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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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Oh, the follies!

We are finally in Denver! It’s been a dramatic couple days and I have a lot of updating to do so there will be a flurry of posts over the next day or two. Bear with me!

Tuesday was a hellish day. It was my first monitoring appointment at my OB’s office and it just did not go the way I wanted it to. K drove me over to the clinic and promised to join me after he got some coffee to jumpstart his day. However, before he got there I was undressed and ready for the scan. The doc came in, liberally pumped lubricant on that vile ultrasound wand and started off. He was looking at my right ovary first and he nodded his head as he measured what I assumed (and hoped!) was a follicle.

How many, I asked nervously. I don’t think he heard me for he remained quiet for what seemed like an eternity. 12, he said, looking at me and smiling. Oh really, 12?? That’s simply wonderful, that’s possibly the best– … I cut the sentence off right here as I realized he did not mean the number of follicles but the size instead. Wait, there’s more there right?, I asked. Not really, he replied. There’s got to be some small ones you can’t measure right now, I insisted. He shook his head grimly saying that there was just the one and moved the wand over to point at the left ovary.

My stomach did that uncomfortable sinking thing it does whenever disappointment hits me. It’s a mixture of despair and deep, paralyzing fear I think that makes me head swim and makes me want to run, flee to the comfort of my bed so I can safely hide within the covers and keep all the demons at bay.

This is much better, he said as he scanned leftie. Better, to him, was 4 follies sized at 16, 14, 11 and 10 mm. This made me feel even worse for I knew that the 16mm one seemed too big for this early into the stimming process and I instantly started worrying that I would ovulate before time and my cycle would get canceled. The rest of the scan was a blur as I tried hard to control my lurching stomach and my woozy head. Doc looked back at me as he walked out urging me to have faith and to remember that it only takes one (if only I had a penny for every time someone says that to me!). I could barely look at him for I knew another sympathetic word would have me sobbing my heart out. I hurriedly scrambled into my clothes and walked out the clinic downstairs to get my blood drawn at the lab.

The lab assistant seemed to be having a good week as I found her once again in a rather cheerful mood. She whisked me in and had me out in under two minutes, promising me that she would send the bloods out soonest. I walked out to find K sitting in the lobby waiting for me. One look at my wan face and he knew something was wrong. I told him about my 5 follies, about my worry that I was responding too fast and yet, not enough and then I told him I did not want to talk about it at all. I felt sick to my heart, I wanted to crawl into a black hole and never come out, I wanted K to hold me and tuck me away in some corner of his shirt pocket. I was angry, I was sad, I was frustrated but most of all I was scared. Petrified, really.

The drive back home was a somber affair. I walked inside, ignoring my parents questioning looks. Shook my feet free of their shoe-d confines, drew the drapes tightly shut and crawled into my bed, covering my face with the blanket. I knew everyone was worried. I wanted to tell them I was okay even though I was far from okay. I did not know how to do it. Again and again my mind insisted, how could there be just 5 follies. From an AFC of 13, I get only 5 stinking follies? Even my first IVF I had 9 follies.

What made everything worse was that it was a special day for us–an Indian festival that celebrates marriage and married life. I really like celebrating this day with all its attendant rituals, especially dressing up in traditional clothes. Yet, here I was in my sweatpants and a ratty old sweatshirt, feeling numb and ignoring my rumbling stomach. K called many times to try soothe my fears but with each passing minute I grew more and more anguished. I cried for hours on end, my poor parents trying their best to get me to calm down. At one point I was so exhausted from all the crying and not eating that I dozed off. I woke up to realize it was late afternoon. CCRM still hadn’t called which meant they did not have the results with them yet.

The next couple hours were crazy stressful. CCRM was about to shut for the day and the nurse had called me to let me know she had neither the u/s report nor the labs. I called the doc’s office and had them re-fax the report. The labs seemed to take an eternity but a call to quest revealed they had been faxed early afternoon. I was at the edge of my patience. I was worried that I might ovulate too soon and wanted to start the cetrotide sooner but of course needed the nurse to confirm that with me. Furthermore, I wanted to know if the cycle was at risk of being canceled. Finally at 4.58 pm mountain time, my nurse called and told me they had everything but that Dr S had left so she would have Dr. Schoolcraft look over my reports and advise me on next steps. I waited by the phone and in about 20 minutes she called back to let me know that I had to start the cetrotide the next morning, keep all other doses the same and travel to Denver as planned. To my concern that things were looking bleak, she said it did seem that I was responding fast but then my follicles were of similar size and my estrogen level (at 209) was where they like to see it at this time.

It wasn’t quite the thumping vote of assurance but then, under the circumstances, this was the best that could have happened. At least there was no mention of canceling cycles. Moreover, she told me they preferred doing their own measurements and bloodwork as they did not trust results from other labs. With that in mind, I finally ate and tried to salvage what was left of the day. My adorable husband had already given me a wonderful gift–a beautiful down jacket to keep me warm in Denver–and he now helped me pack and get things in order for out trip the next day.

As I wrestled a nagging headache in bed at night, I prayed hard to God to carry me over this one.

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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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The long weekend that became a week long!

How was everyone’s Labor Day weekend? Well you’re about to find out how mine was! As I mentioned in the last post, non-medicated IUI was what we had decided for this month and that’s what we did. The u/s on CD 11 showed 3 strong follies at 17, 17 and 18mm with the doc refusing to believe I wasn’t on injectables (go acupuncture!!) and we were asked to BD that night and trigger the night of CF 12. On a side note, it will never cease to be amusing for me to get instructions on when the spouse and I should be getting naughty!

The trigger shot was causing me a huge amount of anxiety… I am dead scared of needles and the only way I survive getting so many pricks (I’ve got a record number this year) is simply by squeezing my eyes shut and refusing to open them till the band-aid has been applied. The pain I can handle; the sight of needle penetrating skin-NOT! Hence it was left to the husband to do the deed. We got some pretty rad instructions from the pharmacist and looked up videos but preparing the medicine was the most nerve wracking thing ever. I have no clue how doctors trust their patients to do this stuff! I managed to inject the diluant into the powder but then the damn mixture refused to get re-injected into the needle. I went into panic overdrive but the spouse totally played the winner as he not only managed to do what I couldn’t but also injected me so smooth I couldn’t feel a thing! The IUI itself went very well; doc was certain I was ovulating and said she got a clear shot at my cervix (yayy!). We went back home happy and took a nap to celebrate (it had been an early morning!).

Trouble came knocking in the evening. First it was just this sore feeling in the tummy that became progressively worse and turned into a raging stomach ache that had my curled up fetal style and screaming for my mommy! I couldn’t move, I couldn’t breathe it was like someone had bashed up my insides with a baseball bat and, for added effect, taken a few shots at my back too. To make things prettier I puked up all my dinner. DH called doc and was told I likely have mild OHSS which will take a few days to go away. Wonderful! I drank tons of Gatorade as told and rested (couldn’t move if I’d tried!). The next few days the pain did get better (that was without doubt the worst pain of my life! Worst!) and I got an u/s to make sure things were okay. Doc said ovaries were slightly swollen but nothing to worry about.

The days after the checkup, the abdominal cramping went away and so did the terrible back ache. However I had a recurrent fever and this crazy bitch of a pain in the back of my head which felt like someone had taken pincers and was pulling at my nerve and releasing it. It would go away for a while but then come back. Tylenol would help bring the fever down but it drew the line at the pain (Tylenol to me: “sorry buddy this bitch ain’t my thing!”).

So today is day 6piui and I feel better without a doubt. Temp was normal in the morning and so far the bitch ache has stayed away. Fingers crossed!

One thing the docs did warn me about is that in case I get pregnant this cycle the OHSS type symptoms are likely to reappear. Sweet.

It’s been painful, it’s been lonely and it’s been miserable. My husband has, as always rallied around me but this time we both anew felt the ache of not having any family (or good friends) around us. That’s why I had started this blog. So I could vent here and be brave for him. But sometimes I wonder if anyone even reads it. If the reading stats are actual people or just some digital bots who clearly wouldn’t give a damn about babies!

So… if you’re reading this and you’re human… say hello! It would mean the world to me.