And I thought my medicine cabinet was full before…

Here it is! The complete list of medication and other stuff coming from the pharmacy bringing this bill to $5753.07 with insurance covering a whopping $9.38 – oh yeah, and they covered the BC pills, too.

 

Medication SIG Quantity Refill Substitution
Dexamethasone 1 mg – Tablets 1 PO Q am, start 2/14/13 15 0  
Doxycycline 100 mg – Tablets 1 po BID x 6 days, start after trigger 12 0  
Ganirelix 250mcg Prefilled Syringe — mcg – Injection Start when directed in the evening, SQ 5 1 DAW
Menopur 75 IU – Injection Inject 150 IU SQ qAM, start 2/16/13. 20 1 DAW
Syringe 3cc 22g 1.5 in — N/A – N/A To mix Menopur, Saizen, Novarel 30 1 DAW
Needle 27g 1/2″ — N/A – N/A To inject Menopur, Saizen 30 1 DAW
Novarel 10000 IU – Injection “Trigger injection” take as directed 1 0 DAW
Follistim Pen Device — N/A – N/A To inject Follistim 1 0 DAW
Follistim AQ 900IU Cartridge . IU – Injection Inject 225 IU SQ qAM, start 2/16/13. Keep refrigrated. 2 1 DAW
Follistim AQ 300IU Cartridge — IU – Injection Inject 225 IU SQ qAM, start 2/16/13. Keep refrigrated. 2 1 DAW
Needle Disposal System — N/A – N/A Use as directed 1 0 DAW
Nexium 40 mg – Capsule 1 PO qPM, start with trigger 2 0  
Saizen 8.8 mg – Vial Inject 0.6mL SQ qAM, start 2/16/13. Refrigerate once mixed. 2 0 DAW
Tylenol #3 30 mg – Tablets 1-2 tabs po q3-4 hr prn pain after egg retrieval. 18 0  
Needle 27g 1 1/4″ . None – Injection UAD IM FOR TRIGGER 2 0 DAW

An IUI cycle with Injectables

One IUI cycle with letrozole and injectables looks like this:

Day 2: Transvaginal Ultrasound & blood tests
Day 3: Letrozole pills
Day 4: Letrozole pills
Day 5: Letrozole pills
Day 6: Letrozole pills
Day 7: Letrozole pills
menopur shot foronemenopurshot

Day 8: menopur shot

Day 9: menopur shot

Day 10: Transvaginal Ultrasound & blood test
hcg trigger shot foronehcgshot

Day 11: IUI

Day 13: luteal hcg foronelutealhcgshot

Day 16: luteal hcg

Day 19: luteal hcg

Day 28: Home Pregnancy Test

IUI #2 Again!

Here we go! Day 3 of this cycle.
5mg Letrozole days 3, 4, 5, 6, 7 in the A.M.
75 units Menopur days 7, 8, 9 in the P.M.
Ultrasound on day 10, hopefully followed by HCG trigger and IUI then BFP, right? That’s how the plan goes… right?

P.S. Anybody else have night sweats and trouble sleeping leading up to a new cycle? I’m also wondering if I’m losing more hair than normal. My estrogen has been really high (95 yesterday). Maybe that’s a cause? Anybody else? Ideas? Should I be asking my doc about this? I suppose so.

Anovulatory

I looked it up. “A menstrual cycle in which one does not ovulate and oocyte.” Well, thank you. I actually wanted to know more about it – why does it happen? when will it end? is it possible to just have a reeeally long cycle and end up ovulating?
I just feel surprised that this would even happen. I have been taking my basal body temp. for over a year and this has not happened before. In the year before that, I kept track of each cycle length. I suppose it is possible that one of those could’ve been anovulatory, but they were all right around 28 days… I guess if this cycle is around 28, I will know it could happen and still be considered a “normal length.”
Still temping and it has gone up .7 degrees a few times only to fall back down the next day. Strange. I don’t know why, but every month I am hopeful that we will get the news we want and the end of each month leaves me hope crumbled. Now, I find myself hopeful again even though the IUI has been cancelled, I’ve been told I’m not responding, that this is an anovulatory cycle, and every day taking note that my temp. is not doing what it should… I still am hopeful.
Thankful for my amazing husband, supportive family, and our jobs.

IUI #2 delayed

We used the same protocol for this IUI as the last (letrozole cd 3-7) and I ended up with another no LH surge ultrasound on a Sunday morning. This time, I didn’t have one monster-size follicle that was beginning to ovulate, I had a large number of small ones. My hubby was watching the ultrasound screen I couldn’t see this time and he said he counted around 10-12. There were six larger ones, with the largest of those only being 12 mm. (4 follicles 10 mm each in right ovary; 1 follicle 11 mm and 1 follicle 12 mm in left) They want to see them at least at 18mm before triggering ovulation. With six, they are concerned about multiples, so I will continue using OPKs and will also be monitored over this next week, starting with another ultrasound on Tuesday morning.

Hopefully, a couple of those six take charge and dominate, growing nicely over the next few days so we can have the best chance at success this cycle. It feels so strange to talk about my body like this. There is so much our bodies do while we are oblivious to it all. If only I could go back to being oblivious…

Update: The ultrasound Tuesday morning showed no progress. Lining at 5.8. I get to keep testing and do another ultrasound Thursday. (left ovary: 12mm, 9mm, 9mm – right ovary: 10mm, 10mm)

IUI #1

Of course, things can’t go the way that would be convenient… My ovulation tests didn’t detect a surge until I went in for an ultrasound this morning. That means a Sunday IUI it is! Excited, but I feel bad making people work on a Sunday morning.

The ultrasound this a.m. showed one follicle in my left ovary that was as big as my whole ovary! I didn’t know they did that. There was a little fluid around the follicle which evidently means that it is in the beginning stages of ovulation. We could have done the IUI today, but since we were told our best opportunity would be tomorrow morning, we’re going that way instead.

The femara/letrozole didn’t have any side effects that I could tell of other than the extremely sensitive scalp, which the DHEA caused before all on its own. I have the HCG which arrived the other day in the mail. The needles freaked me out. I’ll learn how to do that part tomorrow after the IUI and I might google for some videos just to be prepared.

I am so thankful to have met people along this journey who can share their experiences. I have also relished reading all the success stories and messages of hope. Thanking you all for sharing your journeys!

Let the Testing Begin

July of 2011, we met with my OBGYN. I felt anxious, but excited and had faith that she would know exactly what to do. She did not see any red flags in my history and no reason to be concerned. She advised us to consider the Clomid Challenge along with some blood tests to see how my body responds. I wasn’t sure if I was ready for that yet, so she recommended ovulation predictor kits, ClearBlue Digital – which worked really well for me and eliminated any confusion with results. The tests were positive on days 11 and 12, then on day 12!

September of 2011, we decided to go forward with the Clomid Challenge and Semen Analysis. The SA was “normal in every way” and they even remarked “we don’t often see people with such high numbers in all areas” Yay! I took 100mg of Clomid on days 5-9 and actually felt quite good, a little loopy, but quite good. Blood tests planned on day 3, day 10, and 10 days past ovulation.

October of 2011, I get a phone call that my blood test for 10 days past ovulation is canceled because of the day 3 test results of my AMH level. My OBGYN had consulted a reproductive endocrinologist about the results and they were referring me to move on to the endocrinologist immediately. My AMH was 1.0 and, at age 28, that was “low.” I was told that we had a 10% chance of conceiving on our own and 30% with IVF.

The earliest date I could get in to see the reproductive endocrinologist was late October which left me a few weeks to worry, stew, and do “research” along with calling my insurance company to find out they cover nothing beyond testing and diagnosis and they only cover up to $2000 total for a lifetime of infertility testing and diagnosis.

During this time, I met with an Abdominal Massage specialist who was also an herbalist. She had an amazing ability to help me understand what was going on with my body, what could be done, and what next steps could be. She also talked to me about what she could do with herbs and massage – the massage was amazing! I went to visit her again in November and she taught me how to do the massage myself to increase blood flow to my reproductive organs.

My appointment with the reproductive endocrinologist involved even worse news – only a 1% chance of conceiving on our own. She recommended the most aggressive approach – IVF with strong meds. She told me that statistics show I would go into menopause by age 32 or 33 and that I have ovaries of a 40-year-old…. Not what a 28-year-old dreaming of a family wants to hear. She ran down a list of indicators for my low AMH – family history, drug use, infections, surgeries, etc. She could find no reason for my low AMH. We were able to do an ultrasound to count my follicles (antral follicle count) and found 8 in my right and 5 in my left ovary – many more than she expected to see with such a low AMH. A “normal” count for age 28 would be around 24 or 25 follicles. The RE recommended Acupuncture, but didn’t know of any other “treatments” to improve my AMH level. We asked to have my day 3 tests repeated since all the other hormone levels were great. We also agreed to have tests done to identify if I carried any genetic mutations or conditions that could prevent pregnancy or explain my infertility. Genetic tests all came back normal.

November 2011, I began Acupuncture. I find it very relaxing, cleansing, and re-energizing. I think I will continue with acupuncture as part of a healthy lifestyle. I also began a diet focused to aid Traditional Chinese Medicine. My acupuncturist adds herbal supplements to my daily intake of prenatal vitamins and calcium supplements. I also began taking my Basal Body Temperature in October even though my OBGYN and RE didn’t see any reason to. My acupuncturist and the abdominal massage therapist both value the information from basal body temperatures. It is also much cheaper than continuing to buy ovulation predictor kits – and I don’t have to pee on anything!

Day 3 tests are repeated and they match the first tests from September. My AMH is 1.1, so I take that as an improvement :) and credit it to my massage, acupuncture, diet and herbs along with doing my best to de-stress.

December 2011, HSG was performed and my fallopian tubes are clear. My uterus has a little indentation, but not a full-blown septum. Nothing the RE was concerned about. I had major cramping during the HSG – the kind of cramps that make you nauseous and send that warm wave across your body. Once the catheter was removed, cramps were minor. I spotted the rest of the day and had achy cramps, but nothing that stopped me from my normal activities.

My husband and I have decided since my schedule is so busy during January, we’ll wait until February to consider IUI with Clomid. I’m not interested in pumping my body full of medication, so I will ask about any other options (Femara, Lupron, Injectables?).