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 38 (25 DPIUI)

When I wrote the other day that there was more to catch you all up on, I had no idea how much more would happen in the following days. And because this could get lengthy, I'm going to do a list of events as they happened. Lists make me feel more in control, and right now think I need that.

• To remind you: After my last BFN Dr. D put me on a natural cycle with just estrogen to try to stop the mysterious ovulation bleeding, I had a sizable cyst on my left ovary, and she suggested I start acupuncture.
• The acupuncturist that Dr. D wanted me to see was $500 for just 1 consult and 2 treatments. Not chump change, right? Turns out though, this Dr. is an extraordinarily famous (like world famous) infertility acupuncturist. We'll call him The Guru. 
• During this time, I continued to bleed past my regular period and was now on day 6. WTF? I attributed it to my body getting used to the estrogen.  
• The next few days were full of back and forth arguments with Mike about the cost/benefit value of acupuncture. Mike like facts and he only found a few (good) studies that proved acupuncture worked, and those were for only back pain. He feels pretty strongly that acupuncture may indeed work, but going to the local acupuncture school (for less than 1/4 of the cost) would have the same result as going to The Guru. I didn't agree with him and insisted that if Dr. D really wanted me to go to him, I had to at least give it a try. Besides, we'd invested so much up to this point, didn't we want to explore all available avenues? Finally, my parents stepped in and said that as a combined (very early) birthday and Christmas gift, they'd pay for a few treatments with The Guru. My mom and dad both felt strongly that if I didn't pursue this, I'd regret it. So I called and made an appointment.  
• I woke up the next day with an UTI. Fuck me, are you serious? (I've been having chronic UTIs for the last 2 years). I go to see my GP and get on some baby-friendly antibiotics because I should be ovulating in a week or so. Maybe the UTI is the cause of all this bleeding?  
• The the midst of the acupuncture debates, I reached out to an old friend I'd not spoken to in over 10 years. She was a year older than me in High School but we'd always gotten along really well. I'd recently heard through a mutual friend that she'd gone through 7 failed IVF cycles. Let me say that again: Seven. Failed. IVF. Cycles. She still doesn't have a child. I know the gravity of that is not lost on any of you. I wanted to talk to her because I knew she was a huge advocate of acupuncture and I was hoping to find out why and gain some clarity (let me just say for the record, making the decision to do acupuncture or not should never be this difficult, but I am indecisive and toggle endlessly over everything. We ended up talking for a full 2 hours and in that time, I felt like I had 17 "ah-ha" moments. She never lectured me, but she did say, "Tutti, this process is one that you have to experience for yourself so I don't want to tell you what to do or how to act. But after going through all of it for so long, I wish someone had told me certain things so I wouldn't have had to make so many mistakes along the way." It was probably the most amazing conversation I've had since I've started on this journey and I felt like she gave me so much wisdom and the ability to acknowledge my hope again. After hanging up the phone, I felt... lighter. I went to bed and woke up the next morning feeling... renewed. I really hope I can hang on to that. I need to hang on to that. She also ended up asking her acupuncturist if she recommended anyone in my area area (we live in different states). Guess who she referred? The Guru. Huh, that's kind of crazy.
• The bleeding still hasn't stopped. It had been 8 days at this point. Great, so on top of the crazy ovulation bleeding, it seems as though I just bleed all the time now. Then in dawns on me, maybe I'm bleeding because of that cyst on my left ovary? I decide to give it one or two more days, then I'll call Dr. D. 
• I have to say, my consult and acupuncture treatment with The Guru was pretty cool (happy bday and Merry Xmas to me!). Long and short of it, he felt that everything was hormone related. I can't say that I don't disagree with him either. He insisted that I shouldn't be bleeding if I'm on estrogen and to call Dr. D the next morning. He went on to say that my body just wasn't handling all hormones very well and he recommended that I do another full natural cycle (as in NEXT cycle). And by natural he meant: no estrogen, no gonal-F, no progesterone, nada. He said my body needed to get back to its baseline. It was tired and confused by all the hormones. He felt my pulse and said it was 'erratic'. I'm still not sure what that means but he had a concerned look on his face when he said it. Then I went in for my acupuncture treatment with him and I quite enjoyed it. Although, I did find it next to impossible to keep my thoughts from racing. He had me do a full hour treatment because he really wanted the bleeding to stop. Then he sent me home with some cRAzY looking herbs and an appointment to see his associate the next week. 
• The next morning (yesterday) I woke up and was... wait for it...still bleeding. It'd been 10 full days. I followed The Guru's advice and called my clinic. I filled Dr. D in on my symptoms as well as what The Guru said. After listening to everything, she said, "I'm going to follow his lead and have you go off everything right now. What is happening is just not right. I know this is going to sound crazy, but take another pregnancy test just to make sure. Then email me in a few days and let me know if the bleeding has stopped. We'll get to the bottom of this, I promise." 
• Hours later, I cooked up my herbs and holy hell, this stuff is beyond nasty. I plugged my nose and guzzled two cups which made me have to pee. Then I remembered how Dr. D asked me to take another pregnancy test and scoffed at the idea. But for some reason at the last second decided to indulge her.  
• It was positive. 

In 35 years, I've never-ever had a positive pregnancy test. I didn't even know if I could get pregnant. I'm still waiting for my beta test results. Understandably, Dr. D said, "don't get too excited". And I can't- I've been bleeding for 10 days and I *know* that's not good. But it does mean that I'm most likely able to get pregnant. At least, I think it does. I'm trying to take all I've learned this week and see the good in this situation. I'm not scared right now, just hopeful. I'm going to keep acknowledging my hope from here on out and embrace it, regardless of what happens. My life changed in many different ways this week. I'm not sure how it's going to read yet, but my story has a new chapter.

P.S. On our way home from the beta test, I turned to my husband and with the biggest smile I said, "See, I told you The Guru is a miracle worker."

Cycle 16, CD 8

I hate it when I get behind, and I feel like I've been doing that a lot lately. I have 874 blog posts in my head and only have time to write .75 of one. Blarg.

So let's catch up. After my BFN last week, my RE called from her cell while running out for lunch. I don't know why, but that meant a lot to me. I guess I felt like she was thinking about me, even when she didn't "technically" need to be. Our conversation went as follows:

Dr. D: I'm really sad and frustrated right now. I want this as much as you do.
Me: Yeah, I am too. So WTF?
Dr. D: I have a consult set up with 4 other RE's today to discuss this crazy bleeding issue that's going on. I'm going to do some extensive research when I get home. I'm determined to figure this out.
Me: I really appreciate you putting in the overtime on me.
Dr. D: How could I not? Hopefully we'll have a plan for you when you come in for your CD2. Oh, and I feel pretty strongly that you should start acupuncture. I know there is a cost to it, but I think western medicine has failed you. Let's try eastern. I know a great fertility acupuncturist in your area. It usually takes 3 to 4 months to get into see him, but if you are up for it, I'll pull a few strings and get you in as soon as possible.
Me: I think you might be right, and I appreciate the sting pulling.
Dr. D: Don't worry about it, we're in this together.

So yeah, I think I needed to hear all that from her. I needed the reassurance that she was just as worried about me as I am. And to know that she was consulting with other doctors about me? Huge. I might have even given a little fist-pump after I got off the phone. And I'm not even from Jersey.

On my CD2 appointment, she said that all the doctors she consulted with felt like this bleeding issue was hormonal. The theory is, is everyone's estrogen drops during ovulation, but maybe mine is dropping further and longer than it's supposed to for some reason. This can coincidentally cause unexplained bleeding and breast tenderness (gosh that sounds familiar, no?). Treatment for this month: Estradiol in the form of a pill everyday, and once I get that positive OPK, I'm going to double up on it. The only complicating factor is that I have a big juicy cyst on my left ovary (a lingering reminder of the $1500 we spent last cycle?) so I'm on a lower dosage than she originally wanted me on. Stupid cyst.

The only thing I'm struggling with is that I am forced on, yet another, natural cycle (besides the estrogen & progesterone). I mean, I know it doesn't make logical sense to go forward with Gonal-F and an IUI, because until we figure out this other issue, it's all a waste of money. But emotionally, it's hard. It's hard because I feel like time is slipping away. It's hard because I know that no matter what happens this cycle, the chances of me getting pregnant are less than 1% (sadly, a hard scientific number, not a ficticious-Tutti-being-drama number). So yeah, I'm sad about that. But at the same time, I know it's the only thing that make sense. Going back and forth between my head and my heart is taxing.

There is more to this story though, and I'm kind of excited for tomorrow. More to catch you all up on! There is a little, tiny light at the end of my tunnel.

Ewww. Was that too literal? I meant it figuratively speaking of course.

Cycle 15, CD 14 (2 DPIUI)

I started the progesterone today, but not before the mysterious bleeding started.

I'm crushed.

Cycle 15, CD 12 (??DPO)

I feel like I've been pulled in a thousand different directions lately and every time I sit down to write- I get yanked away. I don't like how that feels because I have a lot of things on my mind.

Most importantly, I have this insane fear that I've already ovulated. And my IUI isn't until tomorrow. Here's why:

1) I goofed on my Gonal-F dosage and didn't tell Dr. D. I was supposed to be on 75mg for 3 days and then switch to 37.5 for the remaining days. I did 4 days of 75. I didn't mean to, I just spaced it. I've been being monitored, so I didn't tell anyone. Mostly, because I feel like my RE already thinks I'm slow. I don't know why I think this- but I do. I don't want her to think I'm an idiot. But now I'm nervous I goofed things up.
2) I started getting EWCM last Wednesday. Over 6 days ago! I've never had it for more than 3 days before I O'd. I mentioned this to the RE on staff Friday (mine was out of town) and he didn't seem phased. But still, it seems like a lot.
3) My boobs started getting (very) sore on Saturday. From experience, this doesn't usually happen until after the big O.
4) I felt really bloated Saturday. It could be my mind playing tricks on me but I triggered yesterday (which usually makes me hyper away of my overies) and I feel fine today. I don't want to feel fine.
5) Last night, there was a tinge of red when I went to the bathroom. It's that damn mysterious bleeding again. Thankfully it was a very small amount (less than the previous 3 cycles) but still, that usually happens after I ovulate.
6) I'm an idiot and didn't testing OPKs until Saturday. I don't know what's wrong with me but if I was flexible enough to kick myself, I totally would.

I don't know if this is all paranoia, or my meds screwing with me, or if it's got some truth to it. I'm going to mention these things when I go in tomorrow, and I'm really hoping that she'll do an u/s before the IUI. Just more reasons for her to think I'm an idiot, but whatever. The last thing I want to do is spend $825.00 on a procedure that has no use.

This not knowing it just making me feel really out of control.

Cycle 14, CD 14 (1 DPO)

Remember how Dr. D wanted me to do a natural cycle this month so we could 1) run a few tests and 2) see if the bleeding happened on it's own? Well, guess what I woke up to this morning? Just 60 hours after my positive OPK I started bleeding. And here I was so positive that it was the Gonal.

I immediately started with the progesterone this morning but I don't have much hope for this cycle anymore. Blood is both toxic to an embryo and active bleeding flushes it out of the uterus. It's not even like we are closer to figuring out what is going on with my stupid body. In actuality, we are even further. I didn't have this bleeding just prior to November. So WTF?

I called my RE's office in the off chance she wanted me to come in for blood work. Personally, I think it's a good idea. I'd like to confirm ovulation. I'd like to see where my estrogen levels are (a likely culprit of all of this). I guess I'd just like more information. But Dr. D isn't big on doing a lot of bloodwork. I mean, she certainly does it and understands its importance, but she also isn't a believer in doing several blood draws each cycle like I know a lot of other RE's do. I don't know. I guess I just wish we had some answers.

My real worry is, what happens next month when we start back with the meds and IUIs. If I go through all that only to start bleeding right after the IUI then we have lost yet another cycle and a large chunk of change. And will continue to be sitting at square one.

UPDATE: A nurse from my clinic just called back and nope, they don't want me to come in. Apparently we have to wait for the biopsy to come back and then go from there. I just feel like getting information from my blood couldn't hurt the situation. It would at least tell us something. Then again, every time I doubt Dr. D it turns out I'm wrong.

And here I had secretly hoped that I'd be one of those women that miraculously got pregnant on her own after undergoing months and months of treatments. Hope is getting scarce around these parts.

Cycle 14, CD 6

When I called to set up my CD2 ultrasound earlier this week, the nurse told me that Dr. D wanted to see me and Mike for a WTF consult instead.

Fuck me. This is going to be the big IVF conversation, isn't it?

But it wasn't and I think sitting down with my doctor and finally getting everything out on the table was a good thing. After all, this was the first consult we've had since starting with this clinic back in June. In fact, for my (and Mike's) sanity, I wish we had done it sooner. Those 10 minute u/s appointments only leave you about 30 seconds to ask questions once the vag-cam is finished its probing. Ugg. I hate that thing.

Here are the highlights:

• My stinking thyroid: We are going to continue testing my thyroid every month from here on out. Dr. D confirmed that conception was probably not a possibility with it being as high as it was. The problem is, it went wonky sometime during the previous 6 months but we don't know exactly when. So all that Clomid, the IUI, Gonal-F, freaking out, was most likely all for naught. But we will never really know. I had it tested after the consult and it is currently at .773. Not between the target of 1 to 2 that we want, but not low enough for my RE to change my Synthroid dosage either. 
• Stupid Gonal-F: She thought the bleeding and crazy sore boobs sounded like it was due to a huge spike of estrogen brought on by ovulation. She's attributing it to the Gonal-F, though she's never seen or heard of anything like this before (go figure). The fact that it's only happened during the two cycles I've been on the Gonal seems like more than a coincidence. Not what I wanted to hear but at least it's a reason. She also said conception was probably never a possibility the last two months (which is what I was afraid of) because even if there was an embryo, it most likely would have been flushed out with the blood. So much for the last 8 months of trying. Fuck me. 
• Plan for this cycle: Dr. D suggested that we do a natural cycle this month. Of course, my stomach dropped and my gut reaction was to whine and plead like a little girl that wanted the newest talking teddy bear, but I need to trust her. She wants to see if the bleeding happens without the Gonal this month (I have a feeling it won't). And though I know our chances of conceiving are only 2% on an unmedicated cycle, I know that giving my body a break isn't a bad thing either. I will follow along, if not begrudgingly. 
• More tests: She also wants to do a sonohysterogram this cycle to look at my shiny uterus (I'm not sure if it's really shiny, but that's how I see it in my head) to see if there are any polyps. And if my ute gets the A-ok, then she will go a step further and do an endometrial biopsy to make sure there is no infection in my lining. My eyes just about zoinked out of my head when she mentioned this last one. I had an endometrial biopsy 4 years ago. Yeah, it didn't go so well and I ended up passing out on the side of the road after I left my Gyn's office. I woke up in an ambulance with the worst stomach pains I've ever experienced in my life. No joke. If I had a gun, I would have used it on myself. And I don't say things like that lightly. I have a fucked up vaseovegal response (inherited from my mom) which proves to be tricky in situations like this. As in, this is exactly what triggers it. Needless to say, I'll be going armed with vicoden and Mike to that appointment on Tuesday. Lord help me now. 
• Reviewing old tests: Dr. D is going to request the original films from my HSG. She said that it's not too common, but she has caught mistakes in the original reading of these things. Wouldn't that be a kicker? 
• Future plan: Provided the natural cycle is a bust (which of course it will be), we will continue with injectables (more than likely not Gonal) and IUIs. The stats show that our chances go up to 9% (big leagues) with medications and IUIs. So we'll be all over those like white on rice. She said we'll see how it goes, but at least 3 more IUIs and then we'll talk... 
• Future-future plan: IVF. Naturally, it's a last resort but she said that if we indeed have incompatible eggs/sperm, than this is our best bet (I don't know what she is talking about, I get along with everyone). She said it's too early to go the IVF route at the moment (which was reassuring to hear) but that we'll be looking at it in the next 6 months if nothing else works. Sweet, we have 6 months to save up $20,000. Maybe I'll have a yard sale...

Like I said, it was helpful and both Mike and I left feeling a little better. Like we had a plan. Mike was able to shoot a bunch of over-my-head questions at the doctor, and apparently she answered them satisfactorily. Which is good because it makes Mike feel better, which in turn makes me feel much better. So for now, we are able to put some old issues to bed and concentrate on the future. A future that I desperately hope has a positive ending.

No pun intended.

Cycle 13, CD 16 (4 DPO)

I got a positive OPK on Wednesday night (yipee). However I started to bleed on Thursday night (freakout). Not enough to need a tampon, but more than enough to make me very worried. And this is exactly what happened when we were on vacation last month; if not a tad worse. We thought it was a fluke last time, but apparently it wasn't. I can't help but notice that this has happened exactly 24 hours after each OPK *and* on the only months I've taken Gonal-F. I called  my clinic yesterday because and they told me to start on progesterone every 12 hours. So I did. And... it appears that has worked. Or, at least the bleeding has stopped. Thank god.

Overnight shipping for progesterone because of the holiday and all the pharmacies are closed.  Sweet.

Since I only spoke to the nurse, I emailed Dr. D for some (more explicit) answers- but I've yet to hear back from her. I understand it is the day after Christmas so I kind of don't expected her to answer, but at the same time it's my reproductive success at stake- so I kinda do. I just want her to care as much as I do. I just feel like she is over worked and barely keeping her head above water. Everyone needs rest, and I know she doesn't get any. I'm assuming that since my bleeding is not an emergency, it goes into the "later" pile. Sometimes I feel like a jumble of symptoms and I only get a very vague and hurried pseudo-explainations. I just want to make sure my treatment is best for me. Sometimes I feel like that is impossible.