Just Another Curveball

So hubs had his urologist appointment last night. We weren't sure it was worth doing, since the concern is morphology possibly caused by varicocele and we're doing IVF anyway (likely with ICSI) but we decided to exhaust all testing just to be sure. So he went.

Based on some research regarding morphology, we were definitely expecting the urologist to mention varicocele. And he did.

But the doc was a little more concerned than we anticipated. See, it turns out that Homme InFertile happens to have some cysts. Are these caused by varicocele? Are these masses that could be cancerous? I wasn't there, and my darling husband didn't seem to ask many questions. My guess is, he was a little overwhelmed. But now I feel left in limbo. Of course I want kids and a family and all that, but my priority in this moment is making sure my husband is healthy and ok. So I'm worried of course.

He had blood tests done, and an ultrasound and is now having to do another sperm analysis and culture. After that is done, he'll go back for a follow up appointment. But that's scheduled for 2 weeks from now, which is a long time to stew in this new information.

Anyways. Not much we can do but continue to wait for more clarity. Luckily I'm really super busy working these next few weeks, so a helpful distraction I guess. Would just love to know that my lovely husband is going to be okay. Where's a crystal ball when you need one!?

"I feel drunk"

So today was the day I've been waiting for... dreading perhaps, but also excited to get done. My biopsy day along with SHG and trial transfer.

I couldn't eat past midnight so last night made a late dinner, nice and healthy, and ensured I drank lots of water before bed. I was feeling prepared and organized and proud of myself... that is, until my husband FaceTimed me. I could feel his guilt, and I tried to hold it together to not make him feel any worse, but my anxiety got the best of me and started tearing up, unable to speak. I had to hang up... it was just making me think about it all too much and I just wanted to go to sleep and wake up the next morning and get the show on the road.

So that's what I did. I didn't have the best sleep, which isn't surprising given my stress about it all. I woke up before my alarm, worried it wouldn't go off. Neurotic much!? I had a nice long cuddle with my pup. It's like a real life teddy bear!!!

Then I got myself organized and my mom and I headed down to my appointment. I didn't realize it was a holiday (being Canadian and all) and so we ended up being there really early since there was no traffic. When we got there I checked in and sat in the waiting room. Was nice to have someone there with me.

Then a nurse came out, called my name and brought me back. She was really sweet, gave me overly detailed instructions, and then left me to change. I was lookin' and feelin' pretty sexy ;)

She came back and had me fill out a bunch of paperwork - really I couldn't have done this when I had underwear on? Once that was done she put in my IV (ouch. not fun) and I was thankful she was gentle with me. I think she felt bad that my hubby wasn't there with me and that I was so visibly anxious (I couldn't stop tearing).

Once I had my IV in I had a bit of waiting time. DH texted me, only making me more emotional, and then to top it all off the first song we ever danced to came over the music sound system. Floodgates opened. I rely on him so heavily, but he really is truly my best friend and anchor and I would have loved to have had his hand to hold up until the procedure. Oh well.

My anesthesiologist came to give me the rundown on what to expect, asked me if I was allergic to any drugs (this was the 4th time I was asked today... clearly they've had a problem with this in the past haha) and then got my stats - height/weight etc. to calculate dosage I think. Then he took me into the room.

Best part? I stood up forgetting my butt would be hanging out and he had to kindly close my back for me. I clearly was so consumed in my fear I didn't even feel the al fresco situation going on in the back. Oh man.

Then we got settled and doc came in and went over our procedures, had me repeat back to him what I was having. We were talking and the last thing I remember is me telling him he was going blurry.

Then I woke up... feeling... very confused "How did they get me here?" I asked my mom, now sitting in the room. She didn't know but just laughed at me with my eyes halfway open slurring my words. "I feel drunk" I said to her. So she took some pictures of me to send my DH to let him know I was alright.

Looking goooooood haha

"I feel drunk... but I'm good!"

I had zero pain. zero nausea. And soooooo much relief. Once my nurse gave me a juice to help me refresh, and sat me up, my doc came in to debrief.

mmmm juice. Nurse offered me a second because I downed it so fast.

1) SHG - no concerns. no polyps. totally normal looking. this is good news! :) yay
2) biopsy - went well. test results in about 10 days or so
3) trial transfer - issues as expected... he had to pull with itty bitty forceps on my cervix to straighten out the path or something to that effect, and then he was able to get in. He could see why my past transfers were noted as difficult, and has a plan of action going into our future transfer now, so good thing we did it!

So that's it for now. The waiting for this "horrible" but in the end, easy peasy simple procedure is over. Now the waiting for results... That I can do. All my anxiety is gone and I feel so much better. Especially after my nap with my fur baby again. Dogs are the best!

nap time

Bloodwork cancelled!

Hey all... so my clinic called me as I was on the way to my appointment to have blood work done for immune and NK testing. They didn't realize their lab doesn't do that specific testing on Fridays....

REALLY?

ARE YOU KIDDING ME?

WTF?

These were the emotions and thoughts that rushed through my mind. I've been waiting a while to do this test, and we picked a day and time that was most ideal for my hubby (all appointments are between 9 and 11 am and he works). Had we KNOWN in advance that blood testing for NK and immune wasn't doable on Fridays we obviously would have scheduled another day earlier this week because....
.... he's away for a full week starting tomorrow. This pushes EVERYTHING back. So frustrating. I took a few deep breaths, whoosawwwwd a little (if you don't know what I'm referencing, it's from the movie Bad Boys haha) and then once I calmed myself sent this email to my doc:

Good morning Dr. _____,
My husband and I were supposed to come in today to get blood drawn for immune testing but were called last minute to be advised that it cannot be done on Fridays.
We were somewhat disappointed we were told 30 minutes before our appointment especially since my husband is away all next week. Had we known in advance, we could have done this another day earlier this week. Disappointing as this is, mistakes happen and we just want to put together a plan to move forward and I'm trying to decide whether at this point we should bother.. so a few questions would help us if you don't mind...
I noticed in some of my research that sometimes NK activity can be recognized in the uterine biopsy. Is this true?
Is there a difference between localized NK activity in the uterus versus the bloodstream?
What information would we be gaining from this testing that would alter our protocol other than possibly a steroid like prednisone or intralipids? ie. what information from Eric's or my test results would contribute to a change in approach?
In your professional opinion do you feel as though this immune testing is of high importance to our treatment? or will it depend on what results come of our biopsy/shg?
On a separate note:
What is the cost for PGS? We are considering the possibility of doing it if we have a high embryo yield.
Is PGS something we need to decide on prior to beginning our cycle, or is it something that can be flexibly added/removed as we progress?
Thank you, as usual, for your time and expertise! :)

Now hopefully I came across as a calm, sane person (inside I didn't feel that way haha). I'm a little hot headed sometimes and out of principle hate when people are stupid. I felt like this was one such instance, but not sure who the stupid individual was... haha whooosawwwwww ... let it go. poof. gone.

I did NOT mention the funny thing. What's the funny thing you ask? Well the funny thing is that all morning I had been questioning whether this was a road I really wanted to go down. Do I believe in Intralipids? Do I think its the answer to our infertility woes? The fertility industry is very torn on the topic, more heavily weighted against it with articles explaining elevated NK could be related to stresses from the blood sample drawing, to the fact that elevated NK are existent in perfectly fertile couples, to little to no evidence or correlation to therapies used and positive outcomes. I mean its all over the place. Do I want to be successful? Yes. Do I want to sit and get multiple IVs and pay out of pocket for it if I don't need it? No. Do I want to pay $500 out of pocket just to have the test when I don't know if I even want the therapy or believe in the validity of it? BLehhahghhh... I dunno!?!!? NO?

Why is there so much for an infertile to decide about!?

So moving forward, Monday I still have my biopsy/SHG/trial transfer, and part of me believes that's what I need. Honestly... part of me thinks my uterus just needs a good scratch, clean out, and ripe new start. I dunno. I feel so confused right now.


*****
update:

Doc got back to me. I think we'll forego testing and if the therapies are covered just go ahead and do them. We're only doing 2 more transfers tops at this point, so might as well go all in and give ourselves the best chance possible.
I also read this blog post of another gal, and it encouraged me to just give it a go. Never know.

To PGS or to NOT PGS... that is the question...

So I count myself incredibly fortunate to not only have amazingly supportive, intelligent friends to discuss my infertility journey with, but also one in particular who not only once upon a time offered her own womb to grow my child (you kidding me!? amazing) but who is also a genetic counsellor. Let's call her Genetic Gina. Genetic Gina is super smart, always has been. I've known her since primary school, though I recall our friendship really blossoming in grade 8. Genetic Gina has always been someone I could count on for good, solid, well thought out, and logical advice, and yesterday was no different.

Now I don't like to take advantage of my friends, so was hesitant to reach out at first, but knowing she's also not one to pry into my personal life (she herself is very private), I felt that if I didn't just ask we'd likely never talk about it. So I texted her to see if she'd be open to having a phone date to discuss the pros/cons of PGS and what her thoughts were for my particular circumstance. She of course said yes, which I was super grateful for.

Now most of my friends have no idea all the terminology and vocabulary used in IVF and fertility/infertility etc. Genetic Gina is of course different, working specifically in a fertility clinic as a genetic counsellor. So its such a nice experience to talk to a professional, who is also your very dear friend who has a vested interest in your outcome.

We started out by me explaining that it is something we are considering given our "unexplained" diagnosis. At least, unexplained recurrent IVF embryo implantation failure...
So I said that our doc believes in immune issues and I really believe that's a source of my personal problem, even knowing she's very logic/science driven and probably herself doesn't stake much weight in intralipids etc. I skimmed over it quite quickly and explained that should that testing come back negative, we are strongly considering PGS, and wanted to know if its something I should consider regardless.

Her take was basically that if I was willing to do more than the 2 cycles I'm planning (1 fresh, 1 frozen) she'd say maybe not due to the high cost and our young age. But since I'm only planning on stimming once more and then doing a frozen transfer if needed, she suggested that if I have a high yield of embryos that it would pinpoint the best place to start and would be a good way of ensuring the best possible outcome. Ultimately, if I get 10 or so eggs and we have the money, she says go for it. If we only have 5-8 eggs she says maybe consider doing an additional cycle instead. All really good advice and hard to put into words on this blog.

Anyways, a lot of our decision is going to be based on how our tests come back, and how our yield is. So its really just sit and wait until we know more at this point. But I definitely have a better sense of my plans based on various IF___ THEN___ scenarios. And on top of that I know I have her to chat to about my decisions anytime!

Just feel pretty grateful right now.

PS> if any of you are interested, here are some articles about PGS/PGD that she forwarded me to help me make an informed decision.

xx

3rd Times a Charm

So first check up I was realistic, I knew I'd need to go a second time. But then being told to go a third within a week (just tracking ovulation) kind of sucked. My body never cooperates.
So Friday (yesterday) I went back. Same old routine ensued... Vaginal Ultrasound (brrr that freezing cold blue jelly is sure to wake you up!), then bloodwork (always the same vein), and then me sitting sipping green tea latte because I get faint.

DAY 3

THE FAVOURITE VEIN WINS AGAIN

ROUTINE GREEN TEA LATTE

Because I experienced a temperature dip that morning I was hopeful I was ovulating on my own. The eggie was nice and big and all the other follicles had diminished, so it was looking like I wouldn't have to have the ovidrel shot to induce ovulation.

I got a call later in the day telling me my blood showed no surge and I would have to take the shot. BOO! My body continues to be on its own timeline haha, which I'm fine with... I'm a little slow moving myself, but not ideal for the eggie health I guess. I dunno.

So I went to the pharmacy and dished out a hundred bucks for a shot to tell my body to release the egg. This is when I really started to get cranky. I've spent a good 2 hours total this week at the doc office to track ovulation, which never happened, and am now dishing out money to make it happen, all the while being "rewarded" with injecting myself with a needle of hormones. Oh needles... how I haven't missed you... Yay. :|

THE SHOT

FAT TISSUE SQUISH

THE ITTY BITTY TEENY TINY WOUND

NOT SO BAD

The shot itself was totally fine. Not nearly as bad as the HCG shot to trigger release that I had for my first IVF. I remember it was so big I had to ice before and after. Maybe this one was smaller because I only had 1 egg to release... not sure. Fingers crossed its just gotten better in my absense and this is what I can expect during my upcoming fresh cycle cuz that was easy peasy lemon squeezie!

THEN... duh duh duhhhhh... the hormones started kicking in. As I said, I was kind of cranky to begin with, but then it was a whole new level. I think I'm super sensitive to drugs, but I started feeling uber angry at my husband (no good reason whatsoever) and emotional. So I went to bed, deciding that was just in everyones best interest haha. But then I couldn't sleep. I was hot, I felt like my skin was crawling, and some crazy ass dreams to top off a horrible nights sleep.

I woke up this morning feeling better. I definitely think I'm ovulating as the ovulation pain has increased slightly, so drugs must be doing their job.

Biopsy is now scheduled for Monday January 18th and my DH (darling husband) is going to be out of town. My mom is trying to get a standby buddy pass off my stepsister to come out and take care of me as I'll be under anethesia for the biopsy, SHG and trial transfers. When I come out of it, they want you to have a chaperone, and although I now have a few friends I could probably count on, its happening mid-morning and they all work. Anyways, hopefully my mom can score a pass, otherwise i'll just suck it up and take care of myself. Us infertiles are tough beasts! :)

Testing Phase

So the testing has begun. I went in on Monday for my first check-up at RE to be monitored for ovulation. Once I ovulate, we schedule the biopsy for 10 DPO (days past ovulation). I've been stressing because I really wanted my husband to take me as they're putting me under in order to do the biopsy, SHG and trial transfer all at the same time, just to make things easier. Unfortunately he'll be away for a week starting next Saturday, and so timing is super unfortunate in that my 10dpo looks like it falls right during that week. Of course it does.

DAY 1

Anyways, I went on Monday to start being tracked. I'm going to be sharing images of the whole experience from start (of testing) through stimming, through transfer and beta. Below is the view from sitting in my stirrups. Quite glamorous.

THE VIEW

THE VAGINAL ULTRASOUND SCREEN

TIME FOR BLOODWORK 

MY HOME AWAY FROM HOME haha

While at my first appointment, the doc actually thought I might be ready to ovulate on Wednesday and that he'd trigger me to ensure ovulation happens and that we know exactly when.

DAY 2

Well I go back Wednesday and no such luck... eggie just taking her sweet time growing. Brutal. Had I ovulated Wednesday, there was a chance the biopsy would get scheduled for next Friday the 15th (the day before my husband leaves). So doc says based on egg size, I needed to go back tomorrow (Friday) to get re-checked. Well this a.m. I had a temp spike which could indicate ovulation. The thing is, my body likes to psych me out, and I often have little random rises that don't actual signify ovulation. So who knows... and based on my egg size its unlikely, but it would be such an awesome miracle if that had of happened on its own and all works out.

If I have to go to the biopsy on my own, I know I can handle it. I'm a pretty tough cookie. I'm just a bit nervous about having any kind of adverse reaction to the meds that put me to sleep. I'd love if I had a network of support here during times like that, but we're newer to the city and although I have numerous friends (and I'm sure they'd be happy to check in on me), I just really don't know them well enough to have them see me at my sickest time. Plus, many of them don't know about our situation just yet. You don't exactly meet people for the first time and share that.. well sometimes I do, I'm quite open... but the depth of it and my sadness about it? no.

So anyways, I'm in a bit of limbo at the moment trying to figure out the date for this biopsy but I'm hopeful to have a definitive answer or plan tomorrow morning. I also called today and made an appointment for our immune testing, and that's now scheduled for the 15th. Yay! We'll see what our killer attack and sperm antibodies situation is like. Give us a sense if we need intralipids for sure or not.

It's looking like the absolute earliest we might be able to start our next cycle would be end of January which would be so incredibly exciting. I'm just not sure how quickly they get results back for all this stuff. If we don't have all our answers by then it'll be mid/late Feb which is totally fine... just a month away'ish.

Just so excited to get going on this journey again. Anxious to start stimming!!!! Gimme dem needles! haha!

xx