Holy protocol, Batman!

I'm not even sure this protocol has an official title because its a bunch of protocols mashed into one. On my paperwork it says "low stim cycle using midluteal Estrace, ganirelix, with saizen and androderm patches and gel" Talk about a mouthful. Dr Rockstar also referred to it as MLEA which is 'mid lutral estrace antagonist.'. Which, to me, sounds the same as LEAP or 'luteal Estrace antagonist priming'... Anyways. From what I understand it'll go a little like this: estrogen & testosterone priming for 10-21 days followed by testosterone patches. Then I'll start stims, which for this low stim protocol will be menopur and clomid. I know, you're thinking "clomid? Really!?" Cuz I did, too. This is partially why it's a 2phase freeze-all cycle. Here's where it gets complicated... So clomid &menopur. Then add a steroid (to help the bod be more susceptible to stims). Then comes ganirelix to prevent premature ovulation of all those big fat follies. THEN comes human growth hormone. Then finally, egg retrieval. Phrew! Hopefully they get a bunch of eggs and all those eggs fertilize into beautiful blastocysts that then go into the deep freeze! Yes, our baby/ies will have been popsicles.

I'll heal, get my $15,000 period and then we gear up for a fancy frozen embryo transfer (FET). I have no idea what the FET will entail but I'm sure it's not going to be your typical, run of the mill transfer.

I've never heard of using HGH until now and apparently it's still very new. Using it for IVF is an off-label use.... BUT it's been shown to improve ovarian stimulation especially in poor responders and increase both embryo quality and therefore pregnancy rate. Something to do with granulosa cells .... I fell asleep during this chapter in micro .... but I digress. We had to sign special consent forms to use the HGH and the testosterone. Hopefully I won't grow a 3rd tit or a mustache. We'll see. Keep your fingers crossed.

I don't have an official IVF calendar yet and won't until I start the topicals in about 2 weeks. I attempted to make a rough calendar based off of the days of priming meds and stims and cycles, etc. If retrieval is in early April, I don't think transfer / BFP will be until May or June. !!!!
I'm glad we are pushing it to get started now because June seems sooooo long away. :/

I had my day 3labs & ultrasound last week and everything looked superb. FSH is still at a lovely 4.7 woot! Next step: I go in for a sonohistogram and trial transfer on Thursday morning.

My new rockstar RE

I went to consults in the greater San Diego and Orange County area for education. I had heard about Dr Rockstar... he came recommended by the fertility clinic doc in Seattle, his success rates are the best for IVF in SD county, his partners are also rockstars.  But I wanted to make sure.  I wanted to compare.  I like to make my own choices and not follow blindly just because so-and-so likes him.  

Needless to say, I was impressed.  I did like one other RE and he was cheap, but he was going to do the same old thing.  Not Dr Rockstar.  Last year him and his partners came up with a 2 phase low-stim protocol for poor responders that has had amazing success.  And when I say amazing, he told me somewhere near 80%.  Why should I believe him, you ask?  The proof is in the pudding.  Meet Dr Meldrum, Dr Rockstar's founding partner: Www.davidmeldrummd.com. He loves learning and graduated 1st in his MD class without ever taking notes.  Author of over a hundred articles and papers.  He fellowed at UCLA and was the first in the US to get a BFP using u/s guided egg retrievals.  Pioneered reproductive laboratory accreditation and was the first commissioner of such to ensure more consistent quality in reproductive labs.  One of the first to research Lupron and the first to suggest its routine use.  If you're reading this and done IVF, I'm sure you've heard of that Lupron drug? 

Dr Rockstar has been director of other SD IVF clinics, instructor of anatomy for canadian medical school, member of Scripps research, instructor & consultant of microsurgery for the Navy, and did 2 years of research at the Banting and Best Institute.  He had the first pregnancy last year using egg freezing.

No I'm not writing their biography.  My point is, we're in great hands.  These dudes have always been at the brink of research breakthroughs and therefore I am a believer.

Of course as part of my consultation I ask about all these damn supplements and herbs I'm taking and was directed to this website: Www.lifechoicesandfertility.com It was put together by Dr Rockstar and his team.  So....  Now I'm not taking Chinese herbs, but I'm def not taking any less supplements. ;)

Stay tuned to hear about this whiz bang protocol and when we'll get started.  

Work Woes

I had a last minute consult with another RE on Monday.  I wasn't supposed to meet him for another 3 weeks and he's such a rockstar his wait list is 3 months long.  I jumped at the opportunity.  Then i got a reaming at work for needing to leave early.  NEEDING to leave early, not wanting to.  Here's the deal with work: I work at a hospital near downtown San Diego that used to be a county hospital.  We get all the homeless and traumas and really sick patients.  There is another hospital in the same system in La Jolla that has all the spoiled doctors and makes all the money with their fancy surgery & technology.  HC hospital (the old county hospital where I was *hired* for) has plenty of staff and everyone loves it.  TH hospital (the prison, as I like to call it) is short staffed and has a bunch if travelers for numerous reasons.

  As part of the budget crisis, instead of making people go home when we have a light schedule they've been sending us up to TH to help them staff.  Out of the goodness of my heart, I've been volunteering to go there on my days off.  Monday was one of these days.  A day I could have been at the pool, doing laundry, getting a pedicure... You get the idea.  But no, they needed help and I think hey, extra money would be nice, so I go.  That morning I do the usz "I need to leave at 145" and the charge nurse throws a fit.    2 hours later I get called into the office. 

Now, at HC they have a nice little system where you write your appointments for the week on a calendar and the interim/afternoon staff usually has no problem letting people leave early.  My charge nurse is a superstar at making her staff happy.  Not in prison.  I was told that I'd have to make my appointments for later in the day because they can not plan on letting people leave early, this is their policy.  Sentara all over again...  (My old job I LOOOOAAAATHED(picture the grinch saying it)). I played the 'I'm doing fertility treatments and can't help it' card to which her response was basically: too bad so sad.  Then, to try and relate, i heard her story about I-thought-i-had problems-too-and-when-i-was-about-to-start- clomid-i-got-sick-during-a-marathon-and-turns-out-i-was-pregnant.  Crickets.  I was so pissed and sad and frustrated I didn't know what to say.   I'm supposed to be OFF today, you a-hole. 

 Then I get to go back in the OR where Brahms lullaby is playing and try to stifle back the hot tears.  The day goes on and 1:30rolls around.  I start tapping my feet with impatience as I'm really nervous about this consult.   In the OR it's a requirement to have one RN circulator per room so it's not like I can just leave. 1:44.... 1:47..... No one... 1:52.... I finally call out to the desk and can imagine feet stomping temper tantrum as I ask if someone is coming to get me out? 1:56 someone shows up.  I'm in a huge, complicated case but sorry you're stupid, I don't have time to teach you all about a bilateral re-do hip replacement.  Ugh. 

The bummer part is TH hospital is literally across the street from my RE. HC is 20 minutes away traffic dependent.  Te commute & extra cash would've been nice but sooo not worth the headache!

The positive side to this shit pile is TH doesn't own me, HC does.  I think they forgot that.  I don't need them, they need me.  My superstar charge was über pissed at them when i told her what happened.  They've been calling for my march schedule (yes, I actually let them schedule me in February.  nice, huh?) and I get to tell them that since my appointments are such a problem they can plan on not having me at all.  They can be short staffed all friggin day instead of just for 45 minutes.  Suck it, jackasses!

well that was awkward...

I finally found a yoga studio I like!  I've only been looking for 3 months... its called HaPa- happy parent :). How cute, right?  The offer childcare for when we get to that point and lots of prenatal and pregnant friendly classes.  Its a really great mix plus its close to work and not too far from home. Score on all fronts.

SO.  Since we're coming up on the start of a cycle (post on that coming soon) I decided it would be good to attend said prenatal class since, ya know, I wanna be all friendly to my fertiles.  I walked in and saw about 9 ladies crammed into this room who all look at least 6 months.  Agh.  I suffered through class and had to "stretch to make room for baby" and "spread your knees so baby can breathe." Yeahhhh.... pretty sure its just fat rolls at this point.  Though I love the studio, I won't be going to prenatal class until its like, fa sho positive.

Worst.idea.ever.

It's a new year!

I guess you could say I'm "over the hump."  I had a really great after-Christmas with my family in town for a week followed by a week of no work and quality time with J.  It was a blissful & much needed break!

 Our New Years was pretty lame.  We popped champagne of course and took a little walk to see San Diego by night.  J and I had fully planned on watching the ball drop in NYC and being in bed by 9:05 PST.    Surprise surprise, they didn't show the ball drop live this year!  We had a great time playing acey-deucey and made it to midnight.  There is a Mexican tradition involving 12 grapes at the stroke of midnight so we toasted, slammed our grapes, and made our resolutions.  I came up with probably my most thoughtful New Year resolution to date: to be thankful for everything that I DO have (a loving family, an adoring husband, financial stability, a home, a job, etc etc) and to trust 'the path.'  Things have a way of working out for J and I.  It's weird, and probably partly because we make the best albeit hardest choices. I.e. J's deployment to Iraq 10 days after our gorgeous wedding.  I know in time we will end up in a better happier place and this will all be worth it.  So that's my goal for this year; head down, grinding forward with the faith that we are headed in the right direction and in due time our dreams will be fulfilled.

As far as the head down grinding forward part: I've been working my asssssss off!  Over Christmas I earned a whole paycheck in 4 days.  In January I've worked 2 weekends followed by extra days during the week making time and a half and taken extra call.  Same in Feb.  California has nurses unions and I get paid really well.  It's almost sick.  Though I do work hard - 16 hour shifts, anyone?  The great news is I am on track to pay off our previous IVFs way ahead of schedule and can start banking for future Egg Ops very soon.  Motivation to work hard and save beaucoup bucks is easier when it's to gain something you are dying to have!

Acupuncture has been going super de duper.  Nothing new to report except a beautiful 12 day luteal phase for the past 2 and current cycles.

In my search to find an RE in SoCal I came across a Resolve support group and have gotten some good intel.  I have 2 appointments coming up this week.  One is mostly just so I can say I gave this guy a shot.  Im worried because he is highly recommended by some and trashed as useless by others...makes me nervous.  The other I am super excited about.  A great fertility center in LA just opened a clinic near us that is a halfway decent drive and I have been super sold by their website (is that wrong?).... We had to drive almost as far to get to our last RE in Seattle so what the hell, right?!

Til next time, Happy MLK day, y'all.

down & up & back down again.

I have been in a super funk this whole month.

After "the talk", I had a crazy two weeks where I was super scared/sad/unsure about DE.  After much debate and stuff, we've decided that in the future if nothing else works out that maybe it'll be a possibility.  For now, we are going to wear out stimmed IUI/IVF.  Well, as much as we can considering how frickin expensive that shit is.  :(  J is super supportive and really wants to do whatever it'll take to make me happy & comfortable.  That man is so awesome to me.  I'm lucky and I know it. 

I spoke with my RE again after he received my labs.  Even after his "beating the dead horse" remark, he feels an AMH of 1.04 really isn't that terrible.  My acupuncturist agrees, and after last months cycle successes she is hoping we won't need drugs, etc to conceive.  I'm a little more skeptical...

This month has not been nearly as successful with the acupuncture/herbs as last.  I O'd late (CD17) and have had a few spotings here and there.  LP is looking like it may only be 7-8 days at the most.  Ugh.  Even though we've gotten lucky and been able to time our BD perfectly these last two cycles, still BFNs.  Part of my super funk is I feel like this is NEVERRRRRRRR going to happen for us!  I'm sick of acupuncture.  I'm sick of pills and vitamins and chunky smoothies with fertility shit in them.  I'm sick of avoiding caffeine and alcohol.  I'm sick of temping/charting.  I'm sick of people giving me fertility "advice."  I have offically gotten to the point where I silently cry when people tell me their wonderful pregnancy news.  I feel like we are still at the bottom of a giant mountain looking up.  We knew this was going to be a challenge.  I just didn't think it would be THIS hard.

Trying to Stay Positive

Flash back to last week.  J and I had a whirlwind weekend.  Wednesday I start a new liquid herb to help support my luteal phase.  My temps are super high and by Saturday I am cramping like crazy.  On Monday, AF is still absent??!?  I know better than to get toooo hopeful but think to myself "if i'm not, I need to got to the doc because something is seriously wrong with my guts!"  I didn't want to test early as I wanted J around to see/hear the news firsthand so I wait.  I fly up to Bremerton Thursday morning for the weekend.  We found out Saturday (well actually friday after a BFN) that indeed, we are just not that lucky.

In keeping with my half-glass-full mentality we are doing our best to see the good in all this.  After 14 months of negative after negative, that's getting a tad difficult.  But alas, there is always something positive to take away, no?  It is apparent to me that acupuncture/herbs is working its magic.  I told myself this month was a win no matter what because *DRUM ROLL* the only time I spotted was the day before AF.  Miraculous!  TMI alert: it was still brown and nasty, and day 1 was pretty gross & terrible too but this.is.HUGE.   My LP in total made it past 10 days.  Miraculous!  My temps were in the "normal" range instead of too cold.  The only time these things have happened otherwise is with drugs i.e. clomid or IVF when my body was hopped up on hormones.  There are many who gave me weird looks when I said I was trying eastern medicine.  When the proof is on paper, there isn't much you can deny.  I'm not silly and agree maybe its just a huge coincidence.  We'll find out in 26 days if coincidence strikes twice.
 See for yourself:   My Chart      

The other reason my bubble is a little burst?  Dr. UCSD called me back after his discussion with his colleagues.  Our conversation was hopeful but realistic.  He mentioned to me POF - premature ovarian failure- and early menopause which I have known for a long time was a possibility.  He said he is up for trying some stimmed IUIs.  We can't really do that until J is home permanently in April.  I asked him if there was anything we could do in the mean time to help our odds (ya know, progesterone, Ovidrel... anything, man, give me drugs!) And I shit you not, his exact words were: "those types of things will indeed prolong your luteal phase.  Since it seems your issue stems from poor follicular growth even if we used them it'd be like beating the same old, dead horse."  I almost died.  Alas, I agree he is right but those were some harsh words!  Sheesh.

In August after WTF#2, I was not prepared nor ready to hear about donor egg.  I felt like (and still do) that we have time on our side.  However I know our success decreases as each month passes.  Hearing what I did from Dr UCSD was a shock.  But a good one.  Kind of like when you shock a heart in asystole to get it beating again.  J and I had a short discussion about DE and what we are up for and open to.  I think I'm getting off that river, DeNile, and letting reality set in.  The challenge now is to decide if that's really the right thing for us and our future.