Test Results, The Clinic and Waiting to Go Home

Well... It feels kind of strange.  Surreal, like I'm not really here, just pretending to be.  But I am here...  In Vancouver, waiting in an internet cafe for time to slip by so I can head to the airport and wait for it to slip by some more.  My iPhone is almost dead so this computer is pulling double duty as I've plugged my wireless device into another wireless device with, yeah, you guessed it, a wire.  When will they get these things to charge wirelessly?

I was up all night tossing and turning, scared I'd miss the plane, that David didn't set the alarm correctly, or that it wouldn't work.  Of course it did, and so did mine. :)  Anyhow...  I was up at 4:20 this morning, waiting for 5 to roll around to get to the airport at 6 to take off at 7.  Ugh.  I'm so tired now! 

Flight was pretty routine, I am not keen on landing at the best of times and landing on an ice covered runway during a snowstorm doesn't ease my un-keen-ness at all.  However, I digress.  I arrived in Vancouver in time to walk out the front of the airport doors, slide into a waiting cab and got to my appointment with 5 minutes to spare.  The clinic had good energy, a little too clinicy for my taste... very ultra modern decor, but it was all nicely done and the staff were very nice.

I put down a $500 IVF deposit and we were off and running.  I was weighed (oh, God... gained 23 lbs since starting fertility treatments a year ago!! OMG)  and measured (same height as starting fertility treatments - oh well) and then told to strip from the waist down.  Now I've been in a lot of doctor's offices, striped from the waist down, but this was a really long, scary wait.  I know I wasn't left that long, but I was really truly anxious, and why do they put your butt facing the door so when the doc comes in he gets a nice dose of bum-line to start the introductions??

Doctor Havelock was very young.  I'd guess mid 30's.  Kind of has a Micheal J. Fox look and expressions.  I was really shocked at how upset I was at my previous treatment, and asked them to be patient with me, I had not realized how much stress and pressure I had been under, keeping track of all my meds, doses, appointments, etc.  He was great, and took care to show me the ultrasound and explain what he was doing as we went along.  

First he inserted the cathetor into my cervix, it didn't hurt at all, not like when Dr. Lang used the *evil* teneculum to clamp down on my poor cervix.  Dr. Havelock is my new best friend.  He got the thing in without any pain or even hesitation.  Okay, so anyhow, then he has the nurse hold a tube of saline, and he goes in with the vaginal ultrasound.  I have had so many vaginal ultrasounds that I barely noticed the vainal ultrasound.... hmmmm

Anyhow... so he looks at my ovaries and says they are excellent.  Good size, 10 anterior follicles on the left and 12 on the right.  Ten is considered good/average, so the doctor was very pleased.  Then the saline was slowly injected, some mild discomfort there... and the uterus was ultrasounded.  And it was great.  Doctor said the walls were nice and smooth, no abnormalities, and looked great. 

Now we just need the final blood tests performed so we can move onto getting the solid dates in place.  Those should be done on the 4th...  But the clinic said they'd give me my dates tomorrow so we can coordinate flights, hotels, etc. 

So I am sitting here... the cramps have really set in (doctor said they would) and I just downed three painkillers with a foul grapefruit/kiwi drink that won't see more than an inch missing from the bottle.  Hopefully the meds kick in soon.

Oh, and on a final note.. we did get extended medical so our drugs and travel costs *should* be covered....  Yay!  Now into a cab to the airport and wait another few hours to climb onto the plane, fly to Edmonton and then finally drop into Grande Prairie (and David's arms) at 10:30 tonight, for the 2.5 hour drive home... *yawn*

It's Like Being In Line For The Roller Coaster

You can't wait to get there, but you have a ball of dread in your stomach at what's going to happen.  There's nothing anyone can tell you to keep away - you hear stories that conflict each other.  Some tales are dripping with excitement and wonder and a smug knowing accomplished with a tender nudge.  Others... others are filled with dire warnings and a firm hand, one that holds you back. 

But it's our ride.  We've paid a horribly high price for the ticket.  We're not only committed, we're obligated... to something that doesn't have a name, a heartbeat or a voice, only the hope of one.  So we'll take it, and we'll share our story at the end.  We'll be a lot wiser at the end of it, we'll also be very happy or very sad.

I'm off to PCRM in Vancouver on December 30th for a sonohystogram and more bloodwork, as well as my injections class.  Should be interesting to know if I've been doing my injections correctly for the past six months - I never had as much as a 'how-to' flyer given to me.  Oh, and the drugs should be interesting... I was on clomid for 12 months and started to experience vision issues, then found out I am only supposed to be on clomid for a maximum of 6 months, and the vision symptoms I was experiencing are indicitive of my retina detaching.  Lovely. 

I had CD3 tests performed on December 23rd, but won't find out the results until the 30th... I am hopeful they were good!

My other blog is a baby blog

Haha, right?  Seriously.  I have an empty 'Wilson Baby Blog' all designed and empty and waiting for some kind of news about a pregnancy.  I started it last February when I was so sure that pregnancy was going to stick.  Haha, right? 

Well, I guess we'll see over the next six months if we'll get to use that empty shell and use some of the pretty designs and ideas I put into it.  Oh yeah, and the blog might take flight as well. 

We start IVF procedures in January.  Seems we might be flying down to Vancouver at the end of the month for more tests and initial/first round of consultations and official introduction to our IVF path.  yay.  I mean... Yay!

Okay I have to admit I am a little excited.  A little hopeful.  It seems in the IVF world we are pretty good candidates for those old success rate sheets.  I mean we  have no fertility issues, we've gotten pregnant, I've done my duty as a breeding mare before and David's boys are up to par.  I'm 'average' age in the IVF realm and in good health.  Hopefully the end of January will be the beginning of a pregnancy. 

The Final Step

In a vastly fertile family, it seems kind of freakish that I will be moving onto IVF.  David and I had big talks about it and while he has more fear than I do about the entire thing.  I want it to be over one way or the other.  I am tired of every month, every plan, every season being about me 'maybe' being pregnant.  Plus the drugs make me fat.  I really dislike being fat.  I have managed to gain 20 lbs of fat since I started the drugs and not one bit of it can be contributed to pregnancy.  It's actually non-pregnancy fat.  Not cute and charming like pregnancy fat, which can be easily overlooked when you have a cooing, gorgeous newborn to distract those intruding eyes.

So the papers came in the mail today.  The legal forms required to procreate.  I remember when getting pregnant meant having a few too many beers and praying feverishly for your period and avoiding the pregnancy test until you were about ten days late.  We have to have STD tests; AIDS and Hep B and C and small pox and even syphillis and chicken pox.  Yes I know the 'pox' are not STDs but they are still on the list.  Nobody wants to create a baby from impure ingredients I guess. 

And I get to have another FSH test.  It was a year ago this month when I had my first one.  I wonder if all my 'good eggs' have been wasted on the useless IUI cycles we did (mostly uninseminated - is that a word, un-inseminated?)  I mean, did I have like... 30 good eggs left and they are gone?  Can my FSH really raise in 12 months...? 

This thing is going to a whole new level and while my hopes are raised, I am all too aware that the height from which I might fall is raised as well. 

Ultrasound, Check - Follicle, Check - Doctor, ummmm Doctor???

Yep.. you got it.... I went for my ultrasound this morning and the ultrasound tech went to talk to the doctor but came back ten minutes later saying she couldn't get in touch with him.  So, she gave me the stats, or at least most of them.  I have one follicle that measures 18mm X 15mm X 23mm on my right ovary, and 9 smaller ones that she didn't have sizes for.  My uterine lining was a nice 8 mm which is good for where I am in my cycle.

So I'm on track.  Everything is going just swell.  Except there was no doctor to be found.  I called the office all day and finally had a neighboring receptionist go over and try to get them to answer a message, but there was nobody there.   Sigh.

It's not like I would be triggering tonight or anything.. and with that one big egg waiting to burst I doubt if he'd have me do more injections, so I don't think anything will be really affected at this point, but I am looking forward to hearing from his office in the morning.

I somehow have a bit more hope now.  Maybe it's because two more of my blog buddies are pregnant, and another just gave birth.  I am always, always the only non-pregnant one.. but that can't last forever, can it?

Upcoming Schedule as of Today.... (in anticipation)

Trigger on Wednesday night around 10 p.m.
IUI on Friday morning around 10 a.m.
BD Friday around 2 p.m.
Test around December 17th
Do not tell anyone until Christmas - including David if I am so lucky as to get a bfp
EDD August 27th.

Wannabe Check - Tomorrow - 11:45 a.m.

We've decided that's what we'll call it.  A wannabe check.  Counting and measuring the little 'wannabe' follicles...

I was supposed to have my U/S today but we weren't able to get it booked in, so we opted for the next best thing - tomorrow.  I usually take 1 or 2 amps of FSH after my first ultrasound on Monday, so I took 1 amp just in case.  This is a strong drug but I am very confident that I was safe to take the half dose.  I am rather worried about my uterine lining... I was spotting until last Friday and am not confident that it will be thick enough.  Regardless, it's all too late now and I can only hope for the best.

There's always one

I am on several TTC message boards. For the past fourteen months I've been a loyal follower, avid poster, and eager, upstanding member of the freakishly addictive online pregnancy-obsessed community.

At first I was soaking up any bit of attention, comfort, or answer that I could glean from other cracked, stinging women who had also lost their pregnancies. I cried at my keyboard, I typed in stunned disbelief as the last of the innocence I'd known slowly leaked out of me into a maxi-pad. I took out my anger and fear on the boards instead of my two bewildered teenage sons and grief stricken husband.

Slowly, as the blood eventually stopped flowing and six long weeks of nothing took up that painful, blurry summer, I began to offer some kind of support to other newly-raped-of-innocent non-mothers drifted into the board. I got a bit of a reputation for poignant advice. I also got something else. Hope. I started to see other non-mothers report newly discovered lines on previously barren pee sticks. I started to see them progress into later stages of pregnancy, and then I started to see them deliver.

Through it all, through two more miscarriages and about twelve months, I got to hold onto a big, glittery ball of hope. Every bit of good news, every new pregnancy or birth just added to the glitter and shine! I was never bitter, never envious of other women who were sporting expanding waistbands and contracting levels of comfort. I was inspired and revived by all the women who were getting pregnant - all around me!

I started to notice, sometime around September, that I was forgetting my ball of hope, leaving it laying around the house, forgetting to take it with me when I left for work in the morning, or when I was going to yet another doctor's appointment.

I think it was around the same time that five, yes, five women in both my online and real life circle became pregnant in ONE WEEK that I started to clue in. Holy fuck. I might not ever get pregnant. I sat down and calculated the women who I knew in the past year who had moved onto 'the other side'. Twenty-six. One woman was actually already starting to try again with a four month old still nursing her oh-so-fertile breast. These are not women who I've seen get bfp's online. I've seen HUNDREDS of those. These are women who I actually talk to, know their stories, and they know mine. It began to dawn on me, I was the ONLY ONE in my moderate circle who was not only facing losses, but now, oh thank you!, I was facing secondary infertility.

So the nice, round, glittery ball of hope started to feel more like a rock that was placed in my bed, just under the sheet, and right in the place I love to curl up and sleep my worries away. It's getting in the way. I am starting to wonder at the purpose of it, and why I wanted it in the first place. New pregnancies are still adding to the ball, but not in the shiny happy way it was in the beginning. Now the pregnancies add bulk and sharp edges to my ball of hope, and makes it heavy and I feel stupid lugging it around. I think other people think I look stupid with it, too. It has turned from a pretty, glowing centerpiece for family dinners and doctor reports to an obscene, embarrassing thing that nobody really wants to comment on. They secretly wish I'd put it away, bury it in the backyard, or simply forget it for good. What good has it done me, anyhow?

We've agreed on two more IUI's. One of which I am currently being ultrasounded, stabbed with needles, medicated with strong pills, and will have the actual insemination performed on Friday. What used to be sensual and warm, filled with hope lovemaking has turned into sterility, time-sensitive deadlines, drugs and bright, strong lights.

After the two IUI's, which I really don't have a hell of a lot of hope for, (remember that is just an ugly rock now), we will move onto at least one IVF. I somehow have reserved some positive energy for that possibility, but not a lot. After that? I guess I really will bury that stupid, used to be glowing ball of hope. Just put it away forever, out of the house, maybe in the back shed under the old skis and discarded, plastic flower pots that I just might use one day, but haven't been inspired to yet. Just more hidden away junk with an old, dull, awkward rock underneath it. I'm sure my husband will quietly discard it in the summer, when he quietly cleans out the shed while I'm at work. And I'll be forever grateful for his silent burial of what we used to treasure so highly.

My boring update...

Well. It is. Boring!

Last cycle was a medicated IUI and a complete bust. No double line, just a great chart and lots of hope.

Then I had a lil' breakdown. Nothing dramatic, nothing worth writing home about, just a 'submission' of sorts. Acceptance of what is, and what is not. A promise to keep trying, a promise to not lose myself in the process.

So my doctor wants to do a little checking before we start another round of meds. I've got an ultrasound booked for tomorrow to check for cysts and make sure we can safely continue this month. I was on birth control for about a week. I haven't been temping or bothering with even thinking about ttc much, until this morning, when I finally took my temp again. If we are not doing the meds then David and I will be going au natural again and I must need to know when I ovulate, so I can take the lovely progesterone. No temping after ovulation, however. No stopping the progesterone early, and no testing until two weeks. I'm never good at that last one.

Da Faxt

December '08 - 7DPO Low Progesterone Result = 9.6
**** January '09 - Medicated 7DPO (Clomid 50mg) Progesterone Result = 40
**** February '09 - BFP / MC @ 5 Weeks Progesterone = 4.7
**** March '09 - Diagnosed LPD Luteal Phase Deficiency
 **** March '09 chemical pregnancy (beta 17dpo was "5")
**** April/May Cycle '09 - BFN
**** June '09 5th Round Clomid HSG 12DPO - BFN
**** July '09 - 6th Round Clomid 50mg BFN
**** Medicated IUI Scheduled Aug 14 - 100mg clomid, Repronex Injections, HCG trigger & Progesterone after Ovulation .... Overstimulated Ovaries - Over 12 large follicles (20mm+). IUI Cancelled! ****August '09 100mg Clomid, Repronex Injects 2ampsX3days, 1st Follicle Ultrasound Aug 31 Two Dominant Follicles - 15mm & 3 following close behind! Lining only 3mm... U/S #2 - *8* Mature Follicles, Lining at 8mm / Trigger on CD13 / IUI Sept 4th...Doctor *forgot* to book the proceedure - Sperm was processed for SA and ultimately destroyed. BFN, of course. October cycle - taking a break, no meds... just me and Mr. Wilson. OCTOBER 16th Cycle
**** Medicated IUI Scheduled Oct 28th - 100mg clomid, Repronex Injections 2 amp CD6/8/10 & 11. Ultrasound Oct 26 - 5 follicles 12-16mm lining 6 mm/ 5000 HCG trigger on Oct 27th, IUI Thursday at 10 a.m. Testing on November 7th - BFN.
****November '09..... BC for one week to hold off cycle to check for cysts - Ultrasound - all clear, 100 mg Clomid  days 5 to 10 / Repronex Injections 2 amps CD 6/8/10

Passing the Time

This month is a breeze. No needles, no pain, no worry about the cost, the pain, the timing... the mood swings, the anxiety from the meds.... all gone.

Instead I am back to the lovely feeling of 'what if' and enjoying the thought of making love to my husband in order to make a baby instead of waiting for hours to be inseminated by a harried doctor in a frenzied emergency room. It's kind of nice. Okay, it's really nice.

I'm keeping myself busy. I'm going to rehearsals almost every night of the week, and started pottery classes one morning a week. The store is running beautifully and our great big, beautiful new deck is just about done. Instead of spending all my time exploring reasons for my miscarriages, and trying to figure out what we can do to make it all work, I am spending evenings meeting new people in the community, laughing and learning.

I'm obviously still looking forward to motherhood. We're going to ovulate this weekend and have every intention of covering all our bases. And of course I'll be on pins and needles for two weeks.... but it all seems a lot more managable. Maybe the drugs cause me to make more out of it than I realize.....?

David and I got pregnant last year all on our own. Who knows about this time?

Back to Basics

Yepper.... I seem to have much more luck getting pregnant without my doctor. *laugh*

Between him being gone for my August cycle and not triggering me in time, causing me to miss that entire cycle, to him forgetting to book my IUI and destroying the sperm.... well I had a lot more chance of conception when he wasn't around. Which makes me have hope for this month... since I called first thing on Monday morning to schedule my ultrasounds and found out he's gone for a month. Jezus. It's a good thing I never started my meds again before I called to book the ultrasounds. He never had a message for me, never told me he was going..... *sigh*

So David and I discussed it and even considered taking the meds anyhow and triggering on our own, but both realized that would be pretty stupid and most likely a sure way to piss off the doctor. So we thought we'd just relax, give my body and his nerves a break from the body and roller coaster of emotions.

Our big plan this month doesn't include timing and monitors and injections and ultrasounds. It does include beer, laughter, perhaps some lingerie and having nobody involved in our baby making except. for. us. :-)

Upwards Sidewards Whateverwards...

I am in more acceptance than ever. That might sound defeatist, but it's actually pretty good. Accepting that I have two more years to have a baby with my amazing husband... accepting and re-realizing that I have excellent chances of pregnancy... accepting that this isn't our month, and accepting that what is, is.

Got another bfn yesterday at 12DPO....and am just happy to confirm what I already knew and get off the freak train that the hormones put me on.

Yeah, well...

What can I say. I was upset. Really. Really. Really. Upset. No real reason, nothing has really changed from two days ago until today. Maybe it's the approaching reality that I'll have to face my period once again. Maybe it's the guilt from screwing up the IUI. Maybe I'm just human and have every right to a pity party, as long as it's short, and I can scoop myself out of the litter box without getting too much bitterness and grit in my teeth.
So I was thinking.... get a gawd-damned grip, woman! Stop feeling sorry for yourself! Adding drama and anger and bitterness (even though you feel them from time to time - you're no saint, ya know) to a situation that is far from hopeless and extremely exciting and can only enhance my life if successful... is STUPID! And rationalizing. I can feel the emotion from the hormones and still maintain dignity and strength and grace. I know that being a person, a woman, a mother, is sometimes not about getting what you want, but dealing with what you get with grace and gratitude.
And there is nothing quite so healing as warm hugs and encouragement from friends and a good chuckle in the face of a challenge. I have made it my own personal decision that I'm going to keep up the baby path until I'm at least 40...... that's two more years and girl, you better find a way to keep your chin up because there's going to be more challenges, more fear, more questions, more pain and more pregnant women parading thier beautiful bellies arond your store in the next 24 months!

I can do this... I can't say for sure that I'll give birth again, but I know I can do everything in my power to give this life that I want to birth the best chance in the world of becoming!

So I dug around and found some humor to spice up my depressing blog! I have to admit, it also spiced up my own attitude. I actually got a chuckle out of many of these cartoons.. these were a few that really stood out. I hope you enjoy them, and get a smile or two.

First Real Non-Pregnancy Breakdown?

Yesterday was a joke. I started out the morning thinking about how to write about 'getting over the pain of a miscarriage'. I wanted to talk about living in the present, focusing on the future and all that crap. Instead I ended up bawling my eyes out, hunched over the sink in our tiny bathroom, missing my lost, never-known baby-to-be. And as with any good pity party, anger heard the noise and made an abrupt, unannounced entrance. Party crasher.


Through tears and ruined makeup I started at myself in the mirror. I couldn't stop crying, and I couldn't stop staring at myself. Wondering why I am doing this. Why I am putting David through this.... realizing how quickly I am losing hope, and how I have begun to accept the fact that each month I will be 'looking forward to trying again'.


Planning a nursery, checking out cute onesies, anticipating those first flutters and kicks, bringing the wonder of being a parent into my husband's life. What used to be happy conversation has turned into something 'better left unsaid'. I don't often indulge in those dreams anymore. It's been downsized to only being able to fantasize about being pregnant, I think about David being a father, I sometimes stand in the shower and place my hand over my stomach, trying to imagine being full of baby again.... but they're Fantasies, not Hopes. They are dirty, secret thoughts that I know I'll never 'really' get to experience, but the sick wanna-be-mommy part of me gets off on. I don't admit openly to them anymore.




And the worst are the women who were trying and trying and trying and get pregnant. They're like reformed smokers. Caution, here's the anger part. Sorry to any of my trying and trying and trying and now pregnant friends who are reading this - I am happy for you, and you are most likely more considerate and understanding than most if I consider you a friend. But my friends aside, those women are the worst. They remind me of reformed ex-smokers. It's like along with pregnancy they've totally forgotten what it was like to want, to wish, to be let down again and again. They're the ones with the smug, holy advice to just keep trying, it'll happen, or relax and stop trying, it'll happen.... and you hope you're not actually tilting your head and looking at their glowing faces and swollen stomachs with as much disbelief as you are feeling. You don't want to rain on their little pregnancy parade, after all.

I'm not cruel. I would never take those pregnancies away from those wonderful women. They deserve it as much, and sometimes more, than I do. After all, I do have two beautiful grown sons who are sure to produce grandchildren one day. Babies will still be part of my future. I just mean.... why can't I be one too? One of those smug, relaxed, happy swollen souls. I'll even bear the cross of facing my still infertile friends if it could.just.be.me.


Okay, today's not proving to be much better than yesterday. I'm crying so hard I can hardly see the screen. I need to go to work. I need to forget about wanting, about wishing, about hoping, about those stupid lines on pregnancy tests that seem to disappear even if I do manage to coax my body into producing one.

Post Non-Perfect IUI Pregnancy Tests

So I tested this morning. Bah. I never get early bfp's in the morning, mostly because I wake up about four times a night and my 'fmu' is about as diluted as you can get. I've sworn to only test every second day, but honestly, I am going to waste another test and do a 'real' test tonight when I get home from work. There "might" be a bit of a color change, but I'm calling this a bfn and will until the line is easily visible at the ten minute mark.

Post Non-Perfect IUI Daily Updates

7 DPO
The progesterone is really kicking in. I was confrontational last night, I have waves of nausea, and my bbs were very heavy and sore. I can't even start to think these are pregnancy symptoms because I have been down this particular path before.

6 DPO
More of the same. Moderate aching in the boob type area. Some lower back discomfort. A 'pulling' sensation in my uterus/ovary region, to the point it was uncomfortable to walk... that passed after a few moments, came and went throughout the day. Still kinda gassy. Lots and lots of peeing at night and during the day - I feel like I have to go really bad all of a sudden. Still not a lot on the old hope horizen... but you never know, right?

5 DPO
Okay. Not a hell of a lot to report here. My boobs are sore. Not killingly sore, but after months of looking for any sign of soreness and finding naught (I love using those fancy-ass words), well, I know soreness when I feel it, even if it's just a little bit.

And. I have lower back pain. Of course, sore boobs and sore back are also right up there with progesterone side effects.

Is gas? I mean I'm pretty active in the toot department lately. And peeing three and four times a night.

Know what I hate? This could all be NOTHING. Could all be because of the little yellow pills I 'supposit' every night.

I guess I have to admit I'm hopeful this month. Not a lot, but at least a little. More than I was last month, when we weren't allowed to have sex during ovulation.

3 DPO

Well I will chalk it up to the progesterone, but I am weepy. Weeepeee. I even cried in a restaurant today.... David, as always, gets this cautious/amused/concerned look on his face. He humors me, he comforts me, he waits for me to gain control. And then I laugh. Embarassed. And explain for the twenty-second time that day that it's the hormones. I'm peeing a LOT, but I did last month as well and I think it has to do with the drugs as well - everything swollen and over-productive in there. So nothing really to report for 3 dpo except time in pretty much crawling by. Tick. Tock. Tick. Tock. Ti.. you get the picture...

This is what a BFP looks like.

Unfortunately, it's not real. I got a shot in the ass of hCG, the 'pregnancy hormone' last Wednesday, two days before we did the IUI. It forces a timely ovulation. It also makes you feel pregnant. You know, sore boobs, bitchy moods, absentmindedness, and, oh yeah, positive pregnancy tests.

I have to 'test out the trigger' which means I test every couple of days until either:

• It goes totally blank, which means if I get another line, I'm pregnant;
  


• It starts to get darker, which means I am getting more hCG than was in the shot, and I'm pregnant.

Of course, if it goes blank and stays that way, well.. you know what that means. That means I have a few days of feeling sad and empty, and gear up to do this again next month. Anyhow, this is my 2DPO report.

Not What I Expected..

I couldn't believe it. It was 9 a.m. on Friday morning. I was at my mother's house, enjoying a wonderful breakfast of soft boiled egg, crispy bacon and buttered toast. Why does everything taste better when your mom makes it?

We had successfully collected the *ahem* sample and gotten it to the lab. I felt really awkward because there had been people waiting there for over an hour, and I bullied my way to the front of the line, wanting to get the swimmers processed as soon as possible. That's when the trouble started.

My doc had given me a requisition for a sperm wash about two weeks earlier. It didn't have a label on it, so I didn't fax it in right away - which I usually do with all my requisitions. I had collected the label from the doc in a hurried appointment the previous day, and it was buried safe and deep in my purse. I had planned on going directly to my office, getting the req, slapping the label on it and faxing it over to the lab. I told them at the lab that the req would be on it's way shortly. They smiled, took the bottle, and moved onto the next person.

Now, somewhere between leaving the hospital and getting to my office, my mind wandered. I don't know if it was all the drugs they've been injecting into me, or the anxiousness of the day, or some deep seated refusal to get pregnant, but whatever the reason, when I left the lab, I decided I was hungry. Really hungry. I didn't want to go home, because I would get tied up in chores before work, and I didn't want to eat in a cafe alone, so I called my mom and tested the waters for a 'mom breakfast'.

Notice I did not return to the office, with the precious label and put it on the precious requisition and fax it to the lab? Yeah. Glad you noticed. I didn't.

I was at mom's when the blood drained out of my face. No, my entire system was drained. I felt a sinking horror when I realized I had forgotten to follow through. It's not like me, I am hyper sensitive to all my numbers, my levels, my timing, my meds. And when it came down to the wire - I totally fucked up.

Freaking out, trembling, I dialed the lab and asked if they had started processing the sample. They assured me that they had. And.. I asked... they knew it was for a IUI scheduled at noon, right? No, they said. There was nothing on the board for that day. They had started processing the semen for analysis. It was destroyed. Unusable. The tears started.

I didn't know what else to do. I called my doctor. I called the lab back. I got the main lab tech on the phone, imploring how upset I was, how stupid I had been, how I had spent nearly two thousand dollars in meds, taken injections, and had been trying for so long... how upset my husband was going to be.... After assuring me that the sample was truly destroyed, she went on to tell me that my requisition was only a backup... that the doctor was supposed to book the IUI in, and the lab would be alerted and ready for the sperm wash. There was nothing on the board. Nothing at all. She said they didn't know what to do with the sample, so they assumed. The guy never called to confirm anything.... my mess - up was one of three.

Then the doctor called, or at least his secretary did. I was supposed to get David back and get another sample. David, who was already over an hour away, on his way to work, and had already lost major brownie points for taking part of the morning off and his crew waiting around. David was supposed to turn around, drive an hour back, and manage another sample before 9 a.m.. David, who was really seriously annoyed at the news that this was being asked, I'd say pissed off, but he doesn't display anger towards me, so annoyed is about as strong a word as I can honestly use.

I wondered how potent a sample would be only 3.5 hours after the last one was taken. I wondered if my already work-stressed and sperm-released husband could even manage to produce enough of a sample to take to the lab. I wondered if the lab, which closed at 11 a.m. would even have time to process the sperm, if we managed to get one. I wondered, I felt like crap, and spent the next 45 minutes doing some serious beating up on myself.

After my strong spout of self-abuse, David called and said he was on his way home. He was going to give it another go. I couldn't believe it. I called home, and asked my teenagers to vacate the house for an hour, no questions asked. I told them they had 30 minutes to leave... they were more than happy to oblige, as long as I didn't tell them why David and I needed to be alone in the house. I figured that if my superman was going to try and pull this off, he would need total privacy and lack of distraction. Pun totally intended.

So we arrive at the house at exactly 10:55. I had put in a call to the lab, asking them to hold off on closing for half an hour. The head tech, who by now knew my voice, agreed, and again said it wasn't really my fault - that the doctor should have booked the procedure, and agreed towait for our sample.

The teenagers, (arg!) were still in the house. Still half dressed and half awake. One was putting on her makeup. I announced they had to get out - now. No putting on makeup, no getting teeth brushed. They had to LEAVE. David at this point is already in the bedroom. The clock is ticking, and I don't know if we even have a chance of doing this. The kids, freaked out and not wanting to know what was going on, left. No makeup, no clean teeth, just gone.

At 11:09, David was back in his truck and headed back to the pipeline. His bosses never even knew he was gone. I had a surprisingly good sample... and a new respect for David and his ability to FOCUS. I still felt miserable about cutting our chances so horribly, but at least we still had a chance...

The woman at the lab grabbed the sample as soon as I walked in and said.. there's not much.. but all we need is ONE! And so the process was at last underway. She said it wasn't as good as the first sample... but it was surprisingly good for such a short time between. They never did an actual count.

After three hours of wandering the hallway, my doctor, who had been in surgery, finally got time to perform the IUI. He said, men produce 15000 sperm a second, and all they needed was one. He said, if we didn't have a good chance, I wouldn't do this. He said, afterwards, go home and gestate.

So I went home, laid down, shook my head at the cluster fuck it had turned into, and hoped that we had a chance. Any chance. I figure... that even a few million really healthy, lively sperm, directly thrown on top of 8 beautiful, eager eggs had to give us more of a chance than normal intercourse with a normal cycle. I figure, we have as good a chance as ever. After all. It only takes one, right?

8 Is Our Magic Number!

I was so freaked out and worried about the lining. I even meditated about it. I popped baby asprin (to increase blood flow), put a hot water bottle on my tummy (because it felt good), and did more positive manifestation than I have in a long time.

Speaking of the water bottle, I just asked my gorgeous baby boy to get me one... (sorry, distracted).

Okay. Why Eight. Magic number. Sorry. I'm a bit woozy from the day, not to mention all the drugs I've had injected into my system in the past week. Oh yeah. Eight. 8.

My lining, which if you read the previous post, was a concern, but it was a nice, healthy 8mm. And those five follicles... well we were up to a beautiful Eight. Capital E. Are we nervous about multiples. Yes, nervous and excited. We want more than one but not more than three. Three is our limit.

Anyhow, back to Eight. I am not sure how the math works and I haven't figured out how to google such information, but if I have 20% chance of getting pregnant each month with one egg, don't our chances increase if we have 8, that's Eight with a capital "E", eggs? I should.... hope so?

Getting Pregnant When My Husband is 2 hrs Away...

Okay. Let me catch you up. It's been a hell of a week. Yesterday I went in for my first ultrasound. I was told I had to have a full bladder so I drank 40+ ounces of water only to find out it was a transvaginal ultrasound (which I asked twice about when I got the appointment). So... after I went pee (whew), we proceeded.

The girl (yes, she was that young) who did the u/s was so quiet, wouldn't let me see the screen, or comment on generally anything at all, so I was a little uncomfortable, but it all went by easily enough.
After changing, Dr. L came in and said everything looked good but my lining was thin. 1.3mm. 1.3mm????? I was concerned. He went on to say it 'should be fine', and pushed forward. I have two dominant follicles measuring 1.5cm, and three lesser ones trying to catch up. Dr. L thought I would ovulate all five follicles - a great sign. I got put on two more amps of Repronex, one for that day, and one for today, and off I went.

I went. I went directly to my laptop and began googling every term imaginable to do with thin uterine lining. My findings were dismal. Horrid. Tear-bringing. There is no way I could grow a decent (over 6mm) in just a couple of days! Why bother fertilizing the eggs if I would just flush them out when I got my period.

Resigned, I called my doctor this morning, mostly to ask about delaying my trigger and just having sex naturally on the weekend. He was annoyed with me, and said my lining wasn't that bad.... and I realized we had miscommuncated. My lining was 3 mm, not 1.3, and the secondary follicles were 1.3cm. I am not sure how that happened, but I don't care. I have three days to get my lining to at least a 6 and I prefer 8. It can grow 2 mm per day, and with my growing follicles and injects, it could be 5 today, 7 tomorrow, and possibly grow a bit before the trigger hits.


I am beyond excited and hopeful about this cycle. And a cute FYI... my due date would be David's birthday!

And in regards to the title of this post? David 'contributes' to our adventure first thing Friday morning, then takes off to work as normal.. the sperm are washed, and kept safe and sound until the IUI at about 1 pm on Friday. So David will actually be in another province when we potentially get pregnant!

The Countdown Begins..

I'm nervous. Excited. Scared. Hopeful. So many words to describe what I'm feeling, the experience of having some real solid hope again.

David works about 45 minutes from here right now. He is staying in our travel trailer and once a week I drive down in the evening to stay the night. It's been pretty cool... it's our official 'date night', which kind of means we get to have dinner and sex without worrying about teenagers barging through the door. Yay. You appreciate the little things when you are older, ya know.

So last night was date night. we were having dinner and I asked him if he thought I was being too optimistic, too excited. David is not a pessimist, but he is honest. He's an anchor when I begin to drift away... and I needed this part of him. I wanted to hear how he really felt.

"I think we have every right to be optimistic and to expect good results," he said, looking directly into my eyes. "Everything points to this working".

And it totally changed things for me. Even if it doesn't work. Even if it's a total bust. Even if it's just me and David at the end of September.... well, I'll still know that there's me and David. We're in this together, and that makes this journey worth it, whether we reach the destination or not, we're in it together.
Oh, and of course I am even more optimistic.



************************************************************************************

So that night, I was able to take my second round of injections. I am taking Repronex. It's used to stimulate my ovaries and encourage them to produce lots of wonderful little eggs that are just waiting for a good looking sperm to come along.

I don't like taking the needles. Wow. Who would have thought? It was harder this time because I held the needle over my skin for at least a full minute. That was worse than the needle, which I ended up not feeling at all. No blood, no bruising, no swelling. I'm getting to be a good reproduction junkie.

Wait a day and then take another shot, wait another day and take the final shot. Get ultrasound on August 31st to check for follicles. Decide from ultrasounds on which day to trigger with the hcg. Then... IUI. Yay!

Oh Yeah... the Injects....

So last month (July) we started... OFFICIALLY started... 'real' fertility meds. I happily and hopefully laid down a little over $800 and went home with a paper bag full of drugs. Baby drugs.


The problem was... my doc... was out of town. I knew there was supposed to be 'some kind' of monitoring, but I didn't know how much 'some' was. So. I dug in. I was actually looking forward to the injections in some kind of horrid way.

I was freaked out, but so anxious and ready to get the show on the road. So I mixed the drugs, went into the bathroom and prepared myself. With needle posed, I contemplated what I was about to do. And... I contemplated how I was going to do it.

Finally, I realized that it wasn't going to hurt any less if it took any longer. The first time I made the big three inch trip between the needle and my tender tummy, I only managed to get the needle into the skin before I stopped. Then I had to keep pushing and it was painful... like I could feel the needle cutting the flesh slowly. I bruised. But I was proud of myself. There was a little blood.

The other times were much easier. I made a smooth motion and didn't put the needle too far in or too far out. I injected the meds slowly... taking about 30 seconds and pulling the needle out quickly. That's a big tip for anyone who is doing this. Pull the needle out fast.

And then, there was the doctor getting back. I think I was on CD12 or something and he was a tiny peeved at me for going ahead on my own. I went in for the ultrasound. I knew things weren't good when the doctor actually called me by my first name, from a room down the hall.

"Sooooonnnnnyyyyaaaaaa," he called in a sing-song voice. "Come in here and seeeeee thiiiisssss."

So David and I trudge down the hallway and there are three technicians and the doctor standing around a monitor, with my little ovaries as the star of the show. It appears I had 10 mature follicles. Um. Too many. Can you say... litter?

So. Not only did I lay out $800 bucks on drugs, but David and I were cut off having 'fun', and... AND we lost an entire month.

The good news? Yes, there is good news. I responded to the drugs like a 20 year old. We have excellent, excellent chances for the upcoming months.

Tomorrow I start my clomid again, and then the injections again on Tuesday. Wish. Me. Luck.

Yay... everyone's pregnant!!

Except me! Yay.

Okay... I may be feeling a bit bitter. A bit left out. A bit angry. I now have nine, yes, nine wonderful, deserving online friends who were not pregnant when I met them, but who are all either pregnant, or have had babies. Look at how beautiful and shiny happy they are! And, yes, the bloated bellies are not limited to online chicks.... three close friends in town, all whom had struggled with miscarriages and are older women, like me, are very well into their second trimesters. I can't say that these women are some of the most deserving women out there who are TTC... I'd just like to say that I kind of figured that I was in their league! Ya know?

I'm not angry or bitter at their success, I'm just feeling helpless to join them. I have all the tools, all the resources, all the will and desire...... it just hasn't happened yet.

So I've had a few cries lately. I've spent a few showers (it drowns out any audible sad noises and I don't have to keep getting up to get tissue) getting some of the fear and anger out of my system... and even got pretty emotional talking to David last night. David, who is the most amazing man I have ever been blessed to know... who always knows what the right thing to say is, who always knows when to say nothing, who knows me better than I know myself.

Okay. Enough of the pity party. It's boring. I hear it too many times to participate for long. I really don't believe in it.

On to the good news. Last month (this cycle) I did injectable meds for the first time. I responded well. I mean, I responded exceptionally well. I responded beyond exceptionally well. I responded so exceptionally well that my loving husband was not allowed to get even remotely close to me. Okay, so we lost $800 and a month of trying. Well, so what. There are millions of women who would pay for my problem.

I am currenly waiting for my period to show. So we can start again. So I can take hormones and inject FSH and wait and undergo IUI and then. Wait. And wait. Any maybe it will work, and maybe it won't.. but maybe it will. We are aiming for an IUI on September 4th....

It's Happening Again

I am 7 DPO. The last two cycles I wasn't hopeful at all, no sore back, no emotional outbursts, nothing like that, and I wasn't surprised when AF showed on time.

But now, like the February and March miscarriage months, it's happening again.

And to be honest I am terrified. My back is hurting so bad I am on the verge of tears. I mean it really hurts. My breasts are sore and I am super over emotional. I cried three times yesterday, over nothing. I feel overwhelmed and exhausted. Either I am pregnant again or I have just pushed myself too hard for too long and this is the result.

Forced to Obsess

I have a 22 year old staff member who I am pretty close to. She's worked with me for two years, and is a very kind girl. She's not the first person to say, "I think you need to stop trying so hard, and just let things happen." If I weren't taking my temperature, and charting, and saw my doctor, I would have just kept miscarrying over and over. (I have very low progesterone). If I don't keep track of my CD, I don't know when to take my clomid. If I don't know when I ovulated, I wouldn't know when to start my progesterone. If I don't take pregnancy tests I wouldn't know when to stop, or increase my progesterone. It was only because of my insistance on getting betas and progesterone tests that my LPD was detected...less than 1% chance and I caught it.... I'm travelling to my wedding this month. I'm sick of testing, and temping. DH and I got pregnant 3 times out of six monthswe were actually able to BD during Ovulation. GETTING PREGNANT IS NOT THE ISSUE... it's KEEPING MY BABIES.... How do I *relax* when I am FORCED to monitor myself?

Finally. An Answer and Some Relief

Okay. So... at 17DPO I went and got a beta done and it was the worst number we could have had... it was 5. Which means that technically I was pregnant, but at that many days past, it was either a really super late implantation or the end of a chemical pregnancy. We were in limbo for a while... my temps were still really high, but after a couple more HPT's that were BFN.. we opted to stop the progesterone and let my cycle end.

I finally started spotting this morning - I suspect this will progress quickly into the beginning of my next cycle. I'm VERY excited about this - we are almost an entire week overdue.

THE GOOD NEWS:
The good news is that my progesterone supplementation is working. It kept my temp high (even for a few days after stopping) and certainly delayed my period. That means that when we get a good fertilization and implantation, we're at a very high rate for a successful pregnancy.

THE BAD NEWS:
Well.... no real bad news I guess... other than another chemical pregnancy. I don't mind those - it's just the dangers of testing early. If you play that game, you take those risks. I would rather give birth in the first few months of 2010 so that David is closer to coming home, and avoid that entire christmas baby thing if possible. Fun, but not really logistically perfect with the store and David being gone all winter.

Pregnant, Bitch or Nut

I can't even say it with conviction. Even though I just spent my first bout of gagging and urping into the toilet bowl. Just a nice conversation with David one moment and the next I am contemplating just what a crappy housekeeper I truly am when 6 inches away from the toilet seat.

Even though I cried so hard I blew snot bubbles at David over such things as

• my new jeans were too big


• my shoes were all wrong for my outfit


• I hadn't done my toenails so I couldn't wear open toed shoes


• David wasn't helping enough at the store


• when David DID help, he made me feel bad


• or I had to give him too much direction

Then.... when I was done with all that.. broke into hysterical laughter and then sobbing again... finally cleared up the boogers and tears...he said,

"You are either pregnant or nuts."

Bam! Sobbing again!

Okay I can laugh now. So can David... he was really awesome with it all....

So with being a certified bitchy nut, I also had a very sore back and boobs.

Here are my latest tests...

The skeptic tells me to beware. These tests were pretty much DRY before I got anything I could actually photograph. But... the dreamer in me thinks...evaps don't have color. Evaps don't get darker over time. Evaps don't happen three days in a row. And that cheapie internet stick at the top? I've been TRYING to get a freakin' evap for days now... That line is thicker than I could hope for...

I don't know. I feel pregnant.... and I don't feel scared this time.... I just wish those lines would come faster. Never enough, eh? Never enough? Gun shy.. this would be my fourth pregnancy in a year.

My niece asked me the other day, in a concerned voice, if we were going to 'keep trying'. I was kind of shocked at the question... is that what people think? That we should give up? That it's not working for us, that we are too old, or infertile? I don't think of ourselves that way at all... after being immersed in the Grief & Loss boards, our problems are the common cold when compared to the real cancer of infertility. We get pregnant just fine... and our issue is easily solved with proper medical care. It's just getting a good, sticky egg, and that's just a numbers game, one we apparently are getting better at playing.

Signs Of The 2 Week Wait

They are HURTING. Hurting Hurting Hurting and it's annoying because it COULD be a side effect of the progesterone. I don't mind hurting boobs if they are possibly a sign of pregnancy. But if they're just confirmation that the pills I am faithfully inserting into my va-jay-jay every night.... well that just adds insult to injury.

Pre-Ovulation:
I started myself on some excellent pre-pregnancy vitamin supplements...
3 mg Folic Acid
Omega 3 Prenatal
B6 300 mg
Vitamin E 800 mg
VitaminC 1000 mg
Aspirin 81 mg
Jameson Prenatal


1 DPO: No signs, didn't start the progesterone because I wanted to make sure I'd really ovulated and it wasn't just a flakey temp rise (that never happens but you never know).

2 DPO: Another temp rise and I cannot resist putting in one progesterone suppository (100mg) in the morning... if there's an egg in there I am going to do all I can to make sure he's got a place to grow! 200 mg Progesterone evening dose.

3 DPO: I had a HORRIBLE night's sleep! Went up several times to go pee and then was restless from 3:30 a.m. Don't trust my temp this morning but I have to take what I can get. I would like to see my temp higher above the cover line but the cover line is really high this month! Trying not to obsess about that and focus on the fact that my rise was very good compared to where ovulation temp.
*sore boobs tonight
*backache
*peeing all day long
*very tired
*bloated
*evening - metallic taste in mouth

4 DPO: Better sleep last night, but was up three times by 4 a.m. to pee. Sheesh.
*extreme metallic taste in mouth
*tender breasts
*frequent urination
Author's note: I really have a hard time believing in symptoms prior to implantation; however, last cycle I was extremely bitchy, and I am starting to feel that way again. And no, this is NOT normal for me. I went to go to bed last night and made David get OUT of bed because I wanted to change the sheets. heh heh.

The thing that has me thrown off the most is this horrid taste in my mouth. It's like the air passing over my tongue is full of metal.

5 DPO: We spent the day travelling to Edmonton, AB. I can honestly say I was enduring some heavy mood swings - not like me at all! I mean, I was bitchy, and totally wrong about everything I was bitchy about. It was un-warrented bitchyness. That sucks. I only get so many bitchy outbursts a year and I am using them up during my actual, short lived pregnancies and (?) trying to get pregnant hormones! OH, and did a poll of 35 preggo women and 58% had metallic taste in mouth during early pregnancy! Good news *manic laugh*.... Anyhow, symptoms for today....
*extreme metallic taste in mouth
*tender breasts (and ITCHY!)
*frequent urination
*lower backache
*fatigue
*mood swings

6 DPO: Well to be honest I didn't have much for signs yesterday (I'm writing this 7DPO)... we did tons of running around Edmonton, getting stuff for the store renovations and eating at our favorite restaurants. I did have the metallic taste throughout the day but it seems to have subsided today for the most part. Did have a great night's sleep but a temp drop.... possible implant dip??
*somewhat mettalic taste in mouth
*lower backache
*very tired - lethargic, even
*frequent urination - could be due to extreme thirst?? lol
*extremly thirsty

7DPO: Had a great night, woke up quite a bit and couldn't resist taking my temp. A solid 37.1 every single time..... a def rise from the dip yesterday but not fully climbing up to previous temp of 37.2.... it's the first time I've ever had a drop like that (needs to be .3 of a degree drop to be considered a possible 'implant dip'). We drove home from Edmonton today - it's about an 8 hour drive with Dave's bronco on the car trailer...

*still slight mettalic taste in mouth

*combative - mood swings

*tired - fatigued

*slightly sore/heavy boobs

8DPO - Of course I broke down and tested today.

Now I'm not going to jump up and down and start making phone calls and planning out the nursery. I'm not even really excited about the fact that most people agree it's a line - it's an IC (Internet Cheapie) which are notorious for evaporation lines, and it's at 8DPO which is STUPIDLY early to test. But it's fun to ponder - like playing bingo... and addicitive.. like playing bingo and knowing you'll eventually win.

*mettalic taste in mouth
*gassy - little burps all day (I had this as a major sign for the past two pregnancies)
*restless legs (had this last time too)
*fatigue
*mood swings
*full and heavy feeling breasts
*daytime temp consistant at 100.4 ((???))

9DPO: Back to work Monday. Argh. Tired but got off my rear and made it there to put in a few hours. Still horrible little 'burpies' all day. Tested with IC's this morning and of course BFN...so I held my pee ALL day and peed on a FRER this afternoon. I didn't see anything until it dried. Now, before you get all freaked out about me posting a dried test, I will tell you that all my early FRER's were dry before getting a good line.... and I can't find one TTC woman who has witnessed an evap on a FRER , even a dry one. So here's tonight's drama shot....




It looks "Promising". Not "Final" or "BFP!", but very promising!

*metallic taste in mouth
*burps
*lower backache
*gassy
*fatique
*heavy boobs

LPD Luteal Phase Defect

The luteal phase of the menstrual cycle spans the time between ovulation and the onset of the next menses. Luteal phase defect (LPD) is a common but misunderstood condition that frequently affects fertility.


Many people describe LPD in terms of its symptoms, e.g., a shortened luteal phase or disrupted basal body temperatures (BBTs). Quite simply, however, LPD is a failure of the uterine lining to be in the right phase at the right time. Since embryo implantation is highly dependent on the state of the lining, LPD can consistently interfere with a woman's ability to get pregnant and carry a pregnancy successfully.

A Normal Menstrual Cycle
In an ideal menstrual cycle, the body begins to produce follicle stimulating hormone (FSH) several days after the onset of menses. The increased levels of FSH result in the formation of a mature egg-containing follicle on one of the ovaries. When the follicle has adequately matured, a surge of luteinizing hormone (LH) is triggered. This surge performs two interrelated functions:
It prompts the follicle to burst and release the egg into the fallopian tube, where fertilization may take place.

As the follicle begins to refill after bursting, the increased levels of LH cause the fluid inside the follicles to change into a thicker yellowish substance.

The resulting structure is now called a corpus luteum rather than a follicle, and it is responsible for producing the hormone progesterone in the second half of the cycle. As a result of elevated progesterone levels, the uterine lining will thicken and develop additional blood vessels, which gives the embryo a place to attach. Progesterone will also prevent a premature onset of menses in which a pregnancy might be lost. In a normal menstrual cycle, the corpus luteum will produce progesterone for approximately twelve days.

A Cycle with LPD
A normal cycle can be disrupted in several places. Three causes of LPD include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems can also be found in conjunction with each other.

Poor follicle production has its origins in the first half of the cycle. The body may not produce a normal level of FSH, or the ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected.

Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. For reasons not wholly understood, the corpus luteum sometimes does not persist as long as it should. Initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses.

Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, should an embryo arrive and try to implant, the lining will not be adequately prepared, and the implantation will likely fail.

Diagnosis and Treatment of Luteal Phase Deficiency
With the above information, it is easier to understand the many symptoms associated with LPD. Progesterone is responsible for the rise in basal body temperature during the luteal phase. Women who monitor their basal body temperature will thus often note that luteal phase temperatures do not stay reliably elevated for twelve days. Additionally, women who monitor the time of ovulation often notice that their next cycle begins sooner than the normal 12-14 days after ovulation.

Once a diagnosis of LPD is suspected, a serum progesterone test will often be performed at about seven days past ovulation. A level less than 14 ng/ml indicates that progesterone production in the luteal phase is inadequate.

Should progesterone levels prove to be low, the temptation is often to "treat the symptom" by giving the patient progesterone supplementation during the luteal phase. In the case of inadequate corpus luteum performance, progesterone support may indeed be the appropriate solution. However, inadequate follicle development may also be causing the low progesterone levels. Thus, it is important to measure midcycle follicle size (via ultrasound) and estradiol levels (via a blood test).

If follicle development is normal, then progesterone supplementation during the luteal phase is normally the correct treatment. If follicle development is inadequate, an ovulatory stimulant such as Clomid or an injectable drug may be in order; these drugs help the follicle to mature more appropriately, which has the double benefit of producing a higher quality egg and a better-functioning corpus luteum.

Women whose linings fail to respond to normal progesterone levels often have normal follicle development and adequate progesterone levels at 7 days past ovulation. An ultrasound image of the lining at seven dpo, however, will show a lining that has failed to convert from the triple layer lining typical of the time of ovulation. In this case, women are often given additional progesterone supplementation in the luteal phase in the hope that a higher level will be the push that the lining needs to convert appropriately. Some doctors use injections of human chorionic gonadotropin to further stimulate the corpus luteum. However, these injections can cause false positive pregnancy results.

Endometrial Biopsies
An endometrial biopsy is the gold standard in diagnosing LPD. Many doctors feel comfortable basing an LPD diagnosis on progesterone levels, luteal phase length, and ultrasound lining appearances. However, especially in persistent cases, many doctors will use an endometrial biopsy.

The endometrial biopsy is normally performed a few days before the next menstrual cycle is expected, ideally after a negative pregnancy result for the cycle has been obtained. The procedure consists of sampling a small amount of uterine lining and sending it to a pathologist for evaluation. Because the evaluation is done at a cellular level, the knowledge gained from it is at its most detailed and precise. The pathologist categorizes the lining as being typical of a particular cycle day. If this categorization is consistent with the actual cycle day that the sample was taken, the result is considered normal, and the uterine lining is in phase. If there is a discrepancy of more than two days, the lining will usually be considered out of phase.
LPD is a common disorder, but it is fairly easy to diagnose and, in most cases, it is extremely responsive to the correct treatment. The most important part of the process is determining the exact cause, because that will determine the most appropriate treatment.

Hmmm? What's That Taste?

Bitterness, is it? Well, miss perfect can't always be perfect, right? That was not a real question, it was a self-directed sarcastic remark that I am sure a lot of people, okay, maybe only a couple bitchy ones, would love to throw at me right now. No need. I'm perfectly capable of self-flagellation. Hand me the whip.

Better yet, let me observe the world with a teeny bit of anger and resentment, that way I don't leave any bloody marks across my back and I can just be quietly, invisibly oozing emotional blood, and don't have to cause anyone around me discomfort. (or satisfaction - reflecting on said bitchy people mentioned above)

Okay. So I know it's time to snap out of it. I know I was right, the doctor was wrong, I lost the babies (I can NOT get it out of my head that I was carrying twins). And that chapter is behind me and so forth. I know it's not like me to dwell on crap that I can't change. It's. Not. Like. Me.

But this snapping out is taking a few days longer than usual. It's happening, slowly, but surely... I think that with the oncoming ovulation, a full pharmacy of progesterone supplements and a more than willing husband trying to knock me up again, moving forward is getting a little easier every day. But this one is taking days, not hours, to move past.

Several of my WTE buddies are newly pregnant. It is the first time I have felt both total joy and amazement that someone I have been 'in the trenches' with is pregnant.... and a real anger at being shoved back to the other side of the fence again. Left behind!

Sigh. Not that I didn't feel a true heartache when I last announced my happy pregnancy news on the Grief & Loss board.... so many women trying for so much longer, enduring much more emotionally fatal blows with late-term losses, infertility. I actually had survivor's guilt over being pregnant and not taking every single wanting female with me. Is it selfish to want survivor's guilt over the realization that I am still on the non-survivor side?

No Shit, Sherlock.

LUTEAL PHASE DEFICIENCY: http://www.reference.com/browse/luteal+phase

Luteal phase defect (LPD) occurs when the luteal phase is shorter than normal, progesterone levels during the luteal phase are below normal, or both. LPD is believed to interfere with the implantation of embryos.
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Sorry for the swearing. I am in a swearing kind of mood these past few days, and it's NOT related to being pregnant. It is, however, related to NOT being pregnant. Gawd. Did you get that? I had to read it twice to make sure I did.

Well maybe I'm not so sorry after all. I mean, I did just lose another pregnancy to what I am pretty sure was medical idiocy. The last words I said to my doctor two weeks ago, as he told me the beta results at 17DPO were a shitty '6', were, "What if my progesterone was still low?"

"It won't be."

"But what if it is?" I pressed, searching his face.

"But it won't be," stupid, 'you are an idiot' grin.

"What are the chances of it being low?"

"1 per cent; that's not the problem, we have you on clomid. That's taking care of your low progesterone."

"So if it's low this time, then we have something else totally on our hands?"

"Yes, but it won't be low."

"But, what if it is?" I asked again, about as amused as he was by our conversation.

"I'll be shocked."

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The JERK didn't even act like he remembered our converastion. Didn't he read his notes on my file before David and I went into the office today to see him?

"Have you started to bleed yet?" He asks me this because if I haven't, there is a chance I am still pregnant and progesterone could save the day. I know this, and it is like salt in my womb. Ya, stupid pun, I know, I know...

"Yes, I miscarried the day after I was here last time."

"Oh, yes, I see... well, I'm gladyou came in. Your results were very low, I am going to give you a little pill... you take it right after you ovulate..."

I sat down, concentrated on holding my temper and keeping my jaw off my chest. Watched him fumble through his computer until he got to my file. "How low?" I asked, dumbfounded at his ignorance. I know how low my levels are because I went to see my GP two days ago and got the number from her. I want to hear it from his flabby lips.

"Oh, here it is.... Oh! I already gave you the prescription! Um... it was 4.7, that's very low." He's realized something is up... and I can see the SHOCK settle into his features, and he's trying to cover it.

"I know it's very low. 1% chance of it being that low. But I knew what was happening.... I asked for the progesterone before you got the test results, but by the time you gave it to me, I was miscarrying."

Abrupt change of attitude, body language... he knows.... he remembers... and he knows I remember.

"There was no reason at the time to believe you needed this prescription. You must have two low readings during your lutueal phase in order to be diagnosed with luteal phase defect."

I remind him that I was diagnosed in December with my first reading, and that it takes up to three weeks to get results back. I remind him that this was my third miscarriage in a row.

He sputters, "Three?"

"Yeah," I slump back in the chair, wondering if he ever does a history on his patients and actually writes it down somewhere, "9 weeks in July, chemical pregnancy in October, and 5 weeks this time. That's three."

"Well, that puts you in a very different category..."

I interrupt, "In a 1% category."

"Yes."

And so forth it goes. He knew AFTER my tests that progesterone would save my pregnancy. I knew BEFORE my tests.

Q&A About Progesterone and Clomid - Ask Away!

I am getting a bit of a reputation for my 'progesterone' rants, and trying to do at least something in my power to make sure that nobody who knows me loses another baby because of some dumb ass doctor, or because we are not educated properly when TTC.

So... I am trying to create a space here where I can answer some of your common, unusual, or downright interesting questions. Please keep in mind that I am NOT a medical expert and am NOT 100% sure of anything I am copying, or websites I am linking to. I am just a mom with two miscarriages and an idiot for a doctor. Ex-doctor. Ahem. I digress.

Q. Will breastfeeding affect my progesterone levels?

A. When you are breastfeeding, the milk producing hormone, prolactin, is high while the menstruating hormones estrogen and progesterone are low. The more exclusively you breastfeed (no other fluids, foods or bottles), the higher your prolactin level will be, which will delay menstruation.

If you are no longer breastfeeding exclusively, your hormone prolactin will begin to drop. Eventually your menstrual period will return under the influence of rising estrogen and progesterone levels.

http://www.peelregion.ca/health/family-health/breastfeeding/your-questions/you/medications.htm

Q. Can I Take Progesterone During or Before Ovulation?

A. I searched for a couple of hours, trying to find a credible website that had information on this question, but came up with nothing except a few forum references that I didn't think were really worth posting a link to. Everything I've read tells the reader to start progesterone on the third day after ovulation (I assume to confirm ovulation has occured). The few things that I did happen to read suggested heavily that progesterone before ovulation can actually prevent ovulation from happening, or at least seriously mess it up.

So the real question is, why would you want to start progesterone before you are ovulating? Since the main purpose is to aid the body in building a healthy uterine lining, something that occurs (or should) naturally after ovulation, then it only makes sense to introduce the hormone in tandem with the body's natural timing.

Q. Will taking the progesterone vaginally seep into the uterus and harm a developing embryo?

A. Well I spent some time on this question and although there was no SPECIFIC reference to the hormone 'seeping into' the uterus (through a not quite closed cervix), there have been thousands of records of post-progesterone-supplement births, with no harm to babies. Those who use synthetic progesterone have a teeny, slightly higher rate of cleft pallet, but this risk is miniscule compared to the baby not making it past 6 weeks in the womb.

Back to the question. Progesterone inserted vaginally (or any progesterone, for that matter) SHOULD be absorbed into the body (specifically the uterus) in order to help build a strong lining. This hormone *should* be raging through the female body after ovulation, and especially after fertilization... so I don't think that something our body produces naturally will likely be of any harm to a developing embryo.

Progesterone Supplements (oral & vaginal)

Most of this was taken from an excellent blog that I stumbled across. Many thanks to the Stirrup Queen for compiling this information... as a writer I am flattered by imitation, so in my utmost belief that most of the world thinks exactly as I do (or should, anyhow), I am sure she is happy that I have endured to copy her work.... right?

Why would you be taking progesterone supplements?

There are a few reasons you might be taking progesterone supplements, which can be delivered orally, through vaginal suppositories, or via intramuscular injection (commonly referred to as PIO).

Some examples:

(1) You have low progesterone levels. This is usually diagnosed by having a blood test done 7 days post-ovulation.

(2) You have a short luteal phase regardless of the results of the 7 dpo progesterone results. I believe that any luteal phase less than 12 days is considered short.

(3) Even if your progesterone level and luteal phase are fine, if you are doing IVF (and depending on the RE, IUI) you will probably be prescribed progesterone supplements. Taking the supplement just covers your bases.

Why would you take them orally or vaginally?

The oral supplement is definitely the least invasive way to do the job if it works for you. However, when you take progesterone (or apparently any hormone) orally, it must be metabolized by the liver, which makes the delivery system inefficient and less effective.

As for vaginal supplements versus injections, for most women, there seems to be no difference in the results. Many clinics use the suppositories because they feel after all the pre-procedure injections they just don’t want to prescribe more injections. Some clinics state that when they switched to suppositories their pregnancy rates increased. However, there does seem to be evidence that some women have a better response with the injections.

What to expect:

You can expect to take the supplements until you take your beta. If it is negative, you will stop and your period will arrive. If it is positive, you will continue taking the supplements for at least a few more weeks and possibly through the entire first trimester. If you are having blood tests done after insemination or transfer and are using vaginal supplements, your blood tests may not reflect high progesterone levels. Do not freak out if your level seems low compared to your friend doing injections. The vaginal suppositories are not systemic- all the progesterone stays right around your uterus and does not show up in blood tests. That doesn’t mean it isn’t there.

The common oral supplement is prometrium. If you are taking this, expect to feel tired… fast. Twenty minutes after taking this you may feel dead to the world.

There are two vaginal forms:

suppository (yellow pill--see picture)
suspended in gel (white bullet-like pill--see picture)

The suppositories can be either prometrium (yes, the exact same pill you can take orally) or they can be pharmacy compounded. Not all pharmacies have the capabilities to compound these suppositories. I have read that it doesn’t matter if you use prometrium or pharmacy compounded. Whether you use prometrium or the compound suppositories, your dose will typically be 2 to 3 times per day.

Expect to feel like you have constantly wet your pants. The prometrium is like a vitamin E--a softish gel capsule. Prometrium is much less oozy--one or two pantyliners a day should cover you just fine. You may notice some of the yellowish coating on your pantyliner. Gross, but normal. Prometrium can be kept at room temperature. The pharmacy compounded suppositories are very oozy. These need to be kept cold or they will melt. When you take it out of the wrapper, it feels kind of waxy. But if you let it rest in your hand, the surface feels slick and oily. This is only the outer coating--if you look at the non-pointy end, you can see there is white goo inside the waxy shell. You may notice some of the disintegrated shell on your panty liner amongst the ooze. Also gross, but also normal. The suspended in gel supplement (Crinone and similar products) comes in a pre-filled applicator (the pharmacy will give you an applicator for taking the prometrium vaginally but using your finger may be more comfy and is easier to wash.). You might see some of the suspension gel ooze out.

With all of these supplements, you may feel some bloating. They also cause me to have to pee a lot--especially in the middle of the night.

David Comes Home. Tomorrow

At last. It seems like a lifetime since he left for work last September. I've seen him every month, but not for long... except Christmas, when I think we had 12 days together...... I was working huge long heavy hours..... But... the winter is behind us now, and we have spring and summer and fall and the wedding and the house and making babies ahead of us. So much to look forward to! I am beyond blessed with the men in my life. Mason, Jerry, and David... my boys.

How delicious it is as a mother and wife to have all of her family near her at once. I know it won't be forever, I know the boys will eventually find a path they'll want to follow and I know that David and I will as well. I hope the paths are close, and I hope they cross over many times each year, but whatever happens, I know eventually they'll go in different directions.