Tuesday, November 27, 2007

Kicks and Wishes

Okay, I'm at the point where I'm kicking myself for what we did or didn't do and wishing we'd done things differently.

I wish that when we had sex Friday night, we used the PreSeed. It was how I got pregnant twice before on our own. The PreSeed may have helped with the CM issue and Chris' count may have been okay that night. Right now I consider Friday a waste if I was hostile to the sperm and since I ovulated 3 days or so later.

I wish we had sex late Sunday instead of waiting until Monday morning. I'm really kicking myself for this one. I hated to wait Chris up at midnight which was the earliest we could have sex for the PCT. So we waited until Monday am. Then that only left 24 hours between ejaculations for the IUI. It would have given him another 7 hours to produce more sperm if we'd done it at midnight.

I wish he'd taken the Tylenol Medicine right away when I tried to give it to him.

I wish he wouldn't have gotten sick. I wish he didn't forget his vitamins last week. I wish he got more sleep at Thanksgiving. I wish he would listen to me when I tell him he needs to stop driving every 2 hours and walk around.

I wish I wasn't angry about this. I wish we weren't down to this.
I wish, I wish, I wish.

Can someone give me a big kick in the butt? Please? I hate being so negative. My friend had a lower count for her IUI but I'm hopeful for her. And here I'm being a big jackass about mine.

IUI...no one came to the party

Dead sperm again. There was 18 MIL with 44% motility pre wash.

Post wash number of sperm inseminated: 3.8 MIL with 90 % motility.
Forward progression 2+

They like to see 10 million post wash. I know it's better than nothing, but crap. Not what I wanted to see. I wanted to cry on the table but kept my tears inside. The nurse tried to make it sound better by saying the 90% motility was great. Well there's not very damn many of them. And the forward progression isn't awesome. It's close/within normal range. 2.5 FP would have been better. I guess this was in between 2.0-2.5.

And the IUI hurt like a MFer. It hurt more than any other procedure that I ever had. More than the SHG, HSG, Uterus lining biopsy, copo with biopsy. She asked me if it was hurting really bad and I couldn't speak. I could only breathe.
Prior to the IUI, the nurse asked me to empty my bladder. I read on T-TTC that a full bladder can make it less painful to put the catheter through the cervix. Next time I'm not going to pee!

And yeah, I'm pretty sure there's going to be a next time.

And next cycle I want Chris to do another Semen Analysis prior to the Clomid and IUI. I want to make sure his levels are back up before we try this stunt again.
Also I want to make sure he doesn't have an infection and a lot of white blood cells in the semen.

A fever could impact sperm for up to 3 months since it damages the immature sperm in the testes too. Sperm take 3 months to mature. So in 3 months there will be a fresh crop of sperm that weren't exposed to the fever.
There's so sense wasting our time off and money. This is too expensive OOP on top of us both losing complete days of work with no pay.

What a fricking time to get a cold. Chris ever the tough guy, had refused to take the Tylenol Cold medicine. It could have helped with the damn fever on Sunday. Maybe it would have broke sooner.

Post IUI, I'm still a little crampy and bloated. I was bloated feeling prior though so it may just be my ovaries all out of joint from working so hard.

I feel like those four potential eggs are all lonely right now. No one came to the party. Crap. Now I'm crying. :(

Monday, November 26, 2007

Hopefully I killed his sperm

We didn't do our homework until this morning. We should have sex late Sunday night but I felt bad for Chris. Chris got a cold yesterday. He woke up at 1:30 AM shivering like crazy. I forced him to take some Tylenol Cold for the fever but it may have been too late.

I had the Post Coital today. My RE used a catheter and syringe to pull out a sample of my CM from inside my cervix. She was disappointed in the amount of CM and she had trouble getting the sample. I had a small amount of EWCM on Saturday but none yesterday or today.

I killed all of Chris' sperm. There was only one alive and still swimming. Well hopefully I killed his sperm. If not then the fever did him in.

There was one other alive sperm, but it was not swimming right. She said the pass or fail is 5 alive and swimming sperm in the field of study under the microscope. She said there were a lot of sperm, just all dead. She thinks it's the Clomid that made me hostile to the sperm. To get around this Clomid side effect we are doing the IUI tomorrow. I asked her if the fever Chris had could cause sperm count problems and she agreed that it could. Lousy timing, she said. Yeah, real lousy and costing us a lot with time off work plus the cost of the IUI.

My RE said we'll know tomorrow when they do the sample. If there's a lot of dead sperm or a low count, then the fever is affecting it. If tomorrow's sperm count is bad, we won't have much of a chance. The IUI is all or nothing.

Sunday, November 25, 2007

The Anchovies Worked

Chris told me eating anchovies would help my follicles grow. Well it worked!

Today I had good news at the CD 12 ultrasound. According to the nurse, I have 2-3 mature follicles so out of those hopefully I'll have one good egg. It's great that I have maybe 3, but it's not a guarantee that any of them will be good ones. So far I have a track record of sucky eggs=miscarriages.

I didn't get to write down the exact numbers but here's the approx sizes:
22.something mm
18.something mm
18.something mm
17.75 mm

If there's a next time, I will write them down. I didn't think ahead today or I would have had a pen and paper ready.

I was instructed to bring the Ovidrel with me to the appointment. I reused the freezer packs and thermal envelope it was originally shipped in to keep it cold for the trip down to the office. It's been in my fridge since FedEx made the delivery.

After we did the u/s, the nurse gave me the option of her injecting me with the trigger shot or her teaching me to do it. If she did it, then I would get charged.
So I opted to do it myself. She prepared the syringe by getting the air bubble out of it. Then it was all mine.

It's a pretty short needle that goes straight into your stomach. It honestly didn't hurt and was easy to do. Chris said he had to turn his head away though. Do you think this guy will last in the delivery room? Wimpy! ;)

This Ovidrel will trigger ovulation in 36-48 hours. It's basically like a shot of LH to make the follicles release their eggs. I say it's like a shot of LH but in fact it's HCG- the pregnancy hormone which is chemically similar to LH. That becomes important later.

If the follicles over mature, then the egg quality goes down.

I'm so happy and thankful to God about the timing of this all. I was so stressed out on the timing with our days off work. If I had to go back in a few days for another ultra sound check, it would have meant a lot more time off work for the monitoring and Post Coital Test. This way even my progesterone blood draw next week and beta blood draw can be done on our normal day off.

We have to have sex tonight or early tomorrow morning, no more than 10 hours from our appointment. Then they are going to do the Post Cotial Test to make sure the CM is okay after taking the Clomid. If my CM isn't fertile enough or if there's only dead sperm left, then we have to do an IUI on Tuesday.

The PCT is kind of humilating but they do it all the time. I just don't like the idea of us having sex and then them checking on it! Chris said he wasn't going into the exam room tomorrow. He said he couldn't face the doctor if "the best part of him" was running down my leg. Ugh. He was so cute and understanding just a few days ago. What happened?

Hopefully we can save our time off and our money by skipping the IUI.

Monday, November 19, 2007

"It will help your follicles grow."

"It will help your follicles grow." Those words actually came out of Chris' mouth this afternoon.
It was very strange. What happened to the clueless guy who had no idea about anything? He keeps surprising me. Just last week, he asked what our sex schedule should be leading up to ovulation. He's interested and actually wants to know? He even understands that there is a timing issue? Wow. It is a little trickier this cycle since we are doing a PCT and possibly an IUI.

Now back to "It will help your follicles grow." He told me this in reference to the anchovies he was trying to slap down on my casear salad. Hmmph. I didn't buy it. When he turned away, I flopped most of them back over on his salad. I did eat two just in case they really do help my folicles grow.

Saturday, November 17, 2007

Asparagus and Cheese Frittata

Asparagus and Cheese Frittata

This was inspired by Williams Sonoma's Grilled Asparagus Frittata I made it in a double fritatta pan but you can do this in one oven safe skillet and just finish baking the eggs in the oven.

Asparagus and Cheese Frittata

1 lb. asparagus, tough ends trimmed off
1 Tbs. extra-virgin olive oil
Kosher salt and freshly ground pepper, to taste
2 1/2 Tbs. unsalted butter
1 onion, thinly sliced
2 cloves of garlic, thinly sliced
6 eggs
1/3 cup milk
1/2 cup finely grated romano cheese
Crumbled Gruyere cheese for garnish

Cut the asparagus into 2-inch pieces. In a bowl, toss the asparagus with the olive oil, salt and pepper.

Heat the deep half of a frittata pan over med-high heat. Place the asparagus on the pan and cook until tender, 5 to 7 minutes. Transfer to a plate.

In the deep half of a frittata pan over medium heat, melt 1 Tbs. of the butter. Add the onion and garlic and cook until soft and light golden, about 5 minutes. Transfer to the plate with the asparagus. Wipe out the pan with a paper towel.

In a bowl, whisk together the eggs and cream until frothy. Stir in the asparagus, onion, romano cheese, and season with salt and pepper.

In the deep half of the frittata pan over medium heat, melt 1 Tbs. of the butter. Add the egg mixture and cook until set, 7 to 10 minutes, using a rubber spatula to gently lift the cooked edges and allow the uncooked eggs to flow underneath. After 3 minutes of cooking, in the shallow half of the frittata pan over medium heat, melt the remaining 1⁄2 Tbs. butter.

Place the shallow pan upside down on top of the deep pan, then flip the frittata into the shallow pan and cook, covered, for 3 minutes. Remove the deep pan and continue cooking until the eggs are completely set and cooked through, about 5 minutes more.

Gently shake the pan to loosen the frittata, then slide it onto a serving plate. Garnish with Gruyere cheese.

Friday, November 16, 2007

CD 3 Ultrasound

I went for my CD 3 u/s prior to starting the Clomid. I met my doctor's nurse, Leslie. She did the transvaginal u/s and really the only one I saw the entire visit.

My u/s was fine, no cysts on my ovaries so we are good to go. At the previous u/s Dr W found 3 parovarian cysts on my left ovary. She said that I shouldn't be concerned about them but to let the nurse know about them because sometimes they can be confused with ovarian cysts. So I in a round about way, mentioned them to Leslie before she started looking at lefty. I didn't want to tell her how to do her job, but I wanted to prevent any trouble. Who wants to have a second of trouble while on an exam table half naked? She had some difficulty finding all three of them. But eventually she got them measured to make sure they weren't growing or doing anything weird.

I admit that I'm slightly disappointed with their u/s viewing. Dr Creepy Skulker had big wall mounted plasma TVs for our viewing pleaseure. Dr W just has the standard u/s set up with monitor by the exam table. No biggie, of course.

I guess I was just spoiled. There's nothing like seeing your innards up on the wall. Some were even 3-D shots. (How some of those pregnant women would be jealous of a 3-D ultrasound! Ah yes, the "benefits" of IF.) For my viewing pleasure, my uterus was up on the wall, on a plamsa TV screen. But it certainly wasn't in HD. And it certainly is disappointing when there's no baby in there.

I'm sure all of us would much rather be on the other side of the fertility aisle and not reap those lovely "benefits" of uterus snap shots.

Afterwards I asked my questions.
Do I need to use an OPK and be prepared to trigger with the Ovidrel if I get a positive? No, the CD 12 u/s should be plenty of time.
Do they supplement with estrogen if my lining is thin?
Yes, but that's rarely necessary. The baby aspirin should help with that too.

I wish I'd asked about the PCT. Some studies say that it's not a very good test of hostile CM. Plus I've read that normally they are done within hours of having sex. We're set to do it about 12 hours after.

Monday, November 12, 2007


Today was my last BCP! Yay. I really hated taking those for no purpose other than to verify that my tubes were open. Two pregnancies in two months usually means at least one open tube. But just to be on the safe side, I did the HSG.

I picked up my St Joseph's Baby Aspirin and OPK's today. I'm increasing my folic acid too. I had read an article discussing that sometimes overweight women need more folic acid. There are also various clotting disorders that are treated with additional folic acid. I tested negative but I've also read some clotting disorders can test negative normally but show up only in pregnancy.
Trish gave me a good March of Dimes link that helped pushed me over to the mega dose of folic acid. It is a water soluable vitamin so my body should get rid of what it doesn't need.


I will ask my new RE at my CD 3 u/s but for now I'm going to increase my dose to 4 mg to start with. I have a feeling she will be fine with it since I'm on other preventative measures like B/A and P4.

I have a small bottle of folic acid 400 mcg to go through before I head to Sam's for the industrial size bottle. Again thanks for the tip, Trish.

400mcg X 7 pills = 2800 mcg + 1000 mcg (1mg) in my PNV= 3,800 mcg or 3.8 mg

Anyone want to double check my math? 7 freaking pills is A LOT of one vitamin!

For kicks, this is what I'm taking:

Prenate Elite
81 mg Baby Aspirin
100 mg B6
2800 mcg Folic Acid
20 mg Acipex
Patanol oph. solution
100 mg Clomid CD 5-9
Oridrel at LH surge
200 mg Progesterone starting 3 days post Ovidrel

I take more crap than my 87 year old grandma. I think that I may add some B12.

Now I just need get my period and my CD 3 ultrasound out of the way. Then here comes Clomid!

Who knows when old AF will show up. I haven't been on these BCP before and I've been spotting off and on all month. So really who knows? Tomorrow would work perfectly. Thanks in advance, AF.

As to "I think" I'm ready part: I'm pretty anxious. This is it. We finally get to try again. April seems like a long time ago when I got pregnant the first time. I worry about all the monitoring logistics with this Clomid cycle. I worry that I won't get pregnant. I worry that it will result in another chemical pregnancy. I worry I'll have a later miscarriage. I worry.

I worry Dr Creepy Skulker is right and my eggs suck.

Sunday, November 11, 2007

Grandma Nash's Apple Squares

Grandma Nash's Apple Squares
1 cup sifted flour
1 tsp baking powder
¼ tsp salt
¼ tsp cinnamon
¼ cup butter
½ cup packed brown sugar
½ cup sugar
1 egg
1 tsp vanilla
½ cup chopped apple
½ cup finely chopped walnuts
1 Tbsp Cinnamon sugar (mix ½ cup gran. Sugar with 1 ½ tsp cinnamon) There will be a lot extra of this, I just saved it and kept it for my next batch
Combine flour, baking powder, salt & cinnamon
Melt butter, beat in sugars, egg & vanilla until smooth
Stir in flour mixture, apple & walnuts until thoroughly combined
Spread into greased 8x8x2 in pan
Sprinkle with 1 Tbsp cinnamon sugar mix
Bake at 350 degrees for 20 min, or until top springs back when pressed with fingertip. Inside will by slightly gooey, moist.
Cool completely, cut into squares.

Friday, November 9, 2007

HSG and spilliage

This is my last appointment with Dr G. I'm so ready to switch to the new clinic.

Before every procedure they do a pregnancy blood test. Blowing a fertilized egg out of the uterus is generally not a good thing.

So I had to get there an hour before my procedure was scheduled for this blood test. I go back and wait for the nurse to finish some other paperwork. Dr G is skulking around back there just outside of the blood draw area. I only look at him out of the corner of my eye. I really don't want to talk to him. Next thing I know, he's doing wall push ups. Directly across from me. There's a whole clinic and decides to show off directly in my eye sight. Weird, I tell you.

And again the blood draw is painless. Cheree is good but it still bothers me that she doesn't glove up.

I now go back out to wait for the blood test and the okay to take my 800 mg of ibuprophen.

They finally call me back. Again, I'm the last patient left in the office. I'm hoping the doctor isn't in a hurry for lunch or worse yet shaking from hypoglycemia.

We have some chit chat as I get prepped. "Slide a little farther down the table, please." I swear you can have your butt hanging off the table and they still want you farther down.

Mine wasn't an xray and it wasn't the SHG. I've had that one too. They used some different imaging options on the u/s machine. They had me empty my bladder so they could use the external u/s to verify they were getting the stuff into my uterus.
He shot my cervix up with novocaine. Then we waited for a couple of minutes to get me numb. He dilated my cervix and put the catether in and then the dye medium which had lidocaine added to it. Then they put the balloon to keep the dye from coming out. Then they switched to the transvaginal ultrasound. It was just very crampy but it never lasted very long. Deep breathing in and out helped control the pain. I got to see the pictures on the tv screen on the wall.

Everything is open and clear. I have great "spillage." My tubes are open. Well duh, doctor, that is probably how I got pregnant twice.

I have cramping now that varies in intensity. Nothing horibble so far. I feel like crap right now but I think that I'm hungry and feeling a caffiene headache. I didn't drink all of my coffee this morning. Maybe that's a sign I should give it up.

They told me to drink lots of water to help with the cramps. Maybe that helps your body to get rid of the contrast dye? I'm also to avoid aerobics. I don't think that was on my schedule today anyway.

It was awful trying to get out of there without setting up the IUI cycle. I hated to tell them because I wanted them to be nice to me.
Breaking up is so hard to do!
I told them we were going to Ohio to visit family for the holidays and were unsure of our travel schedule. :(
I tried to get a copy of the HSG images on CD per my new doctor's request but they wouldn't give them up. I even had them ask Dr G. "He doesn't do that." I'll get a release from my new doctor and fax it to them. Hopefully they will comply with the law and transfer my records without too much fuss.

I'm spotting a little bit. I took a regular pad with me this time. That clinic thinks pantyliners are enough for everything. Nope.

I'm free! I'm free! Buh-bye creepy skulking doctor! Hello, new RE!

Wednesday, November 7, 2007

I have DRUGS!!!

Fed Ex just brought my Clomid, Ovidrel, and progesterone!!

I have drugs! Yay.

And of course, he rang the the door bell while I was in the shower. I'd been up since 5:00 AM but didn't head for the shower until around 9:00. Stupid? Yes. I thought it was still early yet.

As soon as I started rinsing my hair, I hear the knock. I had actually ran to the upstairs window while dripping 1 minute before because I heard a noice outside. I was very anxious for my meds. So this time I see the truck outside.
I grabbed my shorts and tshirt off the floor, ran down the stairs dripping wet. Yelling, "yes, I'll be there just a minute!" I get to the door and struggled putting on my clothes while checking out the peek hole. Now yelling, "Just a second more!" I managed to put my shirt on inside out and backwards. I also had water drops on my glasses. Very cute!

I signed for the package and offered the driver a water or Pepsi. He declined. I wouldn't have taken anything from the crazy looking lady either.

I ordered from Freedom Pharmacy. Tricia recommended it and my RE office uses them too.
I need to check on buying Clomid locally if there's a next cycle. Again thanks, Tricia.

So here's my drugs and cost breakdown. I feel that it's cheap considering what injectibles will cost (approx $1500/cycle)

Clomid 100 mg a day for 5 days: $31.90
Ovidrel .5 ML shot $44.25
Progesterone 200 MG (30 caps) $75.00

The progesterone is for two cycles so it's not too bad. And it seems like overnight shipping is included. The Ovidrel requires refrigeration so that's the rush to get it delivered. I need to pick up my Baby Aspirin and I'm set!

Tuesday, November 6, 2007

Jumbled messes and timing

I've been looking at the IUI calendar my old clinic gave me. I think they were going to have me continue taking active BCP another week longer than I normally would to delay my period a week. Otherwise the IUI and monitoring would be around Thanksgiving.
They are closed Thursday through Sunday that week. Nice, huh? How convienent, for them, not their patients.

I'll ask what their game plan is when I go for the HSG on Friday just to see what they say. I'm not officially breaking up with them until I get that done and hopefully have a copy of the XRAY. But I'll tell them that I don't want to order the meds yet and we may wait a month or something to put them off. Breaking up is so hard to do. In my mind it's over but I have to tell them. LOL

Any way Dr W (new RE) said that I could start the Clomid cycle whenever I was ready to stop taking BCP. My last active pill is 11/12. Normally on BCP my period takes 3 days to start so that would be 11/15. But these are different pills and I've been spotting since CD 14. Who knows what will happen. Which creates a lot of stress for me. I need to have a plan.

So let's say the earliest I'll start my period is 11/13 (the first day I'm not taking active BCP) that would make my CD 12 ultrasound on 11/24 which is Thanksgiving weekend. My new clinic is open in the AM so that's no problem. And that day would work out since we'll be home CD 12 & CD 13 without taking a day off of work. That would be perfect! But of course that won't happen then.

Being on the road during this is making me more nervous. They talked in the office like I would come in for the CD 12 u/s and bring the Ovidrel to be shot up. But reading the instruction sheet, I see it talking about LH surge. (The didn't tell me to use OPK. Although of course I would!)

So it sounds like I need to be prepared to trigger if I have a LH surge earlier than CD 12.

It's a jumbled mess in my mind. I'm so nervous.
New clinic, new medicines, new worries and old worries!

Monday, November 5, 2007

Hopefully I have the right egg

My "old" doctor (yes, I'm changing clinics) called me this morning and wanted to reschedule my HSG from today to Friday. So now I'm going on Friday to that alone without Chris and will have to drive that night. :( Oh well, it's just one day.

The new RE (Reproductive Endrocrinologist) is Dr W. She asked me why I was there and I told her Recurrent Pregnancy Loss and Low AMH (Anti Muellerian Hormone- that's the only test I "flunked" at Dr G's and indicates poor ovarian reserve.)

She immediately said she doesn't have much use for the AMH test! Yes!
The old doctor was basing everything on that test. She said it's too new of a test and the result values are not very standardized yet. It was originally studied in London and they use a different value measurement system. Repromedix is a big fertility lab and their website says very plainly that AMH should not be relied upon soley to determine ovarian reserve.

She's very hopeful since I have normal FSH, LH, estradial, follicle count and ovary volume. She thinks those are much better indicators of ovarian reserve. She would love if the AMH test was accuarate but she's had too many women with low AMH have successful pregnancies. She basically said that the AMH shows I'm not a fertile as a 20 year old but we knew that already. She feels that it's just indicative of my age. Now if a 20 year old had low AMH, then it would be a more serious problem.

She also said IVF was something that should be worked up to. There's many steps to try before going there. She said she was confident that I would have a baby. I know that's a standard pep talk but it was still nice to hear her say it. It was nice to hear after the other doctor was all doom and gloom.

Did I ever mention that Dr G is creepy? I told Chris once and he didn't get it until the other day when he felt creeped out too. Maybe someone telling you that you need IVF helps push them over to creepy-dom but I think this guy comes by it honestly.

Back to Dr W: She said it was up to me whether I have the HSG done. It wouldn't hurt and may help since it would "blow out" my tubes. That could clear out any debris in there. So I'm still getting it done on Friday. Again it was nice to hear that she agreed that I didn't *need* the HSG since I've been pregnant twice on my own. One of those tubes has to be open!

I had an ultrasound and there aren't any cysts in my ovaries. So I probably didn't ovulate even though I had all those cramps around CD 13-14 like normal. She said it was still possible but there was no evidence of it.

All her RPL patients are on baby aspirin and prosgesterone. BA helps with implantation issues and is given to those with known clotting disorders. Progesterone helps support the uterine lining. Both are extras to help with a pregnancy. They do no harm but could help. So I'm to start this next cycle.
On CD 3- next week! I'll go in for an ultrasound to verify there's no cysts. She said CD 3 blood work wasn't necessary since I've had two normal FSH cycles. Wow, a doctor wanting to save me money!!

On CD 5-9, I will take 100 mg of Clomid. Clomid masks the estrogen receptors in my body which will cause more FSH to be release. More Follicle Stimulating Hormones = more follicles= more eggs hopefully. Dr W says that it will increase the risk of twins to about 10-15%. Clomid does have some side effects so we'll do a PCT to verify that I'm still sperm friendly and my uterine lining is okay.

On CD 12 I have another u/s and will probably trigger with Ovridel. Ovridel is an injected medicine that mimicks the LH surge. It will "trigger" ovulation, maybe of more than one egg if the follicles are mature.

We are to have sex and then go in the next day for a Post Coital Test. If the post coital is bad, then I'll have an IUI the next day to get the sperm where they need to be.

I'll then start progesterone supplements (think she said 3 days post trigger). Progesterone is produced naturally by the CL cyst in the ovary. However there's some debate whether low progesterone causes a miscarriage or a bad pregnancy causes low progesterone. I'm glad I found a doctor that is willing support with progesterone just in case it will help.

We'll do this for 3-4 cycles before moving on to injectibles. At 3 cycles, we'll talk if I want to do the 4th or move on to injectibles.

So that's the game plan. Baby aspirin, Clomid, timed intercourse, IUI if necessary, and progesterone.

She sounded very positive that we just need to get the right egg and the right sperm together. Hopefully I have the right egg!