Empty Circle means empty uterus

When i was responding to comments on my blog yesterday I was struck by two comments...  one person suggested that the circle was a fill in the blank... leaving us to put our own emotions on the lack of ovulation.  Another suggested that it was because it best expresses how you feel with negative test after negative test... that empty feeling inside.  As a result all I can think now is that the emptiness of that circle will lead to another emptiness in two weeks time.

Despite the continuing negative tests and the absolute lack of a faint line at all on any ovulation test at all I am playing the second guessing game:

1) did i miss it?
2) is it going to happen late?
3) did it happen early?
4) maybe I didn't do it right?
5) my boobs are sore, so I must have ovulated right?
6) my BBT is a little higher than normal but not as high as post ovulation - what could THAT mean?
7) maybe I am already pregnant, and what I thought was my period was actually just break through bleeding and i watched this show where this woman didn't know she was pregnant until she actually gave birth so it could totally happen even though there was a wand looking at my uterus on day 3 of this cycle and they took blood and they saw follicles growing for my next cycle... it could still happen right?

I sometimes wonder if delusions is a symptom of infertility.  I so desperately want to be pregnant that I am willing to play mind games and engage in a complete suspension of disbelief.  But, I should probably accept the reality... this is not going to be my month.  But, to be honest, I'm still going to play the maybe it happened game.

Too Stinking High (TSH)

Have I mentioned that I love my RE?  If not it bears repeating.  I think I might have a little girl crush on her.

I should probably preface this next blog with a little medical background on myself.  See.... I'm what is known as a medical freak.  I'm a zebra... for those of you who don't immediately understand this reference there is a quote they tell young doctors:  When you hear hoof beats think horses, not zebras.  Well the problem with that is that some people actually are zebras and I am one of them.  The quote is meant to remind young doctors that there is a reason that diseases are classified as rare... that's because no body has them.  It is meant to remind young doctors that they are not the future Dr. House finding weird and wonderful, obscure diseases that are given only a paragraph in most medical text books.  Most people are coming to you because they have a cold.  The common cold.

The problem with this is that many doctor's will disregard all of the symptoms of a disease that is staring them in the face because they have had it beaten into their heads that it is just too rare... that they will never in their practice see a patient with such a rare disease.

About 3 years ago I was diagnosed with Cushing's.  This is a disease in which a tumor causes your body to produce a ridiculous amount of extra cortisol - the stress hormone.  It causes many delightful symptoms like weight gain, facial hair, high blood pressure, type II diabetes, infertility, etc, etc etc.  The problem is that a doctor will look at an overweight woman with high blood pressure and type II diabetes and tell her to just lose weight.  Wanna hear the craziest thing about cushings?  You can't.  You actually can't.  They have done studies where they have shown that looking at a picture of a doughnut will actually change your metabolism as though you have eaten it.  Now that's a messed up disease.

Cushing's is found in 1:1,000,000 of the population... but wait... there's more... there's an even rarer form called adrenal cushings which is found in only 1:5,000,000 of the population and this is the form i have.  As a result I have had my left adrenal gland removed, which can cause a lot of stresses on a body.  I wear a medical alert bracelet just in case i suddenly topple over.

Because of this diagnosis I want you to believe me when i tell you i have seen a LOT of doctors.  In fact I have seen a LOT of endocrinologists.  When I had my surgery the chief of surgery dropped by my room to see, in his words, the "famous patient".  No joke.  I'm a freaking medical marvel.

Despite all of this I am in awe with my RE because she did something that blew my mind.  She checked my test results the second they came in.  She called me because my TSH was too stinking high and wants a retest.  I find so many doctors will wait until their next consult before they look at your test results.  My father drove a car for 6 months after tests showed he was legally blind because his optometrist didn't look at the results.  So my RE looked at my results and took action.

You see why I'm a little bit in love?

Rise and Shine little Antral Follicles

That's it... Day 3.  And my husband and I are requested to attend the opening of the fertility clinic.  7:30 am appointment for day 3 blood work and ovarian reserve monitoring.

Right ovary has 7 follicles with a volume of 2.7
Left ovary has 8 follicles with a volume of 3.6
No fibroids (yay - that much I know is good)
A XXXX cyst.  The doctor says this fast and i can't catch the word, so i'm not sure of what it means

Now, comes my date with Google as I try to figure out if any of this is good news.
I think my numbers are at the very lowest range of normal possible... is it enough?

Our visit to the clinic. Part the First.

First, I want to say that I think I love, love, love our RE.  She is funny and nice and when she took my medical history and heard I'd had a miscarriage she said "that sucks" which to me is exactly the right thing to say, because it does and it did.  And there are no right words to make it better.

I am a little annoyed that she seems to be pregnant herself, but about 4 or 5 months along... I will try not to hold this against her as she pushes her 8 month belly into my face at our next appointment.

She wants us to try, with miliatary precision for the next 3 months again.  I don't know what it is about the 3 month waiting period but all the doctors seem to want to prescribe that first.  It is mostly because we did get pregnant within 6 months even if it didn't stay.  She was less enthusiastic about my AMH numbers than my doctor was, she thinks my doctor might have checked the wrong units, so she's ordering that again.  My husband is quite relieved that his sperm is very normal and he can go back to his Y fronts.... I think the ones I bought him are much sexier... maybe i can make an argument for boxer briefs.

Right now we have blood work ordered and I have to do a follicle test on day three.  So, i'm sitting here hoping my period makes an appearance early enough today that I can have the test done on Sunday morning rather than Monday.  I don't want to fight through traffic to get to the clinic on a weekday if i can help it and my husband would come with me on Sunday which would be nice.  I like when he's there.  He makes me smile. 

I don't think i've ever wanted my period to come so badly.  I mean I shouldn't be hoping right, until it does there is still a chance that I could be pregnant.  But I've pretty much given up that hope this month because my temperature has been a little bit lower the last couple of days.  I"m pretty sure it was 36.26 this morning... but i took it in the middle of the night and i sometimes dream that I do that.  And when I took it when i woke up this morning it was 36.5 but I had been awake for about 5 minutes and snuggling with my hot blooded husband.   He's nice to snuggle.

We decided to go out for dinner last night to celebrate the fact that we won't have to pay for any fertility treaments for at least 3 months and we went to the Keg.  The Keg is a Canadian chain that is sort of an upscale steak house.  My husband ordered prime rib but instead got brought a sirloin.  We only just politely asked what we had and they tried to replace his meal.  I pointed out that my husband didn't really care what kind of meat he had as long as it wasn't made of soy.  They sent over the manager to make sure we were ok and she comped us his meal and a dessert each for the mix up.  I want to say that The Keg has the BEST customer service of any restaurant that I have ever been to.  They bend over backwards to make sure you enjoy your dinner and that is one of the reasons my husband and I go so often.

Plus if you say "How are you?" they respond "I am well, Thank you for asking", which is so cute it makes me giggle. 

I guess the chicken comes first...

Basal Body Temperature:  36.27

In the old riddle "which comes first the chicken or the egg" you know if your BBT doesn't rise there is no egg.  Therefore, the chicken comes first.

I had harboured these secret unrealistic hopes and wishes that somehow we would squeak one in.  That I would go meet our reproductive endocrinologist and she would order blood work that would reveal their services were not necessary because we were already pregnant.  That will not happen.

So, in a bid for silver linings I am happy that we will not have a baby born too close to Christmas, because that always sucks.. plus we were sort of thinking of doing Christmas in Florida this year and waking up to sunshine instead of snow.
 

Did I or didn't I...

Temperature:  36.22 or 36.77

Last night was a late night.  Very late. 

I woke up this morning in time for work... took my temperature and fell asleep while doing it.  The beeping of the thermometer woke up me... it said 36.22.  But... was it actually in the right place, under my tongue, or was it off to the side as my tongue lolled out of my mouth.

Then... when I woke up again and the reading on the temperature was 36.77.  This is higher than normal for my BBT post ovulation.  But I don't know if i was asleep long enough after getting out of bed for it to be my BBT.  Actually it is higher than normal for my non-basal body temperature.  So, i am left in doubt.. .did i?  or didn't i?

I know that you can have an LH surge from the ovulation kits and not actually produce an egg.  So, I don't know yet if have a chance to get pregnant this month or not.  I will have to wait until tomorrow.  I don't want to wait until tomorrow.

UPDATE:  when I got home from work I noticed that you can get almost a 1 C temperature drop if you take your temperature with your mouth open. So I am keeping my fingers crossed for tomorrow.

Semen Analysis day has arrived!

I don't think people who need fertility clinics are supposed to live in the suburbs.  See, suburbs are where you go when your family has outgrown your chic city flat and you want a back garden for your wee ones to run around in while mummy sips ceasars on the back deck.

We live in the suburbs.  This was especially irritating today when my husband had to present himself at the fertility clinic for his 7:30... errr... test.  And because it was his first visit he had to be at the hospital front desk by 7:00 to be registered and get a hospital card.  That's an hour from our house.  We are not morning people.

We were talking about his test last night.  I didn't know what to say... do I wish him luck?  Tell him to have fun?  It all seems a bit odd when he's about to make love to a plastic cup.

I can't help but be curious about the set up.  In my mind it should be red brocade like some den of inequity from Victorian England.  I expect stripper poles and video tapes (yup... i don't expect a dvd player for some reason), and probably even some curtain you can pull back for a peep show.   I basically think the man's side of the fertility clinic should share a wall with a strip club.  It might help to keep them interested.

Instead, it is reportedly a basic hospital exam room with some magazines spread on the doctor's desk.  My husband elected to bring his own visual aids... he downloaded a movie into his smart phone last night so that he wouldn't have to flip through the dog eared copies... although i find myself curious as to how old the magazines are.  Do they buy new ones every month?  Or have the same copies been there for decades.  And  why did he have to be there so early?  Is it really just a regular doctor's office from 9-5 and whichever doctor emptied the coffee pot without making fresh coffee yesterday is punished by having his or her office assigned to the early morning fertility men? 

I find myself sort of hoping that they will find our fertility issues are just because of my husband's previously too tight underpants.

What do you want first... the Good news or the Bad news?

So the first batch of tests are back on me.  And there is good news and bad news.  Actually, from a fertility point most of it is good news.  I have the ovarian reserve of a 31 - 35 year old.  Woot!!  Joyous happiness!!  I don't think i could ask for much better.  My FSH is 6, my AMH is 3.53.  I barely know what those letters mean let alone the numbers attached to them, but I was told first things first that's good.

FSH is follicle stimulating hormone.  So what does that tell me... well the follicle I know is where the egg comes out.  And if FSH is too high then it means that your body is trying overcome the fact that you aren't ovulating by really, really, really trying to ovulate.  In fact if you aren't ovulating regularly then it is early menopause.  So, for me, it's a good sign.

Then there's the AMH.  AMH = Anti Mulleriam Hormone.  Can I digress for a minute to tell you how absolutely impossible this test was to have done?  It needs to be done on a specific day of the cycle.  Day three as it turns out.  Which, on the cycle where we had the blood work done fell on a Saturday.  Ok, no problem.  As soon as I knew it was going to fall on a weekend i scoped out the closest blood clinic that was open on the weekend.  There was one LifeLabs near us that was going to be open until 5pm.  Perfect.  Hoping to avoid the early morning "i have to have this lab done fasting" rush we took our time... enjoying a lovely day without work.  We pull up to the clinic at about 11:40.  5 hours and 20 minutes to spare.... except that the AMH test is an unusual test, no every lab does it.... in fact lifelabs doesn't do it at all.  Armed with my smartphone i start trying to find a lab that does do it and one that is open weekends.  Gamma Labs, 15 minutes away... closes at noon.  We don't make it.  So now what....

My mother suggests we try the emergency room at our local hospital.... so we go, sit amongst the ill and wait our turn to ask the question... and nope, they don't do the AMH either.  Our last chance.  A hospital in the next city over, downtown does the test.  We grab some lunch and head over.  It took three hours of waiting.  Our nice leisurely Saturday turned into a visit through 4 cities and towns, 2 emergency rooms and finally a blood draw.  So may I say, with great pleasure i received the news that I have the ovarian reserve of a 31 - 35 year old.  It makes it all worth while. 

But, of course, the bad news.  First, in case they ever see this, let me start by saying that i love my in-laws.  They are kind and nice and funny and smart... but they do this one really dumb thing.  They are conscientious objectors of the MMR vaccine - well all vaccines, but the bad news includes the MMR vaccine.  We've always known this and planned that when we welcomed our sweet bundle of joy into our life we would be forced to stay away from our family until our sweet bundle of joy could be vaccinated.  But my blood tests revealed that despite having a booster shot only 5 years ago I am still not immune to any of the measles, the mumps or rubella.  Which means i can't offer my baby protection while living inside my body.... And all three viruses do really bad things to babies in utero. 
Oh yeah, and to make things even worse people vacationing have brought measles back, and public health is issuing a warning this week for doctor's to be on the look out for people with measles.

so... how soon do we start staying away from our in-laws?  Before we even start the IVF process, just to keep me safe?  Or do we wait until our $5000 egg cycle is underway, which could be months. 

And how do we navigate the holidays without destroying the family love....  it all makes the great ovarian reserve seem a little less great.