I started the process of IUI #3 on the heels of failed IUI #2 (oh, and everything else that could go wrong, WENT WRONG). It was definitely a test of our marriage, dealing with all this crap at once, but overall we did well and came out stronger. Dr. Angel agreed to discontinue the use of Letrozole and focus on the Bravelle, and this is what happened:
CD 5: Bravelle, 150iu
CD 6: Bravelle, 150iu
CD 7: Bravelle, 150iu
CD 8: Bravelle, 150iu
CD 9: Bravelle, 150iu
CD 10: Bravelle, 150iu
CD 11: Bravelle, 150iu
I started out with a handful of measureable follicles, the biggest being 9, followed by 7, and a mixed batch of 4’s, 5’s, and 6’s. I reeeeeally thought I was going to get my ‘fabulous 4’ (my goal has always been 4 follicles per cycle). But NO. From CD 8 onward, it was glaringly obvious that I was going to get my usual: 2 follicles. My right ovary simply refuses to produce any follicles (worth measuring). Even with double the amount of Bravelle. And what’s more, by CD 11 my growth had stalled, and the lead follie (Batman) was maybe 13, and the second follie (Robin) was maybe 11. So in the words of Emeril, Dr. Angel “kicked it up a notch!”
CD 12: Bravelle, 225iu
CD 13: Bravelle, 225iu
CD 14: Bravelle, 225iu
And finally at CD 14, ‘Batman’ is at 17 and ‘Robin’ is at 15. But I am now utterly confused. I have now taken 23 viles of Bravelle. My AMH was tested in November of 2012 (about 14 months ago) and my AMH is 4.57 (which is high). WHY the f*ck do I only get TWO follicles from TWENTY THREE viles of Bravelle?!!!!!
I fuggin’ tried to google “high AMH and poor ovarian response” and guess what–this appears to be such a juxtaposition that one simply CANNOT find an article that puts “high AMH” in the same sentence as “poor ovarian response”. Or, if you know of an article, please point me in that direction. I am confounded. I am set to trigger in the morning on CD 15, to be followed by IUI’s at 24 hrs post-trigger and 36 hours post-trigger. I am SO stressed that I will ovulate early and screw everything up. Or that Mr. MLACS’s sperm won’t ‘defrost’ properly. Or, you know, some other natural disaster…
CD 15: HCG Trigger shot, 10,000iu
**Uterine lining measured 10+ **Follies Measured 20+ (Batman) and 18+ (Robin)
It’s like I’m psychic. See above where I said “I’m stressed that something is going to go wrong”. Yesterday I tried to call the RE clinic where Mr. MLAC’s sperm is ‘on ice’, but they close at 4:30 and it was 4:40 when I called. So I called again this morning to see what I needed to do to get this sperm for my IUI on Saturday, and the lovely receptionist says “Uh, well our clinic doesn’t have any patients scheduled for tomorrow so the docs (the Andrologist) may not accommodate you”. GREAT. F*cking brilliant. F*cking figures. And I blame myself, because I had intended to call on Wednesday or Thursday. The receptionist said that Dr. Angel’s office could contact her office and they may “work something out”. I began to hope that the pains on my left side were ovulation pains, so maybe I could just do the IUI today and be done with it. I got in the shower and said (out loud) “Ok God, I’ve done everything I can do here, so it’s really up to you. I really hope this is ‘the one’ but I need your help, so, there you have it.” I went to see Dr. Angel and I informed his nurse of what the RE clinic told me, and then reiterated it to Dr. Angel–who told me that his ‘usual’ receptionist has a good rapport with the RE office and would make the call. And good news: I am to go to the clinic to pick up the ‘spermcicles’ at 8am tomorrow, and then (God willing, if Doc Angel’s OB patients would kindly avoid going into labor) I will have my insemination tomorrow morning as planned. Well, not exactly as planned. There will be no ‘double IUI’. I get one shot at this, since Mr. MLACS is not home to have sex to ‘cover our bases’. No pressure or anything.
CD 16: Insemination day 24 hours post-trigger (from frozen sperm) 91 million count, 14 million motile, uterine lining 11+
Today was insemination day. I was SO nervous. I went to pick up the sperm and the andrologist informed me that Mr. MLAC’s sperm didn’t “thaw well”…and I have to wonder if it’s the sperm’s fault, or the andrologist’s fault (she intoned it was the sperm). So she tells me I have 14 million motile, which is “more than enough”, and if this doesn’t work then I have FOUR MORE VILES on ice…What. The. F*ck. WHY didn’t anyone ask me how many viles I wanted to thaw?! I assumed they would do ALL of them! A**holes. I would’ve probably chosen to use 2 viles at least. I suppose they are more accustomed to dealing with people who are using sperm donors, and want to conserve the sperm so they don’t have to buy more. Well, my husband gives me sperm FOR FREE, so, I would’ve preferred to pad my investment (23 viles of Bravelle deep into this IUI already)–but wasn’t given the option. So, I went and parked and waited in front of Dr. Angel’s office, and I sobbed for a minute because I was so frustrated and nervous. Pulled it together just in time to greet the doc. We looked at my follicles, and I was hoping that they were ruptured or rupturing, but they were still there. So, the doc performed the procedure and hung out with me while I ‘marinated’ and made pleasant conversation. Then, I asked if I could talk to him and show him some studies supporting the use of prednisolone in women who are ANA+ (like myself). The doc took mercy on me and agreed to prescribe 10mg of prednisolone–I was grateful. But my worries aren’t over. I took an OPK today and it wasn’t positive. I don’t know if I’ve ovulated, and I’m afraid I will go to see the doc tomorrow morning and find my follicles still have not ruptured. In that case, this would be a predicament–the sperm from the IUI today will likely not persevere. So, if I haven’t ovulated by now, then I’m likely screwed. If I still see my follicles tomorrow morning, my ONLY hope for this cycle will be that my follies ‘stay put’ and allow me to do another IUI on Monday. So, I am not carefree. I tried to push my worries out of my mind, and I rested all day today (which wasn’t hard cuz I was really exhausted).
CD 17: Monitoring shows my follicles have both ruptured and released
I was super uneasy this morning wondering if I had ovulated. Or not. My instinct told me I ovulated yesterday afternoon, after I left the doc’s office. And as it turns out, the ‘dildocam’ showed I had ovulated sometime in the 24 hours since my insemination. So, there’s a chance that things are going to work out after all. I feel a little emotional (like, more prone to cry during those ASPCA commercials) but not stressed out. I’m going to think good thoughts.
**TTC related drugs and supplements: Metanx (folic acid), Endometrin (progesterone), baby aspirin, fish oil capsules, probiotics, *switched to prescription prenatal vitamin
**Medications: Pentasa, Buproprion, Rowasa, Synthroid AND added Prednisone 10mg post-IUI
**I have been 100% gluten-free for 4 months
And I tested with a FRER at 11dpo…totally negative. Had betas drawn that day: totally negative. My TSH has nearly doubled to 3.51 and I can only assume it’s due to my hormones, but this is BAD and now I’m going to have to rectify it. I have no idea how to proceed, but I’m not happy at the thought that I might need to sit out in March and scramble to get my TSH under 2.5 again. Also I am DONE with Bravelle and next time I use injectables it will be with Gonal-F (or at least not Bravelle). Uhg. Now I’m starting to freak out that we’ll need to move on to IVF…and then what if that doesn’t work either???