Bring it!

I had my u/s and labs done yesterday.  No new bad news (how negative does that sound, ugh!).  I do NOT have a cyst (point for me), but my labs still show me in the same hormonal state I was a week ago, preovulation (point for the dysfunctional reproductive system).  So basically, I'm just going to keep going like this until, well, I don't really know how long my body could keep this up.  My uterine lining is very thick, so my estrogen just keeps doing its job, the progesterone is the one that's falling short.  To its defense, its waiting for ovulation to trigger a spike/ drop, then that triggers AF.  The RE is not confident ovulation  will be happening naturally.  The RE labeled this cycle an "estrogenized, anovulatory cycle" (whew, that's a big term).  So, I'm over this cycle, as I sit here on CD 60.  They are giving me progesterone to artificially spike and drop, to evoke a period.  At this point, I just say "bring it", lets get this ball rolling.

The Wrong Direction

My RE followed up with me yesterday about the additional labs he had me get done.  He said it looks as though my hormonal functioning is within normal range and that it looked like I was getting ready to ovulate soon after the labs were drawn (6 days ago).  This means the Lupron is no longer influencing anything and I *should* be back to normal.  He is aware that I am now on CD 57 and attributes it to probably an ovarian cyst.  I've never had an ovarian cyst in my life (that I've known about), why is there more drama to this equation??  He suggested that I go ahead and start the BCP right away to shrink a potential cyst and get prepared for the IVF cycle.  Then I can have a period after the BCP and start fresh.  Call me crazy (well, I am) and I almost couldn't get the words out of my mouth to ask (I felt so ridiculous suggesting this), but I said, "what if I did ovulate and this our one in a million month"?.  He acknowledged my hope (albeit far fetched) and said he would do an u/s and labs tomorrow to find out if there is a cyst and if I did, in fact, ovulate and where I am in this cycle.  Then I could go forward comfortably with the BCPs.

He also said that my AMH has decreased slightly (man, the clock is really ticking, losing ground by the minute!!), but also said it is subject to slight variations at any given time and that it was still in the same range.  He reassured me (well, that was his intention I suppose) that we still have a fairly (his heavy emphasis on the 'fairly', not mine) good chance with IVF.  We did, however, discuss the Shared Success Program the clinic offers.  Its a package deal that gives you one fresh IVF and unlimited FETs (from the original IVF) until you bring home a baby or all the embryos are used and in that case you get some of your money back.  In our original meeting with this RE, he felt very confident that we would qualify for the SSP.  In our conversation yesterday he said that I do NOT qualify based on my AMH.  This to me is devastating.  Not financially, but emotionally, if they aren't willing to take the chance, should we?

I feel like I'm backsliding with all of this. I feel like the more information we get and the further we go, the more obstacles pop up to challenge my faith in this decision.  I'm usually pretty interested and somewhat excited about moving forward and finding things out (curiosity, control, progress, not sure which), but I am not looking forward to tomorrow's u/s.  I just don't want to find out any more bad news about how much harder all of this is going to be.  I feel like I'm physically and emotionally moving in the wrong direction.

I'm too young to feel this dang old

My RE surprised me today when I answered the phone and it was him.  I was taken back that the RE would take the time to call me personally.  Well, as you have probably figured out, it was not with good news that he made such a personal connection.  I had my blood drawn last week for my pre-IVF labs and expected they would come back as normal as the last set I did 5 years ago.  I don't remember getting old in the last 5 years, and I'm still under the "AMA", so I didn't give it another thought.  So honestly when my RE called I was surprised.  Well, apparently there is a fairly new marker for ovarian reserve (how normal your ovaries are functioning), AMH (anti Mullerian hormone) which decreases with age, until you reach menopause and it becomes zero.  Mine, according to the RE, is lower than it should be for my age.  I asked if I was pre-menopausal and he said it wasn't that low.  He explained that it would simply mean that I would most likely not have a chance of hyper-stimming (OHSS), which is good, they will have to probably use twice the dosage of FSH (stim meds), I wouldn't have to worry about unwanted ovulation during stims, and that I would most likely not get a large (meaning normal) number of oocytes retrieved (we had 13 retrieved with our son's IVF, we are probably going to be lucky to get 4-5 now).  Those that aren't familiar with IVF may think the 4-5 is 3-4 more than you need to make a baby, but just because they are mature, doesn't mean they'll fertilize, and doesn't mean they'll make it to transfer.  So starting with 5 may put us, if we're lucky, with 1 blast to transfer.  That, of course, being worst case besides no blasts to transfer.

I asked my RE about my time on Lupron (which is an artificial menopause) effecting the results.  He said that it shouldn't, but also said he's pretty sure its not been studied, so he did not know.  I immediately want to blame it on the Lupron and the fact that I'm now on CD 49 with no sign of AF.  RE said the Lupron should be out of my system by now, but was curious about why I haven't started yet.  He is sending me for more labs to see where I am with normal cycle hormones and repeat the AMH for good measure.  I asked about forcing AF to get started with IVF and he said it wouldn't be necessary and that if all is quiet in there, I can just jump in anytime.  Quite honestly I'm a little afraid of that.  We did that with the FET and it didn't work, so naturally I don't want to make the same mistake.  I'm sure the RE knows what he's talking about and wants to optimize our chances, but I just wish my cycles were normal from the start of the next IVF.

I was hoping that all was still okay with me and with my DH (which, by the way, his SA came back normal, phew!) so I could just worry about the normal stuff, not worry about my chances being decreased because I've waited too long or something is different about me now as opposed to 5 years ago.  I have to try to let my positive thoughts prevail and focus on the things that are working for us (like my DH's swimmers and all that I DO have working right). 

On an encouraging note, my RE emailed me and wants me to email him when I go for my lab work so he can personally call to explain the results.  I have no doubt that we made a good choice in switching to this practice. This RE is really making a positive impression on me and easing my mind that he knows what he's doing and he cares about what he does and who his patient is.  That kind of service in this context is absolutely priceless!

Mother's Day

Today, as every day, I am a daughter, sister, wife, friend, but also today I am reminded everywhere that my most treasured role in life is a mother.  I never take for granted the fact that I have been blessed with motherhood and a beautiful baby boy.  I realize that there are so many women out there that dread this day because they are still waiting (I was there too).  I may be struggling with this second round, but today, there's nothing but joy when I hear my DS, in his sweet 4 year old voice, say " Happy Mother's Day".  So, as backwards as it may seem, today makes me incredibly grateful and it was a joyful day!

On a side note, its now CD 46.  This cycle must end!  I think its time for some medical intervention.

CD 39

Just an update, I'm still waiting (oh, my life story!) for AF arrive.  I'm now on CD 39 (yes, you read correctly, cycle day thirty nine).  I have never had a cycle this long (not even close), ever, with the exception of manipulating BCPs to skip a period.  I took a HPT yesterday, I've decided I would make Saturday my "test day" until AF decides to show up.  Of course it was negative (otherwise, this blog would have gotten a lot more exciting).  Surprisingly, I'm not anxious about all of this.  I'm not fighting the urge to test every waking moment.  I actually don't really think about possibly being pregnant at all.  I'm just waiting for this cycle to end so a new one can begin.  I guess I should probably call my RE if it hasn't started by next week, that would be a little too long for me.

On a different note, as I've said before I do not believe in coincidences and I feel that everything is meant to happen by Divine intervention.  I have not shared any of my infertility "stuff" with any of my coworkers, with the exception of one who just happens to know because of a mutual friend that I have shared all of this with.  I was working the other day and a coworker came into the isolated room that had just me and another nurse in it.  This coworker began to update the other nurse about her infertility plans.  I then shared my story with her and  found out she has arrangements with the same clinic and RE that I am now seeing to do IVF.  We discussed the financing and she shared with me how her and her DH figured out a way to finance it.  Basically, she is ready to do her IVF asap, which is a little sooner than me, so she will be able to help me figure out how to juggle my schedule and IVF and FMLA (also, I now know how we are going to pay for it).  It's as if she came into that room just to answer those lingering logistical questions for me. 

So, we are on track for a fresh IVF.  My reservations about pursuing this are fading.  I also have confidence now that if in the end we do not get pregnant again, I can live with that.  I need to believe that I will be okay if we go down this road again and end up back where we started.  Granted we'll have more debt (and actually we'll have debt no matter what the outcome) but I can be satisfied that we gave it all we had and I can put it to rest.