Waiting is the worst...time went so fast the first two weeks and now the bottom half is just dragging! I found out my progesterone is looking good so I don't have to do any more shots! Acupuncture went well today. He used a needle in a fertility point near the tip of my middle finger (how perfect). I didn't feel the needle but about 10 minutes into it, my whole reproductive area got this heavy feeling and I fell asleep! The funniest thing about the acupuncture is that it is supposed to detox you and get things moving, and after I am done I always have to run to the bathroom and pee for a minute straight! That is how I know it is doing something...it drains me, literally!
Back to waiting...
So in love...
Our Furbaby
Here's Hercules (aka Bear)
Monday, November 30, 2009
Friday, November 27, 2009
Let the 2WW begin!
I had my IUIs done yesterday and today and it was a lot less traumatic than I had envisioned. It literally took 30 seconds. That, of course, is not counting the hour and half we waited yesterday and the two hours we waited today to be seen by the doctor. The good news is Gene's count seems to have gone up or at least the "boys" are healthier. I will attribute that to his giving up coffee, but in all honesty, it could be a million different factors. Right now I am all crampy and can pretty much guarantee I was ovulating today (in fact, it began exactly 36 hours from my Ovidrel shot, which is what the doctor told me would happen). So the timing couldn't be better.
I'll be back to the doctor on Monday to have my progesterone tested. If it is not high enough, I will have to do another shot. I'm curious to see what it is, because it's usually on the low side.
positive thoughts...
I'll be back to the doctor on Monday to have my progesterone tested. If it is not high enough, I will have to do another shot. I'm curious to see what it is, because it's usually on the low side.
positive thoughts...
Wednesday, November 25, 2009
It's on!
Tomorrow and Friday I will have back-to-back inseminations. Bring on the turkey baster! My follicle is measuring 20 and my lining is 8. So everything looks good and I will trigger tonight at 8 pm. Something to be thankful for this Thanksgiving!
Beta will be on 12/11, the day before Gene's birthday getaway. I was thinking to cancel the trip to save some money but I really think if I get bad news on that Friday I will want to get out of here for the weekend, and if it is good news then we'll want to celebrate anyway. So the timing is good! :)
Beta will be on 12/11, the day before Gene's birthday getaway. I was thinking to cancel the trip to save some money but I really think if I get bad news on that Friday I will want to get out of here for the weekend, and if it is good news then we'll want to celebrate anyway. So the timing is good! :)
Tuesday, November 24, 2009
Converted to IUI
We have decided to move ahead with the IUI, since the IVF has been canceled. I think as long as my other 4 follicles don't start acting up in the next couple days, I will be ready to trigger (give myself a shot of ovidrel) ovulation and then do back-to-back inseminations on Thursday and Friday. I am hoping my uterine lining thickens in time, it is at 6 mm now and I think it needs to be at 8. My follicle was 17 mm today, shy 1 mm of being ready, which equates to $400 more I needed to spend to be monitored an additional day. Can my body be any slower?? Seriously...
So tomorrow morning I go back at 5:30 am, again. And HOPE to hear that the follie is 18 mm, my lining is at least 7 mm, and I can trigger Wed night. What I bet I will hear is, your follicle is still 17, lining is still 6, you need to buy another $400 worth of meds for the night, and then come back tomorrow at 5:30 am and spend another $400 on an ultrasound. It is insane the time and money that ONE cycle days adds on.
Will update tomorrow on my turkey baster status.
So tomorrow morning I go back at 5:30 am, again. And HOPE to hear that the follie is 18 mm, my lining is at least 7 mm, and I can trigger Wed night. What I bet I will hear is, your follicle is still 17, lining is still 6, you need to buy another $400 worth of meds for the night, and then come back tomorrow at 5:30 am and spend another $400 on an ultrasound. It is insane the time and money that ONE cycle days adds on.
Will update tomorrow on my turkey baster status.
Monday, November 23, 2009
Cycle is cancelled
Again, I am too upset to cry. I think I just accept bad news as the norm these days. I have one "runaway" follicle as they call it. It is 16mm and the other 4 they can see are all less than 10, meaning they haven't grown at all. So there is no option to wait for the others to grow, because the one at 16 will be mature and ready to ovulate in a few days. I can't believe on this amount of meds I produced one egg. And to hear girls talk about their 20 eggs, 30 eggs, 40 eggs...makes me sick. I am going to see if we can convert this cycle to an IUI cycle. It isn't going to give us a 50% chance but it might at least boost it to 15%. I think the worst part is, I have no plan if IVF didn't work. I always have a plan! And now I just feel like I am lost wandering some unknown land.
Sunday, November 22, 2009
All About E2
I found this online and thought it was interesting and explains it a lot better than my doctor did:
"Estradiol: What It Is and What It Tells Us.
The level of estradiol is measured in almost every blood sample taken during the monitoring of almost every type of assisted pregnancy. It is arguably the most informative of the three tests. Because of this, we will spend more time and space on estradiol. Don't worry-- the other two won't be nearly as long.
Estradiol is a hormone that stimulates the lining of the uterus, causing the lining to grow, and to make itself ready for embryo arrival. (This is not estradiol's only function, but for us, it's the important one). Estradiol is tied into pregnancy by it's method of production: oocytes (eggs) contain follicles. These developing follicles contain 'granulosa cells'. These granulosa cells synthesize the estradiol and release it into the blood circulation.
This means that more follicles produce more estradiol. This helps measure how many follicles are actively developing. The longer they continue to develop, the longer the estradiol level continues. As they develop, the level continues to rise. This rise can further indicate that the oocyte within the follicles is reaching its maturity.
An example of the use of estradiol level is when it is measured during down-regulation cycles. In down-regulation we expect low levels of estradiol: below 30pg/ml. If levels are not this low, this suggests that the ovaries are not yet suppressed, and that the down-regulation should continue a little longer, until they actually are suppressed.
Estradiol And Ultrasound Scans
Blood estradiol is also used in combination with ultrasound scans. Taken together they help indicate how (and if) the ovaries are responding to stimulation. Is there a response? Is it adequate? Is it excessive? To tell us this, the blood level has to be viewed in relation to the stage of pregnancy and the day in the cycle in which the level is being taken.
For example, a level of 1500 pg/ml on day eleven might be considered acceptable in a stimulated cycle, as reflecting the presence of a reasonable number of mature follicles. However, if this level were present on day eight, it would be considered unacceptably high. It would almost certainly reflect the presence of an excess of follicles. At this stage (day eight) they would still be Immature ones. Their quantity, however, would suggest that continued stimulation would carry an unacceptable risk of developing OHSS-- ovarian hyperstimulation syndrome.
Don't Expect Easy Comparison
Before we continue, one important point: levels of estradiol are not the same from person to person. They cannot simply be compared from one to another. People vary-- everyone is slightly different, and everyone responds to a different degree. Some more so than others. A level that is dangerously high in one person-- or dangerously low in a second-- might be normal and healthy for a third. This is why blood levels can't just simply be compared. It's also why blood levels can't always be interpreted with complete certainty in the first cycles. Without prior cycles to 'calibrate' the levels, the meaning of a level can only be determined as to what it usually means-- what it 'probably', or perhaps even 'almost certainly' means.
Despite individual variation, estradiol level does provide very useful information.
A Rough Rule-of-Thumb for Good Estradiol Levels.
Exact figures are not possible. As a rough guide, however, a level in the range of 150 to 500 pg/ml is generally considered reasonable for the eighth day of a stimulated cycle. An approximate doubling of this level every 48 hours is considered promising, as a sign of continued good follicle development.
When the Estradiol Level Stays Flat or Begins to Fall.
Occasionally, the level of estradiol fails to rise during a cycle, or even falls. If this happens it strongly suggests that the follicles are not responding appropriately, and that the oocytes within will not be of good quality. Under these circumstances our advice is almost invariably to cancel the cycle, because a change in stimulation protocol may yield more oocytes-- and healthier ones-- in a later attempt.
Low Estradiol Not Always a Problem
A more common situation is when the level is low in the early part of the cycle. The choice then is to either carry on with the same amount of stimulation, to increase the amount of stimulation, or to cancel the cycle. This decision has to be based on a number of factors. These include:
the previous response to stimulation chronological age how low the level is
the ultrasound appearance of the ovaries is there a pressing need to ensure that an optimal number of oocytes are obtained, as in the case for couples with male factor infertility?
How It All Comes Together with Estradiol.
It should be clear from all of the above that estradiol levels do not tell the entire story by themselves. One level leads us to advise a couple to cancel. The same level in another couple leads us to suggest continuing.
We've already discussed levels that are low. When levels are high, we have the same choice: change the stimulation (reduce it), or cancel the cycle. The criteria to consider are the same as for low levels. The one additional factor is that with high levels we also think carefully about OHSS (ovarian hyper-stimulation syndrome). When assessing the risk of OHSS we look to previous cycles, if there are any. Any suggestions from these cycles of OHSS problems would quite definitely weigh heavily towards cancelling the cycle.
When the decision is to proceed, levels of estradiol continue to be monitored. If they continue to exceed acceptable levels, even with reduction in stimulation, we might reassess the cycle, and once again advise cancelling. If however they do return to normal levels, then the cycle will continue.
What is the limit of acceptable estradiol level? Acceptable levels vary-- it's not possible to give a definite, absolute number. However, any level of 4000 pg/ml or above does require careful consideration. Levels that are much in excess of this usually do lead to cancellation, though not always.
What about the lower limit? This too involves many factors. However, if the estradiol level has not reached a minimum of 600pg/ml then our usual policy is to discontinue the cycle. In practice we usually don't proceed unless the ultrasound shows three or more mature follicles. Since estradiol levels and the total number of follicles are related (as discussed in the beginning of this essay), this by itself eliminates most of the possibility for levels at or below this lower limit. Three or more mature follicles will, under most circumstances, secrete enough estradiol by themselves to give a level in excess of this minimum."
"Estradiol: What It Is and What It Tells Us.
The level of estradiol is measured in almost every blood sample taken during the monitoring of almost every type of assisted pregnancy. It is arguably the most informative of the three tests. Because of this, we will spend more time and space on estradiol. Don't worry-- the other two won't be nearly as long.
Estradiol is a hormone that stimulates the lining of the uterus, causing the lining to grow, and to make itself ready for embryo arrival. (This is not estradiol's only function, but for us, it's the important one). Estradiol is tied into pregnancy by it's method of production: oocytes (eggs) contain follicles. These developing follicles contain 'granulosa cells'. These granulosa cells synthesize the estradiol and release it into the blood circulation.
This means that more follicles produce more estradiol. This helps measure how many follicles are actively developing. The longer they continue to develop, the longer the estradiol level continues. As they develop, the level continues to rise. This rise can further indicate that the oocyte within the follicles is reaching its maturity.
An example of the use of estradiol level is when it is measured during down-regulation cycles. In down-regulation we expect low levels of estradiol: below 30pg/ml. If levels are not this low, this suggests that the ovaries are not yet suppressed, and that the down-regulation should continue a little longer, until they actually are suppressed.
Estradiol And Ultrasound Scans
Blood estradiol is also used in combination with ultrasound scans. Taken together they help indicate how (and if) the ovaries are responding to stimulation. Is there a response? Is it adequate? Is it excessive? To tell us this, the blood level has to be viewed in relation to the stage of pregnancy and the day in the cycle in which the level is being taken.
For example, a level of 1500 pg/ml on day eleven might be considered acceptable in a stimulated cycle, as reflecting the presence of a reasonable number of mature follicles. However, if this level were present on day eight, it would be considered unacceptably high. It would almost certainly reflect the presence of an excess of follicles. At this stage (day eight) they would still be Immature ones. Their quantity, however, would suggest that continued stimulation would carry an unacceptable risk of developing OHSS-- ovarian hyperstimulation syndrome.
Don't Expect Easy Comparison
Before we continue, one important point: levels of estradiol are not the same from person to person. They cannot simply be compared from one to another. People vary-- everyone is slightly different, and everyone responds to a different degree. Some more so than others. A level that is dangerously high in one person-- or dangerously low in a second-- might be normal and healthy for a third. This is why blood levels can't just simply be compared. It's also why blood levels can't always be interpreted with complete certainty in the first cycles. Without prior cycles to 'calibrate' the levels, the meaning of a level can only be determined as to what it usually means-- what it 'probably', or perhaps even 'almost certainly' means.
Despite individual variation, estradiol level does provide very useful information.
A Rough Rule-of-Thumb for Good Estradiol Levels.
Exact figures are not possible. As a rough guide, however, a level in the range of 150 to 500 pg/ml is generally considered reasonable for the eighth day of a stimulated cycle. An approximate doubling of this level every 48 hours is considered promising, as a sign of continued good follicle development.
When the Estradiol Level Stays Flat or Begins to Fall.
Occasionally, the level of estradiol fails to rise during a cycle, or even falls. If this happens it strongly suggests that the follicles are not responding appropriately, and that the oocytes within will not be of good quality. Under these circumstances our advice is almost invariably to cancel the cycle, because a change in stimulation protocol may yield more oocytes-- and healthier ones-- in a later attempt.
Low Estradiol Not Always a Problem
A more common situation is when the level is low in the early part of the cycle. The choice then is to either carry on with the same amount of stimulation, to increase the amount of stimulation, or to cancel the cycle. This decision has to be based on a number of factors. These include:
the previous response to stimulation chronological age how low the level is
the ultrasound appearance of the ovaries is there a pressing need to ensure that an optimal number of oocytes are obtained, as in the case for couples with male factor infertility?
How It All Comes Together with Estradiol.
It should be clear from all of the above that estradiol levels do not tell the entire story by themselves. One level leads us to advise a couple to cancel. The same level in another couple leads us to suggest continuing.
We've already discussed levels that are low. When levels are high, we have the same choice: change the stimulation (reduce it), or cancel the cycle. The criteria to consider are the same as for low levels. The one additional factor is that with high levels we also think carefully about OHSS (ovarian hyper-stimulation syndrome). When assessing the risk of OHSS we look to previous cycles, if there are any. Any suggestions from these cycles of OHSS problems would quite definitely weigh heavily towards cancelling the cycle.
When the decision is to proceed, levels of estradiol continue to be monitored. If they continue to exceed acceptable levels, even with reduction in stimulation, we might reassess the cycle, and once again advise cancelling. If however they do return to normal levels, then the cycle will continue.
What is the limit of acceptable estradiol level? Acceptable levels vary-- it's not possible to give a definite, absolute number. However, any level of 4000 pg/ml or above does require careful consideration. Levels that are much in excess of this usually do lead to cancellation, though not always.
What about the lower limit? This too involves many factors. However, if the estradiol level has not reached a minimum of 600pg/ml then our usual policy is to discontinue the cycle. In practice we usually don't proceed unless the ultrasound shows three or more mature follicles. Since estradiol levels and the total number of follicles are related (as discussed in the beginning of this essay), this by itself eliminates most of the possibility for levels at or below this lower limit. Three or more mature follicles will, under most circumstances, secrete enough estradiol by themselves to give a level in excess of this minimum."
Saturday, November 21, 2009
Slow but rising
The nurse called, my E2 levels are slow but rising and my follicles are slow but growing! So for now nothing is cancelled and let's pray my levels keep going up.
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