It Is Finished

I am a huge Broadway musical fan. I know pretty much every word to every Andrew Lloyd Weber, Boubil and Schonberg, and Wildhorn show, plus a good dozen more that no one has heard of (Jane Eyre, Chess, the Civil War, anyone?). When I'm super stressed, Jesus Christ Superstar is the one I play, specifically the song Gethsemane. It's a rock opera, and during that song, Jesus questions his fate. There is something about the lyrics, music, and cadence of that song, all combined, that perfectly captures what deep mental angst feels like to me. So I listen, way too loud, and it's relaxing. Weird, I know.

At the very end of the show, as Jesus is dying, one of the last lines he utters is "It is finished." Given my current state of mind, that sums up my 15 nights of stims pretty well. (Side note: Perhaps we need a rock opera about infertility? Heck, if one about chess could make a go of it, why not? ) My lining didn't improve after another day of stims, sildenafil, electro acupuncture, and estrace, although my E2 went through the roof. So we triggered yesterday. Now we wait. For the nerdy, this cycle's details are below, with some earlier cycles included as well for comparison. I got my full records from my clinic, and was able to correct errors in things I'd been verbally told about past cycles.

May 2018	AFC	6
	Stim Day	4	8	11	13	14	15
	L follies	5, 4.5, 3	3	3.5, 2.5	0	6.5	8
	R follies	5.5, 5, 4.5, 4	9.5, 9.5	14.5, 13	19.5, 18	19.5, 18.5	22.5, 20.5
	E2	725	252	348.9	812	2124	3119
	P4	<.05	<.05	<.05	0.17	0.29	0.38
	LH	1.32	0.51	0.73	0.99	1.42	1.26
	Lining	4.97 triple	5.2 triple	4.6 triple	5.48	6.71	6.7 heterogenous
	FSH	1100	2200	3100	3700	4000	4300
	Menopur	300	600	825	975	1050	1125

Older cycles

16-Jul Twins (3 CL cysts)	AFC	9
	Day	4	7	8
	L follies	12.5, 8, 8	19.5, 13.6, 7	22, 18, 7, 4
	R follies	11, 9, 8.5	16.5, 15, 10, 8	18, 16, 10, 8
	E2	803	1294	1690
	P4	2.68	1.66	2.59
	LH	8.24 miu	1.03	0.76
	Lining	6.9 triple	6.9 triple	7.3 triple, cystic patches
	FSH	600	1050	1200
	Menopur		0	0

17-Feb Quinn (2 CL cysts)	AFC	4
	Day	4	7	9	11
	L follies	6.5	9.5	11	14
	R follies	9.8	14.5	16.5	20.8
	E2		432	1027	-
	P4	<.05	<.05	0.12	-
	LH		1.15	1.15	-
	Lining	5.9 triple	7.0 triple	7.9 single	7.9 triple
	FSH	600	1275	1875	2475
	Menopur	0	0	0	0

18-Feb MC	AFC	5
	Day	4	6	8
	L follies	14, 11, 8.5	16, 13.5, 9.5	21.5, 17, 13.5, 6
	R follies	7,4	9	14.5, 9, 6.5
	E2	622	1023	1153
	P4	0.07	0.08	0.1
	LH	2.12	1.61	0.72
	Lining	5.7 triple	7.77 mixed	5.5 triple
	FSH	1100	1350	2200
	Menopur	300	450	600

Tied In Extra Innings

More monitoring yesterday, in the cycle that never ends. After 14 days of stims, I have follicles at 18.5 and an 19.5, and my lining is 6.7. I wish I had more confidence in those measurements. Friday's nurse is one who seems to be pretty accurate, but Thursday's nurse gave me measurements of 18.5 and 19, and lining at 5.48. When I asked nurse Thursday about endometrial pattern, if it was triple, she seemed confused and told me it was 'getting there.' My previous monitoring sessions all had shown triple, so that was a change. It also seems odd that the follicles would stop growing at this point, while my E2 doubled overnight. Thursday's nurse is one who often produces seemingly odd measurements from one day to the next (e.g., no growth at all for two visits, then a huge jump at the third), so I'm not highly confident about the reliability of her measurements. I'm going to hope that Friday's measurements are right, and that I get Friday's nurse again today!

And yes, I said today. They want to see my lining reach 7 or greater, so I was to do another day of stims/estrace/sildenafil/dexamethasone and return for my 7th visit Saturday. Excluding the med costs, we've spent $3,900 at CCRM just for monitoring appointments and bloodwork for this TI cycle. I'd say the cost is making me nauseous, but I think that's from the estrace! I'm really hoping that my lining gets better and my follicles don't get over-cooked. I had an electro-acupuncture session yesterday, for whatever that's worth.

Given this cost and the medication usage, I think my 'three strikes" plan will be down to one last shot after this one, if this cycle doesn't work. And let's get real: who expects this to work after 15 days of stims? Blah. How do you go from 2-3 mature in 8 days in February to 2 in 15 days in May? Again, blah.

Tied in extra innings, but the home team's looking weary.

Microblog Mondays: It's Gonna Be a Good Day When. ..

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You know your day is off to a swimming start when you have to give yourself your Menopur shot at work before your 7 am call, and as you're getting everything ready, the syringe rolls off the back of the credenza and gets stuck in the 1" gap between credenza and wall, where neither your arm nor a coat hanger can reach.

In general, I think there are two reactions to that type of situation: you laugh or you cry. On reflection, there's probably a third, which is 'you swear copiously'. I started with that one, then moved on to the laughter. Thousands of dollars, stress, heartbreak, a belly that looks like a pincushion, and it all gets stymied by a 400 pound credenza? I pick laughter, because the alternative would probably be madness. Hell, maybe this IS madness and laughter is how you make the best of it. Thousands of dollars, stress, heartbreak, and I'm going to continue to try to find the simple joys in life, including mocking my own absurdity. (Yes, I did go fishing with a coat-hanger to fish it out, and yes, I was eventually successful knocking it free using an easel-size, cardboard-backed post-it note pad!) If I'm realistic, the alternative for me would probably be sanity, and THAT is a place I never want to go! :)

Bottom of the Ninth, Home Team's Down

It's stim day 8, and I'm down to two follicles at 9.5, lining of only 5.2, and estrogen's dropped from the 700's to the 200's.

By this total stim dose, I had 3 mature last cycle and 2 mature the previous cycle. Even during my second cycle, where I didn't really respond, I had one at 9.8 after "only" 600 iU of stims, and now I'm 2300 of follistim and 600 of Menopur.

The home team is down, by a lot, at the bottom of the ninth with two strikes and a blind guy at bat.

I'm to drop to one vaginal estrace a day, keep my stims the same, and return on Tuesday. I'm really down about this, but I won't give up hope until the end, since we didn't have a good response during Quinn's cycle, and yet Quinn was perfect. So I'll hold on to hope the way I wish I could have held onto Quinn.

It can still get better. Miracles can still happen. I've carried three of them.

Life's Curveballs

Tomorrow's the big day: cancel or continue. Our cycle, that is. I'd like to be hopeful that we'll get to continue. My day 5 estrogen was great. I've always (eventually) responded before. I switched to Gonal-F, which previously gave me my best response ever. I'm doing great with diet, rest, acupuncture, and stress. Everything really should be perfect. This should be as good a cycle as our first one. 

Should doesn't seem to equal "is" often in my life. I've noticed that the nice, fertile CM I had earlier this week is gone. I won't be surprised if my estrogen has dropped. I'm hopeful, but realistic. I had planned for three strikes and you're out, treatment-wise, but maybe I'm going to get carted off the field before my first at-bat, when I get hit in the head with a pitch gone wild. 

Don't you just love life's curve balls? 

No Response

No response from my ovaries. No response from my uterus. Lining below 4, follicles below 6.

Increase dosage, return on Saturday.

It's not looking good, ya'll. I'm on a much higher dosage than I was for my last 'no response' cycle, and still, nothing. Heck, with Quinn's cycle, I'd had half the FSH of this cycle, and still had a follicle at almost 10.

I suppose I shouldn't be surprised, since I ovulated so late my last two cycles. Apparently my ovaries are off. Glad to see my months of acupuncture and clean eating are working wonders. Amazing that I responded in December and February, but not now. Maybe that means there's hope for a better result in the future. Optimism springs eternal.

Mother's Day Nostalgia

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Mother's Day is an oddly conflicted day when you're a mother but have no living children. I am glad that I got to enjoy my 23rd year doing Race for the Cure with my mom. She's a two time breast cancer survivor (victor?), and we've done Race together each year since the first one after she finished chemo. Different states run it at different times of the year, but in MN, it's on Mother's Day, which is a nice tradition. That said, it was hard to be doing the same course again this year that I did last year while pregnant with Quinn. The pain isn't acute, but there was a gnawing sense of loss remembering the spots on the course where I had to stop for dry heaves last year. Only in the land of loss and hormones does one get nostalgic about nausea! 

I'm a few days into my 'strike 1' treatment cycle. I say 'strike 1' because we're adopting a 'three strikes and you're out' model. Three last cycles, then we stop treatment. At baseline, I had an AFC of 6. Not my best, not my worst, either.  I can hope that I'll get a few mature to boost my estrogen. I am trying to hope that acupuncture and sildenafil will also help my lining out. Alas, my period after ~ 2 months of acupuncture wasn't much more than spotting, so I'm not expecting any miracles (although I'm hoping for them). If I can get to 7 and trilaminar, I'll be thrilled. I do acupuncture Wednesday and Friday, yoga on Tuesday. Either it will help, or I'll know that I've done what I could. Relative wins, either way. 


Just for record-keeping, this cycle I'm on: doxycycline 100mg 2x/day; dexamethasone 0.5 mg @ bedtime; Estrace 2mg 2x/day; sildenafil 25 mg suppositories @ bedtime; Menopur 1 vial in am; Follistim 225 iU in pm. I'm not sure if it's the intended effect, irritation, or an allergy to the compound medium but I feel swollen from the estrace and sildenafil. Fun times. First monitoring appointment tomorrow.