Saturday, June 30, 2012

The diagnostic cycle rolls on...

We are back from the beach and this diagnostic cycle continues, even though my body is giving signals that June is over and it's ready for July.

After posting on the boards and getting a bunch of advice from other Cooper patients, I decided that I would just go ahead to the beach on Saturday and commit to the appointment on Monday instead. On Monday, I went in for an ultrasound and blood work, but no post-coital. Only later did I find out that I was supposed to have a post-coital, but I didn't see the point since C and I didn't get very "coital" in our tiny, thin-walled condo that we were sharing with two lesbian friends and my aunt. Nope.

Anyway, the ultrasound revealed that one of my two follicles had "fizzled out" and that I would have to come back on Thursday. Tell me something I already knew - they concluded that I was a super-late ovulater. On Wednesday, C and I had to very awkwardly and quietly have sex, then go back for yet another post-coital/blood work/ultrasound. They found more bad CM that was "way too thick" and inhibited sperm movement and that the dang follicle was still there. They said that it may be that the egg itself had ovulated, but that the follicle was still working itself out, so I was told to start progesterone suppositories on Friday.

Fast forward to yesterday, I started spotting so I called the RE to see if I still should be using the suppositories since it seems like my ute is over this and ready to move on. She said to keep using them and that spotting was not uncommon.

If this diagnostic cycle has taught me anything, I now know that CM is an issue, but that it was significantly improved with Mucinex. I was also being really dried out by allergy meds, so I'm off those. (Achooooo...) Finally, it is abundantly clear to me that even though my ovulation is very regular, it is really off, so it needs to be regulated with meds and monitoring.

I guess it has been really helpful in the decision-making process, however. Initially, Dr. C really wanted to try more things with either TI or IUI before moving on to IVF, but was also open to moving on if we preferred. I think this cycle (and my nine failed IUIs) have convinced me that moving on with IVF is our best option. It looks like everything that needs to be healthy is ready to go for IVF and the things that need improvement are pretty much bypassed by it. We've decided to move forward with a July IVF when this cycle is over.

I am supposed to go in for a beta draw on July 5, so to me that will be the "all systems go" date. Even though my body would like to be "perioding" right now, at least the progesterone is holding that off until next week so we can start this thing off right. Oh, and conveniently it is holding off until I get to do more fun stuff we have planned for this weekend and the 4th of July! (Hey, I have to find the positives in IF sometime, right?)

Friday, June 15, 2012

IVF Consultation

It's been a while and I guess it is time for an update!

Our first appointment for our IVF consultation at Cooper was yesterday.  It was very strange, to say the least.  Dr. C's office is unlike any other doctor office I have ever seen.  He sits behind his desk in in an ornately-carved wooden throne with giant medieval looking furniture all around the room and - I kid you not - Enya playing on a loop from big speakers on the bookcase. 

While we waited for the doctor, a young Zac Efron-looking guy kept poking his head in the door.  When we originally were seated in the office, there was a wallet and keys on the table that had been left by a previous patient.  I figured that this guy was awkwardly looking to grab his wife's wallet without disturbing us.

Much to my surprise, when Dr. C came into the room, the same young guy followed in and had a seat right next to us.  Dr. C said that he was a medical student here to observe, in all his t-shirt, shorts and flip flop-wearing glory.  Under normal circumstances, that would be fine, but this guy sat slumped in his chair almost as if this was the principal's office and he just started a food fight in the cafeteria.  Seriously, dude.  If you are going to sit in on a conversation about my vag, sit up in your chair and put on some pants and a damn labcoat. 

As soon as the conversation started, Dr. C put it right out there - he would love for us to do an IVF at Cooper and he would totally understand if we wanted to start right away during the summer due to my schedule as a teacher, but he thinks there are more options.  He was stunned and dismayed to hear that C's sperm was never checked for antibodies, that I had never had cultures taken of my cervix, that my cervical mucus (CM) had never been tested, and that we never had progesterone therapy.  We have been TTC for over three years and for just about two of them, we have been taking Clomid, Femara and ovulation triggers, then suddenly just whoosh - an RE is telling us that this protocol was almost pointless for us. 

I should say that I thought when I made this appointment that we would be discussing protocol options, maybe taking a few more tests, then getting our prescriptions in order and drawing up our calendar for a July IVF.  After getting all this taken care of, C and I are supposed to leave tomorrow for the Jersey shore and just relax.  We have not been on vacation for years, and I mean we literally have not even taken a day off.

Within a few minutes of talking to Dr. C, though, C was providing a "sample" in one room while I was getting bloodwork, ultrasounds and a post-coital test in another.  After seeing two follicles in the right ovary, no observable CM and excellent test results from C, Dr. C wants to do a diagnostic cycle right now and actually try to get us pregnant this cycle with just progesterone therapy and Mucinex.  He gave a very convincing explanation as to why my previous IUIs didn't work and I was actually thinking that with my new assessment of inadequate CM, this might just be all that we needed.  He ordered us to pick up some progesterone suppositories and Mucinex from the pharmacy, have TI at 7am, then come back at 9:30 today for a repeat post-coital. 

I drove all the way back to the office today for another post-coital, ultrasound and bloodwork.  (Did I mention that the office is in NJ and I live in the Philly western burbs?!)  Now I am starting to get freaked out.  They were able to get CM during the post-coital, but it was only rated "fair."  I was fine with TI, progesterone and an appointment or two, but today they started talking about IUIs and more appointments.  They are saying that they want me to come back tomorrow and Monday, but this is a bit of a problem...

C and I are scheduled to leave bright and early tomorrow morning for the beach.  We are traveling with two friends who do not know about our IF or treatment.  Our only option if they make us come in would be to detour through Marlton on the way to the beach and just awkwardly explain to our friends on the way.  If I have any appointments after tomorrow, however, I will have to drive three hours roundtrip from the shore house to the office.  We have a few daytrips planned with my coworkers and other friends and I may have to cancel these if we proceed with another IUI.  This would be really frustrating, especially considering that I am not optimistic about IUIs. 

Right now I am waiting for the call about my bloodwork, but I am seriously considering not going tomorrow.  If I have to make the drive for an appointment or two next week from the beach, I can get over it, but I don't think I have another IUI in me, especially if it means my friends sitting in the car waiting for me tomorrow.  I guess we will just have to wait and see...