Attitudes

I told a friend recently that it was all about attitude.  On day 5, I was ecstatic to discover that I had ten follicles with 9 leading as potential eggs.  Last round on that day, I was crushed because I only had ten follicles and 4 leading.   (bloodwork E2 119 D5).  Still taking it one day at a time, just following the process.

Day 8, twelve follicles with 11 leading. (E2 479).   Tentative hope.

And today, Day 10, I have fourteen follicles that we can find with all 14 leading.  holy cow!  We're going to allow them to continue to grow for another day.  Maybe even two.  I do think some of them are rather small for day 10  - 12mm.  This tells me that either they have developed as quickly or these are some of the tinier ones the tech thought she might see but didn't want to count since she couldn't see behind my left ovary.

I've been doing my acupuncture, my bodywork.  I've added in some talk therapy to manage stress as well as guided relaxation.  And then there's the usual set of blood draws, ultrasounds, summer camp pick ups and drop offs, and some OT for my girl.  I was going to add in yoga for fertility, but, after speaking with the teacher, we decided that to add in one more thing might totally stress me out!

She did teach me the feet up the wall pose, where you lie on your back on the floor and put your legs straight up against the wall to allow the blood flow to come back to your reproductive organs.  I felt so silly, lying in the hallway with my head in the bathroom door way.  I told her I felt like I was doing everything but sacrificing a chicken to make this happen.  It occurred to me a moment later that I might have insulted her, so I quickly stated how yoga and acupuncture obviously affected circulation and chi and that of course that didn't fall into the whole "sacrificing a chicken" mindset.

One thought that has been stressing me out - TWINS.  I thought I was okay with our plan to transfer two embryos on Day 3 with assisted hatching.  And then my talk therapist FREAKED ME OUT with her talk of hospital bedrest and NICU and probable soft neuro-developmental delays and pre-eclampsia and gestational diabetes and needing not just a few afternoons a week of extra help but needing a full time nanny even with my being home and how would we pay for that or could someone move in who could help for either a few months or a few years.  HOLY CRAP.   So her negative attitude (she worked in high risk obstetrics and a fertility clinic) has now given me a negative attitude. I called my RE (that's reproductive endocrinologist aka fertility doctor) to discuss.

One factor in this is also the discovery of a sharp change in my anti mullerian hormone (AMH).  In January, I had a 1.1, which is actually a little better than normal for a woman of my age.  Between that and the kicking FSH 6.54 (follicle stimulating hormone), egg quality was looking quite good.  I think this is evidenced as well by our having six embryos even on day 3 last round.  You want FSH to be low and AMH to be high to show good egg quality, or egg reserves.  As of May, my FSH was even lower (odd!) at 5.71, but my AMH had plummeted to .39.  That's not a tiny fluctation!!  That puts me at very low egg quality, which can certainly affect the number of eggs which mature and which will fertilize.  So, even with almost twice as many follicles, I could end up with the same amount of embryos or even fewer.

The doc and I sat down this morning and "hatched" out a new plan.  (Oh, ha ha, I am so funny after a blood draw and no food.  Coffee first.)  If we only have two or three embryos on day 3, we'll insert two.  There are greater chances at my age that there could be genetic issues which would prevent development, so it's best to hedge our bets on that.  They don't have the data about SET (single embryo transfer) that they do for younger patients, showing that the odds are about the same to implant one vs. the other.  Although it was from those studies that it was decided we'd do a SET with the last one on day 5.

If we have many growing and doing well, then we will go out to Day 5 and see.  If we have a few that we could transfer, we may still opt to do a SET and then grow the others out one more day and have some for freezing.  I'm feeling optimistic about that since we're seeing 14 follicles.  Last time we had 8 follicles with 7 eggs and 6 fertilized.  If we can even get 12 eggs and 10 fertilized, we are so much more ahead of the game!!

As I mentioned, though, my hormone numbers are very different than we thought.  Still, these draws were done within weeks of the last IVF cycle, so I'm guessing these numbers were about the same during cycle number 1?  (the one which didn't result in a pregnancy - hmmmmmm....)

Looks like that microdose lupron protocol is working very well for me.  I've had far more headaches than last time, beginning from the birth control pills to even yesterday.  They are starting to wane, though, as my follicles increase production of whatever hormones are going on.  Although I have more follies and I'm swollen in the belly, I'm not as swollen in the belly and I've not gotten to the point of feeling like I have rocks in my stomach, sitting on my organs.  That's always been my least favorite part of the clomid rounds, but I gotta say that the headaches tie it.  I appreciate pain killers and my body work specialists for helping with these.

I return tomorrow for yet another blood draw and ultrasound to see if we trigger tomorrow night (that means we'll do another hormone shot to get the eggs to start releasing to make for easier retrieval).  I've got the Bud in summer camp all week because of this crazy scheduling.  And now it looks like some of this has to be done before camp even starts and some procedures over the weekend or even into early next week.

Anybody want a kid for a few hours?  Juggling childcare has been a big part of this stress but it's gotten better with discovering an online coupon for a preschool camp near my home.  I thought I'd be in more pain than this, so I feel guilty for sending Bud off when I can still move.  Last time, I could barely get off the sofa.  I suppose that time will come, though!  It's surprising to me that this saps my energy so much, and yet it can make me so irritable I could enter a prize fight and win.

I suppose that's my attitude right now - working hard, optimistic, yet irritable and tired.  I wonder if they make an emoticon for that.  It's a pretty normal feeling for someone going through fertility treatments. I could sign all my online writings with it.  Maybe a hormonal woman sacrificing a chicken?