Sunday, July 31, 2011

Things That I Can't Live Without

I thought that I would take a break from my bitching and complaining and do more of a lighthearted post...kinda. During this journey there have been some things that have helped to get me through the rough and unpleasant times. Here is a list of the things that I can't live without while going through fertility treatments:

1. Chanel Makeup
 











This makeup is a godsend. I use this foundation along with the Double Perfection Compact to cover up all of the nastiness caused by the fertility meds. This makeup allows me to leave the house without looking like a boy going through puberty. It does a great job of concealing everything...even the blood vessels that have ruptured on my nose as a result of using Lovenox.

2. Google
Yes, I have posted before that I hated Google. It is a great source of anxiety, but it has also helped me get through some uncertain times. I take what I read with a grain of salt, but sometimes it is nice just reading a positive story regarding the situation you are currently in. Does it change the outcome? No. Does it help to pass the time until you get some answers? Sure does.

3. Cheese








I know that this one is odd but it is an absolute comfort food for me. Whenever I feel stressed or worried I reach for cheese. Normally I would reach for a glass of wine but since I can't have it, I have substituted it with cheese. I indulge in Jalapeno brick cheese, string cheese, and even Land O'Lakes deli sliced American cheese. I have always had a serious cheese addiction but I have to say that over the last 2 years it has become much worse.

4. Panty Liners








Yeah, these are a necessity. After using vaginal Viagra, Estrace, and Progesterone, you just can't be without these. For anyone just starting fertility treatments all I have to say is buy them in bulk. Trust me on this one.

5. My OCD
My OCD is often the subject of many jokes but in all actuality it is what helps me stay so on top of everything. Since I am a sticky note and list type of person, I am always organized (that is the understatement of the century) when it comes to my cycles and protocols. There is so much to remember. It isn't just like popping a pill every night. Different drugs have to be given at different times, at the same time everyday. Some drugs start before the cycle, some on CD2 or 3, some mid cycle...you get the point. It also has been a challenge to keep my schedule organized. Trying to balance my work schedule with blood work, ultrasounds, surgeries, and procedures would be next to impossible if I wasn't so obsessive with planning things. As I have said before, I don't have the type of job where I sit in an office most of the day. I travel between two states and have frequent meetings in other parts of the country and even sometimes out of the country. See, OCD isn't all that bad!

Okay, now for the serious ones.
 
6. This Blog
I know that after my 2nd loss that I took a pretty long hiatus from this blog, but I am glad to be back. I find it so helpful that I can take all of my frustrations, worries, and fears and just get them off of my chest. Over the past few months (since I have been back) I have received many emails from both my followers and private readers telling me about their journeys. Even though I wish I never had to go through any of this, I love when I receive an email telling me that my blog has given someone strength or hope. I also love (and need) the support too. No one should ever have to be alone when walking down this road.

7. The Nurse Manager at My Clinic
I cannot say enough about this woman. After all of my late night emails, phone calls on Friday nights or Sunday mornings, calls during the day because I am freaking out about something in my cycle or because I am having a hard time dealing with a loss or a post-cycle difficulty, she still treats me with respect and seems to welcome my "neediness" with open arms. She goes above and beyond every single day. You can truly tell that her job is very important to her and that she takes it very personally. I can honestly say that if she wasn't a part of this journey, my journey would have ended a long time ago. During my cycle after my third loss, I freaked out during one of my monitoring appointments. I started crying uncontrollably and said that I just couldn't do this anymore. She was the one who walked in the room, gave me a hug and then grabbed me by the shoulders and said that I had two choices; I can give up knowing that if I do, this will never happen or I can keep fighting until I get what I want. I don't think that she knows this, but it was those words that gave me the strength that I have, the strength that has gotten me through two more losses, one of which was very complicated. I feel like I owe my life to her and I wish that there was something that I could do to thank her. She has a very special place in my heart.

8. All of My Fellow Infertiles
Where would I be without them? These people are amazing. I have one couple and two women in particular that have been there by my side...and I am happy to report that all of them are now pregnant. The one couple that I have become friends with have been through 8 failed IUIs and 5 IVFs they are currently 38 weeks pregnant with a little girl. One of the women that I have befriended (who has been through hell and back too) just entered her 2nd trimester and the other one is almost 6 weeks pregnant after her first IVF. Through my losses, my failed cycles, and even this current cycle, they are a constant source of support and positiveness. I am so lucky to have them in my life.

9. My Husband
 









He has been amazing. We have had our rough times through all of this, but in the end he is always there for me. He gives me my Estradiol Valerate and PIO injections, he goes to every appointment, he takes care of me when I feel like crap, and most importantly, he puts up with my mood swings caused by the meds. He even, on occasion, has accompanied me to the monthly support group at my clinic. Last August, right after my D&C, my bladder shut down which resulted in me being catheterized for over 6 weeks. I had quite a few complications along with it, not to mention the pain, and he stepped up and did what he had to do. He did the cooking, the cleaning, and the laundry. His number one priority at the time was me and still is today. I don't know what I would do without him, he is everything to me.  

Friday, July 29, 2011

Drama, Drama, Drama...

Day 10 of injections. I thought that once I stopped the Lupron and started the Ganirelix that my headache would go away...I was sadly mistaken. I think that this is the worst headache I have ever had. I am really hoping that it goes away before I start the Terbutaline as I can't imagine this headache being any worse.

The only other thing that I have noticed, and this is a biggie, is that my weight has jumped considerably in the last few days. I'm not sure what is causing it, but whatever it is, it sucks! After breakdown #297 this week regarding my weight, my husband went to Target to buy me a storage bin so I can get everything out of my closet that doesn't fit. He bought me a 34 gallon storage bin and I was only able to fit half of my clothes in there...that is pathetic. As I was putting away the stuff, I was sickened by the size of my clothes. I actually found a bunch of pants and a few skirts that were sizes 2 and 4. Just for the hell of it I grabbed a pair of my size 6 pants and tried to put them on. I couldn't even get them much past my knees. At this point I am sobbing uncontrollably as I am really struggling with this. I can honestly say that if I wasn't in the process of an IVF cycle, this would have been the point when I would have went to my nightstand drawer and grabbed my Meridia or Concerta. I don't think that I explained this before but these drugs completely take away your appetite. I am able to go 3 full days without eating anything when I take these, which I realize is COMPLETELY stupid. I am fighting with everything I have to maintain a healthy diet and I have to say that I am doing pretty well. I just keep reminding myself of why I need to stay healthy. The hardest part about all of this is people obviously notice that I am putting on weight but I can't explain to them why. What am I supposed to say? "I have been pregnant 5 times in the last 19 months and I am also shooting up with the same hormones that are used to beef up cows before they are slaughtered." Awkward! I have been avoiding going out to places my husband I used to go to when I was thinner. I figure that if I go to places where people don't know me, they will just assume that I have always been this fat. If I was pregnant I wouldn't care as much.

I called and made an appointment with a nutritionist only to find out that my insurance will only cover it if you have diabetes. Really? So someone who has a history of a relapsing eating disorder who is trying to do the right thing because they are trying to have a baby can't see a nutritionist?? That is the most absurd thing that I have ever heard of. After talking about it, my husband and I decided that this is still something that I need to do so we are going to contact our local medical center (where I will be delivering...if I ever have a baby) to get a recommendation for a nutritionist who specializes in maternal nutrition. I want someone who will tell me what is best for my baby because that is what I care about right now. I don't want to go to some granola-eating, croc wearing tree hugger that tells me to eat nothing but trail mix and quinoa. I want someone who will teach me what proper nutrition is. I don't just want to be healthy now, I what to make this a permanent thing.

Wednesday, July 27, 2011

Here We Go Again

Yes, here we go again. I went in today for my CD2 blood work and ultrasound and I am perfectly at baseline. My FSH is 5.7, Estradiol was 30, and my antral follicle count was "in the 20s." So it is official, IVF #3 has officially started. Tonight I transitioned off of the Lupron and started 1/2 dose Ganirelix (125mcg) as well as Estradiol Valerate injections. A week from today I am scheduled for a diagnostic hysteroscopy and an endometrial biopsy and then I start stims the following day.

Here is a rundown of this protocol as it is a bit unusual:

7/27-Start 125mcg Ganirelix (given daily until trigger) and 4mg Estradiol Valerate IM injection (given every 3rd day until more than 50% of my follicles are 12mm or greater.
8/1-Start 15mg Prednisone daily
8/3-Diagnostic hysteroscopy (to quickly check my lining) and endometrial biopsy (to encourage implantation)
8/4-Start 600iu Follistim and continue with Ganirelix and Estradiol Valerate. Add in 25mg 4xday vaginal Viagra suppositories and Terbutaline 5mg 3xday and continue through trigger
8/8-Add in 37.5iu of Menopur
Trigger with Novarel somewhere between 8/13 and 8/17-apparently you stim a bit slower with this protocol

There are so many thoughts running through my head right now. This is the most intense protocol that I have done thus far. It has so many components and trying to keep it all straight is making my head spin. I am going to print out a calendar for the month of August and write down what I have to do each day. Due to the amount of meds I am on, my clinic is having me slowly transition onto them instead of starting them all at once. So instead of starting the Prednisone with stims I will be starting it on Monday. The vaginal Viagra and Terbutaline will still start the say of stims. I have never used Terbutaline before and I am a bit nervous. The nurse manager today said it is pretty much like crack but in tablet form. She said that I will be bouncing off of the walls with it. I guess it also causes tremors, headache, drowsiness, and nausea. Yippee, this should be fun!

Tuesday, July 26, 2011

Me: Uncensored

Before I get to the meat of this post, I just wanted to mention that I will be going in for baselines tomorrow morning. I received an email this morning from the nurse manager who told me that if AF wasn't here by Wednesday, they wanted to bring me in for baselines on Thursday. I did, however, wake up to some scant bleeding and apparently that was enough. I am praying that they tell me that I am suppressed enough and that I don't have any cysts. If all is good tomorrow I stop the Lupron and transition to 1/2 dose Ganirelix and start my Estradiol Valerate injections. I am scheduled for a diagnostic hysteroscopy and an endometrial biopsy for next Wednesday. My RE just wants to take one last look before preceding and he also wants to do the biopsy for the sole purpose of damaging the endometrium as this will promote a healing response which should encourage embryo implantation. If the hysteroscopy is all clear I will be able to start stims the next day, August 4th.

Ok, now on to the main portion of this evenings post:

This evening my husband and I ran to the store to look at a few things. At one point I walked past a full length mirror and ended up doing a double take. I stepped back to look again and I was mortified at what I saw. I was absolutely disgusted with the way that I looked, so much that I started crying right there in the store. I couldn't believe how big I looked. Now granted I am "only" a size 10 (sometimes a 12, but rarely) but 2 years ago before starting all of this fertility crap I was a size 4...I even had some 2's that I could fit into. I do realize that a size 10, or even a 12, is not that big. For me, however, it triggers years of struggling. One thing that I have never mentioned on this blog, and something that I rarely talk about, is that I struggled with Anorexia Nervosa for quite some time. It was real bad in my mid to late teens where I dropped down to a mere 97 pounds and was actually hospitalized for almost a month. With continued therapy I did quite well with my eating and my weight, but it was a constant battle to stay on track. In 2001, when I was a paramedic, I started to struggle again. At this point food restriction was not cutting it so I started using Xenadrine, you know, the kind that they ended up banning. I was not taking the recommended 2 or 3 a day, I was taking around 10. I actually ended up in the hospital a few times as my heart ended up in SVT. Since I was fearful for my life, I needed to find another method to help control my weight. As much as I am ashamed to admit this, I went to the extreme of buying two sets of ankle weights that could be hidden under my pants so I could go to my primary doctor to ask for a prescription for Meridia. The ankle weights helped put me over the edge so that I was at an acceptable BMI for this medication. Meridia started to become an addiction. Once I left the ambulance, things straightened out for me again. Before my wedding in 2006, I had a complete relapse eating a measly 200-400 calories a day. In the month leading up to my wedding I ended up dropping almost 20 pounds and actually needed my gown taken in 3 inches on each side. The sick part of all of this is was that I always had a reasonable answer to give someone when they asked me why I was losing weight. After my wedding, things had settled down again.

Now enter fertility treatments. I came off the BCP (after being on it for 14 years) mid 2009. By August I had noticed that I started gaining some weight which was at the same time that we couldn't figure out why my cycles were so screwed up. After my first loss in November, I had noticed that my waist was getting a little thick, but I wasn't too concerned as my body was overcoming a lost pregnancy. As soon as I started fertility meds my weight skyrocketed. Since my #1 priority was having a child I put myself aside and did what I had to do. This didn't become an issue for me again until my fourth loss this past January. Coupled with the devastation of losing another pregnancy, the battle to stay healthy became too much. At this point I was not pregnant, knew that it was going to be months before I could TTC again, so I said screw it and started medicating myself again. I forgot to mention earlier that I eventually ran out of the prescription for Meridia so when I went to Mexico for work, I was able to find it in the Mexican pharmacy so I stocked up on it (you don't need prescriptions there.) So needless to say, I had a ton of it so I started using it. I also had an old prescription for Concerta (a psycho-stimulant drug used to treat ADD) so I also started using that. I lost about 15 pounds in 3 weeks. I don't remember what made me stop but I did. The one thing that I want to point out is that this was the only time during the 2 years I have been in the TTC process that I used these medications or restricted my food and I wasn't even TTC at that time and ended up taking 6 months off. I WOULD NEVER put my future baby at risk.

This is not something that I do by choice. This is not something that I have great control over. The first memory I have regarding my horrible relationship with food is when I was 12. I was sitting in Spanish class when I looked down and looked at my thighs (I was about 108lbs. at the time.) I was grossed out with what I saw so I took off my windbreaker which was tied around my waist and covered them up. From that day forward I would never wear shorts or a bathing suit again. Also, from being on Prednisone for quite some time due to severe asthma, I blew up topping off at over 200lbs during high school. Now being a Freshman and Sophomore in high school and being overweight was not easy. My breaking point is when I got pushed down a flight of stairs by another girl because she thought that I was so fat that I looked pregnant and she didn't like that. God I hated high school!! When I was 16 I ended up having major surgery on my stomach and esophagus so I was on a liquid diet for almost 2 months so the weight just melted off. After returning to school 8 weeks later, I noticed that I was being treated differently and all of the popular kids were noticing me more. So needless to say, I attributed it (at the time) to my weight loss. So that is how it all started.

After tonight I realized that I cannot do this on my own anymore. I need help. I have a poor relationship with food and I need someone to be the moderator. After talking at length with my husband we have decided that it is best if I go and see a nutritionist, sooner rather than later. The whole thing with restricting food and taking pills is how I feel in control over the situation...even though it is controlling me. I need to have control with this issue, but I want to do it by becoming conscious of what I eat. I am not looking to lose weight right now as my main priority is getting and staying pregnant, but I want to be as healthy as possible so that it will carry over into my pregnancy and beyond. I don't want my child to end up like me, and being a (almost) psychologist, I know that if my child sees my current relationship with food that it could influence how they are when they hit the "body conscious" stage in life. I want to do the right thing. I need to so the right thing.

Yes, I'm Complaining Again

This headache from the Lupron needs to stop. It feels just like the headaches I used to get with the spinal taps...yup, it's that bad. I have tried drinking some coffee as that usually helps. It feels a tiny bit better for about 30 minutes after but I think that the coffee is triggering rebound headaches as they come back with a vengeance. Advil isn't working, Tylenol isn't working...nothing helps. I emailed the nurse manager from my clinic a little while ago and asked her if we can just do baselines sooner rather than later as I can't take much more of this. The worst part is that I am leading an in-service tomorrow for about 25 people and I don't know how I am going to do it. This headache as turned me into quite the bitch. Has anyone else experienced headaches like this with Lupron? I have been on it one other time for down regulation and many times as part of a Flare protocol, but I never experienced anything like this before. Maybe it is because I am on double the dose this time??? All I know is that I can't wait to stop it and replace it with the Ganirelix. Enough is enough!!

**I have been trying to type this post all night but every time I stare at the computer screen the discomfort gets so bad that I actually get nauseous. This post has been a work in progress for about 3 hours.**

Sunday, July 24, 2011

I Hate Lupron!

I completely forgot how awful Lupron is when you use it for down-regulation. The last time that I used it for this purpose was in November as my last cycle we did the Flare Protocol so there was no type of suppression used prior to starting stims. Apparently my pituitary gland did it's "dump" of FSH and LH last night and all I can say is that I thought that I was going to die...or just plain kill myself. About 4am I woke up from a horrible dream (one where I was pregnant and someone shot me in the stomach) with a horrible headache and extreme nausea. I also had such horrific pain in my legs...it was almost like the inside of my bones hurt and no matter what position I was in, it wouldn't get any better. The worst part though was the hallucinations and the shear panic I was experiencing. When I woke up I immediately sat up and looked over at my husband...he was not there. I ran downstairs crying, couldn't find him so I ran back up and then I realized he was laying in bed sound asleep. I laid back down in bed but I had this overwhelming feeling that something bad was going to happen. I kept seeing movement and hearing noises like someone was in my house. I laid awake for almost 3 hours crying as I came to the realization that all of this was in my head and I couldn't make it stop. I came close to waking my husband up as I was actually scared. I was worried that this wasn't going to stop. What would I do? Go to the ER and tell them that I am hallucinating because of fertility meds? Yeah, that would earn me a trip to a psych hospital for sure. I ended up finally dozing off and when I woke up, it was over. I felt normal again but was a bit shaken from the whole experience. I immediately remembered a similar incident from last November and it happened around day 5 of my Lupron administration and that is exactly where I am at now. Last time, however, I was driving when it hit and I turned into a mad women and almost smashed my vehicle into the side of our house.

After this whole experience I decided to go on Dr. Google to see if any other women have had this type of reaction to Lupron. To my surprise, I found so many others that have completely lost it. Some have had to cancel their IVF cycles, others needed Benzos just to function, and there was one woman that I found that was actually hospitalized. This did make me feel better but it worried me at the same time as I never want to go through that again. I went and read the Product Insert for the Lupron and it said that up to 45% of women experienced psychiatric side effects from it. I obviously fall into that 45%.

So now that waiting game begins. I took my last BCP last night and I continue with 10 units of Lupron until AF shows up. Lupron can screw up things a bit where AF can come late but if it doesn't show by Thursday I will call my clinic to see if I can go in for baselines. I am not sure if I will even bleed after that last bleed I had about 2 weeks ago. Since I have been on the pill I am assuming that there isn't much of my lining that will shed so I will have to stay vigilant so I don't miss it.

On a different note, I received a phone call Friday afternoon that completely blew me away. The nurse manager at my clinic told me last week that the IVF prices were going up starting August 1st but she wasn't sure how much. I called the clinic's main financial department and spoke to one of the women over there. She went over the new prices and explained everything fully. Yes the prices are going up, but considering what you are getting not to mention the quality of care that comes with it, the prices are amazing. I asked if there were any specials coming up as I missed the last one by about a week. In December my clinic ran a special for 1 week where if you bought a 2 IVF package, they would give a 3rd cycle for free. She said that she didn't know of any and they actually didn't find out about the previous one until the day that started running it. About an hour after I talked with her she had called me back. I figured she forgot to tell me something about one of the packages but that wasn't it at all. She was calling to tell me that because I had missed the special last December that they were going to give me a free IVF cycle so I do not have to pay anything for this current IVF! I can't believe it!! I am so thankful and overjoyed and feel so blessed to have this wonderful "family" in my life. I always say that if it wasn't for their care and support, that I don't know if I would still be doing this. There is, however, a part of me that feels guilty. I know that there are many women out there that can't afford IVF and have to give up for financial reasons. I knew going into this that I only had the funds to do one more package and then my journey would come to an end but still, I could afford one more package. So, I have decided that once my journey comes to an end and I end up with my little miracle in my arms that I am going to pay it forward and sponsor a patient at my clinic and help them out financially through IVF. This process has changed me forever and I would give my left kidney to help someone else out. I know what it feels like to think that I may never be a mom and it is the most awful feeling in the world. I am hoping that through this sponsorship that I can keep another woman from ever having to feel like I have.

Thursday, July 21, 2011

Happy F**king Anniversary!

Today is officially two years since this nightmare began. Just to recap, this is what has happened over the past 2 years:
  • 5 losses
  • 3 IUIs 
  • 2 IVFs (not to mention the months we tried on our own)
  • bladder failure with catheterization
  • 3 D&Cs 
  • 4 rounds of Methotrexate 
  • 29 weeks worth of waiting for my HCG to return to negative after losses 
  • 3 hysteroscopies 
  • 1 septum resection 
  • removal of 3 polyps 
  • 1 SHG 
  • 1 HSG 
  • 2 hospitalizations
Excuse me while I go slit my wrists.

I can't believe that it has been so long. I can't believe that I have done all of this work and I am still right where I started. There are days when all I want to do is cry and there are days when this sadness and anger is fuel for my journey. The worst part about all of this is never knowing if I will ever be a mom. I wish that I had a crystal ball that could tell me if it will ever happen. If I know that one day, if I stay at this, that I will have a baby, I could keep going forever. Unfortunately, life does not work this way. I also realize that there are no guarantees in life. I have had 5 pregnancies, two of which have had great betas, great heartbeats, and everything seemed like it was going so well. Well it wasn't. Sometimes I just wish that I could still do IVF but then not have my HCG levels checked or any ultrasounds until around 10 weeks...just use an HPT like the rest of society does. I think that all of these appointments make the process worse because if things are not "perfect" we agonize about it until our next blood draw or ultrasound. People don't understand why I get upset when they tell me that I am "lucky" that I get to be followed so closely when I get pregnant. I don't consider myself lucky at all. I would give my left kidney to be able to just get pregnant naturally, take a HPT because AF is late, and then go in for my first OB appointment at 8 or 10 weeks. That would freak me out at this point as I know all of the things that can go wrong, but to have that innocence back would be great. 

Today was a day filled with drama. Apparently my RE and the head RE do not agree on the use of Neupogen and the Nitro patch. My RE is fearful that something might happen to me as there is not a lot of research regarding the long term use of Neupogen. In a very long email that I received tonight, my RE indicated that he was worried about things such as leukemia, melanoma, and cancer with the use of Neupogen in someone who is healthy.  He is also very fearful about the effects that the Nitro patch will have on me since I obviously have no heart conditions that require it. This is all experimental. My RE has informed me that he will have no part in the use of the Neupogen or the Nitro patch but the head RE said he will. Well, the Neupogen isn't even an issue anymore as my insurance will not cover it, and I cannot afford it out of pocket. I am still up in the air about the Nitro patch. I want to wait until I start stims as I don't want to use a medication that I don't need. If my lining does fine, then I want to leave well enough alone.

Tonight I started my Lupron. I also found out that my RE only wants me to do 10 days of BCP, not 14 so that is going to shorten things a bit. Since the nurse manager said to do 14 days of BCP originally, I may just split the difference and take it for 12 days...I just want to avoid having any cysts, something that I am notorious for.  I am praying that I will not have any cysts at baseline given that I had 17 eggs retrieved. If I do I can only continue the Lupron for a max of 14 days (and that is even pushing it) until we would cancel this cycle. When I went in on the 7th, prior to me bleeding, I had a bunch of "cysts" on each ovary. These were left over from where the eggs were aspirated from the follicles. They do go away on their own but could take up to 2 months. I have had them pretty much after every cycle but going on a pack of BCP always got rid of them. On a positive note, my medication delivery is confirmed for Saturday morning. I had to set it up for the weekend as apparently my insurance is refusing to pay for the medication unless it is signed for due to it's value. Since I work during the day and I am not home, I had to make special arrangements for it to be delivered over the weekend. They were not thrilled with this but oh well, as me if I care!

Tuesday, July 19, 2011

Thank God I Am OCD...and a Control Freak!!


I called Medco this morning, which is my pharmacy carve-out through my insurance, to check on the status of my medications as I will need some of it for next week. When I called yesterday they said that a request for additional information had been sent to my clinic and they were waiting on that. When I called today they told me that they have no history of any prescriptions being sent from my clinic. What? So after 20 minutes on the phone with them I called my clinic and the insurance specialist was actually on the phone with Medco about my Neupogen. I informed the receptionist that it wasn't just the Neupogen, nothing was received. I called Medco back about 3 hours later and they finally had the scripts. I was so happy to find out that my insurance has authorized all of the medications...and boy is there a lot of them! The only thing that we are waiting on is the Neupogen..the $560/per injection one. I thought that I only needed 14 but apparently my clinic called in 30...umm, that is almost $17K for just that med! If this med gets approved I will be on over $35K worth of medication just for this one month!! That is ridiculous!!

I am absolutely praying that my insurance will cover the Neupogen. Since IVF isn't covered by my insurance, I just emailed the insurance specialist at my clinic to see if we could use the same ICD-9 code for the Neupogen that we used for the IvIg. Since I have CVID, I am hoping that they will just approve it. The cost of one IvIg infusion is roughly $7K and I have one every 30 days, so why can't they cover this? I know that I am sounding greedy but I don't care!

On a different note, I saw my doctor this afternoon and I finally told him about my Barcelona trip. He told me that I absolutely could not go being on these meds. He was going to write me out today but before we jump the gun I would rather wait until the first week of August to make sure nothing changes. I don't want to inform my company that I am not going only to find out that due to cyst or something that I have to discontinue these medications which would permit me to go. I am terrified about telling my boss but I am just praying that he will understand. This meeting is not a typical training, it is more of an informational meeting regarding the global status of our company as we recently expanded into other countries. Not that it isn't important, but I would think that missing this meeting over a training would be better. Reason #347 why infertility sucks!

Monday, July 18, 2011

Blah, Blah, Blah

I am in somewhat of a hateful mood today. First I find out that my insurance is no longer covering my Lupron so now I am forced to get the compounded version of it because that is all I can afford, but I also found out that my insurance has requested more information from my clinic before they will fill the rest of my meds. I am so scared that they are going to cut us off and I will have to pay for my meds out of pocket. If that happens, I am screwed. I went on a few pharmacy websites to see how much my meds would be out of pocket. A Follistim 900IU cartridge I found for around $1200 each...and I would need ten of them. Neupogen is $561 per injection and I would need 14. Ganirelix is $120 per injection and I need 14. Do the math. This isn't even considering that I would also need E2V injections, PIO, Noveral, Nitro Patches, Crinone, and Lovenox.

I am so frustrated and so angry. I swear that the next person who claims that they know how frustrating TTC is because they have been trying for a few months, is going to get punched in the face. No one, and I mean no one, should complain about the difficulties around getting pregnant if they have been trying for only a few months. That is a slap in the face to me and my fellow infertiles. You want to know what "difficult" is? Come walk one day in our shoes and I promise that you will run the other way. I am 3 days from my 2 year anniversary of this nightmare. In these 2 years I have been through 5 losses, 3 IUIs, 2 IVFs (not to mention the months we tried on our own), bladder failure with catheterization, 3 D&Cs, 4 rounds of Methotrexate, 29 weeks worth of waiting for my HCG to return to negative after losses, 3 hysteroscopies, 1 septum resection, removal of 3 polyps, 1 SHG, 1 HSG, 2 hospitalizations and countless days in tears. How the f**k is this fair?

I am sitting in tears as I write this because I know that this nightmare is not over. I know I have no choice but to move forward in this journey but I am scared shitless. I am completely alone as no one around me, except for my friends that have also been down this road, can even remotely begin to understand. I try to talk about it but I realize how uncomfortable it makes people so I quit while I am ahead. You would think that this process would get easier since I have been doing this for so long, but it really doesn't.

Sunday, July 17, 2011

Anxiety, How I Missed You...NOT!!!

I knew that sooner or later my excitement about starting this cycle would become complicated by anxiety...and it has. The first thing that freaked me out a bit was the fact that I forgot about the Lupron shortage. I received a call from this "compound" pharmacy yesterday, wanting to setup payment and shipping for my "Lupron." The cost was 3 times what I normally pay for it so I asked them why. They said that my insurance does not cover "compounded" medications like they do brand medications. When I asked them to elaborate on how Lupron was compounded they said that "well, we as a pharmacy have figured out what the raw ingredients are in Lupron and we are able to make it here." Umm, what? This is not a science project and I am not going to be your lab rat. I immediately called my local pharmacy and they told me that they have one box in stock. Since I am the only patient that they have on it they are holding it for me. Since Lupron is used for the ever so important process of "down-regulation" I am not willing to take a chance using a medication dreamed up by some pharmacist who may not know their ass from a whole in the ground. If some naive first time IVFer wants to take that chance, that is up to them. I will be calling that "pharmacy" first thing in the morning to cancel my order then I will call my clinic and have them phone in a new script.

I am also starting to worry about the whole "husband needing to give me shots" thing. With this cycle not only will he have to give the PIO injections everyday after ET for 10 weeks, but he is also going to have to give me E2V injections every three days starting in roughly 2 weeks. These injections are timed and have to be given within 30 minutes of the time you picked to give the first one. So if I do them at 9pm the first night, they have to be given between 8:45 and 9:15 from there on out. Now I have to worry about my husband's work schedule, making sure he is home every night that I need him. I am also starting to accept that my trip to Barcelona in September for work is probably not going to happen. I become so anxious when I think about traveling with refrigerated medication, not to mention doing the time conversion for my injections and figuring how in hell I am going to give myself shots in my ass. I can totally handle the ones in my stomach, those are a piece of cake, but the ones in the ass I just simply can't do. I have yet to mention to my doctor that I am traveling out of the country as I know that he will forbid me to go and I am not ready to deal with the drama from work about not being able to go. My boss is very wishy-washy when it comes to me doing infertility treatments and I have had no choice but to tell him as I need to take time off when I do them. He has said some pretty hurtful things to me about my losses and the fact that I do IVF and I actually get sick when I have to tell him something that relates to work and the need to use vacation time as I am never sure how he is going to react...it creates the worst anxiety ever. He actually tells me that I should just move on to adoption and give up on having my own child (just in different words) so I know that he is not supportive like I would like but what can I do? I think the worst thing that he has ever said to me is when I told him last July that I was pregnant (for the 3rd time) and he asked me what the chances were that this pregnancy would make it. I held it together in front of him but went home and cried all night afterwards. I wish people would understand that I did not choose this "route" in life. I would give anything to be able to just "have" a baby. The most important thing in my life right now is doing what I have to in order to start a family. Don't get me wrong, I am very appreciative for the job that I have and I put in full effort and strive to do my best, but it is not the most important thing in the world. Is it wrong to think like that?

Thursday, July 14, 2011

Let's Get This Dog and Pony Show on The Road!


This morning I went in for my Beta HCG and to my amazement, and to the amazement of everyone else at my clinic, my HCG was down to 3.1. This is the first time out of all of my losses that my body has been able to "take care of things" all by itself. No chemo, no D&C, no nothing! About 30 minutes after they had called to let me know that my HCG is now negative, they ended up calling back. We had to review a few things for this new protocol but they had the results from last weeks blood work. My anti-thyroid antibodies came back completely normal, which is great. However, my DHEA level came back quite low. Normal DHEA levels for someone my age, range from 80-300. Mine however were only 37! DHEA levels naturally decline with age but low levels in someone my age, which apparently isn't that common (go figure), is linked with things such as premature ovarian failure. We already knew that something was wrong as my AMH is only 0.67 (similar to someone in their late 40s) and the fact that I only had 2 chromosomally normal embryos out of the 17 retrieved this last cycle. I was originally taking DHEA but the side effects were a bit much so my RE lowered the dose. I was having a problem with hair loss, oily skin, and acne (I looked like a boy going through puberty!) I am now being put back on 25mg three times a day and I have no choice but to suck up the side effects. This coupled with the fact that I am starting on a pretty hefty dose of Prednisone, I will look like a bald, hormonal beached whale!

Speaking of protocols...we are already starting this new one! I get to start BCP tonight which makes me very happy. Instead of taking the whole pack, I am only taking it for 14 days. Seven days into the pills (next Thursday) I will start the injections of Lupron, 10 units nightly until AF arrives. Once that happens I will go in for baselines and then stop the Lupron, switch to 1/2 dose Ganirelix and begin my Estradiol Valerate which is given as an intramuscular injection every 3 days. The normal dose is 10mg but I guess we are upping the ante as I will be on 20mg injections. I have heard these are quite fun (note the sarcasm) and are 100 times worse than the Estrace. Hello major bitchiness! Ten days after the onset on AF is when I start my stims and I will be using 600 of Follistim and then add in 37.5 of Menopur after 5-7 days. We are trying to get the Neupogen approved through my insurance as well. I thought I would only need 14 days worth but it ended up being 30 days, so the cost has gone from $4000 to $8000. It is a drug that is given to patients undergoing chemo and those going through a bone marrow transplant, but studies have also showed that it can greatly improve the endometrium. I am crossing my fingers that the insurance will cover it. In addition, I will be using a Nitroglycerin patch to help my lining. Apparently the Nitro patch can make you quite sick but at this point I don't care, I will do anything if it can help.

All of my meds were ordered today and I am actually quite excited to get them. They are a reminder of what I am trying to accomplish. In a sick sort of way, I am comforted when I do my nightly injections. Not only do I like the routine, but I feel as though I am contributing to all of this. Let's face it, the fun and joy of getting pregnant is gone forever. No longer can I just have sex followed by 10 minutes of having my ass propped up on a pillow with my legs straight up on the headboard (so nothing leaks out) in hopes of getting pregnant. Ahh, the stupid things I used to do...

Monday, July 11, 2011

Options

I haven't figured out if this is going to be considered an early "miscarriage" as my HCG did rise appropriately over a course of 7 days or if this will be deemed a "chemical pregnancy." Either way, it is a loss and my body is obviously trying to "clean things out." This is the first loss out of 5 that I have not needed any intervention such as Methotrexate or a D&C so I did not know what to expect. Last night I started with what seems to be the heaviest period I have ever had. I have already had 2 mishaps today as the pads can't keep up with the bleeding. I think the worse part is the cramping and the headaches. I am hoping that this will start to let up soon. This morning I did POAS. I used one of those stupid 6 day FRERs that detect levels as low as 6.8 and I did get a very faint positive so I know that the HCG is still in my system. My HCG has to be a 10 or below in order for me to start on BCP so I am praying that it will be that low by Thursday when I go back in. If it is close, I am going to ask to come back in on either Saturday or Monday as I don't want to wait another whole week. I am just praying that it is in fact going down like it should.

Over the past couple of days I have been thinking about where I am heading. I know that I may face more miscarriages, ectopics, and chemicals if I continue on. I am still wanting to move forward and I am ready to start another IVF cycle, but I don't know when it is going to come to the point where I can't do this anymore. I hope it never comes to that, but if it does I want to be prepared. Prior to these last two losses, my husband and I met with two adoption agencies to see what our options were. I knew in my heart that adoption was not something that I wanted to do as I wanted to be a mom to my own child. After having these last 2 IVFs result in pregnancy yet fail, my attitude is starting to change dramatically. As much as I would love to have a child that is part me and part my husband, I want to be a mom more than anything. I have been thinking more seriously about adoption and my husband and I are now seriously looking into it. With the 2 agencies that we met with, the cost to adopt a domestic infant is roughly $31K. After spending all of this money on IVF and genetic testing, I just can't whip out that kind of money without some planning. I have emailed my company as most major companies offer some assistance with adoption...most offer to cover 50% of the cost but I am not sure if that is the case with my employer. The other thing that I found out is that there is a $13K tax credit for adoption which I believe that we would be eligible for...not sure about the income requirements though.

I am up in the air about how fast I want to move with this. The initial process takes roughly 6+ months to complete as you need to have meetings with the agency you choose and most are booking out pretty far. You also need to have a home study and this also takes some time to complete. The home study costs $750 and depending on the agency that we go with, that could be the only fee that we would have to pay until we are matched with a birthmother. With one agency the initial up front costs are around $11K because they charge $5K to make a profile for the birthmothers to look at and you also pay for application costs. The whole process from start to finish takes approximately 18 months but can very greatly on the number of infants that they get into their program and if a birthmother chooses us sooner rather than later.  There is a part of me that wants to start the process now as I am not sure if I am going to survive fertility treatments for another 18 months. There is a big part of me that is saying that after these next two IVF cycles, I am done. My entire life, not to mention my husband's, has been disrupted. We have completely stopped living as everything for the past 2 years has revolved around getting pregnant, fertility treatments, and losses. All of this is so hard to swallow but I am hoping that it will become easier as time goes on. It's amazing how much one's life can be changed in such a short time.

Sunday, July 10, 2011

Thank You

I just wanted to thank everyone who responded to my last post. It was really nice to hear how some of you have found faith and have used it to help in this journey. I am trying to figure out a way to help myself with this issue. I am not sure if I want to go talk to someone or if I should figure this out on my own. The one part of this that I struggle with the most is feeling like my fate is purely my responsibility and that I have the power to control everything that happens. Thinking this is putting so much pressure on me as I feel like when something goes wrong, it was either my fault or that I just have really bad luck. Back when I had faith it was nice to just think how everything happened for a reason, a greater reason that we would never understand. Having now experienced my 5th loss, I sometimes feel myself struggling with the thought that I could control the outcome of my pregnancy. There is a part of me that thinks that this will never have a happy ending as, biologically speaking, my body just isn't capable of producing a child. Having that thought in my head is really difficult as it makes me question why I am getting ready to jump feet first into this again. Obviously there is something that is keeping me going. There is something there that is giving me the strength to continue on with this journey. I am not sure what it is but I am very thankful for it.

Some women have said to me that there is no way that they could have survived what I have gone through. If you would have asked me 2 years ago if I could, I would have told you that I would never have been able to handle it. Well I have. I ask myself everyday how I am still standing, how I am able to continue on. I really don't know that answer to that but I can tell you that I just can. I know that I could have more heartache and pain in the future, but I believe that it would be more so not having a child in my life to love. I often think how meaningless my life would be without a child. Whether it is faith, luck, or pure biology, I hope that one day, everything will just work out...I just need it to!

Thursday, July 7, 2011

Where Does Faith Come From?

I was brought up Catholic. I participated in Sunday school, sang in the children's choir, made my First Communion, and continued weekly religious instruction up until high school. Since I was pretty sick as a teenager I was unable to make my Confirmation as I was in the hospital for treatment pretty much every other week over a period of 2 1/2 years. As an adult, at the age of 23, I went back and made my Confirmation after going through a series of classes with my church. We were not "overly" religious, we just knew that we believed in God and that one day we would live with him in Heaven. Little did I know how quickly things would change for me. As time went on the "naiveness" of childhood started to disappear and I was left facing all of these experiences from my childhood that I didn't know how to handle. Realizing how much my past had affected me, I quickly became angry as I did not understand how God could have let these horrific things happen to an innocent child. I soon came to realize that I had been dealt an unfair hand, and things were not getting any better.

When my Dziadziu passed away back in 2006, I forced myself to believe again as I wanted to still feel connected to him. The only way that my heart could heal was by knowing that he was in Heaven looking over me. On July 1, 2009 I had a dream that my Babci and I were at her house packing a suitcase. When I asked her where she was going she said that she was taking a long trip. We went to the train station where we boarded the train together. We sat next to each other and started talking. I remember saying to her that I forgive her and I know that it wasn't her fault (referring to her aggressiveness due to her dementia.) She started to cry and told me that she was so happy to hear me say that. The train stopped and we got up. As I started to walk down the isle she told me that she was getting off but I had to remain on the train. I was confused but I listened. The train started to move again and I watched as she disappeared as the train moved on. The train returned to the original train station and I got off. When I woke up from this dream I was a bit taken back and I didn't know what to think. I got ready for work as usual and left for an early morning meeting. As I was turning off of my road, my phone rang and it was the nursing home. They were calling to tell me that Babci had passed away about an hour ago. I knew right then and there what that dream meant. Over the past couple of years, I have been holding onto that dream as I just couldn't believe that it was a coincidence.

After my 3rd loss last August I really started to question everything again. I just didn't understand how this could be happening. Four days after the D&C my bladder shut down and required emergency surgery...it was in no way related to the D&C. I ended up being catheterized for almost 7 weeks. It was at this point that I knew that I no longer had faith, life was just a crap shoot and I had the worst luck in the world. After finding out that my HCG rose last week from 7.8 to 13.4, even though an extremely low HCG, I started talking to Babci and Dziadziu again. I laid in my bed and cried to them, telling them that I need to find my faith again as I am too weak to do "life" on my own anymore. I asked them to give me a sign, something obvious, so that I would know that I could believe again and I had nothing to fear as my fate was ultimately up to God and all of this was just somehow part of a bigger, better plan. When I found out on Tuesday that my HCG had jumped to 110.6, I couldn't help but feel that this was my sign. The nurses even agreed that it was an incredible jump and that things could be okay. I wasn't letting my guard down, but I did have a glimmer of hope. Driving to my clinic this morning, there was part of me that was thinking that this could all be okay. This was going to be the miracle that will give me my faith back. About an hour after I left the clinic, my phone rang. They had called me to let me know that my HCG had dropped to 50. Every little bit of comfort and hope that I had towards life was gone. I kept telling myself not to be stupid as how could I expect that transferring one embryo, even though chromosomally perfect, would result in a pregnancy. Granted, the fact that it was chromosomally normal raised the chances of a successful pregnancy from 25% to almost 70%, but I knew that when we were told that we only had one good embryo to transfer that this would never work. The part that I don't understand is why did it have to start to implant? Why did it continue to develop and why couldn't this just have been a negative cycle? This is now my 5th loss, how is that fair? I am starting to think that this dream is a dream that cannot be.

As I sit here holding my dogs collar in my hands, as the tears role down my face, I realize that the last good thing from childhood is now gone. I have lost my best friend, my faith and another pregnancy. I wonder how strong I really am?

Wednesday, July 6, 2011

Saying Goodbye Is Never Easy

Today I said goodbye to my best friend of 15 years. It is never an easy decision to make but the look in her eyes said that she was ready. Matty was there for me during some of the most difficult times in my life. At one point, she was the only friend that I had. She will always be in my heart and I will be forever grateful for the love she gave and the joy she brought me over the past 15 years. I love you Matty and you will always be in my heart!

Tuesday, July 5, 2011

What The F--k!

Today I went in for my 3rd Beta. I decided to wait at my clinic so that I could be there when my HCG came out so that we could make a decision on which intervention we should use to get rid of this. After what seemed like an eternity one of the nurses came out and said "well, your HCG is 110.6 and your progesterone is 24.9." WTF!! I immediately started crying because this wasn't the plan. We were supposed to have some answers today and now I have to wait even longer.

A few hours after my appointment the "gas pains" that I have been having since late last night started to intensify to the point where I needed to lay down. I figured that it was just the progesterone so I wasn't too concerned. I immediately feel asleep and woke up a little while ago to find that I have started bleeding. With all 4 of my previous losses, I have never bled, not even with the ectopics. Just to be safe I called the "on call" nurse for my clinic just to let her know what was going on. I felt a bit stupid but her reassurance that I was doing the right thing by calling made me feel so much better. She had me take 2 extra strength Tylenol and I have to touch base with her at 9pm. The pain is fluctuating between a "my ovary is going to explode" type of pain with a dull ache across my back to pure cramps. I am thinking that it is too early for the ectopic, if it is one, to be causing this pain. Since my HCG is still low, I would think that it wouldn't start causing a problem until it got a little higher, but I'm not sure about this. I have been VERY lucky with my ectopics so far as neither of them damaged any part of my tube since they were caught so early. I am actually hoping that this pain is just my body starting to miscarry. I know that sounds awful but I really need this cycle to come to an end...I have had enough! Also, if this is yet another ectopic, this will be my third but it also means that both my IVFs resulted in a tubal pregnancy. Why would that be?

I will keep everyone updated as to what is going on. I an planning on this being uneventful but with me, who the hell knows. If everything stays quiet, I go back to my clinic on Thursday for a repeat HCG. If this pain doesn't subside or gets worse they told me that I would need to go to our local medical center tonight where my RE has privileges so I can be evaluated. I personally would rather just wait to see what happens. Obviously if the pain got so bad that I couldn't stand it I would go, but I would prefer to wait it out to see what happens on it own.  

Monday, July 4, 2011

If You Can't Say Something Nice, Don't Say Nothing At All

It is pretty sad that I am referencing a quote from a Disney movie when this post is going to be nothing but a bitch fest...how ironic! I have been struggling all weekend with this whole being in limbo thing. We know that my HCG went up, but what the hell does that mean? I absolutely refuse to sit back and let time do its thing. When I did that in January, my HCG took 11 weeks to return to normal (3 rounds of Methotrexate and a D&C later.) I POAS this morning and unfortunately I got a nice strong positive which probably means that my HCG is going up. We already know that this isn't a viable pregnancy so lets get this freaking show on the road. Why are we going to sit and watch the number trickle up?? I have decided that when I go in tomorrow morning for my Beta that I am going to ask if I can sit in the waiting room until it is processed. This way we can figure out what we are going to do. Best case scenario is that miraculously my HCG will drop over night and it will be negative tomorrow, but lets face it, we all know how my luck goes. I am assuming that it will probably be somewhere between 30 and 50. I am worried that if it is, they will make me wait as it is yet another "appropriate" rise. Just because it is appropriate doesn't change the fact that this pregnancy is over. What are we going to do, wait 5 weeks and watch it go up to 1500 so we can confirm that there is nothing there?? I don't think so! I am going to beg them tomorrow (if my HCG warrents it) to be given Misoprostol so we can get this show on the road. I just really need this to be over. I just realized today that since the first of the year, I have spent exactly 6 months just waiting...waiting for my HCG to come down, waiting for the septum resection, waiting to heal, waiting for my pregnancy test, and now, waiting for my HCG to return to normal...again! I am done waiting!

Over the past few days I have realized that I have turned sour. Any bit of "positiveness" I had about this whole infertility journey is gone. I am finding myself needing to step away from those that are currently going through the IVF or IUI process. I honestly do not have anything positive to contribute. There is nothing positive about doing this. After going through what I have gone through, how am I supposed to be positive? There will be no more "this is your month" or "I feel so good about this cycle." I am done with that bullshit! I know that those who haven't been through what I have can't even begin to understand what its like, and there aren't that many that I personally know of (actually none.)

In two weeks it will be our 2 year anniversary (if you want to call it that) of starting this nightmare. Here it is, July 2011 and I am still childless and going through yet another failed pregnancy. After 5 failed pregnancies I am starting to believe that this is never going to happen for me. My own RE is even saying that it may take years and more miscarriages...if it ever happens. I sometimes wish that I was on the other side where I never had a positive test and all I had were BFNs. I absolutely hate when people say "well, at least you know you can get pregnant." Yeah, that's great. I can get pregnant but my body kills it every time. Yeah, that is so much better! Getting pregnant to only have the hope and happiness ripped away from you time and time again is so much better isn't it?

Friday, July 1, 2011

Is An Adult Beverage Too Much to Ask For??

Knowing that this is over, I was looking forward to enjoying a glass of wine tonight. I woke up this morning before my appointment and POAS...there was a faint line. I knew going into my clinic that my HCG went up. It ended up going from 7.8 to 13.4. Since technically it is an "appropriate" rise, I still must continue all of my medications and proceed as if I were pregnant. My clinic has to cover their ass. I go back Tuesday morning for another level. My RE said today that if it is slowly rising over a period of time, that we will have to intervene. If my level plateaus or shoots up we will have to assume it's ectopic and I will need to be treated with Methotrexate again...more Chemo, ugh! If it is going up but only by a point or two we could always use Misoprostol to induce the miscarriage. Sounds like fun, huh?

After having my blood drawn, my husband and I sat down with my RE for almost an hour. I trust him with my life as he is a straight shooter and he feeds me no bullshit. After this current loss, we can safely assume that my lining is the cause of all of the previous losses. What can you do to fix it? Nothing. He said that it could feasibly take 2 or 3 years for this to work for me, but he truly believes, that if I stay at it, it will happen. He said that we could face more miscarriages or more chemical pregnancies by going forward. He said the length of time that I can do this for is dependent on how I am doing emotionally and mentally, not to mention financially. He did say that the easiest and quickest way for me to have a baby is through surrogacy. I would consider this, but again, I have no family or friends (that currently aren't pregnant) that would do this. He said that as long as a woman has a uterus, she can be a surrogate. I asked him if there was a cut-off age and he said that there really wasn't. He said that some one in their 50's could do this for me. This is the time that I really wish that I had a family. How awesome would it be for someone that you love and are close to give you such an awesome gift. To do surrogacy I will basically go through IVF up until the ER. Once the eggs are removed from my uterus and fertilized with my husband's sperm, they embryos would be transferred back into the surrogate's uterus. The only thing that the surrogate would have to do is use vaginal estrogen and progesterone for a few weeks prior to the transfer and for 10 weeks after.

Since my husband and I don't have anyone in our families that would do this (you just can't ask them) surrogacy is not an option. Since we have no other choice we are going to proceed with more IVF. For my next cycle we will be doing a Agonist/Antagonist Conversion Protocol with Estrogen Priming. I will take BCP for about 8 days or so and add in Lupron. Two days after starting Lupron I stop the BCP. AF should arrive 3-5 days after stopping the BCP. When AF starts the Lupron is stopped and low dose Ganirelix is started along with estradiol valerate injections every third day. High dose Follisitm is then started and 37.5U of Menopur is started 4-5 days later. The "estrogen priming" is continued until more than 50% of my follicles are at least 12mm in size. Follisitm and Menopur are continued until trigger. This protocol was developed for poor responders and those with poor egg quality. In poor responders, Lupron given along with stims can over suppress the ovaries which leads to very poor response. However, Lupron is needed prior to starting stims as the pituitary gland needs to "dump out" all of its FSH and LH. If this is done after the start of AF, egg quality can be affected because of the initial rise in LH and FSH. Lupron is replaced with 1/2 dose Ganirelix at the start of stims so that the risk of over suppression is minimized. Typically the estradiol valerate is started prior to the onset of AF and then discontinued. This will take away the effects it has on the endometrial lining as AF naturally thins your lining and we are trying to thicken mine, not thin it. The estradiol valerate is discontinued early in follicle development so the medication doesn't impact egg quality. There are no guarantees with anything, but this is something that we haven't tried yet.

Along with the above mentioned protocol we are also going to incorporate Nitroglycerin Patches and possibly Neuprogen to help with my lining. The Neuprogen costs about $4000 per cycle and we are not sure if my insurance will cover it. If they won't there is no way that I can afford it. I will also be having an endometrial biopsy prior to the start of stims so that the lining will be damaged in hopes that it will over compensate to repair itself by thickening. Also, when I go back to check my HCG on Tuesday we are going to test my Anti-thyroid Antibody level, and my DHEAS level. Tuesday can't come fast enough!