Monday, June 8, 2015

On to the next one

Despite my tiny fibroid companion, I am officially deemed healthy enough to try to conceive a child. This marks the first time I've been healthy enough to get pregnant since...well, since I was pregnant.

It's been a long, hard 2015 so far, but we're hopeful the second half will bring much happier days. I had been feeling emotionally stronger as the days and weeks went by, but I always had a feeling that reaching this point would help, and I was right.  I feel more like a happy couple trying to start a family than a sad couple grieving a loss.  There are still difficult moments and days, and I will be forever changed, but a sense of optimism has found it's way back into our lives.

We are currently still doing what is known as a "regular" cycle.  This basically means we're trying to have a kid the old fashioned way (more or less), rather than moving to IUI or IVF. Furthermore, I am fortunate to have regular cycles, with no reason to think ovulation is not occurring.  This is important to note because it means that I have it a lot easier than so many couples who are dealing with infertility.  I don't want to give any sense that my experience is either unique or the norm for infertility (or easy, for that matter).  The treatment varies wildly by a number of factors, including: diagnosis, where the couple is on their journey, financial constraints, religious beliefs, and the RE being seen.  Not to mention the couple's choices based on all of the above and more.  Believe it or not, we still do have some say in this process, and sometimes breaks are needed.

With that very long disclaimer in mind, I present to you: a cycle in the life of TTC:

CD1:  This typically is a really tough day.  It means the last cycle was a bust.  However, this time it marks a new beginning, so it's actually more bittersweet for me.  I call my RE's office to schedule the cycle's first ultrasound and bloodwork, which must occur on cycle day 2 or 3 (or 4, if you're like me and are sometimes trying to work around work travel).

CD 2:  This month I manage to get in on CD2.  I get my bloodwork done (never fun), and then the ultrasound (also never fun).  Although let me tell you - after everything I've been through the ultrasound and bloodwork are like a damn walk in the park.  While in the ultrasound room, I note the tech is writing a lot of stuff - way more than usual.  So I ask what is going on, and I am told my "ovaries are not empty".  When I ask what the heck that means, I am simply told, "The nurses will explain more when they call."


(Have I mentioned I figured out how to add pictures in here?  Be prepared for so.many.gifs.)

I had some wonky cycles before getting pregnant (including ovulating on CD5 once) and they never phased me *too* much.  But the thought of our first cycle after 5 months of waiting being a bust is enough to make me lose my mind.  So I call my husband, and then we both proceed to be in a bad mood for about 2 hours, waiting for the nurse to call.

When she does, she doesn't even mention the stuffed ovaries.  When I ask I get a breezy, "Oh yeah, you've got stuff in there leftover from the last cycle."  I feel like the nurse is not comprehending that the sky is falling.  But when I push a bit, she says not to worry.  I'm told come back in on CD8. 

CD8: Ultrasound and bloodwork today.  Well, those non-empty ovaries may have an explanation after all - I actually have an 18mm follicle at this point.  For those who don't know what that means, here's a quick lesson:

Follicles (within the ovaries) will grow during the cycle as the egg within it is maturing.  They will grow until reaching ovulation, at which point the egg is released. Follicles are typically 20-24mm at ovulation, and ovulation occurs at day 14.  

So the fact that I am rocking an already 18mm follicle on CD8 is unusual.  It probably means what was seen on CD2 was this follicle already growing.  It's times like these when I want to scream at my body.  I have no idea why this is happening and as someone who lives off of getting as much knowledge as I can about things, this is really frustrating.  I've been asked to come back in tomorrow.

CD9: Ultrasound and bloodwork today.  (Noticing a pattern here?)  That 18mm follicle is now 21mm. It grew 3mm in 24 hours.  Typically, they grow 1 to 2 mm a day.  It's like my follicle is on steroids.  The catch is my hormone levels are no where near what they need to be to ovulate, so that sucker is just going to keep on growing... 

CD11: Ultrasound and bloodwork today.  24mm!  And the good news is that now my hormone levels seem to be on board.  My estradiol is 246 and LH is 81.  LH is the hormone that surges about 48 hours before ovulation.  Everything is looking good finally!

Before our loss, I viewed this process as such a thorn in my side.  Getting to the RE and getting poked and prodded constantly just seemed like adding salt to the wound that was opened after not being successful conceiving on our own for a year.  But having to sit on the bench for 5 months has really shed a different light on the situation.  Just knowing that we have a shot this month, that I have a 20% chance of getting pregnant, is so incredibly exhilarating.  

I'm sure I'll feel different if we go more than 3 months or so of this, but in the meantime, I'm snatching the happy up and clinging tight.

CD14:  Ultrasound and bloodwork today.  The ultrasound showed I did indeed ovulate on either CD12 or CD13.  It would have been easier to pinpoint if I had been able to go in on CD13 like they wanted me too, but I was traveling for work.

So now the progesterone fun begins.  I use Crinone every morning, an additional 400mg suppository at night, plus Prometrium taken orally for good measure.  It's a lot of progesterone.  I wasn't always on so much, but it seems my own progesterone is quite low.  This hormone is what builds up the endometrium (or lining of the uterus), so without enough of it, my lining may not be the plush landing a fertilized egg needs.

I'm now in what we call the two week wait (2WW).  I'll go back in a week for another ultrasound and bloodwork, this time with an added shot of Lupron to help implantation.  Otherwise, it really is just a waiting game to see if everything we've done this cycle will lead to a pregnancy.  It's depressing to say, but mathematically speaking, chances are, it will not.

CD20:  Ultrasound and bloodwork today, with an added bonus: a Lupron shot to the stomach!

CD22:  Crazy has officially set in.  I would describe it myself but this blog already does a way more amazing job than I ever could:

Below is a snippet from this post that summarizes how I am feeling:

The second week of the two week wait is spent on the edge of your seat. I have a cramp – is that my period or is it implantation? It’s probably my period. But it is the day that implantation is most likely to occur. Could I be pregnant right now? I wonder if I’m pregnant RIGHT NOW. My baby will probably have my eyes. If I’m pregnant right now what’s my due date? Should I pee on a stick right this minute? I probably should. But it’s still too early to get a positive, then I’ll just be disappointed. But I want to pee on a stick. At least then I won’t be so disappointed when my period comes. No, just wait. But that cramp… OK… If I implanted today, I could have a good shot at a positive pregnancy test by… Wednesday. Ok, Wednesday we pee on a stick. As long as I don’t have any PMS symptoms by then. But I’m having nothing but PMS symptoms… Ugh… Who the hell decided PMS and pregnancy symptoms should be the exact same?! What kind of cruel irony is that?!?! I want to speak to someone about this. Do you think I’m pregnant? There’s no way I’m pregnant.

CD25:  While tomorrow is the official blood test, I've already tried 2 at home tests, both of which turned negative so fast it was like they were taunting me.  It got to me a bit yesterday.  It's not so much the failure of the one month, because I know in the scheme of things it's just the first try, one little month, and chances were low it would happen - but, it cracked open the window for all the negative thoughts again.

Well, there goes my last chance of getting pregnant at 33.  

We're going to be older than I thought when this happens.

Are we going to be able to keep up with a kid?

What if this never happens?!

It's scary, and very frustrating.  We have NO IDEA why it didn't work.  Everything was timed perfectly, and I was monitored like crazy.  How could it not work?

I don't know, but it didn't.

CD26:  Blood taken for the pregnancy test. At this point my poor arm seems like it's rebelling because I couldn't get it to stop bleeding.  And now I wait for the answer that I already know is coming.  I'm going to let it go to voicemail.  Having to answer back to the nurse like a normal human being after she says it's negative is not really possible anymore, no matter how much I expect her words.

Finally got the call at noon - negative.

At this point I have had 7 blood draws, 7 internal ultrasounds, and a shot to the stomach.  I hope you can see the frustration, and why it's so incredibly upsetting when people tell me I just need to relax. If only it were that easy.

On to the next cycle we go, just as soon as it starts.

CD32:  I am still waiting.  So I got bonus blood work today!  Also, a fun little procedure to scrape progesterone out, because apparently my body hangs on to it.

This happened to me before, and the main problem is that the rest of my body ignorantly kept chugging along, and I ovulated on what appeared to be CD5, but was really CD10.  However, because of the mismatch between ovulation and period timing, that cycle was a bust because it would not have given my body enough time to build up a lining for pregnancy.

This unfortunately means the next cycle may already a bust, and it hasn't even officially arrived yet.

Pardon my language, but I am so.fucking.frustrated.  Really?  I get ONE cycle to try before something else goes wrong??

No more Crinone for me it seeems, so at least we hopefully have a way to prevent this from happening again in the future.  .  

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