Checking In

Just a little post to check in. This break has been amazing for Scott and me so far. It has been great to be away from the charting, appointments, monitoring and medications. My body is adjusting back to life without meds and I think that my sanity is finally beginning to return to me!
I've been focusing on work, working out, and enjoying what I do have. Scott and I have planned some great camping trips for the summer, and I am thrilled that I can enjoy a beer or a glass of wine without worrying what cycle day it is and whether or not I should be imbibing.
We are looking forward to spending the Fourth of July weekend with friends and family.

Summer Break

Well, Aunt Flow arrived again. I am feeling okay about it and Scott and I are ready for a real break. We are taking the entire summer off. Our original plan was to do 3-4 cycles with Femara and Ovidrel, the meet again with our RE and move on to injectables and IUI. We just finished our third cycle of the Femara. We talked and both decided that we could use some time off. So, we will wait a few months before we meet with our doctor and discuss our next plan of attack.
I will still blog, so please keep checking in. We have a lot to figure out over the summer.

Second Opinion, Support, and General Updates

Lately I have been second-guessing the approach my current RE is taking with our treatments. Since my diagnosis of DOR we have been doing medicated cycles with Femara and a trigger shot. We are in our third cycle and only have one more round to go before we regroup and discuss other options.
In my slightly obsessive research I discovered that most women with DOR go through more aggressive treatments. After our first cycle on Femara, I called my doctor and asked if we should move on to something more aggressive, like injectable meds and IUI (aka artificial insemination). She wanted me to stick with the Femara treatments for a few more months first and that she has had a lot of success using it to treat unexplained infertility.
But, I don't have unexplained infertility. I was diagnosed with diminished ovarian reserve, remember?!?!
This brings me to last week. I received an email from a RESOLVE partner which led me to investigate other clinics in the area. I made an inquiry and the actual doctor from the clinic called me! I missed his first call and he left me a voicemail. I was very impressed. We played phone tag for a few days but I was finally able to speak with him. We spoke for about twenty minutes and I gave him the run-down on my numbers (FSH, AMH, AFC, SA) He said that he would take the same approach by starting with a few cycles on Femara and then regrouping to discuss our options with injectable meds and IUI. He did say that given my slightly elevated FSH (he said slightly! Maybe my numbers aren't as bad as I feared) that if we moved to the injectables he would take a more aggressive approach. He also said that with my age, he is not as concerned with the elevated FSH and has had great success in treating cases like mine.
I did some more research on their clinic and found that they have been very successful. The only downfall is that the clinic is about an hour from my house. We will need to seriously consider this issue as we decide how to proceed.
This conversation made me feel so much better and renewed my faith in my RE and our current plan.

---------------------------------------------------------------------------------

I may have mentioned to some of you that I found a support group. Resolve had been a great resource for me lately and I found that they offer real-life peer led support groups. I went to my first meeting just about a month ago. There were about thirty people there; some couples but mostly women there without their husband or partner. Being surrounded and supported by others feeling the same things I am, going through similar struggles, was really rather wonderful. While at the meeting I found out that there is a second group that meets during the month as well. Some of the women and couples go to both meetings. I decided to go to the second meeting. Each group meets once a month, and the meetings are two weeks apart. So, I am now going to both meetings and it has been a very good thing for me. Scott isn't quite ready to go yet, but he is incredibly supportive and glad that I am enjoying them. This seems to be the popular theme with most of the women who attend, the husbands like to stay home. Which really is fine with me. We all deal with this differently and do what works for us.

Fingers Crossed

I went in to the RE's office this morning for my mid-cycle bloodwork and ultrasound. This cycle I went in two days earlier than what we normally schedule. This is because the Femara seems to make me ovulate sooner than I do on a non-medicated cycle. The last two cycles I took Femara I had to call the doctor the day before I was scheduled for monitoring. I was already getting a positive OPK and because of this I had to rush to the office to do my bloodwork and ultrasound a day ahead of time. We decided to be proactive this time and start the monitoring a little early.

At the office there are two ultrasound technicians. For my first cycle of monitoring, I had the "good" tech. She talked me through the entire ultrasound, telling me how many follicles she saw andthe size of each follicle. She was great. The next two times I had the "other" tech. She was all business. She didn't chat, didn't tell me what she saw, and I had to wait until the nurse called me later that afternoon before I knew if I had any follicles at all.
This morning I had the good tech again! She talked me through the entire ultrasound, told me that there was a 21mm follicle in my right ovary, along with three other small ones. The three other follicles won't mature and release an egg. My left ovary also had three small follicles which won't release eggs. This may not sound like the greatest news, but I think it is fabulous! This means that I do have a good number of eggs left. This means that my diagnosis of DOR isn't all that horrible. This means that if the Femara doesn't work then I have a really great chance with Bravelle or other injectables.
The good tech also gave me an ultrasound picture of my one fabulous follicle. I took the photo with me and tucked in into my purse.

The nurse called me this afternoon and confirmed what the good tech told me. I have one fabulous follicle in my right ovary and a handful of smaller follicles that aren't large enough to release eggs. My E2 was 97, which seem a little low, but it is earlier than when I usually have the blood draw so I am not concerned. She didn't give me my actual LH level but just said it was still low and that is good. I took an OPK (ovulation test) tonight and it is still negative. So, now I take the Ovidrel shot tomorrow morning and the waiting game begins. Here's to hoping that this cycle works!

Amaze-balls!

National Infertility Week ended May 1st. I ran across this video on many, many websites over the week and wanted to post it here. A project was started on one of the infertility blogs, I think it was on Stirrup Queens, and it was called "What IF". In the online communinity IF stands for infertility. The "What IF" project allowed those struggling with IF to all post a "What IF" comment on the board. It could be a fear, a hope, anything you wanted. The project receive a lot of attention, and one woman made a video of her "What IFs". It really touched me, and I wanted to share it.

What IF? A Portrait of Infertility from Keiko Zoll on Vimeo.

Another One Bites the Dust

Well, just as I suspected this cycle was a bust. Aunt Flow made her appearance this afternoon, exactly on schedule, just like she has for the past 25 cycles. Is this really happening to me, to us? I don't even close my office door any longer when I call the RE, speaking clearly into the voicemail saying:
"This is Corinne. My medical record number is 12345678. I am calling to report the outcome of this cycle. I started my period this afternoon. I will be staring my next round of Femara on cycle day three and I need to make my appointment for my cycle day twelve bloodwork and monitoring. Please call me back, you may leave a message if I don't answer."
Then I hang up and dial the online Fertility Pharmacy and order my Ovidrel. "This is Corinne calling to refill my prescription for Ovidrel." With my door still open, I hang up and call my local pharmacy to refill my Femara, and I cross my fingers when I pick it up that my insurance is still allowing the co-pay and that I don't have to pay the out-of-pocket cost because after all, I am using it for a fertility treatment, which is not supposed to be covered by my insuranse.
The Ovidrel is shipped to me at work in a huge refrigerated Federal Express overnight box. When our warehouse manager delivers it to my office the morning it arrives, I will have to immediately take it out of the package and put it in the refrigerator in our break room. I hope no one is pilfering the fridge later that day, looking for a sweet treat to steal, peeking into my goodie-bag only to find a prescription box with my name on it, containing a syringe filled with my next month of hope.
I am not really sure what I feel tonight. I am a little sad and a lot empty. Is that even possible; to feel a lot empty? I am really beginning to wonder if this is going to work. The more I read about Diminished Ovarian Reserve, the more afraid I become. Reading blogs and other women's experiences telling me to run, do not walk, do not pass go, but run like the wind to the nearest RE and inquire about IVF. Like yesterday.
With each passing cycle, I am afraid that I am coming closer and closer to never being a mother. What if this never happens for us? What if I am only able to watch other people's children grow up? What if it's only Scott and me? I don't think I can handle that possibility.
I've listened to all sorts of advice. Take a break, take this vitamin, take a deep breath, take some time to relax, take some royal bee jelly, take some wheatgrass. Okay, well, I don't know what to say to those things. My whole body aches to see those two pink lines.
So, do I take the Femara or do I take a break? What if I break? I just don't know if I can take any of this anymore.

Just a Little Update

I haven't posted in a while and I thought I would try to recap the past month or so. I was seriously looking into starting acupuncture, I even scheduled an appointment for an initial consult and acupuncture session. I was inspired by the book The Infertility Cure. It discusses Traditional Chinese Medicine as a treatment plan for infertility, which uses acupuncture and Chinese herbs.
The week before the appointment, I got cold feet and canceled the appointment. While it was with a certified TCM practitioner, the practice was through the Oncology Department at a local hospital. I felt that if I was going to see at TCM practitioner, I really want to see someone who specialized in women's health and infertility.

Scott and I also took an entire cycle off. It was freeing for the first two weeks or so, but then I was feeling a little sad that we missed our window for that month. It made me realize that while there can be enormous amount of stress during a cycle, I am willing to endure it for the hopes of a successful cycle. I waited impatiently for my period to start, and when it did, I called the RE's office to let them know that Scott and I were ready to start another medicated cycle.
I filled my prescription for the Femara, and ordered my Ovidrel from the online pharmacy we've been using. It saves us nearly $70 each month. I also scheduled my mid-cycle monitoring for Tuesday the 13th, which consists of blood work and an ultrasound. Monday I took an ovulation test, and it was positive. Well, it really shouldn't be positive until Tuesday or Wednesday, so I called the RE's office when they opened at 9;00. I didn't know if I should wait and go in for my scheduled monitoring the next morning, or if I needed to go in that same day. The nurse called me back at 10:00, asking if I could come down now for my bloodwork and ultrasound. I was hesitant to have to leave work, but after talking to my boss, she said to go ahead and go. I didn't share all of the details with her, but she does know we are going through some type of fertility treatments.
I went to the office for the monitoring, then went back to work; two hours later. Ugh. The nurse called back that afternoon to tell me that I had two mature follicles, one at 25 mm and one at 17 mm. My E2 was 486, so everything looked good. I was told to take my trigger shot that night. For those of you who are not familiar with a trigger shot, it is used to release the mature eggs that my body is producing for better timing. I got home from work, took the trigger shot, ate dinner, and then I got a migraine. Those of you who know about my migraines know that once I get one, I am relegated to the dark and quiet until it passes, which is usually about six hours. Needless to say, there was no baby-making going on that night. Which means that I probably lost another cycle, and any hope for having a 2010 baby.

I was and am pretty upset about it. But, it is not anything I can control. It is frustrating to think that we paid all of that money for the monitoring and medications and then missed our window for this month.

The good news is that I finally decided to go to a peer-led support group hosted by Resolve. They meet once a month, and this month they also had a guest speaker who is certified in Traditional Chinese Medicine. The speaker was interesting, and the group was amazing. It felt good to be surrounded by other women and men who know what this journey is like, who have been there and struggled too. I met a few women, got some email addresses and phone numbers, and will definitely go to the next meeting. It's a 40 minute drive on a Friday night, but it was so worth it.

Taking a Break

Just a short little post to update those of you who are following our Blog. My first cycle on Femara and Ovidrel, which was our 23rd cycle trying to get pregnant, ended this afternoon when I started my period. Scott and I have decided that we are going to take a break for a cycle or two. I need a little break from the charting, monitoring, doctors appointments, and generally the stress. Scott is being wonderfully supportive and agrees that a little break could be good for us.
We will resume the treatments and trying sometime in April or May.

So, How Are You Doing?

This is a question I hear quite frequently from family and friends. When I hear it, I am reminded that others are thinking of Scott and me during this journey. I know that the question comes from curiosity and wonder and care for us. What I don't know is how to answer the question. I usually tell people that things are going well, briefly explain where we are in our process, mention a medication or two that I am taking, and then say how I am really hopeful that this is the month for us.
What I don't say is how hard this really is. How I never in a million years thought that after nearly two years Scott and I would be here as only the two of us. That at times, the grief is nearly unbearable. During this process I have been excited, hopeful, afraid, terrified, angry, hopeless, fearful, jealous, tired, crazy, numb, relieved and disappointed. And thanks to some of the medications, I can feel all of these feelings over the course of one day!

Sometimes I wish I could post a list of the questions and comments that are acceptable to ask me along this journey. The problem is that what is acceptable one day, might set me off the next.

I guess as an outsider, someone who has never struggled with this, some can't quite grasp the daily reminders that I have had to learn to deal with. The friendly co-worker who asks me, as I am leaving work early to see my RE (fertility specialist) for yet another round of blood work, if I am going to the doctor for bloodwork to confirm I'm pregnant, when I never even mentioned the word bloodwork in the first place. I want to say "No, I'm going because after nearly two years I can't get pregnant and we're trying to figure out if I ever can." Or, "No, I am going see my doctor so she can tell me that I have few eggs left, and my chances of ever getting pregnant without serious intervention fall somewhere between slim and none." Or the co-worker I pass on my third trip to the bathroom in the past two hours because I have a case of the stomach flu starting, and they say "Don't worry kiddo, it will get better." I want to respond "It's not morning sickness you asshole, I have diarrhea". And then I realize I need to put my own feelings in check. That people may just be curious and hopeful. They may or may not realize that so much time has passed and I am still not pregnant. (All of these things have actually happened to me!)

I wish there were magic words to say, a finite list of acceptable questions and responses I could provide to family and friends so that people aren't afraid to ask me how I am doing or what is going on. I wish there was a sign I could wear that says "Please don't assume". But, I guess the best I can do is to tell you that it is okay to ask me what is going on and how we are doing. I really don't mind talking about it. My responses might not always be short or pleasant, but it is good for me to share some of what is going on.

RESOLVE Article

When I received my diagnosis of DOR, my doctor handed me a pamphlet about an organization called RESOLVE. It is a national infertility orginaztion providing support and resources to those of us struggling with infertility. It was quite a blow when she handed me the information. I couldn't believe that I was actually diagnosed with infertility let alone that she thought I needed support. It took some time, but eventually I perused the website, reading some articles and finding many useful resources. Today I found an article I wanted to share.
I found that most of the points were really great, and that a few didn't really apply to me and what I am feeling. I realize that when people ask questions or offer advice, they are doing so out of support and curiosity. The intent of this post is to let others know some of the feelings we may have when these questions or advice are offered. I hope that the article will help some to understand some of our struggles and feelings. I also hope it doesn't deter anyone from offering advice or asking questions.
I have felt pretty accepting of my diagnosis lately. And after reading the article, I realize that I am indeed going through the grieving process. I am finally at the point where I have accepted the diagnosis and we are ready to tackle it with whatever we can emotionally and financially endure.
There was a point where I was incredibly angry, and unfortunately that fell right over the holidays. Thanksgiving and Christmas were extremely difficult for me, and for Scott as well. But I think we are in a better place now. I can talk with others about what is going on and share our diagnosis and treatment plans. I can answer questions without tearing up or becoming angry. And I hopeful that very soon I will be able to share good news and joy with our family and friends.
The article really affected me because I was able to see that much of what I am feeling is normal! Finally, I am normal. The blog has helped me to express what we are going through and for me to work through my feelings. I am glad that I finally decided to share it with friends and family, and I hope it helps you to learn as much as you are comfortable with about our diagnosis and treatment.
I will continue to keep the updates as "PG-Rated" as possible, and spare the public from the more personal details.