Cycle Day 1

And we get to start the estrogen priming cycle. Which actually doesn't involve all that much. Around CD 9 (ha! optimists!) they want me to start using OPKs to watch for my surge. 10 days after the surge I'll start taking estrodial pills to hopefully jump start my follicles for next cycle. I'll also do shots of ganirelix.

I also take my first shot of Humira on Monday, and the second one two weeks later. Which means I couldn't get a flu shot today since it takes about a week for it to work its way into your immune system. I'll do bloodwork around October 18 to see if the Humira worked as well as it did in the spring.

I had a dermatology appointment today for an unrelated issue, and also asked the doctor about the faded bruising I still have on my tummy from the heparin back in March/April. He said it's not bruising, it's damaged tissue. And it's not surprising given the amount of low level trauma to the area. It's likely to fade over time, but may not ever fade away completely. The tenderness, which I had assumed was part of the bruising, he thinks is also linked to the constant low level trauma.

Starting to feel like I'm slowing moving forward again, which is nice. All this waiting sucks.

Life goes on

Not much to report since the last update.

I ovulated more than a week later than usual (normal is around Day 18 for me, and I ovulated around Day 27 or 28). Glad I kept up with the OPKs -- I was sure I'd just missed it.

For those wondering why I was using OPKs -- my doctor suggested it so we can better estimate the timing for our eventual IVF. After I get my period (likely mid-late next week given my short luteal phase), I'll get my calendar for my pre-IVF-cycle month. Which means OPKs again, and then starting estrogen 10 days after I ovulate, along with Ganirelix. Then after I get my period again, the actual IVF stim cycle starts.

If I have another extra long cycle next month, my IVF cycle month won't start until possibly early November, so I'm hoping it's more normal and we can start at the end of October. (*sigh* at one point I was thinking mid October, but seems unlikely now...)

My Humira hasn't started, since they want to time it with the beginning of my next cycle, and I'm actually looking forward to it since it gets rid of my allergies. (Silver lining, I suppose!)

One thing I didn't mention in my last post is that my doctor brought up donor eggs as the 'quick fix' answer to our infertility. So that's been floating around my head a lot. I really want to be pregnant (again), so I had previously told my husband in a casual conversation that I would rather be pregnant than use a gestational surrogate with my own eggs (not that that's a possibility, since my eggs are the problem, not my ability to carry a pregnancy).

It's definitely something that I'm open to, but I am having trouble reconciling myself to it. Which, after all, is why we're still trying to make IVF with my own eggs work. (And yes, the change in protocol is making me hopeful as so many of you pointed out in the comments on my last post.)

Hopefully we won't have to cross that bridge, and this IVF will be the one.

It's far enough away that IVF #3 is not something I constantly think about. I'm keeping myself busy -- travelled for a week and a half (partly with my husband), and am about to start a consulting project for a few weeks which should be fun and pays well.

On another note, it's incredibly hard to read pregnancy updates from people who got pregnant after I did and are now more than halfway through. I'm really happy for them (and you, if you're one of those lucky women), but it hurts, and it reminds me how close I'd be if my pregnancy hadn't ended the way it did. It's sort of like when you have a group of friends and everyone just grows apart as they get older and start having different life experiences. It's awkward, but it's not personal, it's just the way things are.

Planning ahead

Just got off the phone with my IVF doctor for the followup consult after our failed IVF 2.0. It was a good call.

Clearly ovarian reserve is an issue for us, since we've only gotten 2-3 eggs in our IVF cycles. I hadn't realized that the first cycle one of the eggs wasn't mature, but matured in time for ICSI and made a good embryo.

We know immunology is an issue, but we've been able to manage that successfully with Humira injections and Intralipid infusions.

So for this next cycle we'll switch to a different protocol. Both of my previous cycles were micro flare protocols: microdose of the antagonist Lupron, then adding FSH in the form of Gonal F (and Gonal F and Menopur in cycle #2). For IVF #3, we'll use estrogen priming towards the end of my next natural cycle (the one that starts mid-Sept) instead of doing birth control pills that cycle, along with Ganirelix to clear out whatever follicle emerges. After my period comes (mid October-ish), we'll start injectibles, and then add Ganirelix once the follicles get to 14-15mm to prevent a LH surge.

We're also going to go back to Humira to address my rising TH1/TH2 levels. We did Humira before IVF #1 and it worked great. For IVF #2, my levels were only slightly elevated, so we just did Intralipid, but my TH1/TH2 came back higher after the first Intralipid so I required another. To reset my immune system, I'll do two shots of Humira two weeks apart, probably starting next week.

And, bizarrely , since we'll need to know when my LH surge is, I get to use OPKs this cycle as a dry run for next cycle (since the estrogen starts 10 days after my LH surge). They want to be able to roughly predict the timing for retrieval/transfer. I haven't used OPKs for more than a year!

I'm really glad we're changing protocols. The reading I've been done about low ovarian reserve suggests that the estrogen priming can be really helpful. So hopefully I'll respond well!

I'm also really happy we were able to move this consult up (originally the clinic tried to schedule it for September 2). Since I need to be doing things this cycle, and my doctor wants the Humira done before the estrogen priming starts, waiting for the consult would have pushed things further back than October.

And so we wait

Photo by Michael Gwyther-Jones

My period started yesterday. Early - 9 days post retrieval - but I think the one day of progesterone helped moved it along (we did the shot on Sunday night to prep for the Tuesday transfer-that-never-happened).

So I emailed the nurses at my clinic and asked if I should schedule a baseline ultrasound. And they relayed from the doctor that I had to have a natural cycle first. Would have been nice to know that as soon as the cycle failed. I mean, really... I know this was my second IVF cycle, but since the first one worked, I don't know how the clinic handles a failed cycle.

So we wait. My normal cycles are 32-33 days (long follicular phase, short luteal phase), so it'll be mid-September. The timing works out reasonably well, because I'm going to be traveling the week before and after Labor Day. And our follow-up consult is this Thursday, so we'll have a better ideal of what we'll tweak. But it means that the next IVF will be mid-late October, which seems so far away. *sigh*

Last night was the first time I've let myself think about the fact that we would have been more than halfway through our pregnancy if it had been viable. Tomorrow would have been 24 weeks. And I see so many of my blog and twitter friends celebrating 18 and 20 weeks, and I can't help resenting the unfairness of it all. I'm happy for them, and so glad they didn't have to go through what we've gone through. But it sucks for us. Thinking about when I was pregnant feels like looking through fog -- it's hazy and seems far away. And thinking about being pregnant again feels like a mirage; something that keeps moving away as we try to reach it.

Bust

We got a call yesterday morning scheduling us for an 11am transfer appointment for today.

And then midday when I was driving my in-laws around, I got another call in the car. Which I didn't answer, because I knew it was bad news, and I didn't want to hear it with them in the car with me.

So they went into a store, and I listened to my voicemail. It was my doctor telling me that our one embryo hadn't divided, and so the transfer was cancelled.

We'll do a consult with him soon about the next cycle, but are pretty bummed this one is a bust. Money and two months of effort down the drain. I think the timing for the next one will be early October, based on waiting for AF, three weeks of birth control pills, and then stims again. But we'll see.

And... we have an embryo!

Just got the call -- our late maturing egg fertilized and we're on for a Tuesday morning transfer!

I still start progesterone shots tonight (wasn't sure if the day delay meant those would get delayed, but apparently it's based on retrieval, not transfer, timing).

Still waiting...

We didn't get our call this morning before noon with a fertilization update.

We did get a call from the doctor (never a good sign) around 2pm. Both eggs were immature. One matured overnight and was ICSIed late this morning. So we'll find out tomorrow before noon if it has fertilized. If it survives, we're on for a Tuesday transfer. (Those of you following carefully along will realize this means we can go to the Natalie Merchant concert on Monday -- minor silver lining, but I'm taking there where I can get them...)

The other egg did not mature and had started to degenerate.

So... more waiting until tomorrow morning to find out if we have anything to work with. We're glum but not overwhelmed by it.

Based on some reading about protocols, I'm wondering if the Menopur hurt rather than helped. It doesn't seem like my little follicles grew very much from Tuesday (when they were 7-9mm), and they barely grew from Sunday to Tuesday (when they were 6-8mm). The one big empty follicle prompted the retrieval scheduling (of course hindsight is easy...). This retrieval was Day 16 --my first IVF it was Day 14.

If this one doesn't work it'll be interesting to see what my doctor suggests for the next one.

Staying kinda detached until we hear the news tomorrow. Just trying to pass the time.

I appreciate the positive notes, here and on twitter. Thank you all!