2dpIUI #4

I am once again in the 2WW.  As I mentioned in my last post, I am slated to test on 6/20, Father's Day.  My father and stepmother, who are not in the know about our TTC efforts and treatment, are going to be visiting, so I am going to have to be stealthy about testing.  I have already cautioned MM that he needs to conceal any reaction to either a negative or a positive test from them, as I would not be planning to tell them either way (even if I am pregnant, I would wait until the second trimester to tell my father and stepmother).  We'll see how that goes.  Historically, a BFN has induced an all-day funk in MM.  It'll be interesting to see him hide his emotions from my dad & stepmom.

At this early stage, two days after the IUI, I wouldn't expect to have any symptoms, and I've had none.  (I have been feeling a little anxious, but I think that is more due to a situation going on at work than to anything TTC-related.)  That will probably change soon, as I will be starting progesterone gel tonight (yuck) and usually have some side effects from that.  I was very bloated and uncomfortable the day of and two days following last cycle's IUI, so I am especially glad to be feeling normal this time around.

I am going out of town on Thursday evening.  I'm traveling to my (very small) hometown in New Mexico to see my sister and nephew, who will be there for my sister's 20th high school reunion.  I am very much looking forward to seeing them both!  (MM has to work this weekend and is staying home with the doggies.)

There have been a few BFPs among my blogging pals these past couple of weeks, and I'm happy for them.  Still not happy for fertile acquaintances having kids, though: I saw another law school classmate's post on Fac.eb.ook last night that he and his wife are expecting their second child.  I did not post congratulations, and I was not happy for them.  LOL  I'm such a bad person. . . . .

IUI #4

Just a quick update on this morning's IUI. MM was very proud that his total motile count was 68 million. When he came home, he'd told me that he didn't think he produced much, but his numbers were actually better than last month. Go figure.

The IUI itself was wholly uneventful. The clinic was busy; the nurse (who was new to me) told me that I was their 5th IUI of the morning, not to mention the IVF patients they also had.

I only had a little bit of cramping this time. Now my goal for the day is to stay cool. That may not be as easy as it sounds, given that the forecast high for Tuscon is 108 and for Phoenix is 110.

My test date is two weeks from today, Father's Day.  Ironic, no?

Of course

This morning's OPK was positive.  So I took my hCG trigger injection shortly after getting off the phone with the nurse who returned my call to the RE's nurse line, and our IUI has been rescheduled for tomorrow morning at 10:30.

MM and I both had a feeling this was going to happen.  This has happened to us twice before.  When my lead follicle is already well over 20 mm, my body usually ovulates on its own.  (MM was inclined to curse my body for producing its own LH surge, but I pointed out that my body is only doing what it is supposed to do, what is natural.)

Normally I would be happy about this, because I'd prefer to do my IUI on the weekend, rather than miss time from work, but in this case, rescheduling the IUI to tomorrow is very inconvenient.  I have to drive the 120+ miles from home to Tucson tomorrow to visit M, the 10-year-old girl in foster care for whom I am a CASA.  I cannot reschedule the visit because tomorrow is literally the only free day I have in June to see M, whom I am obligated to visit at least once every month.  My next opportunity to visit her would not be until July 4th weekend if I canceled.

In addition to the fact that I am going to have to do more than 250 miles or so of driving tomorrow, the first half starting right after my IUI, I had planned to take M to a water park.  That plan is, of course, out the window because I won't go swimming just hours after the IUI and can't allow myself to get overheated. . . . which would be bound to happen at an outdoor pool when the daytime high is expected to be over 100 degrees tomorrow.  M was disappointed at the change of plans--for which I could only offer a vague explanation--but I will make it up to her by taking her to the water park for our July visit.

So today will be a long day.  Oh well.  I am planning on taking M on a much cooler (temperature-wise) outing than planned and will stay well-hydrated.  I hope I don't feel quite as icky and bloated as I did last month after my IUI.

I hope my 15-mm and 16-mm follicles have done enough additional growing since yesterday's u/s that they will be releasing mature eggs.  Though, really, our ideal outcome would be one healthy, perfect egg being fertilized.  I'm not picky about how that occurs. . . . I just want it to happen.

Will update tomorrow after the IUI to record the experience (and MM's total motile count) for posterity. . . . 

Cycle 27 monitoring u/s

So I kind-of got my wish: I have four follicles which were large enough to be detected on u/s.  The two on the right measured 15 mm each, and of the two on the left, one measured 16 mm and the other measured 23 mm.

Currently I am scheduled to trigger tomorrow night at 11:30 p.m., with an IUI scheduled for 9:30 a.m. on Monday.  One thing that may throw a wrench into our plans, though, is if my body begins to create its own LH surge.  If that happens, I will have to trigger during the day tomorrow and have my IUI on Sunday morning.  Which in and of itself would not be horrible, but if I begin to ovulate on my own, before the trigger, there is a distinct possibility that three of my follicles will not yet be large enough to contain a mature egg.  

As I understand it, because the follicles continue to grow 1-2 mm per day until they release their eggs, if I wait until tomorrow night to trigger for a Monday morning IUI, there is a very good possibility that all four follicles will contain (and release) a mature egg.  (I'm told that each follicle would need to be at least 16-17 mm to be considered mature.)  Four chances are better than one, so I am hoping that's what happens.

Nurse Favorite said my lining looked "great, textbook" at 9 mm.  So despite having used Clomid for the fifth sixth cycle, that's not a problem.

I'm keeping my fingers crossed that tomorrow's OPK is negative.

Ebb and Flow

I find it interesting how I sometimes have a lot of thoughts and feelings related to infertility that I feel the need to write about, and other times I seem to have nothing to say.  These past few days have been one of those "nothing to say" times.  I haven't been feeling much angst, sadness, anger, etc., about the fact that we still don't have a baby, more than two years after beginning TTC.  I have basically just been taking each day as it comes and doing what I have to do each day (drugs, OPKs) for this cycle.

I suppose it is just a natural ebb and flow.  Even though it is a little perplexing, I am actually glad to not have the constant flow of negative thoughts and emotions at the moment.  What a relief!  (If only they were gone for good. . . . )

I am still feeling a little tired today, but nowhere near how I felt yesterday.  (I seriously only had about an hour in the evening when I had energy and felt like I was dragging myself along the rest of the day.)  I did consult Dr. Go.ogle and found that fatigue is a documented, though not common, side effect of both Clomid and Gonal-F.  So at this point I'm going with medication side effect as the cause of my unusual fatigue.

Tonight is my last injection of Gonal-F (yea!), and tomorrow afternoon is my mid-cycle monitoring u/s.  I better have at least four follicles large enough to contain mature eggs this cycle or, I admit, I am going to be angry.  So don't let me down, ovaries.  ;-)

Will update with my u/s results tomorrow.

P.S. I mentioned taking DHEA to improve egg quality in an earlier post.  I have also done a "shot" of wheat grass three of the last four days. . . . which is supposed to give you energy in addition to helping your health in a number of ways.  I'm toying with the idea of using CoQ10 and/or royal jelly, too.  Any thoughts?

Is it just me?

I am feeling absolutely exhausted today for no reason I can pinpoint.  I have been eating healthfully and at regular intervals.  I have exercised for 30 minutes (or more) three of the past four days.  I drink lots of water.  I sleep at least 8 hours a night, every night.  I no longer drink anything with caffeine, so that can't be a potential cause of my fatigue.

I had blood tests last October to check my thyroid and to check for anemia.  They were all normal.  While I occasionally snore, MM has never noticed any other signs of sleep apnea (and he is a light sleeper who would notice).  I feel like I sleep soundly at night and wake up before my alarm most mornings.

Could being this tired just be a side effect of the Clomid and Gonal-F?  It's not even 11:00 a.m. here, and I feel as though I could go back to bed and sleep for another couple of hours.

Has anyone else experienced this?

It's times like this when I really miss coffee.  *Yawn*

Focusing on other things

I haven't posted in a few days simply because I haven't had much to write about.  Our current cycle is proceeding as planned, and I will begin using OPKs daily on Tuesday.  Not much to tell on that front until my mid-cycle u/s on Friday.  (Oh, one quick minor complaint: the needles on the syringes provided with the Gonal-F are much larger than the needles I used with the Follistim pen.  They are at least three times the length and about three times as big around, too.  Ugh.  I know that my little subcutaneous injections are nothing compared to what anyone who has done an IVF cycle has endured. . . . but I've still been unpleasantly surprised by the difference.)

Oddly, I thought quite a bit this weekend about taking a break after this cycle if I'm not pregnant.  It's not so much that I feel the need for a break, physically or mentally, as it is that I'd like to focus on other things which are difficult to do while TTC. 

For example, I need to lose weight.  While I can do this slowly through a healthier diet and exercise, I'd like to have the ability to jump-start my weight loss with something like the hCG diet or MediFast.  I think it would help me tremendously to see a large initial weight loss, and that is not realistic (or healthy) while I am TTC and taking fertility drugs.  Honestly, given what I've read of others' weight gain on fertility drugs, I count myself fortunate that I weigh within 5 lbs of what I did when we started treatments (albeit still much more than I should weigh).

I also feel hesitant to exercise as vigorously as I'd like to while TTC, at least during the second half of my cycle.  I have no problem doing intense aerobic workouts prior to ovulation and actually am of the belief that they probably help more than they hurt by increasing blood flow to my entire body, including my ovaries.  After ovulation, though, our RE has cautioned me not to do anything that raises my body temperature, and I am afraid that any vigorous exercise also runs the risk of "jarring loose" an embryo who may be trying to implant.  (Not sure if there is any science behind that second part, but it's my mind.)  Given that I am in a part of the country where the daytime highs regularly hit 100 degrees and above this time of year, any exercise that makes me sweat at all seems risky during the 2WW.

Not being able to work out as intensely for half the month obviously adversely affects my ability to lose weight, even if I am eating healthfully.  It doesn't make it impossible, but it does make it harder.

Along with being overweight, I also have high cholesterol.  Losing weight would likely help to lower my cholesterol levels, but if it did not, my PCP has told me that I should be on a statin to lower my cholesterol.  Statins cannot be taken by any woman who is "nursing, pregnant or may become pregnant," so until we give up TTC or I reach menopause, whatever comes first, they are not a treatment option for me.

Also, I think I've written here before about the fact that I suffer from migraines.  (I have since I was 15).  Given that hormone fluctuations are a known migraine trigger, it's probably not surprising that I have been having more migraines in the past year-and-a-half or so than I did before.  I've mentioned in prior posts that I have had to give up all the drugs I used to rely on for migraine control since starting treatment--Advil, Imitrex, and even Excedrin--and how that has adversely affected me.

I would really like to get my migraines down to the infrequent level they had been at for many years prior to TTC, but I wonder if this is even possible while we are still undergoing treatment.  Currently I am averaging at least one day of missed work a month due to migraines (not to mention the days I have migraines which don't occur during work hours).  I know that this is not a high frequency compared to many migraine sufferers, but it is much higher than usual for me, and it's obvious that missing all this work is not a good thing.

Sure, I can modify my diet to eliminate as many triggers as possible--something I have already done to a large extent and am currently working on doing more diligently and completely--but I can't help but think that so long as I am putting drugs like Clomid into my body, no amount of dietary change is going to get rid of my migraines.  I mean, Clomid works by "tricking" the body into thinking that estrogen levels are low and that it should produce more estrogen.  Obviously taking it is going to increase the estrogen levels in my bloodstream.  I'm not sure of the effects of the injectable gonadotropins I am also using, but I know that they affect the levels of some hormones in order to work.

I've cut out alcohol, caffeine and MSG.  I am currently cutting out a whole list of other foods which have been identified as dietary triggers of migraine (many of which are foods I used to eat regularly).  I am exercising regularly again, and I have always been good about staying hydrated and getting enough sleep.  I just don't know if all this will be enough to cut down on the frequency and severity while I continue to use fertility drugs. . . . particularly given the fact that the most effective forms of drug treatment for migraines, anti-inflammatories, are off-limits while TTC.

And forget about any daily migraine preventatives while TTC.  Those are off-limits as well.

Ironic as it sounds, I guess the bottom line is that I want to take a break after this cycle to take better care of myself.  Losing weight and decreasing the frequency and severity of my migraines would only be good for me.

On the other hand, the clock is ticking.  I am 39, and my eggs are not getting any younger.  Even if we are successful in getting pregnant this cycle, I would be nearly 40 before I gave birth.  (Side note: this cycle is our last chance to conceive a baby with a due date before my 40th birthday.)  I feel very much that "time is of the essence" and that there isn't any time to spare.

I don't know.  For now, I am just living each day as it comes and following my protocol for this cycle.  If I don't get pregnant this cycle, I can give the idea of a break some more thought.

P.S. In reading back over this post, I think I have made myself sound very unhealthy, though I have never thought of myself that way.  I have spent my entire adult life overweight to one degree or another,  though I never had high cholesterol until the past two years, and my migraines are just something that I live with, like many people live with other chronic ailments like allergies or diabetes or irritable bowel syndrome.