Two Years and Counting

CD4 results
January 30, 2008, 1:34 pm
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Yesterday I had my CD4 u/s and b/w to check antral follicles and my FSH and estradiol levels. This generally happens on CD3, I believe, but that fell on Monday, and I’d left a message over the weekend telling them I’d started my period and that Monday would be my CD3. They ended up not calling me back til late in the day on Monday, and said the 4th day would be fine.

The u/s went well. The nurse said my ovaries looked “good and healthy,” my lining was thin, as it was supposed to be, and it looked like I had around 8 or 9 antral follicles on each side, with each follicle measuring less than 1 cm. I was originally thinking 16-18 follicles sounded like a huge amount, and it made me glad I’m not doing any meds this cycle so as to not stimulate that many eggs. But when I got back to the office and looked up on Dr Google what the normal amount of antral follicles is, I was surprised to read that the “normal” amount is anywhere from 10-30. So I guess my 16-18 isn’t really all that huge. But the nurse seemed to think that number was fine.

I got my b/w results later in the day. My estradiol level was 34.7 (they want it to be less than 100) and my FSH was 11.9 (they want it to be less than 12.5.) So we’re on for the natural cycle with IUI and the HCG trigger shot. Now, I’m just praying the big day doesn’t coincide perfectly with Matt’s marathon on Feb. 10th. This is his first marathon and he’s pretty excited about it. It would happen that Feb 10 will be my CD 17 which is when I’ve ovulated 3 out of the last 4 months. He said if that happens and he has to come in and give a “sample” on that day, he’ll just miss the race. I’m just praying it doesn’t come to that.


You’re It!
January 29, 2008, 2:22 pm
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I’ve been tagged by Kelly at The Quest for Baby Agosti. Here’s the deal…

The Rules:
1) Link to the person that tagged you.
2) Post the rules on your blog.
3) Share six non-important things/habits/quirks about yourself.
4) Tag at least three people at the end of your post and link to their blogs.
5) Let each person know they have been tagged by leaving a comment on their blog.
6) Let the fun begin!

Random facts about me:
1. While I’m a fairly healthy eater, I can rip through a box of cheez-its in a day or two. I don’t know why, but my mouth waters for them sometimes. It’s a strange obsession.

2. I successfully led my clueless college roommate around Europe for three weeks when we graduated. Not to brag about myself, but if I hadn’t been with her, I’m pretty convinced she’d still be in the Paris metro station trying to find her way out. I returned to Italy with my husband in 2006 and we had a much less chaotic trip.

3. I’m a total cat person. I don’t have cats emblazoned on clothes or backpacks like some staunch cat people, but I really do like them. Most of my friends are “allergic” to cats. Really, I think they just don’t like them and use the allergy as an excuse. I don’t know how you could not like my kitty Gabby. She’s cuddly and sweet (most of the time) and can fetch things.

4. When I was about 11 years old, I was riding my bike at the beach with my brother and turned around to look at him just as my bike rolled over a speed bump. The bump knocked me off my bike and onto my face. On the concrete. I didn’t panic much until I saw the blood dripping off my face. I ran upstairs to my parents who thought I’d been hit by a car because all they could see was blood. It turned out that all that blood was coming from a small cut over my left eyebrow. That, and I’d left a decent amount of the skin from my cheekbone and jaw line on the street outside. I recovered nicely and just have a small scar over my eyebrow that really only shows up when I get hot.

5. One of my biggest fears in life is speaking in front of groups of people. That goes hand in hand with being the center of attention where everyone is looking at you–while you’re having to speak in front of them. A couple of weekends I had to face that fear by giving a toast for my childhood bestfriend at her rehearsal dinner in front of 200 mostly inebriated people. You might think that by facing that fear, I’d conquer it. Nope. My husband said I did a really good job–and I’ll admit I got through it better than I thought I would, but I’d still do many unsavory things before I get up in front of a crowd to speak again.

6. I’ve decided that I’m certifiably a “cold person.” It’s my new identity. I’m basically cold for a solid four months or so in the winter. Lucky for me, I live in the South where winters are short and summers are long. Otherwise, I’d probably just turn into an icicle. Also, my husband might leave me for someone with warmer toes.

And to tag three more people…Andrea Jeannine, Sarah, and Ellen. My apologies if you’ve already been tagged.

I’ll update later about my CD4 ultrasound and bloodwork from this morning.

Follow Up Appt With Dr. H
January 23, 2008, 4:49 pm
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We met with Dr. H. today. I felt so much better after our discussion. Each time I’ve talked with her, I’ve left feeling calm and encouraged. She just has a very pleasant, calm demeanor, but knows her stuff very well and is firm and confident as well.

We discussed the past cycle and how everything looked. She went over all my levels and things that were tested throughout the cycle and said everything looked very good. She looked at M’s numbers and talked us through those saying they were good as well. (I’ll get into that more later.) She said everything looked perfect for the first IUI, which as you all know doesn’t mean much since perfect cycles can lead to a period instead of a pregnancy, but it’s good that my body is doing what it’s supposed to be doing. She said so far we’re in the unexplained infertility category since nothing has come back as having a red flag on it. After we left her office, we agreed that even though unexplained infertility can be frustrating since there’s nothing glaring to fix, we’re still glad everything on both of us has come back normal.

As for the next cycle, she said she’d suggest unmedicated again since my body is doing naturally what it’s supposed to do, and there’s really no need to go on a drug to help me ovulate, since I’m already doing that. I told her I agreed, that I don’t want to get on the meds unless there’s a good reason to. She said she thought she might have to talk me into not going on the meds since a lot of women want to go on them immediately, but that in my case it’s not necessary. She did, however, mention something called either hyperovulation or superovulation where they cause you to produce several more eggs to increase your chances of conceiving. With this, it’s risky because there’s a 20% chance of twins, a 5% chance of triplets, and some other percentage of quads. She said she didn’t suggest this, but that it’s possible. I quickly said no. Later, M said, Yea right, M and Lauren plus 8! (We watch John and Kate Plus 8 on TLC.)

We also talked about the trigger shot. I told her what happened this cycle with me probably ovulating late, and she agreed that stress can cause a delayed ovulation, but that whatever the reason for my late ovulation this time, the shot will help us time it better.

So, our plan is another natural, unmedicated cycle with a trigger shot. She actually recommends us doing 4 of these cycles (3 more after this current one.) She said the chances of conceiving with an IUI are about 10-12% (I can’t remember right now if those are stats for an unmedicated IUI.) 10-12% seems really low to me, but I have to remember that I’m not trusting in stats or in IUIs to get me pregnant. God can work despite statistics or post-wash counts or whatever. Anyway, she said with these statistics, if after 4 attempts, we’d move on to the next thing, whatever that is. She said she felt confident in this course of action, as I’m only 28 and not in a situation where I need to be super aggressive in treatment, especially, again, as everything in my body is as it should be as of now.

As for M, we talked about his levels and his exercise. First thing, she asked how many hours he’s exercising per week now and how many he’ll be doing in training. He said 10 hours, and she basically said that was too much. When there’s a lot of rigorous exercise, the amounts of endorphins that are released affect can sperm production. Also, specifically with the bike, there can be some nerve damage in people who ride for hours at a time, along with overheating due to the spandex shorts they wear. So all in all, she said exercising 3-5 hours a week is fine, and that if he wants to take an hour and a half or so bike ride once a week (which is what he wants to do) that’s fine. Any more than that makes her uncomfortable. I really wanted M to hear what Dr H said about it. Last night I told him I’d probably be uncomfortable with the rigorous training involved in competing in the triathlons regardless of what Dr. H said today. He said his family (ie, me) and trying to have a baby is his first priority, and if his training gets in the way of that, then he’ll gladly stop. His thing was that he wanted a good reason to stop, not just unfounded nervousness coming from me. Or to be more specific, if she came back and said I’m 100% comfortable with you continuing with your training schedule this summer, then he wanted me to hear that and be ok with it too, and to not continue worrying about it and resenting it. Which makes since—medical facts are one thing, and the nervousness of a wife who sometimes worries too much is another, even though I had a gut instinct that she was going to come down agreeing with me at least a little. Not that there are sides in this. I just wanted her honest opinion. And her honest opinion was that 3-5 hours a week is ok, any more than that may not be ok.

She said the good thing is that we’ll be able to tell what the 3-5 hours are doing to his sperm because of the IUIs each month. We’ll know what his percentage of motile sperm are each month, and if the counts start going down, we’ll know the exercise regimen needs to be altered. And I’m comfortable with that, and M is too.

So my plan for this cycle is to come in on CD3 for an antral count (what does this mean? I forgot) and a check of my ovarian reserve, which I think will involve an u/s and bloodwork. Then I’ll start with the dreaded OPKs at day 13 or so, calling when I see any color line on the stick. I asked her about having to come in when I see even a faint line, and she said that’s just so they can see me before the surge starts, especially this time since I’ll be having the trigger shot. If we do the u/s and it’s too early, they’ll have me come back. Then, at the right time, they’ll give me the shot, and we’ll do the IUI I think 36 hours later. We’re supposed to abstain for at least 2 days before collection. When M gave his sample for the SPA test, we’d abstained for I think 5 days, and he had a really big number, 146 million, I think. Then for the IUI collection, the number was much smaller, we think because we hadn’t abstained at all. We actually had had sex the previous morning (a Friday) for the post coital test, then he had to give his sample the next day, Saturday, for the IUI. His number was much lower for that. We’re thinking having a few days of abstention before the collection will make the numbers go up. Then it’ll be back to waiting!

And here I sit. No more thoughts right now, but I’m sure I’ll be back for more later.

Odds and Ends
January 22, 2008, 9:50 am
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I’ve been gone for several days—I was out of town for a wedding, then was off work for MLK Jr Day yesterday, and I took a break from posting on those days. As expected, I started feeling some cramps on Sunday, which is about a week before when my period would come if it were coming, which I’m almost positive it is. Those week-before cramps are always a signal of what’s to come. I do think this cycle was a good learning experience though. Some of your comments have made me realize some things I need to ask the doctor about tomorrow when M and I go back to talk to her further. I’m going to ask if we can do the trigger shot next cycle, but without meds. I’d still like to try again without any drugs, but that trigger shot sounds good to me, just to ensure that at least the IUI is timed well (see my question below about trigger shots). I’m hoping she’ll say ok to me not going on the drugs yet.

I’m also going to ask her about coming in when I see only a faint line on the opk. I understand they don’t want to miss the surge, but I think they risk doing the IUI too early when they’re going by the faint line. The line I saw this cycle was very faint, but I went in anyway, and they did the IUI the next day. The problem was I didn’t ovulate for at least another 24 hours. I guess if they do the trigger shot, the opks are unnecessary, but I’ll ask anyway. What I want to know is how the trigger helps them time it better. Doesn’t the trigger make you ovulate within the next 24-36 hours? How is that better than the opk (if you go by the dark line)? And how to they know when to time the IUI in that 24-36 hour range? For those of you who’ve done an IUI with the trigger shot, how soon after the trigger did you go in for the IUI?

I’m also going to ask the doctor about M’s sperm levels. The analysis he did over the summer showed normal levels, but most were at the low end of normal. Except for concentration. Concentration was very good. I feel like I have to bring this subject up with him very carefully because I understand for a man, it’s a touchy subject. M’s been so great about testing when he needs to, providing a “sample” when asked to, being very supportive, etc. I just don’t want to offend him by asking the doctor to be very specific and honest about his levels and whether or not there’s a problem there. Triathlon season is coming up too, and I need to know if it’s wise for him to start his training back. Honestly, I don’t think I’ll be comfortable with him training for those until I get pregnant. If his levels were sky high, that’d be a totally different subject, and I’d probably be fine with him getting back on the bike and training, but since they’re not, I’m not looking forward to having the triathlon conversation.

Quick Update
January 17, 2008, 10:27 am
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I had my progesterone level checked this morning at 7:45. I decided that having my blood taken at 7:45 is a good way to ensure I actually get to work on time! It only took about 3 minutes, so I was out the door and on the way to work earlier than I would have been if I’d been doing my regular morning routine at home. I’ll find out my results later today. My guess is that they’ll say yes, I’ve ovulated, but then I’ll still just have to wait another 9-10 days to see if my period comes. M and I have a scheduled appt next week with Dr H to sit down and talk with her again. I want to get her opinion on my ovulation possibly being delayed this cycle, and whether or not it could have been due to stress. Have any of you ever had that happen? Delayed ovulation due to the stress? If Dr H thinks that’s what may have happened, I’ll need to figure out a way to keep myself from getting worked up next month. I definitely won’t plan on cooking dinner for the family the evening of the IUI! Maybe I’ll schedule a day of couch-lying, Ellen-watching, book-reading, and pumpkin break-baking.

3 Days Past IUI
January 15, 2008, 10:50 am
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My temp had a sharp spike this morning, so at least I know I’ve o’d, even if it wasn’t when I thought. Now, my thinking is that the stress of the weekend (knowing the IUI would be Saturday morning, then planning a dinner Saturday night with M’s parents and sister and brother in law) got to me and possibly caused delayed ovulation. This is only my 4th month to be charting (we’ve been trying since January, but I was enlightened about charting and BBTs late in the summer) and in these cycles, I’ve o’d on time and regularly, with a nice rise in temps each time. Also, all my bookwork has come back with normal levels of everything so far. That’s why I think this delay in ovulation is stress-related.

The nurse ended up calling me late in the day yesterday, and I explained my concerns to her. In hindsight, I’m glad she called later in the day rather than early (even though yesterday afternoon, I couldn’t believe they hadn’t called me back yet when I left the message at 8:00 on the dot). I was pretty worked up yesterday morning, but by the time she called, I’d calmed down and had thought through things more (and had some good advice and encouragement from you all!) She said since I did a natural cycle with no trigger shot, there’s really no way for them to tell if I’d o’d until I come in for the progesterone check on Thursday, which is exactly what I thought she’d say. She said they don’t trust the temperature thing all the time because so many things can affect temps, which I also figured she’d say.

So, even though I don’t really know anything, my thinking is that this IUI was ineffective, since I’m thinking I may have o’d yesterday instead of Saturday. And although it’s really frustrating and disappointing, I know I need to chalk it up to the learning process. If I end up getting my period, then we’ll look towards next cycle. I’ve already decided I’ll ask the doctor if I can do another unmedicated cycle, but go ahead and do the trigger shot to ensure that I ovulate on time, so the IUI at least is well-timed.

I still have a smidge of hope for this cycle because of that small rise in temp on Sunday morning. It may be just blind hope that refuses to be squelched until I actually start my period, but still. Even though I know logically that the sharp rise in temp this morning most likely means I o’d yesterday, I’ll still hold on to that tiny hope until my period comes—or until this weekend if I get my usual week-before-period-starts cramps. Unfortunately, this weekend coincides with my childhood bestfriend’s wedding, in which I’m the matron of honor and in which I have to be perky enough to deliver a nice toast in front of 200 people at the rehearsal dinner.

January 14, 2008, 10:44 am
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So I’m feeling sort of dejected today. Remember how I said I hadn’t ovulated at the time of my IUI on Saturday? Well, when I took my temp yesterday (Sunday) I thought I’d ovulated because I had a temp rise. I knew in the back of my mind that it wasn’t as big of a rise as it usually is, it wasn’t over the coverline, but it still was an ok rise, so I figured that was a sign that I’d ovulated. I fully expected today’s temp to be even higher. Except it wasn’t. It dropped down a tenth of a degree. So now I’m wondering if I even ovulated. Which is really weird, seeing how the last 4 months, I’ve ovulated on my own, at a normal time, and the temp rises have been as they should be. It’s strange to me that the cycle in which I have my first procedure done is the first cycle I have something weird like this happen. I know stress can affect ovulation–either cause you to not ovulate or to have a delayed ovulation. I didn’t feel particularly stressed over the weekend–although I did cook dinner for my in laws Saturday night. But I had the cramping Saturday night which I figured had something to do with my ovulation.

Anyway, I’m feeling pretty sad this morning, having to occasionally swallow down a lump in my throat. I’ve put in a call to a nurse at the doctor’s office so I can ask some questions. I have a feeling they’ll tell me to just wait until my appt on Thursday. I wasn’t even going to call, but I thought I’d go ahead and let them know what’s going on in case it’s possible for them to do an u/s or something to see if I’ve actually ovulated. If not, maybe they could do the IUI again? I just keep thinking that the insemination on Saturday was worthless if I didn’t ovulate when we thought I would.

Another thought is that maybe I did ovulate, but my progesterone is low, which is the reason for my low post-o temps. The book Taking Charge of your Fertility mentions low progesterone as a possible cause of low post-o temps, so I guess there’s a chance that’s the case here. Even though, again, in previous cycles, my high temps have been adequately high, which leads me to think progesterone was ok in those cycles.

I’m praying, but not sure what to pray for.