IUI#5 update

Unfortunately, IUI #4 ended in a BFN. At first I had high hopes for it, since it was my first injectables cycle. However, my high hopes were dashed by having only one follicle and my gut feeling that the timing of the IUI was a little too late (we BDed the morning before just in case). Of course, hope is a wicked thing, and towards the end of my cycle, I started feeling positive again since I was feeling similar to the way I felt at the end of my 2nd IUI cycle when I got a BFP.

When I went to get the dosages for my meds for IUI #5, I was caught off-guard when the doctor decided he wanted me to have a hysteroscopy right then and there to see if my myoma (which they had been following via ultrasound for quite a few months) had invaded through the uterine wall into the uterine cavity. Unfortunately, this was the case, but the good news is that right now it is still only minimally invasive, and while I was told that I may need surgery to remove it in the next year, I was given the go ahead to continue cycling for now. If this cycle doesn't work, we'll do 1 more IUI (6 total) before moving on to IVF.

Today (CD10) I had a monitoring appointment. I'm not sure why, but I am feeling pretty good about this cycle! I have a few small follies on the right and 2 good-sized ones on the left (at 15 and 16 mm). Lining is 8mm. I am continuing with Puregon today and tomorrow night, triggering Saturday morning, and doing IUI on Sunday. I didn't get to see my E2 and progesterone levels. My extremely bruised tummy will be happy for Sunday!

Everything You Never Wanted To Know...

...about my ute.

Since I'm in the midst of the 2ww (7DPO today), I figured this would be a good time to get you all up to speed on a somewhat relevant bit of my history. Plus, I know when I was wondering what was wrong with me it was helpful to hear others stories. Be warned there may be TMI for some.

First the back story:
In December 2007 I was working outside at my job. Woods in Virginia. On an Army base. Just me and 5 guys. It was my time of the month (no biggie, used to that in such situations). This day was different. The bleeding was so heavy I was going through a tampon AND a pad in about 10 minutes. Clots passing that were quarter to palm sized. The guys were asking if I was OK as I was pretty pale (in hindsight, I was probably anemic). Needless to say we did the bare minimum we needed to do that day and then baled. The rest of my period was fine. I figured it was some fluke thing.

Until June 2008. In mid June I started spotting mid-cycle. I was on BCP at the time and figured it was just time to change the type of pill. So we changed the type of pill. Still spotting. Changed pill type again. Still spotting daily, sometimes pretty heavily. In the meantime at each follow-up appointment I'm being screened for everything under the sun that could cause the bleeding. Syndromes. STDs. Cancers. Stuff that really gets the mind racing. Nothing like knowing something is definitely wrong...but not having anyone be able to tell you what that something is.

There was another incident of extremely heavy bleeding in late August 2008. I remember the exact date as it was at my best friends wedding. Awesome Timing. I spent half the event in the ladies room trying to keep up with the bleeding. I got back from my trip to the wedding and got in to see my doctor ASAP. Enough already.

My normal OB/GYN realizes she's in over her head as the issue isn't being resolved and refers me to a specialist. This was in Sept 2008. THREE MONTHS of constant spotting/bleeding later. This specialist, my first male OB/GYN, puts me on a different pill. This pill actually made a difference with the bleeding. Got it down to about 5 days of spotting in the 3 weeks of active pills. Doctor isn't satisfied with the results. Wants it down to 0 days. I get an unexpected uterine tissue sampling done in his office that afternoon. Cervix manually dilated and they scrape out some tissue. No anesthesia. Not Fun. Sample comes back negative for uterine cancer (woo hoo!). Since there are still no answers, its time to go in and take a look around.

The Resolution:
In January 2009 he performed a hysteroscopy and D&C. For those that aren't familiar with what those procedures are, I'll give you a quick description. In a hysteroscopy, they distend the uterus with either a liquid or gas (in my case, saline). They then insert a contraption called a hysteroscope to look inside. In my case he was looking for the source(s) of the bleeding.

(Image Credit: http://tinyurl.com/4fzpoqo)

Once he'd had a look around, and removed the two culprits, he performed a D&C. During a D&C (aka Dilation & Curettage) the cervix is dilated and then the contents of the uterus are removed. Though most commonly associated with miscarriages, D&Cs can also lessen heavy bleeding like I was having.

The Diagnosis:

Submucosal Uterine Fibroids. One of the least common of the types of uterine fibroids, accounting for 5% of all uterine fibroids*. These fibroids grow on the inner side of the uterus and I had two of the classic symptoms: Unusually heavy or prolonged menstrual periods and bleeding between periods.*

(Image Credit: http://tinyurl.com/4gtvw7h)

I want to note that uterine fibroids are very common and rarely cancerous. My doctor said roughly half of the women of childbearing age have them. Most of those women have no idea they are even present. My type was enough of a rarity that I got to be a case study for my doctor (Go Me!). Unfortunately, that meant he needed all the pictures of the inside of my ute (I know, I'm strange in thinking stuff like that is cool...but how often do you get a photo like that???) To my knowledge I have two fibroids in my uterus still. One was left during the D&C as they didn't have the tools to reach it. Its up at the top of my uterus. The other was found via ultrasound during my miscarriage, its on the sidewall. I've only had two minor bouts of spotting since the D&C. Nothing to worry about really. And honestly, just knowing they are there is more than half the battle. The worst part of the whole unexplained bleeding deal was not knowing what was wrong. Finding out was so empowering.

I've had about 5 different doctors swear up and down that my having fibroids should have no bearing on my ability to get and stay pregnant. Crossing my fingers they are right.

So, there ya have it...everything you never wanted to know about my ute.

Take care,



Reference:

* http://tinyurl.com/4fcr8dp

(To any of the Buds reading. Could one of you tell me the trick to get it to say photo credit where I have the links listed under the images? Thanks!)

Spent $600 in 5 minutes!

Hi Buds and Bud readers! Long time, no see. I've been trying to stay away from all things baby for awhile but wanted to submit a quick report.

I had my $600 out-of-pocket hysteroscopy today, just to confirm that my uterus isn't scarred shut or some other nightmare diagnosis. I am happy to report that it looked flawless! I am not happy to report that I wasn't told to take Ibuprofen beforehand and this time it hurt like hell. But it was totally worth it to confirm that my uterus is in good shape for our upcoming frozen embryo transfer.

Speaking of which, I started Lupron last night. I am also on BCPs (for now) and my suppression check is on November 18. I'll begin estrogen patches and supps shortly thereafter. So now it's hurry up and wait until December 17. We will definitely be thawing and transferring 2 this time. Assuming all goes well, we'll still have 3 frosties left for another cycle.

Will get caught up on the Bud reports this weekend.
Take care everyone!

Golden Bud

FSH & Hysteroscopy Results

Well it looks like its time to try and make a baby again....

The Hysteroscopy
Last week I had a hysteroscopy with Dr. T and the procedure went well. I love my new clinic already. As they were putting me to sleep Dr. T told me to dream about visiting my family in Panama on a sunny beach. When I woke up I had a heating pad on my stomach and a pillow underneath my head. Dr. T came in and told me the procedure went well and that he removed a small polyp. He also said my uterine lining looks good and that anatomically we are good to go for my fresh IVF cycle in November.

FSH Results
Dr. T also gave me my FSH results after my hysteroscopy and my FSH is 5.9 and he said he is pleased with that. I will continue birth control pills and make an acupuncture appointment at the clinic next week, as well as make a payment on my upcoming cycle. Below is a chart explaining FSH from Advanced Fertility in Chicago and I found it to be quite helpful:

Day 3 FSH level	FSH interpretation for DPC Immulite assay
Less than 9	Normal FSH level. Expect a good response to ovarian stimulation.
9 - 11	Fair. Response is between normal and somewhat reduced (response varies widely). Overall, a slightly reduced live birth rate.
11- 15	Reduced ovarian reserve. Expect a reduced response to stimulation and some reduction in embryo quality with IVF. Reduced live birth rates on the average.
15 - 20	Expect a more marked reduction in response to stimulation and usually a further reduction in embryo quality. Low live birth rates. Antral follicle count is an important variable.
Over 20	This is pretty much a "no go" level in our center. Very poor (or no) response to stimulation. "No go" levels should be individualized for the particular lab assay and IVF center.

Tons of Baby Dust to Everyone,

Surgery was a success!

Went into my RE appointment thinking I was just having a vaginal ultrasound.... wasn't I surprised to find out I was having a hysteroscopy?! All was well though. It wasn't painful or uncomfortable at all so they didn't do the local anesthesia they normally do for it. My RE's words were "It didn't hurt because I did it." He's just a little cocky...

The hysteroscopy showed a beautiful and perfect uterus. Everything has healed up beyond Dr. P's expectations and he said it's looking absolutely wonderful. He held up the "before" pictures from before he started my surgery and compared them to the screen showing what it looks like now. It doesn't even look like the same uterus anymore. It's absolutely clear in there and you can see both tubes wide open. The endometrial tissue has grown tremendously and there is no sign of the scarring from surgery where the fibroid was.

He was beyond impressed and had a huge smile on his face the entire time. This is a man who rarely shows any personality or emotion. When I remarked about it to Debbie, his nurse, she was laughing and said that he's always bursting at the seams when he knows he did an exceptional job.

He said I can stop the Premarin and Provera today and that I am to return for CD3 bloodwork to check my estradiol and FSH levels when I get my next "natural" period. In other words, not this coming period since it will be hormone induced. Then is CD22 bloodwork to test estradiol again and progesterone. I asked him if we were okay to try on our own naturally this month after my period starts and he said without a doubt, absolutely and he strongly encourages it. We'll also try on our own naturally with timed intercourse the following cycle. He said after those 2 cycles, I will come back in 2 weeks after my CD22 blood work and we'll discuss the results and our next steps if I am not pregnant.

I feel MUCH better about that than what he had decided last time (6 months trying on our own starting in October).

Circling in the holding pattern

It's been about a week since I posted. I've needed some time to digest everything I found out.

The day after my appointment with the new RE, he had me come back in for an SHG. What he found was disappointing to say the least.

I have a fibroid. Not just any fibroid, but a HUGE freaking fibroid. It's the same one I was operated on in February. It was submucosal and most of it was embedded in the uterine wall and they could only get what was in the uterus. Since then, it's delivered into the uterus completely and grown. Grown so much that it's actually expanding my uterus and stretching it and distorting it's shape completely. A normal uterus is triangular shaped. Mine is a horizontal oval right now.

My right tube is blocked on the outside by ovarian tissue. He will decide completely once he's inside and can get a better look but he feels that removing it would be the best course of action. He said that when there is a blockage on the outside, there is generally damage inside the tube as well and that it greatly decreases chance of pregnant and increases chance of ectopic.

My left ovary is triple the size of a normal ovary. SHEESH! He has no idea what is going on there but he's hoping that it's overstimulation from Clomid. I'm on birth control pills for another month in the hopes that it will calm down and shrink in size. If it doesn't.... it has to be removed. It's also covered in cysts and he said that he can't safely remove the cysts without risking snapping the ovary off due to it's size and unstable state.

I'm scheduled for another SHG on the 27th of this month to see how that ovary is doing.

My surgery (lap/hysteroscopy) is scheduled for June 2. I won't know what is removed until I wake up from surgery.

I'm praying to God every day that I don't wake up with just a left tube and a right ovary. Because frankly, that would suck.

If I get to keep my left ovary, we have a shot at IUI. If I don't.... our only option is IVF.

But for now... I'm on birth control pills and am actually in a MUCH better place emotionally than I have been in awhile. Knowing 100% that I can not get pregnant is actually a relief for now. There's not stress or wonder or worry. It's nice to live in the moment and enjoy the NOW instead of being completely focused on what's going on.

Cycle 2 Cancelled: Hysteroscopy Results

A Uterine Polyp Rears its Ugly Head...
So earlier this month I was at the beginning of Cycle 2 of Ovulation Induction with Femara, Follistim and Timed Intercourse when I had a Hysteroscopy on day 5 of my cycle. During the procedure Dr. B discovered a large Uterine Polyp that extends from one side of my uterus to the other side and it looked like a tongue. He cancelled the Cycle immediately, so of course I was sad because Mr. Blessed Bud and I were hoping to get PG in October because my birthday was October 7 and our one year anniversary was October 11. On a brighter note, Dr. B thinks that this is the reason for my miscarriages and he says that Uterine Polyps swell up when your body produces estrogen, and the polyps themselves can interfere with the proper implantation of the embryo.


Here is an image of 2 large Uterine Polyps:

Photography Credit

Just What is a Hysteroscopy?
A Hysteroscopy is a technique used to look inside the uterus. A hysteroscope is a thin telescope-like device that is placed into the uterus through the vagina and the cervix. The procedure helps doctors diagnose and treat a variety of uterine problems.

Photography Credit

Dr. B's Verdict...
So the verdict is I have to have a hysteropic polypectomy in order to have my uterine polyp removed. Fortunately this surgery is ambulatory (in and out the same day), and I made an appointment with my OB/GYN Dr. R for a pre-surgery consult so I can have this polyp removed asap.

Moving Forward...
I am truly ready to have this surgery and Mr. Blessed Bud and I are looking forward to cycling again with Dr. B by December...