Wednesday, December 23, 2015

Deciding Our Next Step: Meeting with our RE

I was lucky to get an appointment with not too much of a wait - RE's offices are typically so busy with the day to day monitoring of patients actively cycling, there are a limited number of slots available to just talk. Our RE is an extremely nice guy and really spends time with you during your appointment. During this visit, we spent about an hour with him. 

We discussed all of our options. We could continue to do Clomid, since I haven't had any negative side effects and responded very well to the 100 mg dosage. We could do injectable IUI cycles. Or we could to IVF. Since we got pregnant once through IUI, he thought that was our best option. He mentioned that while injectable IUIs have higher pregnancy rates, they are much more expensive. In my case, he said I would need very little medication and would only need to buy one Follistim pen, so that wouldn't be too bad. But with all the monitoring ultrasounds and bloodwork, that quickly raises the price to roughly $4,000. For comparison, our IUIs with Clomid and limited monitoring only cost us $550. The base price for an IVF cycle (no meds included) is $8,800. So his reasoning was that if we wanted to do injectables, it would be better if we just did IVF because the chance of pregnancy is drastically higher than the IUI. We totally agreed with this!

Together we ended up deciding on three more cycles with Clomid at 100 mg and IUIs with limited monitoring. If we are not successful after three cycles, we will revisit the plan. Our RE also mentioned that my AMH level, which is 3.7, was excellent and indicated I would respond very well to injectable medications. But it also meant there was no rush to be pregnant immediately - I have plenty of time. So if we don't feel comfortable moving past IUIs, he wouldn't have an issue with us doing three additional IUI cycles, but just switching to Femara instead of Clomid. 

We also discussed IVF a bit. He felt that if we chose to do IVF, which he was very clear to say he didn't think we needed it at this point, that he predicts that I will produce many high quality eggs and have a very good chance of having enough eggs left over for freezing that I will never have to worry about fertility again. I have to say, that is such a nice thought! 

It also feels great to have options. Our doctor really let us decide what path we wanted to take. He gave his recommendations and listened to what we wanted, giving the positives and negatives of each approach. We had our heart set on doing more IUIs, so this is exactly what we were hoping to hear!

I'm cleared to start our next cycle on Clomid as soon as my period arrives. Unfortunately, my cycle is a bit off still after the early miscarriage. This looks like the longest cycle I will ever have! Yikes! Just can't wait for this cycle to be over with so we can move on and try again.

Wish us luck!

Monday, December 7, 2015

Not Our Happy Ending...

I wish I had a better update to share. We aren't at our happy ending just yet. It looks like we're just getting started...

In my last post, we were ecstatic that we had just found out we were pregnant! After so long and so many months of it never being "the month".. we were in disbelief. I felt very cautious about the whole thing. But my first clue that something was wrong came even before the pregnancy test. A few days prior, I started feeling a little odd. Some very strange pains in my stomach, although I hadn't eaten anything recently, and I was even woken up in the middle of the night with strange tummy aches. I assume it was some sort of indigestion and took Tums.

But it wasn't just a tummy ache.

It was the worst illness I'd ever had in my life.

But I didn't know that just yet! I happily called our RE's office and spoke to my nurse, who was so happy to hear the news. I was scheduled for a blood test in a few days. But then I started really feeling sick. A strong feeling of nausea. Could this be morning sickness so soon? Googling led to the answer of "possibly since everyone is different, but it's unlikely to start so soon". Within a few hours I couldn't keep anything down. And nothing stayed down for a whole week. I was seriously sick.

By the time I was scheduled for my blood work, I already thought I was in the process of dying. I went into the office, but had to wear a mask and have my blood taken in the back room. I was very careful to not touch a thing or even stand near anyone. I was surrounded by other women getting bloodwork for their IUIs and IVFs.. I would never want to even have a chance of getting them sick.

The bloodwork came back at the end of the day... it was positive. But my progesterone had dropped down to a 2. At that point, I knew it was over. I started progesterone supplements, but I knew my HCG had already begun dropping. My tests had gotten quite dark,.. but then my blood results said only 11. That was very low.

That night, I was so weak and extremely dehydrated from vomiting and ended up in the ER. Over the next week I was pumped full of anti nausea medications - none of which seemed to do much, if anything. At the hospital, they ran my HCG again. It was a 6. It needs to be above 5 to be considered pregnant. By the next morning, I was bleeding and I called my nurse for permission to stop the progesterone.

I was very ill and wasn't able to make it in for my final blood work for quite a while, and I was well into my next cycle. But my HCG was at zero, as expected.

So where does this leave us? In limbo, really. We need to wait to meet with our RE, to discuss our next steps. This current cycle will be med-free and hopefully my body will get back on track quickly.

I'm not sure if I've processed that I was pregnant, then suddenly I wasn't anymore. It's hard for me to understand why this happened. Why give us such a hard road, and then once we finally get there, take it away? But I think the real answer is that life just isn't fair most of the time. It certainly sucks, but that's just how it happens sometimes.

I know our happy ending is still out there.. and hopefully we'll be there before we know it.