CD10: Itchy Arms and Follicles

Today's U/S showed 4 follies on the left, 2 on the right. TWO ON THE RIGHT! This means that my formerly dead right ovary has finally gotten a bit of life back in it. The right side has one follie at 15mm...the rest are hovering around 10. I am starting ganirelex tonight because of the larger one (one of it's dimensions was 17mm so it is at a good point). I worry about starting ganirelex too soon as it might keep the other guys from growing enough.

They'll grow about 2mm a day. I need them to be close to 17mm to trigger...so a 10mm today would be 12mm tomorrow (Tuesday), 14mm on Wednesday, and 16mm on Thursday. Dr. Italian said I'd trigger either on Wednesday or Thursday. My bet is for Thursday at this point. This would mean a ER on Saturday and an ET on the following Thursday....which means that my trip to California for Sharks Fantasy Hockey Camp the following week is going to get canceled. Crap! Oh well. At least I can stay home on bedrest for three days and no one will ask me to DO ANYTHING for them. ;-)

I did my LIT yesterday - it was a white knuckle ride because my centrifuge wouldn't spin above 2750RPM. The procedure requires a 3000RPM speed to get the leukocytes to form a pellet in the bottom of the centrifuge tube. Amazingly, 40 minutes of spinning later I got my pellet. A few washes and spins with sterile lactated ringers and we were ready.

I went back to my notes on my first LIT in Mexico looking to see how fast I reacted in the past. I think I was itchy later that night on the plane home. This time nothing really. Even this morning. But by midday, red itchy welts. Good thing I wore long sleeves to work today.

I started to panic a bit at work though. I started to think, "You know, this is really going way out on a limb to be doing LIT like this. What if I get MRSA? What if I get a nasty assed infection and I lose an arm?!?!"

But then I realize that unless you're working in a clean room (which I'm almost sure they aren't in Mexico) you're always going to have a risk of infection. I worked for a number of years processing human pooled serum into antigens that would be injected into animals. Sterile techniques are bred into my brain cells. Every step has to be careful. I even bleached my centrifuge inside and out before starting. New solutions. New vacutainers. Sterile pipettes, centrifuge tubes, solutions. Fresh gloves at every step. Nothing left to chance.

But even doing all of that still doesn't guarantee that I won't wind up with a random infection. Either here, or in Mexico, this is risky shit. I know it. I don't take this lightly. Not one bit.

CD9 Interlude: A Call for your "Just Adopt" stories

Last week while I was in California, my elderly mother took me to drinks at her friend Claire's house. On the way she tells me, "Please don't mention to Claire you're adopted. I don't want to have to answer questions about it to her". I have never met this Claire person in my life, but I agreed to keep my lips sealed.

We get to the friend's house and sit down. I've been sitting down no more than a few minutes when Claire smiles a big grin at me, clasps her hands together, and says, "So do we have any good news to share?" She's grinning like the Cheshire cat. Does she know something I don't?

First of all, I had no idea this stranger knew my private business. Secondly, what gives with my own mother telling me to keep my mouth shut about MY ADOPTION but it's OK for her to tell someone about my infertile status?

I told her quietly, "No, it looks like I lost it. It was a very early loss."

Then, the unforgivable rolled off of her lips.

Yes, she said it.

"Well you can just adopt!"

I was already dead inside from the failure I had just went through, but I was pissed that my mother shared this information with this stranger. Especially after she'd just asked me to keep my lips sealed about my own adoption.

I would have loved nothing more than to say, "I don't want to adopt because it was HELL being an adopted child!" but I didn't. I love my mother. I don't want to hurt her feelings. But let me tell you that it was no cakewalk being adopted (for me) and my experience plays a huge role in my decision to not adopt.

So drinks continued for a bit and then we left.

On the way home, I told my mother how disappointed I was that she told me to keep my mouth shut about my adoption but that she felt it was OK to share my private history with infertility. A two hour long argument with my mother ensued. In the end, I promised I'd share with her why it was so infuriating by way of printing out loads of "just adopt" rants.

She apologized. No small feat. My mother has a horribly hard time ever saying she is sorry for anything. But she did. A few tears were shed on both sides. I felt bad for being so upset with my mother. I felt so insulted. How dare this stranger tell me that my yearning for a child of my own could be so casually discarded with the wretched, "Just adopt!" Did she adopt HER child? Was that even a consideration for her? Not a chance. It so pisses me off when people who have their own biological children let this roll off of their lips with such ease. If it's so easy, if it's THE SAME, why don't they all run out and do it BEFORE they even consider one of their own?

So ladies, if you have posts or bookmarks to posts about the dreaded "just adopt" insult, please point me at them. I would like my mother to read these for her own edification on why I was so insulted by what Claire said. Maybe she'll also take these to this Claire lady so that she "gets it".

Back to my centrifuge.

It's LIT day. :-)

CD8: Damn the FSH! We've Got Follicles!

My site was down for a few days, but I'm finally back online.

So where are we?

Yesterday:
Intralipids
Baseline U/S and bloodwork
Day 5 of Femara

Today:
Stim day 4 (450 Gonal-F/night)

We did our first monitoring U/S yesterday and despite my FSH being in the stratosphere, I have follicles.

6 or 7 of them!

Dr. Italian said this could wind up being my best cycle yet (with him, that is, not with previous docs). He doesn't understand why my bloodwork showed my FSH as being so high but my follicles indicate that the value is either incorrect or meaningless.

The biggest follicle is about 10mm and the others are all smaller but they are grouped together. This is good if the cohort stays and grows together. We also saw follicles on my previously dead right ovary. Could my screwed-up right ovary be back in the saddle at last? There's still a 1.5cm endometrioma on the right side, which would explain some of the pain that I have, but otherwise it all looks good.

What is also weird is that on CD3, my lining was at 9mm. NINE? Yesterday, on CD7, my lining was at 12mm. WTF? My CD3 lining, without stims, is already thick enough to cycle with? This is weird. Just weird. And after two days of Gonal-F my lining is thick enough to transfer with? What the hell is it going to be after 9 days of stims? 17mm? I am starting to wonder if there is something WRONG with my uterine lining. I have never had a lining this thick in my entire life. I have to assume that he is measuring lining in a way that is different than my previous REs because I know of no functional reason for it to be this thick.

But anyways, I am stunned that this cycle might actually work. Stunned doesn't actually convey what I am feeling. When I heard my FSH value I was in shock. I was on the verge of thinking all was done for. A few people said to wait and not cycle, a few encouraged me to press on. So press on it what I'm going to do since I have follicles. I simply do not have the luxury of time anymore.

My next monitoring U/S is 5:15PM on Monday. I started my new job last Monday and I am so petrified to take any time off for this at all. How to get to appointments without it being noticed or frowned upon? I do NOT want to confide in my manager about this as I don't want to set off any alarms. I don't want him rethinking his decision to hire me that I am trying to get pregnant and then run off on family leave. (I wouldn't even QUALIFY for family leave being that a baby born in this cycle would be born within my first year of work.)

Do any of you ladies have any recommendations or advice about how to get to IVF appointments without using a medical reason? I would hate for my new manager to think that I'm a medical nutcase that is always going to be taking time off, but there's no way to reschedule an ER or ET. Ya know?

CD1: The LIT Laboratory is Back in Session

AF arrived today. A new cycle begins.

My reproductive immunologist's office said that LIT might have helped save my blast from imminent "death by uterus." (My saying, not theirs). OMFG. I hate hindsight.

I told them I'm using anon DS and don't know his tissue type but they said to just use my boyfriend's WBCs as it would still provide protective blocking antibodies. Wonderful. Wish I realized this before. I actually totally forgot that LIT was an essential component of my immune workup. I am an idiot to have forgotten about this.

So I've bought all the necessary supplies online tonight in order to do my own LIT again. Hell if I am flying to Mexico, the UK, or Greece to do this as I want to cycle NOW. I'm starting a new job next week and I cannot possibly fly off at this point.

DIY LIT? Why not. I've worked in R&D in an immunology lab and have excellent lab technique.

On my shopping list:

Sorvall GLC-2B centrifuge with swing out buckets
Sterile centrifuge tubes (10ml)
1000ml Lactated Ringers
1000ml Sterile Sodium Chloride
100 - 10ml heparin (green topped) vacutainer tubes
200 Sterile transfer pipettes
23g BD Butterfly syringes
Box gloves
Fritted separation tubes (already have these from last LIT)
Separation media ( "" )

All that's left to buy on the list after tonight is the gloves, centrifuge, and 23g butterflys.

I'm close. Very close.

I should be up and running in a week to a week and a half. It's worked miracles for my numbers before and should work again in a pinch.

I'm still so pissed that I sold off my collection of centrifuges and donated everything else to a vet office.

So pissed.

I feel like an idiot for not having a brain and remembering to do this before I cycled. Grrr....

The Day After Heartbreak

My site has been down for a few days so beta day came and went without a post.

Since my last post on Sunday, any indication that I was pregnant disappeared with those stabbing cramps I hate late on Friday night. Swollen and tender breasts? Gone. Crampy uterus? Gone.

Quantitative bHCG: 3

It's clear as a bell to me that I had one hell of an immune attack on my single blast. It's exactly as my first IVF was 4 years ago. The only difference was the embryos were two days younger last time (but we transferred six) so who knows if one grew really fast or how many tried to implant that time. This time, I had one. One beautiful 5 day old blast.

I am sick over this. I haven't slept in 4 days. I fall into bed exhausted and sleep a few hours. But it's light sleep and the second I awaken, that's it. I'm done for. No chance in hell of falling back to sleep again. It's been like this since Saturday night when I realized what happened. I am sure that I look like shit by now.

So my 1st and 6th cycles I had implantation that lasted maybe 1 or 2 days at most, but it was attacked by something uterine in both cases. What did I do differently this time that might have helped me get this far?

1. I kept very hydrated
2. I tried to regulate my night time body temperatures (I tend to vacillate between freezing and sweating)
3. I took 1g of famivir a day (I have HSV-1 and HPV) to try to keep my HPV under control with all the estrogen that is surging through my body
4. I took 50mg of pycnogenol a day
5. I took 250mg resveratrol a day for 2 months (stopped in December)
6. upped to 8 fish oil pills
7. 1600mg predigested folic acid (double what I took before)
8. 100mg selenium
9. 2000iu vitamin D-3 (didn't take D3 in previous cycles)
10. Acupuncture before/after transfer
11. Day of ET: Near total bedrest. Light bedrest next two days. Really took it easy until Sunday night when it was clear that it was gone.

Most of this I already did before:
12. 400iu natural E (stopped after ET)
13. Whole Foods complete vitamins
14. 1200mg calcium
15. 6 days cipro before/after ER
16. No caffeine
17. No dairy once cycle started (I'm allergic to casein)
18. No slippery foods
19. No raw veggies after ET

I am heartbroken after knowing that this one was "close" but there is this silver lining in that I now know that at 45 I am able to make a good blast capable of implanting. If I had any doubts about my last hour ability to make a child, it is gone now. I may be close to the end of my rope, but I'm not there yet.

You might be saying how do you know you had implantation with a beta of 3. Besides the symptoms and coincidence of the pain, I also have at least one friend with a story.

A fellow IF friend of mine "A.L." said that she had 8 sequential losses with the same exact symptoms as mine. (We are both patients of the same reproductive immunologist). I asked her how she knew that the stabbing pains were from an implantation and she said that essentially in the first few cycles she actually got a BFP when she POAS...the stabbing cramps would happen and she'd lose it. After the first few losses, her body became more and more efficient at killing the embryo. Eventually she would get the stabbing cramps BEFORE a BFP showed up on a HPT. So...there you have it. There are lots of other similar stories in the reproductive immunology world and I have just added myself to the list.

I went to see my reproductive immunologist today. They weren't shocked. My symptoms were all too familiar to them. Apparently there is a lot of talk about "T Reg" cells and how they affect early loss. I will be getting tested for these T-Reg cells between CD9 and 14. They said that I could do three things to try to keep this from happening again:

1. add in humira to suppress my immune system (but stop 6 to 8 weeks before the cycle BEGINS) and
2. do LIT
3. do IVIg

Lovely.

Humira can kill me. Especially with having a high risk variety of HPV which, btw, only popped up during this IVF cycle. I have had clean Paps my entire life. Apparently IVF estrogen levels can unleash HPV as a nasty consequence. It should resolve on it's own in 8 months IF I STOP CYCLING. Stop cycling? They can't be serious.

My insurance doesn't cover IVIg. At $2500 a pop it's out of reach. Might as well get a surrogate at this rate.

LIT means I either fly to Mexico, UK, or Greece ...OR... I buy a centrifuge and set up a lab again.

My vote is for buying a centrifuge. Easiest fix I can imagine. And it works.

I am heartbroken. I prayed so hard for this cycle to work. I begged for my child to come this time, and try it did. The embryo did all the hard work of dividing and surviving to day 5. I was supposed to provide a safe place for it. Instead my toxic uterus killed it. My body let him or her down. There's a lot of guilt in a failure.

So I am picking myself up by my boostraps because it's all I can do at this point. I'm a hard one to beat down. Really, I am. There will be a 7th cycle, and an 8th if that's what it takes.

CD4 - Do It Yourself LIT

Tired of flying to Mexico and doing that border crossing? Ever wanted to do your own LIT? Now you can.

$350 includes:

2 centrifuges (you could resell on ebay when you’re done or donate to a science class and take a tax break)

Centrifuge Tubes (for the last spin to get the pellet)

3ml Herparin Tubes for blood collection (Vacutainer – expired but they are OK to use)

Butterfly Syringes for withdrawing blood (Sterile, sealed, 30+)

Gauze pads

Alcohol pads

Tourniquet

Centrifuge tube stand (metal and Styrofoam)

Lactated Ringers (Might be expired now) – this is for washing & diluting the pellet. You can easily get fresh online.

Sterile Saline (enough for a few LITs) in 10ml syringes (ready to use)

Sterile Pipettes

Separation solution/media (fresh, not expired)

Instructions as copied from a medical journal on how to do this procedure. I'd love to give you mine but liability, ya know?

Use at your own risk. I did my own LIT after two trips to Mexico - it's fairly easy to do if you have a good lab background and my process gets the exact same results (or better). If not, keep going to Mexico.

Shipping definitely extra as those centrifuges are HEAVY.