Damned If You Do, Damned If You Don't

This morning was my CD10 bloodwork and ultrasound.  I'm still waiting on the "official" results, but based on what the doctor who was overseeing the u/s this morning (we'll call him Dr. L) said, this cycle is more than working.  I had two leading follicles on each side (I'll have the exact measurements this afternoon, but the largest was 17 x 14 mm, so I guess that would call that a 15-16mm follie??  We'll see), as well a several smaller (10-11 mm) follies on each side.  Dr. L said that most likely my doctor (Dr. K) will not want me to do anymore Follistim injections this cycle, because it has definitely worked better than expected, even at the lowest dose (50 IUs).

So like I said, I am damned if I do and damned if I don't.  On the Clomid alone, I was getting nowhere, but now with the Metformin/Clomid/Follistim combo, I am at risk of overstimulation.  Don't get me wrong, words cannot describe how happy and excited I was leaving this morning's appointment.  I was elated.  When I saw the follicles on the u/s screen, I almost screamed.  It was so different from last cycle where I only had a couple follies, and they never got any bigger than 11mm.  But I'm also worried; Dr. L did say that having so many lead follicles can be a dangerous avenue (unless you're proceeding with IVF, not IUI like I am).  I'm hoping to get more info this afternoon, but my biggest fear is that they will tell me this cycle is a no-go due to the risk of high multple births (triplets and more).

Is it wrong for me to say, "I don't care"?  I know that I'm probably not thinking the whole thing through right now, but it's will be hard for me to accept moving on based on a possiblilty.  Dr. L said it can go either way, and its something I should really discuss with my own doctor before making a decision.  He said you can have 10 lead follicles and not get pregnant, or have 3 and get triplets.  Its just how much are you willing to risk. 

So anyway, I'm going to try to focus on work for the remainder of the day and wait on the follow up phone call from my doctor with the official results.  I have my fingers crossed!  Most likely, if all is well, I'll be back in a day or two, and will trigger later this week.

Rollercoaster Ride

Sorry its been a few days since my last post.  If you haven't alread heard, DC has been hit with what is being called a "Snowpocalyspe".  In Fairfax, we got 28+ inches of snow, and they are expecting another 10-20 inches to hit tonight and tomorrow.  I have never in my life seen so much snow!  Here are a couple pictures from my cellphone of my front walkway and back patio:

Anyway, on to whats been going on these past few days.  For starters, as you know, I've been taking Provera, and am currently on Day 7 (only 3 more days, Thank GOD).  This time around, I haven't been quite as mean (with the exception of when I was trying to help my husband shovel our cars out... there may have been some fightin' words), but I definitely feel more emotional.  I have breakdowns over the smallest things, mostly TV shows and movies, but other things as well (more on this later).  Also, something new I hate about the Provera is that is tricks Fertility Friend into thinking I ovulated.  I hate it, because I know it isn't true.

Yesterday was a rough day.  I woke up to see yet another friend of mine who is pregnant... I usually handle this well until the total number builds up, and then I crash, which is what happened yesterday.  I'm truely happy for them, but can't lie... I wish it were me!

I also had my phone-back appointment with my RE.  This was a rollercoaster, let me tell you.  My appointment was for 5:30, and I assumed I was supposed to call her.  So I did, only to find out the office closes at 5:00, and I didn't have a direct number.  I got so desperate, I called the urgent call center just to see if they could help (which they couldn't).  This resulted in complete hysterics!  Coupled with the fact that yet another friend was pregnant, I had a complete mental breakdown.  I felt like nothing ever went right!  Low and behold, it turns out when you appointment is afterhours, the doctor calls you, which she did about 15 minutes later.  I had to pull myself together and act like I wasn't just throwing the biggest temper tantrum of my life.

So on to the phone-back (and otherwise, status update), as you know, this past round of Clomid at 150 mg did not work, so we have a new plan.  Starting today, I will be taking Metformin, and once AF starts, I'll do Clomid 100 mg CD3-7 and FSH injections CD7-9, with a follow-up u/s on CD10.  I'm really excited about the injections but also apprehensive.  So far, my insurance company has been paying for all these RE treatments, as I updated my insurance plan for 2010, but I know the total cost of the FSH can be up to $600, and I don't know if my insurance will cover it.  Right now, I am awaiting the prior authorization, which could take up to 5-days... don't they know you can't make a crazy hormone induced lady wait FIVE DAYS?!  Thats crazy talk.

Officially Out

The doctor just called and confirmed what I really already knew.  My follicles aren't developing as planned, and my estrogen and LH levels do not indicate ovulation is anywhere near.  They said I could wait it out and see, but right now I am in a medically good position to start Provera and move on to the next cycle.  So, after work, I'll be running by the drug store and starting today.

Fun times, right?  I don't know about everyone else, but the last time I took Provera (in August 2009), I was miserable... down-right mean.  There were several four and five letter words that described me.  Alot of people told me the hormones in Clomid would bring out my mean side, but really, that didn't happen with me.  The worst part of the Clomid was how emotional I was.  I would cry at commercials and any happy or sad moment on any movie or TV show.  So, no, I was not a meanie on the Clomid.  Provera, however, made me uber-evil.  I'm not sure how anyone around me could stand me.  And what was worse was I KNEW how mean I was being, and I could not stop myself.  I swear, it was like another person walking around in a Lindsay suit!

Needless to say, I'm not happy.  I was silly to think my first cycle with the RE would be a successful one.  I have a phone-back appointment with my RE on Monday, where we will discuss whats next.  I'm hoping to move on to injectable meds, but we will see.

No Dice...

No such luck, it seems, for this cycle.  Today is CD21, and I had yet another follow up u/s (this was number 4).  My lead follicle was only 10-11mm... which, confuses the heck out of me.  On Sunday (CD18), the lead follicle was 13mm, so please tell me how it is back to 11mm again (which is what it measured for both my first and second u/s).  Do I somehow have magical disappearing follicles???

So, at the end of this appointment, I didn't get the cheerful "We'll check again in a few days"... It was more "Well, by now the Clomid should be working, and isn't, so we can give you Provera so you can move onto your next cycle".

I'm super frustrated.  My last few cycles, I have O'ed, but very late (CD26-29 range).  I was really hoping with the increase in dose, this cycle would be even earlier, but guess not.

And now I am torn.  Should I go ahead and start with the Provera or wait it out to see if I O late?

Time to make a Pro/Con list, I suppose...

The Little Engine That Could

Yesterday (Sunday), I had a CD18 follow-up ultrasound.  To refresh your memory, I had ultrasounds on both CD12 and CD15, both of which showed my lead follicle at only 11mm.  To be able to proceed with the trigger (hCG) shot, your lead follicle needs to be at least 18 to 20mm.  So, needless to say, I was not progressing as I should on this round of Clomid (150mg CD5-9).

Ideally, your follicles should grow 2-3mm per day.  At my follow up appointment yesterday (3 days after my last ultrasound), my lead follicle was at 13mm.  Not too much progression, but at least I am getting somewhere... even if it is only 2mm in 3 days.  The doctor doesn't think this progression is caused by the Clomid, though, because you should expect to see a ready follicle by CD18.  Which bascially means I am suffering these hot flashes and night sweats for nada.  Good times.

So, I'm still in the waiting game, but at least I am starting to feel like I am getting somewhere.  I'll go back on Wednesday, CD21, and hopefully my progress will improve.  Keep your fingers crossed!!

CD15 Ultrasound Isn't What I Hoped

To update on my current status, today I had a CD15 follow up ultrasound to check my follicle size.  To recap, I had an u/s on CD12, at which time my largest follicle was only ~10-11mm.  To be considered mature and ready for ovulation, the follicles would need to be ~18-20mm.  So they told me to wait a couple days and come  back in to check on the progress.

So, as directed, I came back in this morning, and it doesn't seem like there was much improvement.  I didn't get the exact measurements yet (my doctor will call back this afternoon and let me know the formal results), but based on what they said, it didn't look like there was much growth... I'm guessing it is probably ~12-13mm right now.  Normally, your follicles will grow 2-3mm a day, so the news that I probably only grew 1-2mm over 3 days is disappointing to say the least.

Of course, this left me feeling pretty down.  I've already spend the past 13 months feeling broken, but today, its worse.  This cycle, I took 150mg of Clomid, which is supposed to be the max dose (I know some doctors will go higher), and based on what the doctor said this morning, it doesn't seem like its working.  He said typically he expects to see results between CD15 and 18. 

So now, I just wait.  My doctor will call this afternoon to go over the formal results of both my bloodwork and today's u/s and let me know what the next step is.  Likely, I will go back in a couple days to see if they are growing.  If they haven't, then they will likely consider this cycle unsuccessful, and I'll start over again next cycle... big disappointment!


UPDATE: Well its worse than I thought... it turns our my lead follicle is still only 11mm, which means there really was no improvement over the past three days.  I'll be going back in on Sunday (CD18), but it doesn't seem too likely that this cycle will work.