IVF #1: CD5 - so far, so good

This might be the only time I'm really happy for low numbers. E2 is 29.2 and lining is 3mm. All is as it should be for someone who hasn't started stims yet. The ultrasound tech (I don't even know who she is...a doctor? a nurse? a tech?) noted that she saw an empty follicle (presumably from my last ovulation) and some basal follicles. Fertility med holiday tonight, lupron tomorrow. This is getting exciting!

IVF #1: CD4...this time with extra welts!

First injection last night went well. Except for that angry red welt that took over half my abdomen. As I sat around scratching my belly I googled "ganarelix + reaction" and found that it's a pretty common occurence. 30 minutes later I was as good as new. Same drill tonight. Baseline appointment tomorrow morning at 8:30!

IVF #1: CD3

Today is the first day IVF meds. 1 SQ injection of ganarelix (along with all my regular meds: prenatal, vit D, CoQ10, enoxaparin, levothyroxin). I'm excited :)

And amused....

IVF #1: CD2 (*updated)

I've never been so happy to be a crampy, bloated, hormonal mess. There have already been a number of crises and I haven't even had my first date with the dildocam.

Despite asking several times last week, no one at the RE office would tell me when I would start my meds. All the microdose lupron flare protocols I could find online come with weeks of birth control first, which I can't take. So, when CD1 rolled around (yesterday) and no one answered my OMG-WHAT-DO-I-DO emails, and my meds arrived but were missing the microdose lupron, I started to panic. At 8pm, a new nurse called and said my nurse had been out of the office, I didn't have to worry because the RE lab is closed until next week (WTF?) so no new IVF cycles can start this week anyway (WTF!!!!), and I should get on birth control pills until my stims start next week (F.T.W.). Clearly, she missed the part in my chart where I ALMOST DIED FROM BIRTH CONTROL last December.

I wrote an email to my nurse this morning explaining that whomever called me last night was a HAZARD TO MY HEALTH and that this whole IVF timing, birth control, and missing meds thing needed to be worked out. My nurse called me back and treated me like a lunatic, which I somewhat deserved, but mostly did not. She tried to chastise me in her own special way ("I guess I shouldn't have taken yesterday off") and I fell for it, stupidly beating myself up for having a minor email confrontation over something important.

We straightened out the missing medication. Apparently you need a compounding pharmacy for microdose lupron. Then she told me to come in on Friday (CD5) for a baseline ultrasound and to start meds on CD6. I tried multiple times to get her to explain why we were waiting to start meds until CD6 and she just kept placating me with "it will be fine", "it's just how we do it", "you don't have to worry". I'm not a real doctor, but I do play one at my job, and understanding my protocol is important to me. Not explaining makes me think either she doesn't know (which is fine, but I'd rather she just say that) or she is messing with my protocol for the benefit of their lab schedule (would they do that?).

All of this prompted much googling on my part and I found that 1) not doing anything until CD6 is not "standard" and 2) it's all the rage to "hate" the microdose flare protocol (seriously, more than one RE publicly admitted to "hating" microdose flare).

So, as of today I am:
...excited to be starting IVF
...aggravated at how things have started
...scared that my protocol is f'ed up
...wondering if I should bring up my protocol concerns with my doctor or just trust that 1) I don't know everything and 2) she has a degree in egg making
...holding out hope

*updated: they just emailed to say they are adding ganarelix on CD3 and CD4. Here we go....

Bullets

• I think of posts I want to write and then I don't write them. Maybe this will help get me started
• Blood thinners: they make you bleed. Or, more accurately, they make you not clot. I awoke to a shirt soaked in blood the other night. It scared the crap out of me. I was bleeding from one of my old injection sites. Enoxaparin stigmata.
• Over the last few days I've seen my pulmonologist, perinatologist, and reproductive endocrinologist. Guess who cleared me for IVF? All 3 of them!
• Speaking of multiple doctors appointments each week, my job must think I'm dying. Or just a big slacker. I spend more time in waiting rooms than I do at my desk. 
• My period. I have never been so excited to get my period. She should be here in the next day or two. I expected her today. But, things don't go as planned. 
• Retrieval. This is it! The start of our first retrieval cycle. I'll be on a microdose flare protocol (is that code for old-lady-regimen?). No bpc for this clotastic girl. Just straight up microdose lupron, bravelle and menopur. I haven't gotten a clear answer as to when I'll actually start my meds. In fact, they haven't even arrived yet. But hopefully I'll know all the nitty gritty details next week.
• We picked a donor. That was a hard decision. It was between two people, who are both kind of perfect in their own way. I don't think there is a "right" or a "wrong" choice, but I still find myself hoping we made the right one.
• Transfer. If all goes well, transfer will be with my May or June cycle. We're freezing everything and will do a FET. All the docs insist I not get pregnant until 6-months post-PE diagnosis.    

Sorrow floats. But so does hope.

I've been busy getting my act together. And licking my wounds. And going to doctor's appointments. And calling billing offices about doctor's bills (seriously, why can no one submit to my insurance the right way the first time. oh, and btw, having insurance = the.best.thing.ever.)

At first, I was all panic-y about my MTHFR mutations (see previous post). As someone with a degree in mutations, you'd think I wouldn't dive off the deep end and read everything on the internet. And then believe it. But I did. But then I started being sane. And I saw my hematologist. 15 vials of blood later, she released me from her care. No other clotting disorders noted, just the perfect storm of bcp, surgery, and MTHFR. She did suggest that I not get pregnant, but I suggested that she come up with a better plan. So I'm on 80 mg lovenox twice a day for the long haul (until 8 weeks after any successful pregnancy).

I started taking supplements (B vitamins! 3 kinds!), but I still felt off. My TSH came back at 2.9, which isn't even high, but I asked for for some levothyroxin and oh.my.g-d.i'm.cured. That stuff is speed for middle aged people. I love it. Combine it with a cup of coffee in the morning and ICANCONQUERTHEWORLD. That little pill is seriously the highlight of my day. I secretly want to overdose.

So what's the plan? Next week I have a repeat CT, courtesy of my pulmonologist. If my lungs are clear, he will give me the OK for retrieval (March or April) and then transfer (May or June). Hopefully. We'll see. A lot of stuff has to go right. Two days after the CT, we go on vacation (YAY! we are going here and here and a bunch of other places). When we get back I have a pre-conception appointment with maternal fetal medicine. I'm not really sure what that's about, but my RE is requiring it now that I'm super-duper high risk. What's one more person looking at my hooha, right? That same day I have injection training and a trial transfer with my RE (you can imagine how thrilled my job is that I spend more time a the doctor's office than I do at my desk). And the following week, if everything goes well (and that's saying a lot), I'll start my period and we'll start our IVF cycle (What?? Yep, start our very first IVF).

Then, everything goes on ice. My pulmonologist wants me on 6 months of treatment before transfer. My clots were diagnosed on 12/21/12, so that puts us at my June cycle. You know I'm going to be pushing for May though. We're doing PGD (I still don't know if that's the right decision) and that means any resulting embryos have to be frozen anyway (that's just how my RE does it...I know not all labs follow that path). So it all kind of works out. We can do our retrieval cycle, send away for our PGD decoder ring, and then (fingers crossed) put something back late spring/early summer. I love this plan.