Wednesday, February 26, 2014

Trauma for the Greater Good

Remember how I said I was going to do the test for the Beta-3 Integrin protein? That whole thingamajig on the protein that if it's not in your lining, implantation cannot occur? Well, to have the test, you need to have an endometrial biopsy. Which I found out today, if you are doing it to send tissue off to a lab, is NOT THE SAME as a scratch biopsy. (And I have heard that those can be painful.)

This test is not for the faint of heart.

When I asked about it, my doctor said, "Well, you won't like me for about 5 seconds or so. 30 seconds at most." That sounded manageable, like it would be horrible but quick.

Going into the room today, the nurse prefaced it with, "So, you know what he's going to be doing to you today, right?" Oh my god, that is the scariest introduction to a procedure I have ever had, I thought. The truth is, I didn't really know. I thought he was going in, scraping a bit of tissue into a slide or something, and sealing it up to mail off to the e-tegrity lab. I did not realize that it was going to be more like using a vegetable peeler to julienne a nice ribbon of endometrial tissue from around my poor, traumatized uterus.

I got all set up in the stirrups, and I got a play-by-play on what was happening.

"I'm inserting the speculum." Ok, this is usually a bit uncomfortable but not horrible.
"I'm putting the grasper on your cervix to help with the ease of passing the pipette through." Grasper? WHO NAMES THESE THINGS? A little more uncomfortable, but I'm doing great! No biggie! 
"Now I'm passing the pipette through, and you may start to feel some cramping." Ouch, but not terrible.
"Ok, here we go." At first, not terrible, like a bad HSG. But then...
"I'm ok! I'm ok! I'm super!" 
And then the crying started. Because honestly, it was SO not okay. The cramping was intense, like maybe there should be a baby coming out of me at any moment. I am not an expert on childbirth, but I can imagine that that was like a killer contraction. That lasted more than a minute.

At the worst part, I was crying that awful whimpering animal-sound cry and yelling, "I am so unhappy right now!" in a voice that probably belonged to my inner three-year-old. I am proud of my relative ladylike-ness, as usually I swear like nobody's business in these situations. I did start to say "SHHHHIIIII" and I didn't finish, but the nurse was like, "Go ahead, honey, finish it! Swear, we don't mind!" Which made me feel way better, as this is a new clinic and they don't yet know what I am capable of when I come out of anesthesia, which will be happening when I do my next egg retrieval. My doctor knows, because he's seen it before, and while it can be somewhat entertaining, I do worry at offending new people who don't know me yet.

The cramping lasted for a good 10-15 minutes at a less intense rate than when something sharp was stealing a piece of me, but still pretty freaking intense. I've had cramping ever since, but not quite so painful as before.

The tissue sample was curled into a jar as Bryce watched, horrified at how much of me was going in to be tested.

But, it's over. And I never have to do it again. Because as the tears were still dripping into my ears, I said, "But don't I have to have the scratch biopsy before the next cycle?" And he replied, "Yes, but that won't be nearly as bad as this." Whew.

After we got home (it's an hour and fifteen minutes away), I fell asleep for two hours. My body was really, really pissed at me. It still isn't too happy, but it's better. I think it speaks to how traumatizing that was that my body just really, really wanted to just shut down after that.

Bryce was awesome. I held his hand, but it actually hurt so badly that I couldn't even squeeze it. He actually teared up because of how much pain I was in. He is such an amazing support. We had a nice lunch together at an organic cafe just down the road, and I felt so lucky as we sat there in the middle of the day, having a nice meal together. I mean, not so lucky that my uterus was making it clear that it was NOT pleased with the events of the day, but lucky in that even after that awful test we could sit and enjoy a quiet moment together, a strange sort of date in the middle of the day.

Now, we wait. The results come in 24-36 hours from when the lab in California receives the sample, and it was sent out today. Once we have our results we can move forward. If I have the integrin present, then we just figure out when the stim cycle begins. If I do not have the integrin present, then we figure out when to do the Lupron Depot treatment that apparently magically makes it appear again. The interesting thing is that apparently centers that are doing this typically do the stimulation and egg retrieval part of the cycle first, then freeze whatever makes it to Day 5, then you do the Lupron treatment and transfer is delayed. Which sounds good to me, because then the Lupron won't interfere with my fabulous egg harvest. I have had the best success when I am on a protocol where I take Ganarelix instead of Lupron for suppression, because the lupron suppresses me just a bit too much. So I like this idea. Also, increasingly apparently centers are "uncoupling" retrieval and transfer, so that you have time in between to create a healthy lining and for your body to recover from the stimulation and even hyperstimulation (which I have fallen prey to before and that sucks, too). A healthy, non-stressed body is apparently a better receiver of embryos. Go figure. I love this plan. I love that it is nearly upon us. I love that my doctor researched this test extensively to make sure that it was a good idea for me in particular, because it is A HORRIBLY PAINFUL test. He didn't want me to have to do it if didn't seem like it would would apply to me. And I so respect that -- I'd far rather the things I bring to the table be researched AS THEY APPLY TO ME AS AN INDIVIDUAL rather than just done because I want it and it seems like a good idea.

I feel good about where we're going. I feel pretty peaceful, now that my lining is knitting itself back together. I feel grateful for my incredibly supportive husband and for my new medical team. I feel grateful for my friends and family who checked in on me today. I seriously hope that the worst is behind us. Nothing but blue skies ahead. A girl can dream, right? All of this for the greater good, for the privilege of parenting whatever amazing soul is meant to come to us in this crazy, convoluted way.

Sunday, February 9, 2014

Egg Boot Camp

Finally, a few days without setbacks or controversy! I can share with you my personal plan for Egg Boot Camp. (Disclaimer: I am not a medical professional, although after 4 1/2 years of infertility I feel like I could be. This is in no way medical advice, but could possibly be worth talking to your doctor about as an option. Information sharing is fantabulous, but please don't sue me. Also, I am not being paid by any of the products I talk about, I'm just paying FOR them. This is my opinion only.)

Egg Boot Camp (noun): a self-described program I have decided to follow with the help of my RE and my acupuncturist to try to give me the best possible shot at a kickass cycle this spring, using my own eggs.

I am terrified, because I haven't used my own eggs since April 2012. Which, by the time we get going here, will be two years ago. A lot can happen in two years. I've been pretty good to myself and have continued with the organic foods/no plastics/minimal microwaving and if you do you do it in glass or ceramic/limited chemicals in my cleaning supplies etc/low mercury fish consumption, particularly tuna (Wild Planet is awesome but at like $4.00 or so a can it is PRICE, as is anything truly good for you and not full of chemicals). I am the Chemical Police when it comes to my body. While on our break I did drink my fair share of wine, but um, GRAPES so I'm not so worried. All that reservatol and antioxidant stuff had to do something good, right? Given that this is our Final Fertility Frontier, I would like to do everything possible to ensure that I have prepped those eggs within an inch of their lives. Our last cycle with my eggs (under our current, new-yet-classic RE) was pretty darn impressive with 26 retrieved and a fair number of them mature, and more embryos than the donor cycle (and a pregnancy, albeit short-lived),  but that was again--TWO YEARS AGO. So, off to Egg Boot Camp I go. I was told that even though your eggs have been in your body since you were but a wee fetus yourself, the egg recruitment process starts 87 days before retrieval. Yup, 87, not 90, which seems random and arbitrary but I guess no more so than 90 (90's just such a nice even number). So, the goal is to start this all three months before give or take, and see where it lands us.

Egg Boot Camp consists of:

1) LIFESTYLE CHANGES, CONSUMPTION: A couple of things. Originally my plan was to start Egg Boot Camp immediately following New Year's and completely eliminate coffee and booze. That was, um, a little too stringent to be followed with fidelity. I significantly cut back on everything, and now that it's February I am 98% free on all those things. An occasional small glass of wine is not going to hurt anything. Plus, it was stupid to try to go "cold turkey" when Friday night margaritas and sharing a bottle of wine has been such a big part of our entertainment and experience as a couple, and I have grown fond of having coffee in the morning. Most doctors say "restrict" not "eliminate" (until stimming), so I feel pretty good about where I am. So, goodbye coffee and booze. And for those of you who are curious, the booze is for egg quality concerns, and the coffee is for uterine receptiveness (it restricts the bloodflow to the uterus and there is that mystery article someone read that I cannot find that said there is a compound in the coffee bean itself that can be less than beneficial for implantation. I don't care that I can't find it, I want the best chance possible so adios, cup o' joe.). This is frustrating given the people who drink coffee all the time and into their pregnancies without any ill effects, but they are not infertile and I am, so I guess the rules are different. Pffft. Oh, and on the dairy front. I struggle so much with the dairy and the sugar. I am willing to limit both but not totally eliminate. I am going to try almond milk in my GF granola in the morning and see if I can do it. I may try to eliminate most of it during stimming, but being a celiac person who is GF to begin with, going dairy free is just painful. And Western medicine favors full-fat organic dairy as a fertility enhancer, so it is hard to tell which way to go. Sugar is just everywhere. I have reduced my sugar intake, and will continue to do so, but complete elimination is just crazypants to me. Again, what about the sugar-swilling people out there who get and stay pregnant no problem? So unfair that the rules are different once your body betrays you. Grrrr.

2) LIFESTYLE CHANGES, OPERATION HEALTHY BODY: It is no mystery that infertility and weight gain go hand in hand. Which is infuriating, given the many, many voices out there saying that a healthy weight helps you to conceive and leads to healthier pregnancies. On average I gain about 8 pounds per cycle. More when I am stimming, but really it is the dreaded PIO that packs on the pounds. That and the restrictions on movement that come with cycles. I used to be able to lose most of that 8 pounds before my next go-round, but between the compounding effects of so much infertility treatment and the food-therapy that I may have indulged in and the outright depression that so much loss and frustration can cause, that has not been the case for a while now. I started this journey at around 155 pounds, veritable twigginess for me (I swear I carry 20 pounds in my bra, and at my THINNEST as an adult I weighed 146 and looked incredibly silly and topheavy). My sweet spot is between 160-165. I haven't seen 160-something in years, and in December I hit an all-time high of 180-something. Although I am a size 12 and 5'6", which is definitely NOT obese, the stupid BMI chart labeled me at the low end of obese. I was squeezing into my 12s and refusing to buy 14s. I realized the food and booze holiday was over. I wasn't really exercising, either. And I was feeling unhappy with my body, bigtime. Therefore, part of Egg Boot Camp is to get my body in a better place so that when I DO start stimming, I am not at another all-time high. I never want to see 180-something again unless there is baby inside of me. I am not dieting, because to me a diet means deprivation and stupid chemically fake food, and changes that are not sustainable. Instead, I am trying to just limit my portion sizes and eat more veggies and fruits. More fiber, less crap (organic potato chips are still potato chips...). I believe in treats, but if you have treats all the time, they're not treats so much anymore, are they? Also, I am doing yoga/pilates/fusion DVDs. I used to belong to the gym but because I kept having to stop going because of cycles I quit. Too expensive to not go. In addition to restrictions, it is just too hard to fit the gym and school and all the fertility-related appointments (medical! counseling! acupuncture! massage!) into my schedule. DVDs I can do on my own time and I have ones that range from 15 minutes to an hour. I feel better about myself, I can work on those "birthing legs" and my core strength (I have rock hard abs under my PCOS-and-GF cupcake flubbity flub), and I can increase my muscle mass gently with minimal impact on my knees. It is relaxing. It helps me burn fat all the time. Many of my tapes I could do even when stimming, at the beginning at least. I feel better. And I've lost 7 pounds since December. Go me. 7 more would be lovely, or even 10, but I know I'm running out of time. Realistic goals, people. Realistic goals. I just want my pants to fit and to not feel like the Michelin Man under my sweaters.

3) EGG-BOOSTING SUPPLEMENTS: I am currently taking two different thingamajigs to help my egg quality. There are two more to add in before I start stimming.
Supplement #1: Prenatal + CoQ10. I have a fancy new prenatal, Ova-vite. It comes in a 3-month supply box to my house in the mail. It seemed pricey at first at $115, but divided by 3 that's about $35, which considering it's a prenatal PLUS 250mg of CoQ10, is cheaper than what I was paying before for my other prenatal and Wegmans CoQ10 per month. Plus I cannot forget to buy it because IT COMES TO MY HOUSE. The website is here if you are interested in more information. I try not to cringe at the tagline that it is a prenatal designed for women over 35 trying to conceive, because I keep calling them my "old lady prenatals," but really it's awesome that they have created a prenatal that provides egg-quality-boosting stuff. Here is what it looks like:

Front view, this is a week's worth. The white is the prenatal, the orange is the CoQ10.

The oh-so-convenient back--DATES ON MY PRENATALS! I have yet to forget a day. 
I have to say, I have been on prenatals for almost 5 years, and never have I seen my fingernails so healthy and strong. Everyone always said, "Prenatals are awesome for your hair, skin, and fingernails" and I never really saw a huge difference. Until I took these... I have wonderwoman nails! They are super strong and grow really fast. (That part is annoying for me as I am not a long-nail person, but if they are doing this for my nails just imagine what my ovaries are doing!) Also, my hair is pretty happy. All lovely side effects to what I hope will be magical egginess in the spring when we retrieve these suckers.

Supplement #2: Pregnitude. My doctor recommended Myo-Inositol as an alternative to metformin. I do not have insulin resistance, so no doctor that I have seen has recommended metformin. I have heard interesting things about negative side effects of metformin, so I have not minded. BUT, not gonna lie, after so many years of no success, I wonder. So, Dr. Fabulous recommended Myo-Inistol, which apparently does similar things to the body for PCOS people as metformin but without nastiness on the side. Plus it's not pharmaceutical, which makes me feel better. Here is information on Pregnitude (the easiest way I found to get myo-inositol for this purpose) from the PCOS Diva: PCOS Diva Pregnitude Post. Supposedly it can help regulate your cycle and reduce things like the annoying extra hair I have on my face and other areas that keep both my waxer and my razors in business. I've been on it for a couple of weeks and haven't yet noticed a huge difference, except (and apologies for some major TMI but other PCOSers will get this) that my annoying nippy hair, those scary black jobbies that I have to tweeze all the time, IS GONE. I tweezed a few weeks ago, maybe a day or two into the Pregnitude, and THEY NEVER CAME BACK. I could not be happier. This makes me think maybe something good is happening on the inside of my body. The dissolving of the Pregnitude is disturbing, but it truly does not taste like anything. It's just like drinking water. Here are some pictures for your visual pleasure:
Put it in and stir. You can see some powder
at the bottom, but if you stir a second time
it goes away. And really, truly, it does not
taste like ANYTHING. 

The little packet. Gotta love the infertile kitchen counter.

All of this stuff adds to my morning routine, but it's all good. Get those golden eggies ready.

Supplement #3: Fish Oil.  I haven't started this yet. Mostly because it's expensive, and I was waiting to see my acupuncturist. SO, apparently there is more research on fish oil lately and how to pick the best ones that offer more benefits than neurotoxins. (!) I had been taking Nordic Naturals, but I may switch to something else after reading this article from my acupuncturist: The Definitive Fish Oil Buyer's Guide. I thought it was VERY INTERESTING. Fish oil was recommended for two reasons: 1) increase in blood flow (I don't really have anything to substantiate this) and 2) anti-inflammatory properties. So, fish oil is recommended for building a good healthy lining and possibly encouraging implantation receptivity. I have to say that I have done lining checks on fish oil and not on fish oil and I do see a thicker lining with the fish oil. Totally anecdotal, but it also has heart benefits and I can't sneeze at that, either. The krill oil thing is interesting, too--never heard of that but it sounds intriguing.

Supplement #4: Wheatgrass Shots. My most successful cycle in terms of egg quality and output involved wheatgrass shots daily during stimming. I have no scientific data to support this handy, but I felt it worked and it is so healthy for you anyway. I plan to do the same this time around.

4) ACUPUNCTURE: There is more and more research out there on the benefits of combining acupuncture with IVF cycles. Fertility-specialized acupuncture. I had dropped it from my personal protocols because I was frustrated I had spent so much money and had little to show for it, and it was stressing me out, which is the opposite of what acupuncture should do. However, for this Final Frontier, I am throwing ALL I GOT at this pair of cycles (hopefully only one wildly successful cycle). I also was encouraged that CCRM has on-site acupuncturists and recommends acupuncture before and after transfer. I have gone once already since I am trying to get my lining up with the estrogen and everything for my beta-3 integrin test, and I just love my acupuncturist. I did feel relaxed. If that is all it does for me, then great. If it happens to do anything for my egg quality and lining thickness, then bonus. But I can't ignore the research.

5) RELAXATION STATION: Included in most of the previous is a heavy interest in relaxation. While stress doesn't cause infertility, infertility causes stress, and a stressed body is just not at 100% for any function. So, I am committed to trying to reduce it. Through exercise, through blogging, through my fabulous therapist, through the power of NO, through acupuncture, through massage (NOT fertility related, because that proved to NOT be relaxing at all for me, but at a spa-like setting separate from fertility so that I can truly escape), through scheduling me-time. I am not exactly doing this at an ideal time for school stress--the spring is IEP time and so my workload goes insane. However, I give myself permission to do what I can and not worry too much about the rest. I give myself permission to bow out of things during this time if I need to. I give myself permission to let go of my infamous need for The Plan and just let things happen. That's the hardest one. I need dates and schedules (I'm not a special ed teacher for nothing), but trying to plan the unplannable leads to nothing but stress. Control what you can, let go of what you can't. (If I say this enough maybe I will actually believe it!)

There it is. Egg Boot Camp, courtesy of Jess (and Dr. Fabulous and Awesome Acupuncturist and Terrific Therapist). I think it's a good plan. I think it's flexible enough that it won't drive me off the deep end. I think I can stick to it and do the best I can to have the best cycle possible, recognizing that so much of this is truly a mystery and beyond my control. If nothing else, this plan will leave me believing that I DID EVERYTHING I COULD to influence my outcomes. And if we are unsuccessful after all this, then it truly wasn't going to happen. I am at peace with that. Sad at the possibility, don't get me wrong, but peace and happiness are two separate things. The happiness will come later, when we make this parenting thing work for us, just maybe not how we hoped or envisioned originally. Plans change, and maybe our baby is just waiting for us in a place and time we didn't expect. In the meantime, Egg Boot Camp. Because this is the end, in search of a beginning.

PS- If you have research-y things to add about any of these options, please feel free to share in the comments!

Wednesday, February 5, 2014


Well, I am on a bit of a daily roll here. You can tell that either a) infertility is disrupting my daily life more than usual or b) I am a big fat procrastinator. Probably both.

So, today I received a call from Dr. Fabulous (still not liking the code name) and I have a protocol for prep before the e-tegrity test! I am on estrace several times a day gradually building up to when I take crinone 2x a day for about 8 days before the biopsy. And... how exciting... the estrace can be taken ORALLY!!! No disturbing blue pills up the yin-yang that have the oh-so-disturbing side effects when they inevitably reappear! No more trying to pop a tiny item into my lady cave! I am so psyched. I might have to do the last few days vaginally for just one of the three doses per day, but I also might not. I can hope.

The call came in the last 5 minutes of my lunch, and I took it since I didn't have kids yet. Of course, then I had kids coming into my room as we were finishing up and I felt HORRIBLY UNPROFESSIONAL as I was on my cell phone and students are entering. I apologized profusely and said a prayer to the APPR god that I wouldn't have a pop-in observation today to witness this highly unusual behavior on my part, and it was all good. I was done before passing time was up, but still. Man, I hate how infertility makes it impossible to do anything "normally."

Later in the day I checked my phone again and there was another message, this time from our previous fertility clinic. I may have not yet sent the letter I spoke about in my post about saying goodbye to the clinic. I am horrible at confrontational situations, even if it's not angry confrontational but just emotional or awkward. I knew I had to do it, but today ended up being the day. Because our previous RE left me a voicemail about how he has "new ideas" and has found a protocol for thin endometrial linings, which he thinks is our "rate-limiting factor." Not the sperm, not the obvious difficulty creating good-quality embryos and having implantation, but thin lining. Which has happened EXACTLY ONCE, and it was 7.2, which by most clinics' standards is on the low end of ACCEPTABLE. Not "ohmygod you can't make a lining to save your life," but within a normal range. Sigh. He just sounded so excited to have new information and wanted to email it to me, but didn't have my email address. Which is funny because we emailed back and forth all summer, so he had it at one time, but whatever. I felt awful and my stomach was churny, because I hate disappointing people. Even if it is TOTALLY THE RIGHT THING TO DO. I did not at all have second thoughts, but I just dreaded the conversation.

So I sent the email. See, we had sent a New Year's card in January to his home thanks to the stalking abilities of the internet, and it said "Thanks for everything you have done for us." I guess that wasn't sufficient. I know it wasn't sufficient, but I was still hoping I could just kind of slink away. So I sent the email. The email that says Thank you for everything you've done, but after 8 transfer cycles it's time to move on for our last try at this. We need to try a different center. We did all the second opinions and they all pretty much agreed on a similar course of action (or at least that my eggs are not the issue), and it's time to switch things up. It was full of gratitude and acknowledgement that whatever success we find will be in part due to them and we are so appreciative of the compassion and dedication. It was not angry or disappointed (even as I felt bad that he was so excited on the phone, I was still frustrated that the new information is not exactly relevant to my history or our true issue). I did not say who our new center is, although I am starting the transfer process to get those 2PNs to the new clinic. What's awkward is that while the center is new, our RE that we have chosen used to be at our old clinic. He was our doctor for a couple of cycles and so he is not exactly a new variable, just a well-respected and well-loved variable. He is amazing. And add to that a center that does vitrification and is fully capable of thawing and refreezing embryos and ONLY does Day 5 transfers and is willing and able to do pretty much 95% of what CCRM can do... it's kind of a no-brainer. But he did leave that other clinic. So that's kind of awkward.

But, it's sent. And while I was at it I sent one to the counselor who sends me support group emails all the time letting her know we're leaving and could she please take me off the list. That was actually very freeing. Once our materials are out of the clinic and everything is taken care of, it will be incredibly freeing and we will be 100% on our new track, hopefully on the road to success. I just can't get over the awkward feeling for today and I just feel a little guilty. It will pass, though. Somehow I have to figure out how to say goodbye to the nurses. They were just the best.

Who knew that breaking up with a clinic would be so heartwrenching? Maybe I should listen to The Cure on loop, drink some wine, eat some chocolate, watch a bad romantic comedy or a tear-jerking tragedy, and then I'll feel better tomorrow. Isn't that a breakup cure?

Tuesday, February 4, 2014

Oppositional Defiant Uterus Update

Ok folks, this day SUCKED. But, there is a rosy tint to the ending, so hang in there with me.

I went to the OB/GYN's office at 7:30, and the receptionist had no clue who I was or what I was doing trying to sneak in a morning ultrasound. She told me the earliest was 1:30, and I was very nice but was like, NO, I'm supposed to be fit in in the morning, my RE spoke to the Dr. here and when she gets in she'll explain. Luckily she got in 5 minutes later and I was all set.

Except, like a moron, I didn't get a half day morning sub because I figured being squeezed in starting at 7:30 would mean getting back by 8:45, 9 at the latest and so I just needed coverage for 2nd period Reading, which was easy because they were doing MAP testing in the computer lab today (for non teaching folks, MAP testing in this case was a computer based program to test Language skills (grammar and mechanics) that is 53 questions long and adjusts levels based on the response of the person clicking the answers. Very fascinating and unfortunately highly susceptible to dips due to motivation or rises due to lucky clicking, but my kiddos listened to my speech about MAP testing and did their best, which was nice). I did not realize that the ultrasound tech doesn't come in until 8 and there was a prego before me and I wouldn't be seen until 8:40, causing me great stress and clockwatching.

But, I was seen and got back to school on time. There's the silver lining.

Dark cloud: My uterus does not AT ALL look like I'm at Day 15. No trilinear pattern. No stripes. My uterus is truly being oppositional defiant and has decided that it doesn't want to play. I was so upset, I cried my way back to school.

Also, they don't do bloodwork at this office, they send you to the university hospital lab system. Which, had I known, I could have gone to earlier than the appointment, but, since I was so horribly late and made it within ONE MINUTE of my English class 3rd period, I had to leave again at 10:05 to go get blood drawn at the lab down the street from my middle school. Not the best morning. And the results didn't get in on time, because it was too late in the morning. Argh.

Good news: Since this office is doing my monitoring, now I know that if the requisition is sent in ahead of time that I can go to the blood lab that opens early and then go for my ultrasound, since they open for ultrasounds at 8:00. The tech did say that I could call and have her come in at 7:30 if needed. Not nearly as early as the 7:00 appointments I used to be able to get, but priceless in terms of not being in a fertility clinic to start my day. While there were pregos in the office, it wasn't overwhelmingly prego-central.

Bad news: My uterus is screwing everything up. I can't have the test 2/15 now, and I had the whole conversation about whether the test is even worth the hassle to get my uterus to agree to play nicely.

But, my RE talked to an RE at CCRM about the test and got back to me and we are going to do it, but we are going to use estrogen to help my lining actually DO something and then, THEN do the Crinone to fake my lining into thinking ovulation has occurred. Kind of like a frozen cycle. Apparently they do that all the time for resistant people like me, and it doesn't affect the test. This new plan actually only sets us back 1 week, as I'll start estrogen tomorrow, then take progesterone the following week and into February break, and have the endometrial biopsy a week later than originally planned. Okie dokie. I can live with that.

Despite a very frustrating start to the day, and an afternoon spent on the phone with my RE trying to figure all this out (grateful, so grateful that he does the majority of the figuring out, I contribute stuff and my thoughts on things but I am not feeling like I am driving the action, which is such a relief), the end result was reasonably favorable. I can still have the integrin test, we can have that info, and then one part of the mystery can be debunked one way or the other. Lucky me I still have estrace and vivelle patches leftover from the donor egg cycle, so I need absolutely nothing to get started. Let the faking out of my uterus begin, since it is obviously not to be trusted on its own.

Monday, February 3, 2014

Oh Uterus, Why Do You Hate Me?

Argggh. I wanted to write a post about Egg Boot Camp. I wanted to tell you what that is to me, and how it's going. But I ran out of time this weekend to write and am now entering the dreaded Annual Review Season of writing IEPs and coordinating paperwork for the big yearly meetings in the spring, and so my blogginess is destined to slow because my time is sucked away from me. So now, on this Monday after Superbowl Sunday, I find myself facing an issue that is more pressing than the self-imposed restrictions and suggested additions in terms of supplements that are Egg Boot Camp (I will write about that next, I promise, because it's actually kind of interesting).

The issue body never ceases to amaze me in how much it hates me.

One of our things moving forward is for me to have the Beta-3 Integrin test, which is basically a carefully timed endometrial biopsy sent off to a lab in order to test for a particular protein, beta-3 integrin, that is essential for implantation. As in, without it (or sufficient levels of it), implantation is impossible. And it's fixable with Lupron Depot or letrozole added to the protocol, but the test is dependent on timing. (For more information on this test, go here. I am a nerd and prefer to read the side "For Physicians," but you can read the one "For Women and Families" and get good info too.) I first heard about the test from CCRM, and then researched it and asked our doctor (we have decided on a clinic! Go Buffalo!) about it, and he went way above and beyond and researched it further and spoke with the doctor who developed it to see if it would be worth doing in my particular case. I LOVE THIS DOCTOR. More on that in a different post on the completely overwhelming process of three second opinions and deciding on which clinic to go with, which proved both easier and more difficult than we thought all at the same time. Sigh.

Anyway, the difficulty with the E-tegrity test for beta-3 integrin is that it must occur during your luteal phase. Meaning, the period between ovulation and your period. OH WAIT. I DON'T FREAKING OVULATE. So, Dr. Fabuloso (not sold on the code name, but whatever) contacted Dr. Lessey, who developed the test, to see what you can do to address that. The first answer: Clomid to induce ovulation. Hmmm. Issue #2: I DON'T RESPOND TO CLOMID. I've taken it 6 times, 4 for IUIs many fruitless moons ago, and twice for the Clomid Challenge Test, and I have created a follicle exactly... once. The first time. When I was a (relatively and decidedly faux) nubile 33. So, no go on the Clomid, because if I did it and it didn't work, it would cost me another month before go-time on this, our Final Fertility Treatment Frontier. Two other options were discussed: proactive treatment with the Lupron Depot with the understanding that we could be treating nothing, or, the winner, treating me with Crinone at the midpoint of my cycle to fake my uterus into thinking that it has ovulated and impersonating a luteal phase. That one was approved, there were reports on cases testing for other similar proteins using that method that supported it, and I was to start Crinone on Wednesday to get ready for the test on Saturday 2/15. Crinone because I REFUSE TO USE ANY MORE PIO thanks to the nerve damage and numbness/pins and needles/sensation of sitting in ice water that I still feel in my hips and thighs.

So what ever could be the matter?

I started spotting on Saturday night, which then turned into what appears to be a light period and definitively NOT spotting anymore, EVEN THOUGH I AM ON DAY 14 OF MY PILL-FREE CYCLE AND A NORMAL PERSON WOULD BE OVULATING NOW.

Oh body, why must you cockblock me at every turn?

So, lucky me, I get to sneak into my OB/GYN's schedule tomorrow morning to get an ultrasound and bloodwork done to make sure that I am actually midcycle and that my uterus has not gone all wonky on me and decided to do things out of order. Because I cannot have this test if my cycle has gone wonky. And I will lose time and have to reschedule it if things went awry. And, I have to miss the first two periods of school tomorrow because I have to wait and get squeezed into the schedule where I wasn't up until literally five hours ago. I am insanely grateful for the fact that my RE in Buffalo can coordinate with my OB/GYN in Rochester and get this set up so quickly. However, I am also insanely angry that my body can't handle being off medication for TWO FREAKING WEEKS before it gets all wacky. I mean, WHY? WHYYYYYYYYYYYYYY? I am hoping it's just wonky bleeding and not related to anything at all, but then again, why would I be bleeding in the middle of things? Why does it suck so much to be a woman? And for the love of all that's holy, why, WHY can't my body just be normal for a month? I am trying to be so good to it and it is just spitting a big fat raspberry in my face.

I am frustrated. I am worried that something weird is going on. I am concerned that I will need to reschedule the test and it will delay our cycle-cycle and it will interfere with our February Break plans to visit my in-laws in Maine. I am not thrilled that I am unexpectedly having to make awkward calls to my assistant principal letting him know that I can coordinate coverage but that I have a last-minute ultrasound. And then realizing that I'm not sure I made it clear that I'm NOT pregnant and that this is part of my four-and-a-half-year-long saga of trying to have a baby and in the meantime getting a lot of paparazzi shots of my dysfunctional ovaries and empty uterus. Do I somehow work that into a hallway fly-by? "By the way, I'm not pregnant, my body just sucks enough that I can't even manage a test to see if there is one more reason why I can't get pregnant yet?" Awkward. But no less awkward possibly than inadvertently bamboozling my AP into thinking I'm pregnant and just haven't announced yet, and wondering if he's staring at my belly and wondering what's in it. (Chicken wing dip. That's what's in it.)

So now I must get to bed so I can get up early and stalk my doctor's office to camp out in the waiting room like I'm trying to get into a concert, instead of waiting for a dildocam exam where I'm not on the schedule and who knows how many pregos will be waiting there with me. Goody goody. The irony is, all of this is for a highly technological test that could help solve our issues but leaves me feeling like my body isn't even receptive to TESTING. And then I'm reminded of that SuperBowl commercial about technology and how amazing it is and while it was wonderful to see all the medical technology all I could think is "all this wonderful new technology and STILL no one can get us pregnant or tell us definitively WHY we have had to struggle for so long." I actually was in tears of frustration, because while "anything's possible," there are some things that just seem to be outside innovation. But maybe that's just my irritation at having a technology-resistant reproductive system speaking.

I guess all I can do is wait and see. Practice my deep breathing and meditative skills as I try not to flip out if my body is truly sabotaging me. Try not to hold on so tightly to plans that inevitably will have setbacks and change (I really should be used to this by now). Think as positively as I can and try to love this body that hopefully will do something amazing after it's done being completely and totally insubordinate. In the words of my pithy RE, "Tell your uterus to behave itself!" If only it was that simple. If only I could just write a behavior plan for my uterus and solve everything. Sigh.