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CCRM days 1 & 2 (contd.)

… which brings us to today i.e. day 2 @ CCRM (CD 7)

I woke up feeling somewhat refreshed and hopeful. Our only appointment today was a regroup with Dr S. K and I had already been through the questions we wanted to ask him, of topmost priority being his opinion of how I was responding and how he sees this cycle shaping up. We also wanted to discuss embryo banking with him. If you remember, we had brought up this question in our initial consult and in our post OWDU regroup and both times he had suggested we wait on the day of ER for if we make anything above 6 he would not think we need to bank. We wanted to know if his opinion had changed since then.

Owing to a time crunch, lunch today also was at the food court. I had a plate of falafel, tabouli and chicken shawarma from the mediterranean grill while K had some chinese. We checked into CCRM for our appointment and prepared to wait in the lobby. We were called in soon after and seated in a consulting room. That’s when I started feeling really nervous. We had not spoken with the doctor ever since we started this cycle which, if you count the pre-priming and the priming part was over a month long already. I was anxious to hear what he had to say about my chances. I didn’t have to wait for long though; he walked in soon enough and after exchanging some pleasantries it was down to business.

Well, he said, there is good news and bad news. My stomach lurched uncomfortably as my mind got stuck on the ‘bad news’ bit. He said he was happy that the follicles were all a similar size but yes, he was surprised by how little he saw. He did not hold out major hopes for the 9 and the 7 to catch up so, in his estimation, we would be looking at 5 eggs at retrieval. My heart clenched at those words. 5 eggs retrieved would mean at best, if we were ridiculously lucky, 5 mature and 5 fertilized. This was worse than my first cycle where we had 7 retrieved.

We discussed embryo banking which now he was wholeheartedly recommending. He emphasized the financial implications of banking but even though K & I had already discussed it before, all I could think in my heart was I would not be pregnant this year either. Another effin’ year gone by and I am still not pregnant. I tried hard to ignore my mounting frustration and pay attention to what Dr S was saying. He suggested a regroup after retrieval to discuss our next steps esp. what protocol I should be following for the next round. He said we could add in clomid to the cocktail I am taking right now to try kickstart my recalcitrant ovaries into action. If all went well, I would be back here in early January for my second retrieval. Wonderful.

It all seems so damn ambiguous, even this IVF thing. We thought we were covering our bases by going to the best -CCRM. But there is no guarantee ever, is there? Even with some really good test results and a consistent AFC of 13, I seem to be a poor responder and that makes me very angry. I am trying hard not to resent my body for all this but its tough. I see pregnant women everywhere and its hard not to let my bitchy self get the better of me and think ‘oh all you probably needed was some red wine and some mood lighting’. I want so badly to have my own bump, to feel my belly swelling, to hold a tiny little person in my aching arms and to complain of sleepless nights…

Ever since we got back from the appointment I have been quiet as my mind churns in anguish. My darling love, my husband, my best friend is doing such a great job taking care of me yet letting me be. We had planned to go somewhere today, a short trip somewhere close by. But after the meeting, I felt so glum I did not feel like appreciating the natural beauty that surrounds me (and there is SO much of that here in Colorado!). I hate feeling like this. I hate this sadness, this uncertainty getting the better of me to an extent that I am unable to function normally and all I can do is stare into space, trying to calm the noisy chatter in my mind and quell the rising despair in my heart.

I want so badly to believe that there is a happy ending after all this. I want to have faith and I want to feel happy and light with the knowledge that my baby is on its way to me. But I feel immensely tired and sad and just plain bleak. Let’s see what tomorrow’s monitoring brings.

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The suppression check

I had my suppression check yesterday. I think it went well. Thankfully, there were no dominant follicles and no cysts, either of which could have resulted in the cycle being canceled. However, I had very few follicles that showed up in the scan. Just 5 to be precise. 3 on the left side and 2 on the right. The doctor said there were a few small ones he could see on the right ovary but I couldn’t help feeling bummed. I have an AFC of 13 and it’s stayed that way through the past year. Our last IVF I had 9 follicles which had been upsetting enough. How could the number go down by so much? The doc told me not to worry about this; he said this was not an AFC per se and that CCRM also at this stage was not concerned about the no. of follicles (they hadn’t even checked the ‘follicles no.’ box on the lab order they sent). The more important thing was that there were no dominant follies and that things essentially looked good to go. I reasoned with myself that the priming also might have contributed to the low follie count in some way.

I decided to take that info positively and walked down to the Quest lab to get my blood drawn for hormone levels. The lady at the front desk can be pretty moody at times and it was sheer luck that I found her in a great mood. She drew the blood efficiently and sent me packing with the promise that she would courier it out soonest so results could be faxed stat to CCRM.

The rest of the day was a nervous mess as I kept fielding calls from CCRM asking me why my blood-work had not reached them yet. At one point things got pretty stressful as they were about to shut down for the day and Quest had told me that it might take them another couple hours to fax the results out! Thankfully, just 3 minutes before closing I got a call from my nurse and she said they have the report, all looks okay and I am good to go with the stims. In the meantime, I had ample opportunity to get my anxiety levels shooting through the roof as I relentlessly scoured the internet looking for some reassurance that my poor follie count was not an absolute cop-out and there were examples of women having similar numbers yet being successful. All the suppression check posts I found, though, were of women with a thumping 10-20 follies, despite the priming. Thankfully, I had to step out of the house for my acupuncture session which finally put an end to my cyber-stressing! We ended up having a nice evening with my parents and my brothers family joining us for dinner at a restaurant.

I took my first shot of menopur 150IU today in the morning. I know from experience than menopur burns a lot but perhaps because I was expecting it to, it wasn’t all that bad. It’s finally hit me that the cycle is underway and that we are leaving for Denver in 3 days. Hopefully, there will be enough to occupy my mind so that I won’t be going nuts agonizing over each ultrasound and blood-work result. I plan to take my school work with me, go out a lot while we’re there and treat it like a mini-break of sorts. Tomorrow, we are headed to the NorthFace outlet to get some warm gear for our trip.

Keeping fingers crossed!

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CCRM test results

As I return to cyberspace after a long hiatus, there is so much to write about… bear with me as I attempt to fit in the chaos of last month in my next few posts all of which are in danger of being regurgitated today itself (don’t say I didn’t warn ya!).

As if the battery of tests I got done at Zouves’ wasn’t enough, CCRM graciously offered some more to add to the merry cocktail. Some of these (AMH, hubby’d SA) were repeats which they just prefer to get done at their lab while others (amazingly enough!) like the hysterectoscopy, day 3 bloods etc. had not been done before. Also, for all patients above the wonderful age of 35 (which already seems so far behind… sigh!)… they require a baseline mammogram… just in case you’re not wrung out from all the poking, prodding and accompanying stress, here’s a little something more to add to your overflowing cup of joy 🙂

Everything went off smoothly. The mammogram did cause me some anxiety (and not for the procedure itself which turned out to be merely uncomfortable and not hugely painful as I had feared) as the lab tech told me I had dense breast tissue and should not be alarmed were I to be called back for additional testing. Apparently, roughly 50% women have this condition and it makes it difficult to detect things on a routine mammogram. Obviously not thrilled at this revelation, I spent the next week freaking out every time the phone would buzz, convinced that I would be called in but it never did happen! Oh and the whole shipping thing with the day 3 bloods was a little nerve-wracking (esp. since I got my period over a weekend and there are strict missives from HQ to NOT ship blood over weekend) but the local Quest lab stepped up to the task and everything worked out just fine. In fact, the day CCRM received the bloods is the same day they tested and called with the results which I thought was pretty awesome!

So, here are the numbers:

AMH: 1.3 (previously 0.48… yippee!)

FSH: 10.3

Estradiol: 65 (could be artificially suppressing FSH)

LH: 6

AFC: 13 (stayed the same from March testing)

Mammogram: normal (whew!)

Antibodies: only 1 slightly elevated, all other normal

DH SA: Motility back up to 54% (yayy!), Morphology: 2%

Karotype testing for both of us: normal

Genetic panel testing: one indeterminate value for DH (beta thalassemia). However, since I am not a carrier, chances of our baby being affected vlow/ nonexistent)

TSH: bounced from 2.7 back to 2.3 (the first one might have been high cause I skipped my meds a couple days before OWDU. However OB advised upping Levothyroxine dosage to 50mcg from 25mcg. Here’s hoping I don’t lose more weight!)

Phew!

So overall, things are definitely looking up from last time when it seemed to be all doom and gloom. I was ridiculously excited at my AMH going up (even though I get that different labs might yield different results) and more than a little pissed off at Dr Z for stubbornly maintaining that AMH cannot go up! I think the surgery, continued Vit D, acupuncture etc. may have all contributed. Of course, it’s possible that the first result was a freak incident.

The FSH number does concern me. I know it’s borderline (CCRM prefers it to be under 10) but with the high estradiol, the nurse said it’s more likely 11 or 11.5 (not hideously bad but not great either). I’m hoping, praying, begging that my egg quality is not affected.

For now, though, I am going to be happy with these results (which are some of the best I have had ever since we started TTC) and await our next consult with Dr S on Sept. 10.

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OWDU @ CCRM

This should’ve been posted about a month ago but I’ve been in a different mind-space altogether and I suppose ignoring this blog was my way of ignoring everything TTC-related! 

(Aug 7, 2013)

Soooo… we had our initial phone consult with CCRM’s Dr. Surrey (who, btw, is super nice to talk to); he seemed pretty positive about things and asked us to schedule a One Day Work Up, which is their standard procedure. This was on Friday, the 2nd and as luck would have it, I was at the right time in my cycle and a cancellation came through so before we could say ‘Baby’, we were on a plane from California to Colorado!

We took the clinic’s advice to fly out a day before (the appointments began at 645am the next day!) and stayed at the Townplace Suites, a few miles away from CCRM (thanks to them, got a great discounted rate as well!). I’ve been to CO before (accompanied the spouse on a work trip to Vail last year) and I find it breathtakingly pretty. Lonetree, where CCRM is located, is a lovely place with some seriously huge houses, wide roads and lots of sky! While we didn’t have time to saunter about and explore, we managed to squeeze in a trip to the nearby mall (the whole place had wooden floors!!)

Next day, bright and early, we walked over to the reception, checked in and picked up a copy of our schedule. It was quite like the first day of grad school, complete with multiple back to back sessions, orientations and power-points and lots of sizing up strangers! Overall, I would say that the entire affair was extremely well organized, we never waited for longer than ten minutes and everyone was nice and courteous. The only minor complaint I have is about the food; they have a little kiosk that sells sandwiches and stuff as well as some basic beverages (they even provide ten dollar coupons for the same) but it opened late and there was nothing gluten or dairy free that they offered (actually, come to think of it, CCRM doesn’t seem to be a big believer in altering diet–no mention of gluten, dairy whatsoever!). Anyhow, we did get a lunch break of sorts which we used to hop over to a nearby strip mall and chomp on some delish Vietnamese food.

So, back to the OWDU. Basically, it takes you through every possible aspect of the IVF journey at CCRM and provides you with a LOT of information regarding IVF itself as a process. For folks new to the IVF world, there was a great presentation that explained the female biological makeup and how IVF works by controlling hormonal response etc. We found it a little painful to sit through mostly because we were well acquainted with all the info and well–we were starving! But we both agreed that this was probably one of the more comprehensive explanations we had come across and perhaps we would have appreciated it more earlier in our IVF journey.

The rest of the day was a blur of testing, nurse consultation, business office and lab consults etc. An ultrasound for me revealed a normal uterine cavity, an AFC of 13 and good blood flow to the uterus. I was especially happy about the latter because I routinely suffer from cold feet (literally, I mean!) and my acupuncturist has been concerned about uterine blood flow. A hysteroscopy conducted by Dr S himself revealed no abnormalities or inflammation. He was great to meet with, just the right combination of professionalism and a laid-back, friendly demeanor. He told us he was optimistic about our chances and while we had a plethora of more testing to do, he hoped things would work out well.

Another few consultations and 11 vials of blood later (6 for the spouse), we were free to go. We walked out, exhausted and just about managed to make it back to the hotel and crashed! Two hours of a much needed nap later, we were both feeling half-human again. Over a nice sushi dinner, we discussed the day and concluded, cautiously, that it had been a reasonable success and that hopefully CCRM would give us the green flag to try with our own eggs!