Sperm Exposure

(Trying to) Get Back On The Horse

Well, now that I am done moping and raging about the fact that I missed my last cycle I’ve collected myself enough to think about my upcoming cycle. I sent a long-winded message to my RE explaining that I want to stay on letrozole every cycle so that even if I am not making an attempt my cycle won’t get all screwy and be 20 days again. I can’t have that. My RE won’t allow it though. Even though the other RE in the practice had responded to this query in my initial message during the ultrasound snafu and said it was perfectly fine for me to do that. My RE says I can’t because, risks. 😡

She suggested birth control to pause my cycle in order to sync up with my donor’s schedule. The issue with that is I still don’t have a good understanding of what cycle day I’m likely to ovulate because all of the going on and off different medications has changed my cycle. Before I knew that either the 17th or 18th day of my cycle I would ovulate. If I could know that when I use Letrozole I tend to ovulate on a certain cycle day then this would all be so much easier. As it stands I have ovulated on day 12, 15, and 17 so far. I can’t plan anything with that. Even with an ultrasound that gives me and the donor two days of lead time. That’s not enough time for me to arrange flights, hotel and for the donor to adjust his schedule. It feels like chaos.

I don’t know if with a little more time I will be able to learn my cycle even with changing it periodically with birth control pills. If I can then that would be such a relief but my fear is that adding in the birth control will screw up my cycle again. And then I will have to figure out what cycle day I’m likely to ovulate using letrozole and then what cycle day I ovulate when using birth control pills followed by letrozole.

I think my RE is used to the only moving target being the woman’s cycle because the sperm comes in frozen vials that are shipped overnight. So two days of lead time is plenty. But that doesn’t work well when I am a moving target and so is the donor.

It’s got me seriously thinking about pursuing IUI or IVF. But I think if we go that route we will choose sperm from the cryobank. We looked into the process of getting our donor’s sperm processed for a direct donation and it’s a lengthy process and I think will run us about $4000 for all of the testing and other fees. I really like our donor and would love to continue using him but that cost is in addition to the IUI or IVF cost which is obviously substantial.

I work in the public school system. We don’t have that kind of money lying around. I mean we aren’t hurting for anything but our net worth is pretty modest. As it stands if we do IVF I think we will have to get a loan. Which makes me want to cry because we moved here from the bay area which we both loved in order to save money and pay off my large student loan debt. Taking out a loan for IVF does not help us with that goal. Neither does a baby, I know but at least a baby made without IVF wouldn’t put us 10K+ in debt right from the start. It’s just a bigger hole for us to dig out of and I hate that. Especially because neither of us particularly enjoy being here but we are stuck here until the debt is paid.

I’m not ready to make any big moves just yet. I need to find out what the IUI/IVF coverage is from my insurance. I’m expecting none but I figure if they will accept 6 at-home insemination failures as proof of infertility in order to cover some of the costs then it would be worth it to continue until we have met that. If there is no coverage then I think I am ready to move on. I just feel like this isn’t working and I’ll be turning 37 soon so each month my chances are dropping. And quickly. I have above average ovarian reserve for my age but I’ve also got ovarian dysfunction that causes low progesterone. I need a solid, well-researched and scientifically informed plan for the upcoming months. Given that, we will be meeting with our RE to go over our possibilities and talk numbers. Including finances for IUI and IVF.

For my upcoming cycle at the end of the month I want to give the donor another chance. I plotted out the days and figured out a range of potential ovulation dates. I gave him these dates and asked him to keep them in mind when planning upcoming trips. Fortunately, the big trip to China may happen on the very last potential ovulation date so I think I can make the cycle work with the help of a trigger shot this time around. I will discuss this with my RE as well.

After this attempt we will need a new game plan because I will go back to work mid/late August so traveling will be a big challenge. If I need to complete 6 cycles in order to get IUI/IVF coverage we may try more shipped cycles. If not, then it might be go time for IUI/IVF. I’ll have to work through my concerns about cryobank sperm if that’s the case but for now I’m going to cross my fingers that the upcoming cycle works.

 

Uncategorized

July is Out

My temp rose this morning after a positive OPK yesterday. I’m out for July. Oh and for  good kick-me-while-I’m-down measure our donor is traveling AGAIN in the beginning of August. So he is likely to be gone for that cycle too. At this point I think we just need to find a different donor. But that’s problematic because Asian (Chinese or Vietnamese) donors are not exactly plentiful. I was looking up donors on a cryobank website this morning and out of their entire database there are 8 Asian donors who are willing to have contact with the child. And not all of them have sperm available. This is hard. Harder than I thought it would be.

 

Fertility Center · Medical Stuff

Frustrated

This is the post in which I whine and gripe about trying to get pregnant. If that’s not your thing in this moment then I’ll catch ya on another post. If you’re there with me or just into a moment of TTC solidarity, then read on.

SO and I made our first attempt at getting pregnant in February. March we did not attempt (can’t remember why). Following that there was a RE referral and subsequent testing where we learned that my uterus was already implanted with a largish polyp and therefore no further attempts at implanting a fetus would be made until that situation was remedied. As a result, April was a bust.

My surgery date rolled around in early May. Ok, great. One polyp explanted, let’s move on to implanting a baby. The May cycle was strange as a result of the polyp removal as well as starting Letrozole. That cycle was unsuccessful.

June our donor was on vacation. Ok, no problem. Because he would not be around, the RE recommended that I not use Letrozole for that cycle. Sweet, less pills. Cue me eagerly awaiting my July cycle. Well, I must have been a bit too eager because I normally ovulate on day 18 of my cycle and I ovulated on day 12. Wouldn’t have been too big of a deal except my luteal phase was only 8 (!!!) days long. I had a 20 day cycle, y’all. As if having 2 periods in one month isn’t annoying enough, the short cycle means that I will likely ovulate around July 9th…which is the day our donor gets back into town after another trip. So now I’m hoping that the July cycle is not out.

I’ve had some issues with our RE as well. The way their office is run is that you send messages through the portal and then the office staff will either respond if your query is something that they can help with or they will forward the message on to the RE and she will respond. Now, don’t get me wrong, I really like my RE. She’s smart as hell and I think she is highly competent. But she tends to trickle out information instead of giving the whole picture. For instance, after my last attempt was unsuccessful she sent me a message saying she would see me on day 1,2, or 3 of my next cycle (this one) to start Letrozole for the July cycle attempt.

Based on that, I had it in my head that I just needed to get the prescription filled and I would be good to go. I messaged the RE’s office to find out how to get the prescription and the nurse wrote me back to let me know that I needed to come in for an ultrasound before starting Letrozole. Oh, ok… Except SO and I were headed out of town ourselves the very next day for almost 2 weeks and this was the first I was hearing about me needing an ultrasound. The nurse said I could get some labs drawn in lieu of the ultrasound and said she would send over the requisition. She also said that I had my last ultrasound on day 12 of the May cycle (my first medicated one) and asked if I wanted to schedule an ultrasound for July 5th for this cycle, which would be day 12.

At this point I’m freaking out– according to my count that ultrasound happened on day 15 of my cycle and ovulation was 48 hours later. I’m confused by this and ask questions. I also let her know that our donor won’t be available until July 9th which is problematic if I will be ovulating so soon. I asked if there is any way this cycle can be salvaged– can ovulation be delayed? I ask why my cycle was so short last time, was it because I took Letrozole the previous cycle and if so, moving forward can I just take Letrozole each month regardless of whether I will be meeting with our donor so that my cycles will be regular for organizing plane tickets, schedules, and hotels? And lastly that I was happy to get labs if given that my donor would possibly not be around for the upcoming cycle the nurse thought it would be a good idea. My RE was out of the office at this point so I was hoping that the nurse would at least get back to me about the labs.

Crickets. I got crickets.

Not a single message or phone call from them all day. I decided that I would check in with Labcorp to see if there was an order for labs. I couldn’t even tell them what labs were being drawn because I didn’t know. No lab requisition either! At this point it was taking everything in me to draft a polite yet firm message to the RE’s office requesting better follow up and communication.

I mean, I just feel like if the nurse decided based on my message that she wouldn’t be sending over a lab requisition would it have been so hard to send a message letting me know that? Or if she was unable to answer my questions, why was there no follow up message letting me know that she had forwarded the message to the RE and the RE would be getting back to me? And lastly and maybe most importantly, why am I so out of the loop for my own care?!

Why does it feel like even though it’s my body I have no control over any of this? 

Out of the last 5 months I have made 2 attempts at getting pregnant. TWO. I just want to actually try and get pregnant instead of waiting around to try and get pregnant. I am a patient person but this is wearing me down. I recently dreamt my sister told me she was pregnant and I started ugly crying in my sleep. SO shook me awake thinking I was having sleep paralysis. I mean, it’s funny but also really frustrating. And if you knew my sister and the level of frozen over hell there would have to be in order for her to actually be pregnant (firmly in the child free camp!) then it would put this dream further into context. My subconscious literally thinks that my sister has a better chance of getting knocked up than I do.

So my current state of affairs is that things have been really frustrating and I’m starting to wear thin. I’m really sick of waiting and I feel frustrated with my RE’s communication style. I like lots of information. I like research articles. I like to feel like I am a part of my treatment plan. I ask plenty of questions and I am no slouch at dealing with specialists. I have had more than my fair share of the medicalized life thanks to multiple sclerosis. Yet somehow I still have no clue what is happening with my reproductive system. I don’t know what the treatment plan is or key bits of information like the need for ultrasounds.

As a result of poor communication with my RE’s office my chances for attempting in July are pretty low. I’m trying like hell to will my ovaries to ovulate later.

My trip with SO was awesome though. We snorkeled, swam, kayaked, sailed, watched the sunset, drank beer, played magic, watched manatees float lazily around the boat docks, shopped and in general enjoyed the shit out of each other’s company. It was perfect.

 

Thanks for reading my ranty post.

 

 

BFN

It’s a Bust

Well, despite my optimism and anxiety, this cycle was a bust. There is no baby in my dusty uterus. Confirmed by my period on DPO 12. I tested on both DPO 9 and DPO 11 and both were negative so not unexpected. I had been told that there was the possibility of false positive tests due to the Ovidrel trigger but that did not seem to be the case for me.

I was somewhat surprised that I started my period so soon. My lab work on DPO 5 showed that my progesterone was 41. It was high enough that the progesterone suppositories the RE thought I would need weren’t necessary after all. For reference, my previous progesterone labs that were drawn before starting Letrozole showed that my progesterone was 5.3– low. Given the huge spike in progesterone I somewhat expected a much longer luteal phase. I mean, 11 days is good I guess. It qualifies as over 10 days. But I just figured it would be slightly longer. The Letrozole and high progesterone levels basically made me feel exhausted for a couple of weeks. Having MS really doesn’t help at times like that.

Anywho, I’m bummed that I’m going to have to go through all of that again but probably not until July because our donor will be away on a trip for 10 days in June. Those 10 days will likely coincide with my ovulation. Sigh. I guess a month off will be good so that I can relearn my cycle somewhat now that I am past the procedures and have started the meds.

I work for one of the school districts so summer break is so close I can taste it. I have a trip planned with my SO so that will be nice. And since I’m not pregnant I am seriously tossing around the idea of doing a solo backpacking trip for about 2 weeks in July or August. I had wanted to do a month but if I go that long then I won’t have any opportunity for more inseminations before the school year starts.

SO and I talked a little about how long we would like to continue trying for a baby and we decided on a year. If it doesn’t happen by then we will throw in the towel on trying to get me pregnant. At that point we will either consider adoption or being child free. I’ll be 37-38 before our future baby is born. I don’t want to be too old to parent. And I have to think about how my health and mobility might decline as I get older with MS too. I don’t want the child to suffer because I have a chronic illness.

Well, that’s where we are at this point. I wish it would have happened this month but it did not. On to cycle #3.

Sperm Exposure

Getting Real, Y’all

I saw my RE for an ultrasound today. I have two mature follicles 20-21mm on right-raisin (ovary) and could surge for ovulation pretty much anytime. I was given the option of a trigger shot to help control when ovulation happens in order to plan for an insemination so I took it. The shot arrives by tomorrow evening. The donor will be shipping to us given the short time frame. I will inseminate at home on Saturday. Possibly tomorrow too. Holy shit. I am freaking out so much right now.

After 3 months of no attempts whatsoever I feel so unprepared for this. I didn’t expect to be ready for an insemination so soon. I’ve had no signs from my body that ovulation is on it’s way. And I sucked at taking the Letrozole, starting it a day late and underdosing myself at least one day accidentally. So I was expecting to hear that ovulation was still a ways off.

I feel really strongly that this one will work. And that has me freaking out about pregnancy stuff and about being a (gulp) mom. What if I have twins????? If I get pregnant I will have to tell people I am pregnant. What if we aren’t ready to be parents?

UGH, I know I will get over my freak out and will be excited but holy shit I did not expect to feel this way at all. This is what I want, right? This is what I have spent months actively working towards. It’s what SO and I talked about for our future. Right?

 

RIGHT?!?!

Fertility Center · Medical Stuff

Polypectomy

I last left off here after getting my HSG and finding out that I had a polyp or two hiding in my uterus. My RE was firm about removing them before trying to get pregnant because a) my attempts would be way less successful; and b) if I did manage to get pregnant I was at much higher risk of miscarrying. I figured those were valid reasons but it took me a week or so to come around and actually schedule the procedure– anesthesia and surgery are totally new (and scary!) to me. Even though I have MS I am otherwise pretty darn healthy and growing up never even broke a bone or spent a single night in the hospital. How, I have no idea because I basically spent my childhood swimming in pools unsupervised, hanging upside down in trees and riding my bike with no helmet. My grandmother used to tell me we survived our childhood because there were angels watching over us.

Anywho, scheduling the procedure was a big hurdle. Initially, they had nothing until June 2nd. Well, they offered me a potential date of May 19th at 2:30 (no food or drink from midnight) in the afternoon. And they would have to call and check to see if that was possible. Those were obviously not good options and I was kicking myself for waiting a week to call and schedule. Upon learning that I would be sidelined waiting 6 weeks for the procedure and then until sometime after the procedure when I began to ovulate again I started to panic and get upset. Aside from being 36 and knowing that in the best case scenario I will be a first time mom at 37, I was freaking out about staying off my MS meds for another few months with no TTC attempts at all. My MS is very, very mild but I am still currently in the middle of a relapse and that was making the prospect of staying off meds even longer feel super risky.

I messaged the doctor and explained how I was feeling about the wait and the fertility center offered to do the procedure in their office surgical suites instead of at the surgical center. If that meant I could get things done sooner I was all about it. After a few days of phone tag to make arrangements with the scheduler who was out sick, she surprised me with the news that the RE had a cancellation for the very next day at the surgical center. I took it of course. That was a week ago today– May 4th.

Given that the procedure was the next day K and I didn’t have very much time to process what was about to happen. We were both really worried about it and talked about how nervous we were on the way over. But it all went really well. The check-in process went fine and then they took me to the pre-op area. I changed into my fabric tent with the huge hole in the back (AKA gown), took a pregnancy test and had an IV started. The nurses were super friendly and brought me extra warm blankets which was nice.

First I answered health and medication questions for a nurse, then I answered them for the anesthesiologist, for my RE, and then again for the anesthesia nurse. The most common questions were about what I had eaten and drank, what medication allergies I had and there was much conversation about my multiple sclerosis– especially since I am in the middle of a relapse that has caused a lot of numbness and neuropathy in my left leg.

The anesthesia nurse was one of the last people to come in and she pushed something in the IV that would make me “relax.” That must be code for nearly lose consciousness because I felt high. I tried not to show it but everything got really hard for me to follow and I was feeling drowsy and drugged. Shortly after that they pushed me into the surgery area and I’m becoming even more out of it. They push the gurney next to the table and they asked me to move over to the surgical table. It took probably 30 seconds to process that they wanted me to move my body. I moved over and that’s pretty much the last thing I remember until I am waking up in recovery and a nurse is handing me a ginger ale.

Shortly after that another nurse brought me a second ginger ale (did I ask for ginger ale??) and at some point my SO came in. I felt like I needed to pee really badly. They assured me it was just from the catheter but I tried a bed pan anyways (they were right). After what seemed like a few minutes but could have been much longer they let me get dressed and helped me into a wheelchair then we went home.

SO tried to get me to rest but I hate taking naps so I resisted. I stayed on the couch awhile and played on the computer, watched a little netflix and had lunch and some water. The anesthesia was strange. I remember most of what happened Thursday afternoon but not always in the correct sequence. At some point SO left to get the pain meds at the pharmacy and I realized that I was sitting on the couch staring at the wall… maybe a nap wasn’t such a bad idea.

I laid down and watched the live feed of the Okeanos deep sea exploration dive. They had just dropped the rover into the water so it was perfect. I dozed off and on waiting for the rover to reach the sea floor and SO came and hung out in bed with me when she got home. Later SO and I got to talking a little about the procedure and she said there were pictures. Apparently, she had told me about them in the recovery room and also the RE showed them to me after the surgery. Yep, I totally don’t remember any of that.

I took a look at the pictures and the polyp took up the bottom/front area of my uterus. I basically had a natural IUD in there. RE called as I was resting in bed and said that the polyp ended up being a little larger than the 6mm that she estimated on the HSG. Pathology came back yesterday and it was benign.

I took 2 doses of vicodin because I had the slightest hint of cramps. I had very minor bleeding on Thursday and Friday, none Saturday but then I started bleeding again with bad cramps early Sunday morning and continued to bleed lightly until yesterday. Friday I felt pretty good but figured I didn’t mind having the extra day off work. And since I felt fine I decided that I would plant a garden by myself all day long. Saturday, as you can imagine was not a great day after my gardening and neither was Sunday. I felt pretty nauseous most of the day. Saturday night I had chills and then Sunday night I was sweating. Hormones are weird. All week this week I have felt exhausted. I have been falling asleep after work and going to bed by 10. I slept 9 hours last night and needed to sit and wake up for almost an hour before I could function this morning. I have no idea if that is related to the procedure or just an energy ebb and flow related to my MS. It’s a bit of  a crapshoot sometimes knowing whether it’s normal or it’s MS.

Anywho, that’s my story of the polypectomy. Going under was scary but the recovery was mostly a breeze and I can start TTC as soon as I next ovulate. I will start the Letrozole tonight and I get an ultrasound next Friday to see how my eggs are developing and when I can expect to ovulate. It’s a relief that I can move forward with TTC and actually have a good shot at making it happen.

Fertility Center · Medical Stuff

HSG and Ultrasound Update

So, first things first: HSG really wasn’t that bad ladies. If you have to get one you’ll be alright 🙂

The ultrasound wasn’t bad and showed that I have 5 maturing follicles on each side which I *think* is good news. I’m pretty sure that the doctor said my largest follicle was 12 mm or 14mm, I can’t remember. The doc found an area of thickened endometrial lining on ultrasound and said she would check it out a little more during the HSG. I think the ultrasound aside from the lining being thick was good. She commented on my awesome AMH number too. Imagine me mentally patting my ovaries on the back. Good job little raisins!

Now,  onto the dreaded HSG. Prior to my appointment I took 600mg (3 pills) of advil. I think it was a good call and I’m glad the RE gave me those instructions. The test involves a lot of set up of equipment. It feels strange but is not painful. First, in went the speculum. Then she cleaned my cervix with betadine swabs which I hardly felt. I did feel stuff dripping out… which was gross. The doc talked me through the whole thing which was nice. She inserted some sort of tube and then another tube inside of the tube. There was pressure and some twisting but no pain.

I was instructed to breathe deeply and relax. I was really trying but there were so many things going on down there it was hard! Around this time the nurse, who could see my face, which must have had a distressed look on it, began telling me all about a new Italian restaurant that opened up. She told me about the food, about the shopping center, that there was a new Thai restaurant right next to it. I got directions, color scheme, anything that would distract me. I knew what she was up to, but I went with it. It was sweet of her to do that. I appreciated how perceptive she was and how she knew just what to do to help me get through that part of the test. The doc even jumped into the conversation.

Once all the equipment was set up the doc began inflating the balloon to open up my cervix enough to pass the tube through and begin filling my uterus with dye/water/whatever it is they put in there. Ladies, this is the part that hurts. It feels like strong period cramps I would rate as a 6/10 on the pain scale and made me nauseous. Your cervix obviously doesn’t appreciate being pried open and responds with cramps to close it back up. The crampy feeling remains for as long as the balloon thing is inflated. Luckily, that was probably a maximum of 5-7 minutes. The test only lasts long enough for the RE to visualize your uterus and see the fluid flow through both tubes. As soon as that was accomplished she deflated the balloon and removed all of the equipment. I felt incrementally better as each thing was removed. By the end, I only had a slight feeling of nausea and some really mild cramping. Following the procedure I had no spotting and only ever-so-slight cramping a couple of hours afterwards. I didn’t take any more advil and the cramps went away on their own.

The RE reviewed the test results with me at the end. Good news is that both tubes are open so no problems there. Bad news: that thickened area on ultrasound is a polyp. A 6mm polyp. AND she thinks there is another one in there too. In light of that, I will need a second procedure, this time under anesthesia to remove the polyps. The RE said that the polyps are nothing serious but that they would reduce my chances of conception and increase my chances of miscarrying if I did conceive. She recommended removal before any further inseminations.

Which really sucks because this week is spring break and the plan since being sidelined last month was to fly out today to see M for AI. I told the RE that I had just booked a flight to see our donor the night before and she immediately suggested that she write a letter to help me get out of the flight for medical reasons. She’s pretty awesome. It looks like I am sidelined again for this cycle though and possibly the next while we sort out this polyp situation. Sigh.

Anywho, that’s my story of the big, bad HSG.

 

If you have any questions about the procedure fire away. 🙂