Showing posts with label HCG. Show all posts
Showing posts with label HCG. Show all posts

Friday, 21 March 2014

4573

4573 was today's beta, drawn at 9:00am.

My last beta, drawn two days ago at 11:00am was 2915.

The doubling rate is 71 hours.  Here's what the count down to pregnancy calculator says (Thanks Just T for the calculator).

Between 1200 to 6000 mIU/ml72-96 hours
1-2 Months5,000 - 200,000 mIU/ml

So, it's good news (I'm ignoring that 5000 thing)! 

I think that it's only this doctor's preference to see his patients when their HCG is above 5000. I don't think that it is a standard for care, just how his office operates.  

Even though I didn't meet his standard, Dr. Highrisk booked me to see him for an ultrasound on April 3rd.  It's a week after CCRM suggests that I can to go (March 27th).  D's away for a business trip on the 26th to 28th and then it's the weekend so I wouldn't be able to have an ultrasound until March 31st.  

So, I very well may make a trip to my satellite clinic and get it done on the 31st.  While I'm trying to wean myself off of my satellite clinic and get things done closer to home, I'm not sure if I'll be able to do it.  We'll see how my mental health is by then.   

Although I do like the idea of the results of the ultrasound being more concrete by waiting later.  None of that wait and see if something develops in those empty sacs, like we did with the twins, by having a really early ultrasound.  


My aunt (the one with the great reaction) and cousin are coming to visit this weekend.  It was a last minute adventure.  I'm glad they are coming.  It will be a nice distraction and nice to catch up with them. 

Have a good weekend. 


Thursday, 20 March 2014

Doctor hunting

CCRM asked for me to find an OB, and have my first ultrasound with them after March 27th.

Some people, fertiles and infertles  have everything mapped out about their pregnancies and babies before they arrive.  We could never bring ourselves to do this.  It wasn't something that brought us hope, but rather highlighted our infertility.

So, even when CCRM suggested I look for an OBGYN when we started our last cycle, I didn't.  I figured worst case scenario, that I could go to my last OBGYN, even though I haven't been there since I was 28 years old.

I remember my last visit to that doctor vividly.  He told me that my FSH test was normal (later I learned it was meaningless because I wasn't instructed to have it on day 3).  He explained D's sperm analysis, and in a low, hushed tone, mentioned the word "STERILE" and wrote it down on the page in caps.  I don't feel like revisiting those memories any more than the million times I've already have.   However, I did daydream about telling him that after 6 years, since I last saw him, guess what? This is a DE baby with D's sperm!

I asked my friend, a local maternity ward nurse, who she would recommend?  She told me that she wouldn't choose my last OB.   She instead suggested two others.  One was female, the other was male.  Recommendations being equal, I decided to go for the female.

I needed a referral from my family doctor to see the new OB.  His secretary told me that I'd need to come in for an appointment to get a referral.  I suggested that he might make an exception for me, explained a little bit of the situation and she said he'd call me back after reviewing.   Later that day, he called to offer his congratulations and we had a discussion about why I was looking to go to that doctor in particular.

He suggested that I go to the local high risk OB instead.  This surprised me.  I think the blood thinners I'm on and my family history of stroke make him nervous.  It felt a little like over-kill to me, but I figured I would go with it.  I thought, a more highly trained doctor isn't be a bad thing, right?   I figured if Dr. Highrisk didn't want me as a patient, that I could get him to refer me to the other less specialized female doctor that I wanted.

Dr. Highrisk is the only one of his kind in the city I live in.  He's a busy guy.  His receptionist is a busy gal.  And from what I can gather, they don't answer the phone very often.  When you get voicemail, it instructs you to not leave more than one message a day.  Every day that was ticking by, waiting for my call back, was stressing me out more, knowing that my ultrasound appointment time was getting farther and farther out in the future.

Wondering if there is a heartbeat, or anything going on in that ute of mine is driving me crazy.   Over and over I can't help but having flashes of when we had the twins, all of the excitement and then things crashing down,  when we realized we were staring at two very empty sacs.   This week, D called that that experience "the worst horror of his life".  In part because of the situation I'm sure, and in part because of how badly I crumbled after.

I wondering how this ultrasound is going to be? What kind of day are we going to have that day?  With only one embie in there, I'm reminded that there's one shot, once chance at a heart beat.  Knowing that when we get our ultrasound that we'll be 7 weeks along and it will not be too early to see the heart beat if there is one.

I tell myself, as some others in my life do "You got what you wanted, a BFP! This is real! Now be happy! Be excited!  Enjoy the moment!" But that's just not how I'm feeling.  I can't decide if it is infertility that has done this to me, or is it my now my personality after being in the trenches for so long? I never used to be a negative Nelly.  But I didn't know just how ugly the world could get then either.  It frustrates me and saddens me deeply.

Anyways, back to the doctor stuff.  Yesterday, after talking it over with D, I decided to physically go to Dr. Highrisk's office at the hospital.  I was going to say that I was in the area, and that I just wanted to check in...blah, blah, blah.   If I needed to encourage the secretary to give me an earlier ultrasound appointment than what she first offered, I planned what I would say.  Trying to find the right words for a likely desensitized secretary to feel empathy towards us could be difficult.  I settled on something simple.  "We've had six years of infertility and early losses, is there any way he could squeeze us in sooner?".  I hoped it would do the trick.

When I got there, the front desk of the hospital didn't want to let me in without an appointment.  This was probably heightened because the hospital is under an influenza advisory.   I told the receptionist that it was complicated, that I had a referral to be there, but I couldn't get in touch with them.  They let me in.

When I made it to the doctor's office, I breathed a huge sigh of relief.  The receptionist was as sweet as can be.  Her name is Joy.  She was one of those people whose name matched her personality so well.  She was tremendously helpful.  She said she remembered my name, but couldn't find my referral in her big stack of papers.  After searching for a few minutes while apologizing, she found it.  It was missing information, so she had set it aside.  It turned out to be information that would not have been known by my family doctor, and would have taken some time for them to complete.  I was able to provide the information, and fill in some of the blanks.  Phew! for this reason alone, I was glad I went in.

After consulting with the doctor briefly, Joy said he wanted to draw a beta and he could meet with me that day, if I could wait.

So, I had my beta drawn.   I later learned that Joy wanted me to see the doctor so he could prescribe some progesterone support, because of my early losses.  I told her that I was on hormones, that I was being monitored.  We decided that it would be best for the doctor to see the results of the beta (she told me they wanted it over 5000), and then go from there.   She would call me with the next steps.

Once at home, D and I did some figuring on the beta.  I've been trying not to stress about the beta. CCRM has only checked my beta twice.  When I asked my nurse why, and she said that unless it's being done every 48 hours, that it doesn't show anything meaningful.  That it doesn't show the health of a pregnancy.  My local clinic checked betas much more often.  I liked that better.

It didn't seem like 5000 would be possible with the numbers that I've had, even with some generous math.   I wondered if 5000 was some important threshold to be at when you're 5 weeks along.  Was it some deal breaker kind of number?  I've never researched these things very much.  With the embryo donor twins, my betas were sky high.  When I miscarried the embryo from our genetic material, the numbers were strikingly low.

Joy called me later that day, and asked me to come in again on Friday for blood work?  She said my beta was around 2900, and the doctor wouldn't schedule an ultrasound until it reached 5000.

We had a little sigh of relief that something is still going on in there.

Friday's beta will be another piece of the puzzle.  Maybe it will put us at ease, just a little more?

I wish I could just pack up my anxiety away for a little while....okay, forever! Scram, Anxiety! Don't come back! And take your stupid friend Depression with you!

I dream of the day where we see a little heart beat flickering on the monitor.   To see what we've never seen before, and maybe to feel a way that we haven't felt in a long way too.


Wednesday, 12 March 2014

Beta #2

I hit publish, and then the clinic called.

It's going to be a celebration cake!! 383!!! That's just over doubling.

She said that for some reason my satellite clinic also tested my estrogen and progesterone, when they didn't ask for it.

My estrogen is 790 and my progesterone is 14.7.  Two days ago, my estrogen was 884 and my progesterone was 18.8.  I'm on PIO (progesterone in oil) every other day, and 3 Endometrin daily.

She said they want my progesterone over 15, but she thought maybe it was lower because of my PIO shot is due tonight.   But my PIO was on the same timeline two days ago when I had my first beta.  So, that, on top of the cramping I've been getting (even though I'm told it's normal) makes me nervous.

I asked her if I could take more progesterone? She agreed, it wouldn't hurt.  The only risk is discomfort, she said.  So, my butt can thank me that I'm increasing my PIO shots to 1cc every day  (and continuing my 3 Endometrin morning, mid afternoon and at bedtime).  

The nurse wanted to know when I could go in for more blood work next week?  I asked for Monday because I want to have the soonest appointment in case there is something wrong with my progesterone levels.  However, on second thought,  I'm wondering if I should have asked to go back in Friday instead?  I'm not sure if that's overkill, or if I even care if it's overkill.

For once, I'm really glad the local clinic messed up.  Phew!

On Monday, they won't check my HCG again, just my estrogen and progesterone.  She said all that matters is that they see a rising pattern once with the HCG.

Then, sometime after March 27th, I will have an ultrasound for a heartbeat, embryo location, number size etc.

Yay!


Monday, 10 March 2014

Beta

It was 182.  Holy sh*t.  

I go back on Wednesday to check my HCG again.  They want to see it go up by a factor of 0.53 (they said it used to be that they wanted to see it double).

I thought I would be jumping up and down with excitement.  But we're (still) in shock here.  And scared sh*tless.

It's not far from my mind that we've been here twice, and one time with a number similar to this.    My head knows that that this has a significantly improved possibility to end so much better because of the (hoped for) improvement in embryo quality.  But my heart knows this is scary as hell.

Thank you so much for sharing your well wishes and excitement.  Your comments are so nice to read, and mean a lot to me.

Hang on, little embie.  Hang on.

Monday, 10 December 2012

Post-consult



I'm back. 

Colorado was great.  It was everything we hoped it would be.  I kind of felt like it was a fertility-wonderland, complete with a waterfall.  The staff were very professional and we felt that we got some new information.  I'm happy that we went.   

We still haven't made a decision on donor egg vs. trying our own egg.  Honestly, I'm still on the fence.  If money weren't an issue, I would 100% give an IVF with CCS a go for two cycles.  But, being real, money is an issue.  If we spend $60,000 (the rough cost of trying two IVFs) and don't end up with a baby I'll be feeling really depressed and kind of stupid.  The only reason why I prefer own-egg is because in many ways it just feels simpler.  No explaining one day of where they came from and no issues of loss for the child.   I suppose I just don't feel very confident in my parenting skills, because I haven't got the chance to practice them yet. 

It's funny to me how we are back to (almost) the same decisions that we were making over years ago when we decided to adopt the embryos.  

It's very frustrating and difficult to make these decisions. I just want to be done with this part of my life and move on to the part where I am a mommy. 

Some of the things I really liked about CCRM:
- They are organized.  Check in at the desk, have a test, check in again, have another.  We had back to back appointments all morning and things went very smoothly. 
- I felt Dr. Schoolie was kind and was honest with us about our options. 
- The staff seemed to be really well trained and experienced.  I liked that many of the technicians really took time to explain the procedure they were doing, and what they were hoping to see.  

Some of the things I don't like:
- They messed up on drawing enough blood for a thrombosis panel.  I had 16 vials of blood taken, and that still wasn't enough.   16 vials tops my previous record of having 13 drawn at once.  I wonder what my fertility-lifetime total would be? 
- They called me back and said that they doctor isn't sure about whether to recommend a laprosopy and tubal ligation for my left side.  It seems that my HCG showed some hydrosalpinx (sp?), but there was some spill (which means that there is no blockage) however they weren't 100% sure if there is a blockage or not.  Basically the doctor said it was my call on how to proceed with this.  After a few days of marinating on the topic, I've decided that this isn't enough information to make the decision.  I need a doctor's recommendation.  Isn't that what I'm paying  for?!?  I'm honestly a little flabbergasted that they haven't given me more information on this to make the decision.  Oh well.  I guess no clinic is perfect.  That's why I've called back for more information. 

I'll write more later.  I just wanted to break the silence, and get some of my thoughts out. :) 


Friday, 23 November 2012

The Journey, So Far...



I typed out a nice neat little index page with page numbers for Dr. Schoolie when I submitted all 250 pages of our medical reports.

Going through the process of organizing my records was a tedious and emotionally exhausting task.  Each portion brought up memories of how we felt at each turn.  It also made me feel frustrated that there wasn't a more efficient way to navigate through the difficult waters of IF.



May 2008
Semen analysis:  1.6 million
Normal pelvic ultrasound
Hormone levels tested but not on cycle day 3.
June 2008
Semen analysis: 1.6 million
Aug. 2008
D has bilateral testicular biopsy under the direction of urologist.  Findings: bilateral hydrocele and meiotic arrest.
D has infection after this procedure, and is treated twice with antibiotics (for two weeks each time). Up until 1.5 years after this procedure, D has infrequent “stabbing” pains in his testes.
Oct. 2008
Dr. Nada, Enocrinology consult, no findings referred to another endocrinologist.
Nov. 2008
Scrotal ultrasound: focal hypoechoic regions within the superomedial aspect of both testes measuring 1.2 and 1.4 cm.  Likely related to previous biopsies.  Bilateral small varicoceles are demonstrated.  Small right hydrocele.  3mm cyst on left epididymal head.
Dec. 2008

D- Endocrinology consult with second endocrinologist found no abnormal results.
CBC normal.
Jan. 2009
New clinic #2
Semen analysis. 0.6x10 6/ml
Feb. 2009
Semen analysis (washed), total motile count 4 million.
Day 3 FSH: 23.8 IU/L
Day 21 Progesterone: 48nmol/L
Genetic screening and other blood work (day 21 and other).
2nd opinion with Urologist.  His opinion was that the testicular biopsy was unnecessary, and that the results showed only a focal diagnosis.   No further recommendations.
Mar. 2009
Hysterosalpingogram: Right fallopian tube patent, left tube irregular, curved, tortuous and dilated, left tube appears blocked.  Antiverted, anteflexed uterus. Right ovary 2.5cm x 1.3cm, left 2cm x 1cm. Small irregularities in uterine lining.

Diagnosis: Premature ovarian failure, advised to consider donor programs.
April 2009
New Clinic: #3 Dr. Snowflake
June 2009
IVF cycle suggested to be changed to IUI.  Cycle cancelled: My sister had a massive stroke at age 28 (from an undetermined cause).
Sept. 2009
Day 3 FSH: 6.5 IU/L

Operative Hysteroscopy to remove small amount of scar tissue near embryo transfer site. 
Pathology Report: Endometrial curettings (1.0ml of hemorrahigic tissue and mucoid material): proliferative endometrium.
May 2010
Sonohystogram, results normal. (Dr. Snowflake).
Nov. 2010
FET #1: Transferred 1 donor embryo (from couple #1), rated “cleaved 4-6 cell”.
HCG <1.0
Feb. 2011
Adopted 6 blasts via Snowflakes
Created in 2005
April 2011
New clinic: USA, Dr. M Frankenstein
Semen analysis: Grade A, low count, borderline morphology.  Semen frozen (unused as of Oct/12).
Monitored for one natural cycle:
Doctor says follicles didn’t mature as expected.
Decided to proceed with adopted embryos.
Day 2 FSH:  19.6 mlU/ml
Follicle count: 7?
July 2011
FET #2: Donor embryos, 2 unrated blasts.  Embryologist says they are unrated because they were still collapsed 2-3 hours after they were thawed.
HCG <1.0
Sept. 2011
FET #3:  Donor embryos, 2 blasts 6BA & 5BB
 HCG <1.0

Nov. 2011
FET #4: Donor embryos, 2 blasts 4AA & 4BA,
HCG = 75, (6 days after transfer), 1547 (13 days after transfer).
Dec. 2011
Miscarriage confirmed at 8 weeks
Jan. 2012
D&C after incomplete natural miscarriage
Started 75mg DHEA/day
Mar. 2012
AMH tested: 0.42ng/ml
Day 3 FSH 17.5 mlU/ml
April 2012
IVF with ICSI (own eggs)

Medication:
· 40 units of Leuprolide on cycle days 3 and 4. 300 units of Gonal-f for 16 days, the last 8 days of stimulation 150 units of Menopur.
· See cycle sheet for other meds.
· 500mg Flagyl & Doxycycline for both of us in case of subclinical infection (2 weeks).  Started one week approximately before transfer.

Retrieved 9 mature eggs + 2 immature eggs, 7 fertilized, 6 survived.

Ratings on day 5:
1.     EBL: C1
2.     BL: B1
3.     EBL: A
4.     Mor: B1
5.     Mor: A
6.     Mor: “?”
7.     Mor: A
Semen analysis for ICSI
2 transferred, 1 blast 4AA and 1 early blast (unrated)

HCG = 38.4 (10 days after transfer).

Bright red spotting 14 days after transfer (HCG =278), miscarriage 22 days after transfer. 
Tested natural killer (normal), DQ Alpha (normal) and MTHFR (positive for heterozygous copy of A1298C mutation).
May 2012
Day 3 FSH 11.1
June 2012
Semi-natural FET cycle attempted.

Ovulated on day 11, doctor not expecting this early, cycle canceled.
July 2012
FET #5: own embryos, 2 transferred, 2x day 5 morulas, A & B1.

Started new protocol of 81mg ASA, 10mg prednisone, 40mg Lovenox at time of transfer. 
500mg Flagyl & Doxycycline for both of us in case of subclinical infection (2 weeks).

HCG 1.8, then declined.
Sept. 2012
FET # 6: own embryos, 2 transferred, early blast with “?” rating and blast rated 3AB.

Changed protocol (81mg ASA, 10mg Prednisone, 40mg Lovenox) starting one week before transfer.

HCG <1.0
Nov. 2012