Monday, 7 December 2009

IUI #2 insemination

We had our second artificial insemination yesterday. I was sitting in the procedure room, half naked with a towel draped over me for modesty, hoping that my bladder was just full enough. A well dressed woman comes into the room, wearing a short black dress, black stockings, and long black boots. She is holding a tube of sperm, and wants us to read the label to make sure it is correct. We confirm that those are our names, and then she asks me to put my legs up in the stirrups. I realise that she is the doctor!

I suddenly feel very embarrassed and nervous. I am getting accustomed to medical people in scrubs seeing me half naked, but this woman doesn't look a bit like a doctor. Here I am, legs splayed with everything on display, in front of a woman who looks like she's about to go out on a dinner date. I am so flummoxed I forget to ask any questions about sperm numbers or quality.

The IUI itself was a bit painful, but it was over very quickly. Happily, they did not play any love ballads for us while we rested for 15 minutes. They even let me keep an ultrasound picture of the sperm cells entering my uterus (the white dot in the center-right of the picture).




I must say, I am really glad that I have a break from the three-hour round trip to the hospital, the blood draws, and anxiously waiting for the phone to ring between 2pm and 5pm each day. We are taking a break cycle after this one, so we have six weeks of rest and relaxation.

Saturday, 5 December 2009

IUI#2 CD12

CD3-CD7 50mg Clomid
CD8-CD11 Estrogen
CD8 Disappointingly, the dominant follicle is on my right ovary, the one with the partly blocked tube. The follicle is 12.7 mm, and my lining is very thin at 3.4 mm, only 0.35 more than at CD3.
CD10 Dominant follicle at 16mm, lining at 4.8 mm (compared to 7.6mm when I was on Menopur)
CD11 Dominant follicle now ripe at 19mm, but lining only 5.78mm (triple stripe pattern). We trigger with HCG at 11pm. The needle injection hurts.

I have been extremely irritable lately, and my poor husband has had to bare the brunt of it all. He also has this thing about me taking personal responsbility for my actions, so I can't get away with just yelling at him and then blaming it on the drugs. Perhaps they could also percscribe some valium so that I could glide serenely through the days, instead of feeling my blood boil at every minor hindrance.

If this cycle doesn't work, then we will take a month break over Christmas, and then one to two more IUI cycles. If I am still not pregnant, we will move onto IVF. I am ambivilent towards IVF. On the one hand, there will be more medications and drugs and operations. On the other hand, I no longer have to worry about adhesions and blocked tubes, and our chances of success go from 10% to 40% per cycle.

These past IUI cycles have been odd. After so many months of privately monitoring my cycles with temperatures and LH cycles, I am surprised to find a team of midwives now working with me, and wishing me "good luck". I do appreciate the support, and the extra monitoring and knowledge, but the endless blood draws and commuting to the hospital are exhausting. And these area just the IUIs - we haven't even gotten to the hard stuff yet. I hope that all this does not last for longer than it has to.

We go in for the IUI tomorrow at noon. Either way, no injections for at least six weeks. Fingers crossed.

Thursday, 26 November 2009

IUI#2 Day 3

Three days ago.

"An exciting day today, yes?" The nurse asked me while taking my blood.
"Well, it is a rainy day" I answered. I didn't have the heart to tell he that I had already taken a home pregnancy test and recieved a negative result. She just seemed so excited, and then so disappointed when she called me at 4:02pm to tell me the result.

But the good thing is we can sneak in another IUI before everything closes for Christmas. This time I was randomised to Clomid, so fewer injections but perhaps more side-effects.

They are going to start monitoring me earlier, as I responded very quickly to the stimulation last time. My first ultrasound is next Tuesday, December 1.

Today.

Today is day 3, my endometrium is at 3.05mm, I have no ovarian cysts, my bloodwork looks good, so we have the green light.

We have one last chance for a positive pregnancy result in 2009.

Wednesday, 18 November 2009

12dp IUI



Here's how my first IUI cycle went down:

CD2-CD7: 75 IU Menopur. Despite having my wonderful husband to do the injections, they get slightly more painful every day. I am grateful that Mel's book recommends a warm compress, which is a great comfort to my sore belly. Frustratingly, both the Menopur and Pregnyl here in Europe come in these fragile glass ampules that need to be snapped in half to access the powder or solution. This makes the mixing process even more fiddly and difficult.

CD8: Right ovary: several small follicles around 8mm. Left ovary, one large follicle at 15.5mm. I am very happy that the dominant follicle turned up on the side with my good tube. We continue with 75 IU Menopur. They call me to come in again the next day.

CD9: Left ovary follicle now measures 18.6mm, my endometrium measures 7.6mm. It is still strange to see my uterus clammed shut, so used to seeing open pictures on the web. They call me that afternoon, want me to do the trigger that night and come in the next morning for the IUI, which means that I must have started ovulating too soon. Trigger at 11pm.

CD10: Our IUI is scheduled for noon, but doesn't happen until 12:40. My poor bladder is so close to bursting it is all I can think about. The midwives leave us waiting in the room to the sounds of "Eternal Flame" and "My Heart will go On". I lay there, trying not to pee on myself, while being forced to listen to Celine Dion. It is not a very romantic insemination.

CD21: Today, 12 days into the two week wait, with my blood test having to wait until CD29. Fertility friend gives me a score of 35/100 for early pregnancy signs.


~~~~

So, the timing was off, and my endometrium was thin, but at least we will have IUI number 1 under our belts soon. One more 'n' for the clinical trial, either way. If it's negative, then we'll set up the next IUI, and in the mean time I will get my hair dyed and eat lots of soft French cheeses.

Friday, 30 October 2009

IUI #1

Today is Day 2 in our very first IUI cycle.

The lab tests from the laparoscopy came back clear, so I do not have endometriosis. However, with only my left tube completely clear, the odds of pregnancy are slightly lower. The professor estimated that we have a 10-20% chance of success per cycle, with a 40% chance of success over three IUI cycles. Interestingly, he recommends a rest cycle in between each IUI cycle for both psychological and biological reasons.

I have joined the university's head-to-head randomised trial comparing Clomid with Menopur for IUI. Now no matter what the outcome of this cycle, I am increasing scientific knowledge that will help subsequent people with infertility make more informed decisions. They gave me a selection of brown envelopes to choose from, and I chose one that means I will be taking Menopur this cycle. This is my protocol:

CD1:
CD2-CD7: 75 IU Menopur
CD8: Ultrasound and bloodwork - Menopur dose as advised
CD9-17: Possible ultrasounds and bloodwork - Menopur dose as advised

Once the follicles look ripe:

Day -2: Trigger with Pregnyl
Day 0: IUI
Days 0-15: Progesterone suppositories
Day 15: Blood pregnancy test #1
Day 27: Blood pregnancy test #2 and ultrasound, if #1 positive

I am very thankful that I have my dear husband to do my injections. He is an expert at these things, while I can't even bear to watch the instructional video. I am also very glad that I only have one injection per day, it is subcutaneous, and the post-IUI progesterone is not an injection.

The hardest thing will be to try to keep everything in perspective. I am a very goal-oriented person, so if this IUI doesn't end in pregnancy I will feel as if I have personally failed. So my main mission this cycle is to focus on staying happy, to enjoy my time doing the things I love, and to remember that I already have a wonderful life.

Sunday, 4 October 2009

Laparoscopy / hysteroscopy

It has now been one week since my laporoscopy / hysteroscopy. I am recovering well, and they found a cause of our subfertility. I had intrapelvic adhesions between my uterus and abdominal wall, as well as on my fallopean tubes and ovaries. The methyl blue test showed that my left tube is unblocked, but my right tube is partly blocked. The doctor thinks that the adhesions will return in about six months, so we have a few months to try IUI, then on to IVF. The adhesions should not affect our chances of success with IVF.

The surgery really wasn't as bad as I thought it would be. For the previous five days I was on a low-fibre diet, with a bowel prep the night before. On day day of surgery I wore a dress and felt strange without my wedding ring. All the staff were great, especially the nurse who looked after me all day. My husband and I checked in at 8:30, and we had our own private room by 9:30. I got changed into a dashing blue gown with press-studs, sad that they wouldn't let me keep my socks on. I hunkered down under the blanket and started watching TV on my iPhone to distract me. The nurse could see that I was a bit nervous, and offered me "something for the pain" and "something for the anxiety". She looked at my belly and told me it was "good". The nurse took my blood pressure, and did a pregnancy test. At 7 days post ovulation it seemed a bit pointless, especially as abstinence was ordered by the doctor. The funny thing was, I was a bit afraid that it would come up positive, and I would be sent home in disgrace for wasting their time. However, it was negative.

In no time at all it was time for surgery. They even let me hold my toy dog that I had brought with me for moral support (yes, I am 29 years old). The wheeled me until just outside the doors of the operating room. There was a small boy of about 10 who was being wheeled through too, crying and vomiting and sounding terrified. I, on the other hand, was feeling quite mellow. Exactly like myself, but not at all worried or nervous. Yay for tranquilizers. A while later, they had me get off my bed and walk into the operating room.

I lay down, and started to shake. My mind might not have been nervous, but my body was cold and apprehensive. One nurse started sticking all these heart rate monitors all over me, while the anesthesiologist was prepping my drip, strangely in my wrist and not in my hand like in the movies. Everyone was moving very quickly, and they all seemed to know exactly what they were doing. The drip was in quickly, and the anesthesiologist told me that I would feel a bit of discomfort when the medication started flowing. The nurse held an oxygen mask above my nose. I asked them if they wanted me to count backwards from 100, and they said no. The infusion started, felt unpleasant, and within seconds I was feeling very sleepy. I wanted to tell them that I wasn't completely asleep, because I could still hear the beeping, but after that I fell completely asleep.

The doctor's notes say that they first conducted a hysteroscopy, and that my uterus looked normal from the inside. It measures 7 cm. A small biopsy was taken to double-check for endometriosis.

For the laparoscopy, a 12 mm incision was made just underneath my belly-button, and my abdomen was inflated. Three more incisions of 5 mm were then made lower down. From the outside, the uterus looked normal. There were adhesions in the vesico-uterine fold, in the pouch of Douglas between the sigmoid and peritoneum, on the right fossa ovarica (depression that lodges the ovary), and on end of the left fallopian tube. The adhesions were blocking the fimbriae that collect the egg from the ovary and pull it into the fallopian tubes. My corpus luteum was still bleeding. It was coagulated, and a cystectomy was conducted and sent off for further tests.

Methyl blue die flowed quickly through my left tube, but very slowly through my right fallopian tube. The adhesions were removed, my abdomen is deflated, and my catheter and breathing tube were removed.

I remember dreaming about wandering through the cobblestone streets of the city, but the next thing I new two hours had passed, and I was in the recovery room, with my toy dog on my pillow. I was so worried that I would never wake up again that I was just so thankful to be conscious. I started shaking, and the forced warm air under my blanket. I told them I was in pain, and they added something to my drip.

They wheeled me back into my room, and there was my wonderful husband, who hadn't left the room for even an instant. My throat was sore, and they wouldn't let me use my soothers because they had lidocaine in them. But they gave me something else to suck on to relieve my throat. I spent the afternoon dozing and recovering, getting some more infusion of "something for the pain" in my drip, and after that "something for the pain" to put under my tongue. The doctor came over in the afternoon to tell us the results. She said that the adhesions are most likely due to "an infection in the pelvis", which the internet tells me is most likely clamydia, which is very surprising.

I have taken the next week off work. The first 24 hours were difficult. It hurt every time I moved, and I could not lie on my side or sit up without intense pain in my shoulder, due to the residual gas pressing on a nerve. But I was still able to lay on the couch and have a Mad Men marathon, so it wasn't so bad. Every day got easier, and I am surprised how quickly I am recovering. The incisions are tiny, and the stitches are going to be removed tomorrow.

I am so glad that we now have an answer, and I have some neat photos of my uterus to boot. So now that the cobwebs have been cleared away, I am hoping for some good news in the next twelve months.





Tuesday, 22 September 2009

Laparoscopy next week

The midwife called me back last week, saying that she had heard that I had some “not so good” news. She was really kind and gentle, and she has me booked in for a laparoscopy next Monday. At first I was really frightened, but then I had a long talk with my husband and he was very pragmatic and thoughtful.

He said that if I was too worried about the procedure, then I should cancel it. If I thought that the benefits outweighed the risks, then I should go ahead but stop worrying. He also gently reminded me that the best possible outcome will result in childbirth, which is much more risky and more painful. And then it hardly gets easier after that.

So, I thought to myself, am I in, or am I out?

I’m in. Now I’m focussing on the short term and long term positives. A low fibre diet the week before means lots of rice bubbles, white bread, and peanut butter. After the surgery I get a week at home with the cats and a pile of DVDs. We also get an answer to the question of endometriosis. And then our first IUI in December.

Raising a child brings joy and delight, but it also involves dealing with crises, disappointments, and pain. It is messy and complicated and stressful. So I am viewing this process as an educational experience. I need to learn how to communicate my thoughts, fears, and needs. To avoid panic attacks, and to act calmly and rationally. To enjoy the delights of each day, and aim directly for happiness and not for proxies.

Monday, 7 September 2009

Empty

"How was your weekend?" my colleagues ask.
"Great!" I answer, thinking I had my first miscarriage.

I told myself that I would think in all the appropriate terms. Zygote, blastocyst, embryo. I know all the statistics. I know that I had a 20-50% chance that it would end too soon. I wouldn't skip ahead. I would take each day as it comes.

But as I felt those twinges inside me, I got attached far too quickly. I imagined being pregnant during the Winter holidays, and the baby being born in Spring. We would have our first child before I turned thirty.

I should be happy, that I know that we can now at least get pregnant, that somewhere inside me a sperm can meet an egg. Objective: fertilisation - achieved. This should be a good sign.

However, I can't help but feel a little empty.

Sunday, 6 September 2009

Chemical pregnancy

I started bleeding today. Chemical pregnancy. Four weeks and six days since my last menstrual period. Twenty one days post ovulation.

We have a houseguest with us, so I must act normal inside the house. So this morning I sat out on the fire escape, freezing in my pyjamas, quietly sobbing while I watched the people down below. Then I logged onto Fertility Friend and ticked 'miscarriage', and was informed that my status had been changed from "pregnant" to "waiting for ovulation".

I don't know where we go from here. I would like to hope that it is a positive sign, that it means that at least one of my tubes is not blocked and the sperm can swim. But why has it taken us this long to even get to this point? Do I still need a laparoscopy? Do we move straight to IUI?

As I look down at all the blood, I can't help wondering where the little poppy seed is, and how it failed to find a foothold in the dark.

Fading

Friday: The midwife at my infertility clinic called me to schedule my laparoscopy. I told her that I had a positive pregnancy test, so I probably should cancel the appointment. She congratulated me, and I asked her to pass the news onto the professor.

Saturday: I went for a walk through the park in the sunshine. I felt happy and full of hope. My womb felt like it was tugging and stretching. As I fell asleep I had to sleep on my back, because my breasts were so sore.

Today: In the absence of a blood test, I took another pregnancy test. I was hoping that the line would be twice as dark as the one that I took 48 hours ago.

Instead, the line is fading, and my spotting is increasing. Things are not looking good for the little poppy seed.

Friday, 4 September 2009

Zwanger

Yesterday afternoon, I picked up a digital pregnancy test, or a "test de grossesse / zwangerschapstest"" as they are known here in Belgium. Sixteen euros. Sheesh. Luckily, instead of trying to fit "enciente/ pas enciente; zwanger / niet zwanger; gravid / ikke er gravid" into the tiny window, there is simply a plus or a minus. So I come home, and use the fancy test. The hour glass flashes, and I put it down to wait. Three minutes later, I return, and I think that I catch a glimpse of a minus sign. Yep, I think, that's more like it.

But then I pick it up, and this is what I see:



It still feels very academic to me. Like this stick that I'm holding is referring to someone else. I still don't feel any difference - just some very mild pre-period cramping.

Still, I know I have to tell my husband. Maybe that will make it real. I pop out to a local baby store. It takes me a long time to walk in. Once in, I feel as if everyone is looking at me. After a long deliberation, I pick up a cute bear onsie for newborns. It looks disturbingly large. I come home, wrap it up, write a note, and order pizza.

Over dinner, my husband tells me about his day. I am terrified of telling him. I still don't feel like it's true, and that I am jumping the gun or making it up. So I give him the gift, and a card that says "I am pregnant. I am due on the 9th of May, 2010. I love you". He looks at me with wonder and amazement, and pulls me over to the couch. "Wow", he says, as we touch noses. I can't stop holding the positive pregnancy test. It is the only evidence that anything is difference. We spend the rest of the evening discussing wills and life insurance and maternity leave and childcare. It still doesn't seem real.

Thursday, 3 September 2009

Pale pink line

So, this cycle I ovulated sometime after cycle day 13. I had a positive luteinizing hormone rise at day 12, but no temperature rise until day 18. If I did ovulate at day 13, then today I am 18 days into my luteal phase. I took a pregnancy test 14 days past my LH surge, when my period was due, but it was completely negative, as usual. I also noticed I had some spotting and cramping, and thus had a few glasses of wine and a cup of coffee, and waited for my period to show up. Today, four days later, it still isn't here. My pregnancy tests will expire in two months, so I figured, why not use another one, even though my temperature is falling.

I remember reading that usually the second line shows up straight away. But mine, as usual, fades to white. I put it down, but then a few minutes pick it back up again. If I look very, very carefully, there appears to be an extremely faint second line. So faint, I must be hallucinating. I pull up the Fertility Friend gallery of very faint positive pregnancy tests, and they all look darker than mine. I pull it out again. It's more than a shadow than a line. The test strip cost a dollar from the internet, is over a year old, and has been shipped over two continents. It's probably not very accurate.

I have had no other signs. No nausea or sore breasts or anything. I feel completely normal.

If it is positive and I had a healthy pregnancy, I would give birth on the 9th of May 2010. That is far too soon and too real and too scary. My hands shake at the thought. It's all too soon. I'm not ready.

So I will test again this afternoon, and we shall see then. But I might pick up the strip and look at it again.

Hmmm...

Thursday, 13 August 2009

So. Surgery it is.

We had our second infertility meeting yesterday. It is mostly good news. All our genetic tests came back normal, which means that we both have the right number of chromosomes, and aren't carriers for any major monogenic diseases. Our blood hormones also look normal. We found out that my husband's sperm morphology is 4%-7%, which is sub-normal, but not really that bad.

Thanks to Fertility Friend, I know that we have had well-timed intercourse for over 14 ovulatory cycles with no pregnancy.

So the next suspected culprit is endometriosis on my side. This is tricky to diagnose externally. I never suspected this, though when I think back my periods do seem to be getting worse with time since I went off the pill. So the professor recommends a laparoscopy/hysteroscopy.

While it is keyhole surgery, it is still surgery. General anesthetic, filling my abdomen and uterus full of gas, and three keyhole cuts - one for the camera, and two for the robot arms. They say that in 50% of cases like ours, they find mild endometriosis, which they repair with a laser during the same operation. After treatment, they move onto IUIs and notice a doubling in success rates compared to women who do not have their endometriosis fixed. We will then have a 10-20% chance of success for the first IUI cycle.

So the expected timeline would be something like:
October: Hysteroscopy
November: Stimulated IUI #1
December: Stimulated IUI #2
January: Stimulated IUI #3
February: Meeting to discuss options

Now I am waiting for the nurse to call me to schedule my first ever operation. I am quite worried and nervous. They say there is <1% chance of complications and that they do around 10 of these operations a week, but I am still frightened of catheters and drips and anesthetic and incisions. Still, I suppose pregnancy and childbirth is no walk in the park either, so I might as well start to get used to strange things happening to my uterus.

I am not looking forward to the pain.

Friday, 17 July 2009

Internal Ultrasound

Yesterday I had my internal ultrasound. Again, it was at the gynaecology ward of the hospital, so I was surrounded by large bellies and excited couples. I imagine this would be very difficult for many.

It was a little bit disconcerting, sitting there half naked with my legs hoisted up to the ceiling while the doctor was asking me about my medical history. It also didn’t help that the technician was new and couldn’t find my uterus or my ovaries. For a while there I was convinced I didn’t even have a uterus, which had me shaking with nerves on the cold chair.

But in the end, my uterus and my ovaries passed this superficial test. They exist, there is no endometriosis visible, and my left ovary has a bunch of immature follicles that are competing for dominance on this CD6.

I asked the doctor if I could get a copy of the images. He looked completely baffled. He said “why, to show your family?”, like I was going to post my grandmother a photo of my empty uterus. So I just told him that I liked to keep a copy of all my medical records. He didn’t give me any images, but I did manage to wrangle a copy of the report.

As for the results of all our other tests? We do not find out until August 12. I called up the Fertility Centre and they only discuss the results in person, during the consultation appointment. They do not release the results before then.

This is very frustrating. I like to do my own research on the implications of the data, but instead we have a single meeting with the head of the centre to discuss strategy where he is holding all the cards. I know that all the information we need about our own bodily fluids is just sitting in a file someone, and I am unable to access it.

So more waiting and waiting for us.

My insides:
Uterus:
Position: ante
Dimensions: L:53 A-P:26 T:32

Endometrium:
Imaging: clear division
Structure: intact

Right Ovary
Imaging: visible
Morphology: Normal
Limitation: Regular
Size: 31
x 23
x 18
Volume 6.7

Left Ovary:
Imaging: visible
Morphology: Normal
Limitation: Regular
Size: 30
x 30
x 17
Volume 8.0

Wednesday, 3 June 2009

First infertility appointment

It's a good thing that am very happy about my life, because it turns out the infertility center works out of the gynecological department in the hospital. So we watched many pregnant bellies walk back and forth while we waited.

We were then interviewed by a younger woman about our medical histories. She did raise her eyes at my numerous graphs and statistics. She asked me for how long I had had a "baby wish", and my husband wryly noted that she did not ask him the same question when it was his turn. I thought I had prepared quite well, but when she asked me how often we had sex per month, that was not a ready figure that I had with me. I pulled out Fertility Friend's intercourse analyzer of my fertile periods over the past 12 months, and she asked "and outside of these times, you do not have sex?" I denied this statement, but now I am sure that she thinks we are celibate for 24 days out of the month.

Then suddenly she said to me, "and now we shall do an internal examination", and made some sort of gesture with her hands. Now? Did she want me to take off my skirt this moment? Yes, she did. She did not ask my husband to leave the room. She did not walk out of the room or give me a gown. She merely stood there, waiting for me to undress in front of her. I felt very shy, and removed my skirt without even thinking to remove my undies. It was only when I sat down on the paper that I realised my mistake. I removed my undies, hoisted my legs up on the stirrups, and in a few seconds she was in and out with a cervix spear.

This was all a little shocking for me. Why is it the act of undressing feels more weird than actually being naked? And what is wrong with draping a bit of fabric over the top to pretend otherwise?

Once I was dressed again, she called in the doctor came in. He looked at my temperature charts and told me that these were the best charts that he had ever seen, which was to be expected, he said, as I was a scientist. Usually, he said, they ask women to track two or three cycles, never... fourteen. I replied that you get a much better standard deviation with an increased N.

He said that the plan was to test my blood at CD21 and CD3 and do a basic internal ultrasound. In the meantime, my husband would be tested for "male factor" (he dislikes being reduced to that phrase) and if that came up normal, they would conduct further tests on me. They would also begin genetic tests immediately, as they take two months for the results to come through.

Today was my CD21 blood test, then I have my CD3 blood test, and then I come back for my ultrasound in a month. We meet with the doctor on August 12 to discuss our next strategy. I tried to ask my questions about donor gametes and embryos, but he said it was much too early for those sorts of questions. But now we are moving forward, and I feel accomplished. In 70 days we should have plenty to talk about.

Friday, 29 May 2009

My answers to their questions

I want to end up with a diagnosis as soon as possible, so I am presenting them with anything in my history that might lead to a diagnosis.

Age: 29
Length of current relationship: 3 years
Trying to get pregnant: 12 months
Date of last menstrual period: 12 May
Age of first menstrual period: 13 years
Days of bleeding during period: 4 days then spotting for another 2 days
Length of periods: 26-32 days
PMS symptoms: Mild
Painful menses: Moderate cramping, one ibuprofen enough for relief
Bleeding between periods: No
Painful intercourse: No
Endometriosis diagnosis: No
IUD in the past: No
STIs: Tested in 2006, never detected
Did my mother take DES while pregnant: Nope, born after 1971
Breast discharge: No
Excessive hair growth: No
Previous pregnancies: None
Previous fertility treatments: None
Family history of disease: No
Sudden heat/Cold intolerance: No
Weight change: No
Hot baths: Warm baths every night
Exercise: 1 hour per week
Possible previous biochemical exposures: chance of sodium azide, ethidium bromide, Listeria, Shigella exposure
Drinks per week: 1-2 during follicular phase, 0 during luteal phase
Smoker: No
Contraceptive use: 1997-2003 BCP, 2003-2007 Implanon, Oct 07-Mar 08 BCP

Rubella vaccination: 1993
Pap smear: Feb 2008 - normal
Chicken pox: 1997
Blood type: O positive

Tests
LH tests: Positive result before ovulation
BBT: Thermal shift after ovulation, luteal phase ~ 14 days
Complete blood count: Normal
Serum ferritin: Normal
Thyroid stimulating hormone: Normal


Based on these answers, I think they should be able to rule out:

PCOS
Luteal-phase defect
Endometriosis
Pelvic inflammatory disease
Asherman's syndrom
Advanced maternal age



But there is still a possibility of:

Premature ovarian failure
Fallopian tube blockage
Cervival mucus defects
Fibroids, polyps
Pituitary tumour
Male Factor

Sunday, 17 May 2009

Questions I plan to ask during our first fertility centre appointment

* What are your office hours?
* Who will be our point of contact?
* What specific tests would you recommend to diagnose our infertility?
* How long will it take to diagnose our problem?
* When can we begin treatment?
* Do you have ties to a donor egg/sperm/embryo program?
* Is an up-to-date laboratory located on site?
* What is your success rate with IUI and IVF in couples under 30?
* How many pregnancies performed at this clinic have resulted from IUI? IVF? Egg donation?
* Do you have a specialization for a certain type of treatment?
* How much will treatment cost? Does that include lab work, procedures and medications?
* What outside resources do you recommend?

Everwhere

I walk past these windows every day on my way to and from work. I don't know how, but these headless manikins always seem so smug to me.


This is why they are called cycles

Because they go around and around and around:



I am a scientist. I like to live in an evidence-based reality. I need numbers, charts, and graphs. I like to make quantitative comparisons. So now I have year's worth of patterns to analyse.




I seem to be ovulating. While my follicular phase is a little variable, my luteal phase seems to relatively long and consistent. But I don't know anything else about my body. Are my eggs getting lost? Are my tubes blocked? Is my mucus or lining sub-standard?

Once again, just waiting for a diagnosis.

Always waiting, waiting...

442 days later

442 days off the pill
348 days trying to conceive
11 unsuccessful cycles

At first as soon as I ovulated and Fertility Friend would tell me my due date, I would start planning. Due in March - Spring. Due in April - maybe will share a birthday with my husband. Due in May - maybe will share a birthday with me? Due in June - long summer days.

But month after month, I kept on seeing the one single line on the pregnancy test. It seemed aggressively negative.

We have tried:
The Fertility Diet
Temping
LH testing
Saliva testing
Guaifenesin
Pre-Seed
Pre-Conceive plus
FertilAide for Men
FertileCM Supplement

And still nothing.

So, not as easy we had originally thought. Something is obviously wrong. This cycle will make 12, and after that we will be officially infertile. We have our first appointment with the Fertility Centre in 17 days. Hopefully we will get a diagnosis, and hopefully technology will be able to treat it.

For us at the moment, controlling prenatal health is the most important factor for us. So if it is an issue of bad sperm or eggs, we are open to the possibility of donor gametes or donor embryos.
Right now, I just want a diagnosis. Then I can start to strategise. I hate not knowing what is wrong, because then I don't know how to fix it.

I have Melissa Ford's Navigating the Land of IF as my road-map to this unexpected destination. So far, it has been a great source of comfort and information. The introduction reads:

"...while you're here, you should know that you have a friend, in book form, to turn to in the middle of the night, when the sea monsters offshore start howling and you just wish you were home."