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CCRM days 3 & 4 (CD 8 & 9)

I can’t quite say how I expected things to turn out here at CCRM but so far it’s been a pretty action-packed few days. Today was my 9th day of stimming and I’m tiring of things. I haven’t been sleeping well (at all!) and however much I try I’m unable to nap through the day. That couple with the constant poking (stims + bloodwork) and prodding (ultrasounds) has left me pretty darn tired. Strangely though, this hasn’t resulted in my shifting into instant bitch-mode; instead I remain fairly calm about things. Even hopeful!

So without further ado, here are the numbers from the past two days:

Day 8

LO: 18.5, 13, 12.2, 9, 7, 6.6, 5

RO: 16.7, 14.6, 12.2, 6.2, 6

E2: 1369

Day 9

LO: 18.2, 14, 14, 11, 10, 9

RO: 18.5, 14.3, 12.2, 9.3, 6, 6

E2: 1928

So, it seems that things are moving along very slowly indeed. The good thing is that the bigger follies are all a similar size but then a couple of them seem to have actually shrunk a teeny bit which, of course, worries me greatly. The nurses at CCRM, while extremely kind, are all reserved in their opinion of how things are progressing and it being a weekend I could not get Dr S’s opinion on the matter.

All I know is that for now, I’ve been told to continue with my stims for tonight and tomorrow morning and then go back to CCRM at 7 am (!!) for another monitoring appointment. As soon as we get done with the u/s and the bloodwork there, we have to rush to Denver to get another dose of cetrotide from a local pharmacy here ’cause I’m out of it. I asked the nurse today if I would need other stims as well but she said we wouldn’t know till my appointment tomorrow. So we reach the pharmacy, get the cetrotide, finish the injections and then drive back (fast!) to CCRM for my IVF physical appointment. Once we’re done with that we need to check out of this hotel and (they did not have rooms available here starting tomorrow for the next few days) and hang out somewhere till its time to check into the other hotel. Oh and, in between, we have to go back to CCRM yet again so that hubby can do his thing for the backup freeze. Whew! It’s going to be a long, long day.

While I am tiring of the shots, I do want to give all my follies the chance to mature and make beautiful eggs for which I welcome the opportunity to stim extra if needed. I’m praying hard and staying hopeful for what lies ahead.

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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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CCRM days 1 & 2

I write this post with a heavy heart. I wish I had good news to report. I wish things were going as well I as I have been hoping, wishing, praying that they would. But, for some reason, luck does not seem to favor me lately.

Day 1 (CD 6)

We got into Denver late Wednesday evening and after grabbing a quick dinner en route to the hotel, we checked in and almost immediately started the whole injecting process. Hampton Inn & Suites where we spent the first night does not have refrigerators in all rooms so it was quite the complex process getting them to put the medications in the fridge, the coolers and ice packs in the freezer and retrieve them one at a time as needed. Anyhow, once done, I read for a while in bed and by midnight fell asleep. I had a strange, restless night waking up many times to use the bathroom. My nose felt blocked and my throat was uncomfortable congested no doubt from the change in weather. It’s not crazy cold yet but there’s a distinct difference from the NorCal winter we are used to. Early next morning I noticed a significant amount of white discharge and immediately panicked worrying that I might have ovulated too soon. There was nothing I could do, however, till I made it to the clinic for my 9 am monitoring appointment.

We reached CCRM early and were taken in quicky enough. The woman who did my ultrasound was extremely nice and super apologetic that she was causing me a considerable amount of pain. She was just measuring everything twice since the numbers were vastly different from my first appointment back home. Here is the final tally for day 6:

LO: 14.7, 12.4, 10. 7.3, 2

RO: 14, 10, 9, 1

Two very kind nurses sat down with K & me in a small, private chamber and gave us these numbers, explaining that they do not rely on local monitoring too much for precisely this reason–measurements are often under or over estimated and it they all too often miss out on some of the smaller follies. They were both confident that I was doing pretty well and the two smallest follies had every chance of catching up. Our hopes renewed, K & I completed our morning set of injections in the same place and soon after I went in for blood-work. Once done, we stepped out of the clinic feeling lighthearted and madly optimistic about the future. From a dismal forecast of 5 follies we now had 7 measurable and 2 small ones. Things could well still turn out in our favor. K still was of the opinion that we should bank but I was hopeful we might be able to hit a home run with this very cycle itself.

We drove over to Townplace Suites where we had reservations for the next 4 nights or so. It was too early to check in though so we spent the next hour at Target, K sitting at Starbucks and working and me just aimlessly wondering the aisles, feeling cautiously happy. We went back to the hotel only to discover that the room we had checked in to was still a mess and had not been cleaned. A sharp reprimand to the front desk had us moved into a freshly cleaned room with the assurance that we would be charged half the room rate for that night! K worked through the evening, he had conference calls to attend and I slacked of as usual, absorbing myself in a historical romance and spending an inane amount of time googling follicle numbers for poor responders.

In the evening I got a call from the clinic. Dr S had reviewed my reports and wanted me to continue on the same dose of meds. He also did not require me to come in the next day for monitoring but just for the regroup appointment we had scheduled with him. My estrogen level was looking good at 767 and the nurse said things seemed to be tracking on target.

With that reassuring news, we stepped out in the evening to grab a quick meal at the food court in the Park Meadows mall after which we rushed back to our room for injections. Since we’re done with saizen, the nightly regime has become way simpler with only Gonal F which is a pen and therefore does not require any mixing. That done, I settled into bed with my book and fell asleep soon after. I slept well for the most part but had an extremely disturbing dream in which K and I were in a car hurtling down a freeway. I was urging him to drive slowly but just as he was about to slow down a large truck came in front of us and he slammed on the brakes. We crashed into a black wall of space and the last thing I remember before being jolted awake was thinking this is how it feels like to die! How truly morbid, right? I get scary dreams very often and once I wake up I am so frozen in fear that I cannot move for the next few minutes. This time though I nudged K awake and he instantly pulled me close to him. I felt relief flooding my senses and soon enough dozed off again.

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Friends, tests and meds

I always wonder where my blogging compulsions lie –do I tend to write/ express more when I am feeling down and out or when I’m invigorated and energetic? The past few days have been a mix of both! I’ve been extremely emotional and hyper-reactive but I’ve also been very happy and content. We’ve been going out a lot and meeting up with friends old and new. I think the best thing going on in our life right now (sad as this is gonna sound!) is the fact that we now have three couple friends who do not have kids and two of them, seemingly, by choice. It is such a pleasure to be able to hang out without feeling ridiculously envious of someone for their procreational achievements!! Plus, we end up talking about so much that is interesting like travel and news and movies and… just about everything.

One of these couples are actually going through an IVF cycle around the same time as us which is how we got to know them. I met the wife through an online support group and we really hit it off. Somehow our husbands also got along like wildfire and now it’s a strange mix of sadness and hope that I feel as we both move forward with our cycle, knowing that this friendship could fast go south if either of us gets pregnant and the other one doesn’t. I am fervently hoping that this is the lucky cycle for both of us and we both end up successfully pregnant. There is nothing I would like more than for us to have our babies around the same time and to grow closer as a result.

In other news, the errant LH surge was finally located both through a blood test and through CVS’s not-so-amazing strips. Plus (and this is so exciting!), for the first time ever my TSH levels fell below 1.9 to 1.45!! I was so happy to know that the meds were finally working! In that respect it’s been such a great couple of months. Barring my borderline high FSH, I’ve had consistently good test results and so has K. Perhaps this bodes well for the upcoming cycle.

Freedom called today to let me know they’ve shipped the meds; they will be here tomorrow and Monday onwards I start off with the Estrace/ Cetrotide etc. Next week the saizen will be here too. I am cautiously excited! We booked our tickets yesterday and even though there is a suppression check to go through before we are given the clearance to stim, I am quite hopeful things should go well this time.

More to follow…

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Here we go!

Today is day 1 of our treatment cycle at CCRM. Today, K and I started our ten day course of twice-a-day Doxycycline. I got my period late last night and now have to wait for my LH surge to show up. Ten days after I get a positive OPK I start taking Estrace twice a day and from there on the ball starts rolling. My tentative date to start stimming is the 20th (although I think it will probably be the 18th, given my expected date of surge) and I have an estimated retrieval date of Oct 31st! Which means that we expect to fly out to CO sometime around the 22nd-24th of this month.

There’s many things different about this cycle -the estrogen priming, the cetrotide (I used ganirilex last time), the saizen and the dexamethasone. Also the stims are lower to begin with which is something I’m happy about. I am following a strict policy of singular faith in my doctor and no crazy, anxiety-inducing Dr Google searches! If I start thinking of just how many variables are at play here or how long the entire process is likely to be, I know I’ll just implode. So, one day at a time it’s going to be. Right now my focus is to make the most of each day with good food, moderate exercise, meditative visualization exercises and a special treat to just indulge in :).

It’s been a lazy Saturday so far. I woke up to the incessant chatter of rain and a palette of multi-hued green, always a beautiful sight! I’ve not had much by the way of PMS or aches/ pains but I’m taking it easy and generally staying away from household chores etc. Instead, I plan to make best friends with the couch & my favorite throw and get a little caught up on my dissertation related work (which I am lagging SO far behind on!). Hubby’s been an angel, getting me choice delights to tempt my recalcitrant tastebuds with… bless him!

In a way it’s all so fragile. I feel us beginning to hope again – the painfully tender, green & eager stalks of hope trembling their way into the world amidst a sea of concretized disappointment. I want to cover them up with my hands, cradle them, coo and soothe them to suppleness. I want them to ignore their loneliness and their habitat and forge forth towards the sun.

I realize that this could be the beginning of the most beautiful, the most coveted phase of my life or another stepping stone in what has already been a pretty enervative journey! Either way, my goal is to try stay in the moment and stay somewhat neutral especially since disappointment still hovers around in dark shadows and hope, teasingly, skips in and out of view. What matters right now is that I have this wonderful, blessed opportunity and I’m going to relish every bit of it. I’m going to dip into my faith and wrap it around me snug and tight.

Wish me luck!!

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Seductive dalliances with the perennial what-ifs… plus, a calendar!

Last week was emotionally draining. After the consult with Dr S, the realization that we’re about to cycle again hit me and it was all I could do not to get overwhelmed. Distraction intervened in the form of a trip to LA to meet with the dissertation committee. I flew out early morning and got back in around 10. Perhaps it was the physical exhaustion (flight was delayed on the way back), perhaps it the sudden influx of pregnancies in my department or perhaps it was the reinvigorated tussle between dissertation related inertia and enthusiasm -I came back home feeling subdued unlike my characteristic chattery self.

Also weighing on my mind was the big, white elephant in my inbox -CCRM had finally sent the calendar (it looks like the study schedule for a ridiculously competitive exam!) and I have been largely ignoring it, watching it burn a slow hole on my laptop screen. Going with an altered protocol this time means there’s a lot of stuff I’ll be doing which was missing in my previous IVF attempt–adding in estrace, cetrotide, dexamethasone, saizen etc. I swear each time I look at the calendar I can feel my blood pressure escalating at the thought of what lies ahead. I know I should be excited but I’m mostly apprehensive.

Friday, however, brightened my spirits. I went for an early acupuncture session and as always Y managed to relax my frayed nerves. I drove back home feeling significantly better. The rest of the day was a busy blur as I worked on my stuff and K micro managed a Dish TV installation (goodybye pricey Comcast!). I was aghast to walk in on him and the installation guy happily routing a thick, black wire right in the middle of my beautiful living room, smugly announcing that by making sure half of it was submerged under the rug, aesthetics were all taken care of! Men! Friday evening was spent on the couch, watching movies (free HBO for three months!) and guzzling herbal tea.

Saturday, I got to know that my brother (who recently moved to the US and lucky for me, found a place just down the street!) was moving back to the other side of the planet with his family. I am happy for him; this is something he’s wanted for a long time. But it’s hit me hard. Having them here was just so wonderful. They came at a time when we were at our most vulnerable and it felt good having someone to talk to when our first cycle failed. Sis-in-law and I often went out for errands and shopping trips and my nephew is such a delight to be with. It’s going to be tough seeing them go. For the first time ever, we’ve had family here in the US and, that too, living so close to us. It brings me back to the feeling that were my own family complete today, perhaps I would not feel as rudderless and raw all the time. What makes the situation worse is that I work from home and afternoons are really the loneliest times. As I went for my afternoon walk today I passed by my nephew’s school and felt a jab of sadness that soon he won’t be studying in there anymore.

I’m trying hard to stay even-keeled both for the cycle ahead and for the love of my life, my darling husband who patiently supports me through everything even as his eyes tear up often at seeing me sad. One hug from him and the world doesn’t seem such a threatening place anymore. The what-ifs, though, are always around, hanging out in the dark recesses of my mind, waiting to pounce upon me and smother me with their what-if-ness! Just do, don’t think, I keep repeating in my head like a mantra. It’s hard though. I can feel depression creeping in as the fear of another potential failure paralyses my senses. I find it hard to move on yet I only find solace in movement -in walking, in doing the most basic tasks –cleaning, scrubbing, washing dishes, sorting laundry. Sleep teases me, promising a lingering embrace one moment and the very other, deserting me without warning.

I sit on my bedroom floor typing this post. As I look up skywards, I will the clouds to ebb away and for sunshine to become a part of me.

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Yellow, not green!

We finally had our much anticipated regroup with Dr S today. It went by pretty quick and was sort of anti-climactical. I mean I obviously knew, basis the test results, what he was likely to say but somewhere our last failure has left me so wary I was prepared for the worst.

He started by discussing our test results and I believe he mentioned the word ‘good’ when describing my ovarian reserve even though my FSH is borderline high (10.3) and my AMH is below what they consider normal for my age at about 1.4-1.5 (mine’s 1.3). APA testing revealed only one slight elevation on the IgM (mine was 13, normal’s <11) so he said I did not need any blood thinners (interestingly this is something he told us on our first phone consult itself without any testing!)… phew! Uterine x-ray showed an AFC of 13 and normal blood flow to ovaries all of which is good. DH’s numbers also look good with his motility at 55% even though morphology is low at 2% (he did remind us that they use very strict criteria so, with 4% being the normal, this wasn’t too shabby). His sperm DNA fragmentation results will still take another week or so to come in.

So, he is sticking with his earlier prognosis and his recommended protocol for me is

****drumroll****

EPP–Estrogen Priming Protocol

He also wants to add in a growth hormone (saizen??) and probably an antagonist to prevent premature ovulation. He thinks we should wait on taking a call whether to do embryo banking or not depending on how the ER goes. Anything above 6 eggs and we should not need to bank, according to him.

We asked him a few questions which he patiently answered. He will be using a double trigger for me (HCG/ Lupron) and closely monitoring estrogen levels even though I am unlikely to hyperstimulate. When I asked him how I can improve egg quality he asked me if I was taking the supplements prescribed by them and I said no, I am taking then of my own accord. He told me to ask my nurse for a list and then hung up with the promise that a nurse would contact us soon to discuss scheduling.

So, from the above, it would seem that this went pretty well, right? Well, perhaps its the exhaustion from last evening’s yoga class but truth is, I don’t feel too spirited somehow. Perhaps because I am still, somewhere in the back of my mind, coming from a DE perspective whereas he was pretty clear right from the get go that I should try again with my own eggs. Perhaps because I was anticipating getting rejected by them basis my AMH (which had been much lower at 0.48) and my FSH (which I had never tested before). Or perhaps because I just don’t trust my luck anymore! I kept asking K whether he thought we’re in and he said of course silly girl, this is it; we will be cycling at CCRM.

Really?

All I could think about was one strange comment Dr S made–something about this being a yellow light, as opposed to a red one. Why not green, my mind asked? I categorically asked him if there was any further testing to be done or any issues to resolve before we could start and he said no, it all looks good. Then why yellow? K reasoned with me saying that he is probably meant that about the whole process, especially since we made no chromosomally normal embryos last time. He’s probably right. Perhaps I am just being silly and over-thinking things (surprise surprise!).

The nurse is yet to call. I hope she gets in touch with us soon. I need to see my calendar to believe this is real!