which meant that we were shooting [literally] for an island baby. This would be so symbolic in so many ways. So special. So meant to be. Like my world was coming full circle and there really was someone out there looking over me. I won't know until tomorrow if that is the case, but I'm pretty sure it's not. Which, makes me even more sad.

A bit of illuminating news came about earlier this cycle:

• 4/7/11- My Ob checked my thyroid levels because I was having breakthrough bleeding & short luteal phase. Results: .94 (perfect) [question if this was a bad lab or it really was that low]
• 11/7/11- My GP randomly checked my thyroid levels when I went in for my flu shot. They came back at 5.24 (normal is .5 to 5.0 with fertility optimum at 1)

Puzzle pieces started falling into place. I hadn't made the connection earlier because my results had been normal but my symptoms were real: extreme fatigue, frizzy hair, weight gain, inability to concentrate, dry skin, etc. I also knew that this could severely impact fertility. My Synthroid dosage was immediately increased.

A few days later I asked Dr. D if she thought this could be the reason for my infertility issues, she said 'no' [because I ovulate]. But I'd been taking progesterone suppositories for the last 6 months for a short luteal phase, so there was clearly more to it that just ovulation. But I took her word for it and put it out of my head.

After a round table with my family that has a solid background in the medical field and biology- it turns out that I shouldn't have put it out of my head. They are lots of studies that show marked infertility in hypothyroid patients if their levels are above 2 because the oocyte needs specific hormones to be able to be fertilized. Or something.

And add to all this that fertility drugs (Clomid, Gonal-F) have been shown to push thyroid function off due to the increased hormone levels. So why wasn't Dr. D testing my TSH levels every month she prescribed me fertility meds? Why didn't she admit to my thyroid levels very possibly being my problem? Incompetence or covering her ass? Either way, I'm determined to get some answers.. and maybe a new doctor.

Test day tomorrow. I don't know if it's worse testing when you have no hope or some hope. Maybe it's just always a black day.