Thursday, May 28, 2015

OAR Results

Finally, they're in! They're really not bad, a couple of the numbers are a little bit off. A couple of people have tried explaining them to me, and I was told I probably have poor ovarian reserve or poor egg quality, which is very disappointing, obviously. I'm only 24! But I'm going to take all of that with a grain of salt, because neither person was a doctor. I did do some research myself, of course, and since my AMH is a good number, I'm leaning more towards egg quality, which I had a bad feeling about a year ago.

On to the results:

AMH: 3.09 ng/ml
Egg Retrieval Score: 14
Estradiol: 33.5 pg/mL
FSH: 8.04 mIU/ml
Inhibin B: 76.9 pg/ml
LH: 3.89 mIU/ml

Lab Values:
AMH: Satisfactory (0.7-3.5)
Egg Retrieval Score: Good (20 is a perfect score)
Estradiol: Normal (ND to 84)
FSH: 3.0-13.4
Inhibin B: Satisfactory (64+)
LH: 1.1-11.6

So really, it seems like the only issues are that my LH and FSH aren't closer. They're supposed to be very close together, a ratio of around 1:1. My FSH is high for my age, too. I've been told that 5 is where an RE wants to see it. My FSH in February was 8.8. :/

I of course stole a look at someone else's report that she uploaded, and I am almost in the middle for infertile women my age. A lot of them were around 16-19.

I see my RE next Wednesday for a follow-up appointment. I actually sent my nurse a message through the patient portal a few days ago, too. My husband and I were talking and we decided that we have already found a few issues to focus on for the next pregnancy, so we just want to do that for now instead of going ahead with the genetic karyotyping. The nurse said that was fine! So next week I will bring my RPL labs. I'll allow my RE to do a few more tests to check for other blood clotting disorders if he feels it is necessary, just to make sure we don't need to add heparin on top of the baby aspirin. Other than that, I'm hoping we get scheduled for a treatment cycle next month. I'm also 1dpo, so I'll let myself test next Saturday, 10dpo, at the earliest. I have my First Signal all ready in the drawer.

Ignore the graph, I couldn't get it to delete for some reason.






Element Name

Data Value

UOM
Ovarian Assessment Report Antimullerian Hormone Value3.09ng/ml
Ovarian Assessment Report Egg Retreival Score Index Value14Calculated
Ovarian Assessment Report Estradiol Value33.5pg/mL
Ovarian Assessment Report Follicle Stimulating Hormone Value8.04mIU/ml
Ovarian Assessment Report Inhibin B Value76.9pg/ml
Ovarian Assessment Report Luteinizing Hormone Value3.89mIU/ml

Friday, May 22, 2015

What is it like?

First, the easy question.

What is secondary infertility like?

What is crazy is that *ALMOST* all of the general infertility situations are the same for secondary infertility. The "when are you having kids" question? It's now "So, isn't it about time for a sibling/another one?" Baby showers? Still hard (especially after miscarriages). Seeing pregnant women out shopping? Instant heartache. Drawer full of pregnancy tests? Check. (Okay, is it just me, or is anyone else super annoyed and slightly jealous when they hear someone talk about how their period was a couple of weeks late, so they went and bought a pregnancy test? I seriously long for being able to just unwrap a box of Clearblue blue dye tests without worrying about FMU, blue dye being notorious for false positives, it being negative and me wasting money, or having to take 20+ cheapies because you're worried about a miscarriage. I want to live a life where one test will suffice. Give me that fertile ignorance. I don't mean that bad, either. I seriously wish I was completely ignorant to all of this. It would be beautiful.)

My "test drawer". I made myself stay away from Amazon, so no internet cheapies (except OPK's). I always start testing at 8dpo, which is ridiculous and wasteful. Hello, 88 cent test. Hello, 10dpo. Well, I'd love to wait until AF is late, but let's be honest. That isn't going to happen. Oh, and in case you were wondering, that is 16-17 Answer OPK's, 3-4 cheapie OPK's, 2 Answer pregnancy tests, two Clearblue digitals, and one First Signal. Thank you to a sweet family member for picking up those ovulation tests for us after seeing them on clearance!
 
 
Secondary infertility is also different from primary infertility in a few ways though. I always hear "Well, at least you have one child" (I'll get more into that in a minute), "Just be happy with the one you have", or "You're crazy. You have one already, you shouldn't be upset about not being able to have another one". This isn't the case. You don't always feel complete after having one child. Even women who struggle for years for that one child may say "I just want one and I'll be happy. That's it." and later feel the yearning for another. You don't always feel complete with the one you have, and it doesn't mean you aren't thankful. I'm forever thankful for my daughter, and I always will be. But I do want another, for several reasons. Now that we've lost two sweet little ones, I'll never feel complete, and I don't think I could just give up. You have friends that have kids younger than yours that are on their next child or starting on another. In some cases, you have to see these newborns and baby bumps because of playdates. You can't just get out of it.
 
In other words, secondary infertility is just as painful as primary infertility, except for the fact that you already have a child, so that pain of childlessness is not there. This is a big difference, which is why sometimes I feel whiny for being upset over aching for a second child. But honestly, pain is pain.
 
 
What is recurrent miscarriage like?
 
 
Honestly, the best word I have to describe RPL is hell. It is pure hell. My first miscarriage was a chemical pregnancy. I only took two cheapies that cycle, both of which gave me faint lines. I assumed they were evaps since the second test was lighter than the first. Then my period came a day late (based on my luteal phase, not average cycle length). I never really thought of it as a miscarriage, honestly, and I still am detached from it, so that one doesn't cause pain for me really. I do have the "I wonder" thoughts, but I just don't count it normally, except with my doctors. I never got attached, because I never put the pieces together until my period came. Then I was pregnant with Audrey two months later.
 
My first actual miscarriage was devastating for me. I knew I was pregnant for three weeks. It doesn't sound like a long time, but it was to me. I had a bad feeling from the beginning due to lack of symptoms. Something just felt off. When it happened, though, I was just in shock. I have the link to that story here. {Trigger warning}. I honestly was just intensely sad until we got pregnant again.
 
My second miscarriage was painful, too, but in a completely different way somehow. I was scared immediately upon seeing the positive test. To put how upset I was over the first loss in perspective, I lost Sunny on July 17 and got my positive test with Hope on November 8. I spent the entire day before my BFP with Hope just bawling. I cried all day every time I thought of my miscarriage. I felt hopeless, as I was past the point that I thought I should have had a faint line. I was depressed. Then, a friend announced her pregnancy that night and I completely broke down. I was just still so hurt. After we got a positive test, I was worried, but still hopeful that this was it. I was 7 weeks when we had our ultrasound and the heart rate was slow. It was a slow process, but from 7 to 11 weeks, a few things happened that made me realize we were losing her, too, the low heart rate being the biggest one. So I kind of "knew" with Hope, too.
 
 Even though I was almost positive going in that she was gone, the ultrasound broke my heart into pieces. That was December 31, and it is May 23 now. Thinking about that moment makes my head go fuzzy. Seeing her motionless. Seeing her umbilical cord, her little legs, her head, her feet. But she was gone. It was honestly the most heartbreaking moment of my life. It is making me cry just thinking about it. I just knew that she was it, our sweet little rainbow baby, and she was another angel.
 
I can't even say what that loss on top of my other one did to me. I can't explain it, but I just wanted to run away and be someone else. I wanted to curl up in a ball and disappear, just be nothing. Not exist. That sounds awful, honestly, but it is true. I just felt so empty, and I wanted the pain gone. I wanted my babies back. I have said it a million times before, and I'll say it again...I don't know how people who suffer from RPL do it if they don't already have a child. She isn't a replacement for my angels, but she is mine. She is here. I can kiss her, and love on her. Some don't get that. They feel this way without a living child.
 
Anytime someone tells me to be thankful for what I have, I want to say "Don't you understand? I am beyond thankful for what I have. She is the light of my life. But I'm allowed to hurt over losing my OTHER CHILDREN." So many people don't feel the same way that I do, that my babies were, well, babies (and I even have to tell myself this when I don't "count" the chemical pregnancy). Some of those people would feel differently if they'd went through that. It is hell. It is hell receiving advice from people, it is hell when you hear "how many kids do you have" or "when will your daughter get a sibling?" She has siblings. I have three, technically four, kids.  It is hell seeing your baby, a baby with a head, a face, feet, legs, and arms, on an ultrasound screen with no heartbeat and still. Completely still. It is hell.
 
It is one of the most difficult experiences ever, to love a child you can't hold or see. It is so hard to love a child from Earth. A child that is elsewhere. It is so hard to wonder what happened. What caused this? It is an empty pain. An achy, awful pain. It is such a deep pain. It is like living in hell.


Tuesday, May 19, 2015

a better day.

Phew!

I am feeling much better today, thank goodness. After I typed the last post, I started having symptoms of hypothyroidism again. My head felt stuffy and achy for a couple of mornings. Luckily, I went ahead and took more of my thyroid medicine on my own since I knew it had went haywire. My guess is that even though this was three months ago that it was tested and low, it was a recent jump. I hope that's true. My RE bumped it up to the next step, which is double what I am taking now when it jumped up even higher than it had been originally in 2012. I don't really feel like that is enough personally, but he said he would check it again a month from now, so that makes me feel better. He also told me not to worry about that causing a miscarriage. I don't 100% agree with that, but it makes me feel better to know he is willing to check it again in a month, so we can make sure it is in a good spot.

My OAR results still aren't in yet, which is aggravating. They should have been in Friday or yesterday. I really want to know! But I'm super impatient, so it's whatever. The nurse finally put in our labs for the chromosomal testing too, so we will do that during our next appointment. She told me last time that it was cheaper in OK than in AR, so we will have to wait until we go back to do it because I am definitely not paying any more than I have to!

As for me, I'm on cd8. I ovulated on cd15 last cycle and cd16 the cycle before that, so I'm assuming I will ovulate on one of those two days this cycle. However, I can't say that for sure because it is all over the place and could be around cd22 again this time. I seriously hope not. But a late ovulation is better than no ovulation at all. I had some hope before that we could start a treatment cycle next month but it is looking to be at last July before we get to start any treatment, which kind of sucks.

Hopefully I have some better information to update on soon. It seems like all of my friends that started seeing an RE a month ago or even the same week (in one case, the same day) started treatment that day or the next cycle ASAP. I've already had most of the appropriate testing, too, but I haven't had that luck! I think it is because I've miscarried twice and the others haven't, so they want to try and find out if it is anything "big" causing my miscarriages before they get me pregnant. I guess it makes sense, it just still sucks. I don't really think I have bad luck but I guess I still hope that I do.

Friday, May 15, 2015

Tears today.

I'm not really sure what to title this post, and honestly, I don't even know where to start here. I feel so overwhelmed right now. Our first RE appointment went okay. I don't feel much different since we haven't even made a treatment plan yet. I mean, obviously we are GETTING somewhere, which is good, but obviously it is taking even more time and lots of money. After spending thousands already on blood work and testing, the d&c, being pregnant twice, etc...I am just already really over it.

Basically, I got to the fertility center and finished filling out all of my paperwork. We filled out a bit for my husband as well, and then went back to a room where the nurse weighed me, asked a couple of questions, and checked my blood pressure. After that, we went to our RE's office and answered questions on the miscarriages and the one for sure chemical pregnancy I had (in 2012). I almost broke down while talking about Hope. I somehow held it together - I know he is probably used to patients breaking down in front of him, but I knew that if the tears started, that they wouldn't stop for a while. He did a quick exam on me (which was terrible since I was on cd2), talked about blood work he wanted to order, and then we paid and left.

To be honest, it all felt a little bit rushed. I know after starting treatment that it will probably be a little bit different, and I know they have a lot of patients, but it felt like a "take your money and run" kind of thing. They insisted on my husband coming, but they didn't talk to him AT ALL. All he did was fill out a form saying I could receive info on any tests or procedures they do on him, yet we had to pay a co-pay since he is a patient too. It felt like a waste of money for him to be there. The testing they wanted me to have done was prolactin, TSH, OAR, genetic karyotyping, and then test for cystic fibrosis, skeletal muscular atrophy, and fragile x. We agreed to the first three and they told me they would call me with information on how much the karyotyping would cost.

I have only received my prolactin and TSH results so far, and that was this morning through the patient portal. I cried all morning. My TSH went from 1.9 in February to 5.2. To put that in perspective, it was 4.9 in June of 2012, before starting thyroid medication. That is the highest it has ever been to my knowledge, and I felt like crap then. I feel better than ever right now (besides depression and anxiety due to losing my babies).  I don't know what to do. I know they'll call me and up my dosage, which is great, but I know that your thyroid affects TTC. I'm so worried now that if I get pregnant soon, I'll miscarry again, but at the same time, I'm so upset that we may have to put TTC on hold to get this back on track. It could lower quickly, in just a few weeks (which is still an entire cycle) or it could take months depending on what is going on. I'm not happy at all. I don't have anyone to talk to about this. All of my "ttc friends" are pregnant now except for a couple that I'm not really close to. I just feel really lonely and hopeless. I know I shouldn't feel completely hopeless, but I do. It is really starting to hit me that we have so many road blocks. I have so many little things going on that it adds up to something big. This may not happen for us. We may not have a second child.

Audrey climbed up into my lap this morning and I just couldn't stop the tears. I kept apologizing over and over, even though she has no clue what is going on. She is getting older, and while she still hasn't asked for a sibling, I know it won't be very long. Last week while getting ready for bed, she picked up her Minnie Mouse, laid it down in her bed, covered her up, patted her head, and said "Little Sister". Things like that are terrible - they really get me. I want so much to just give her one sibling, and I'm so scared that I won't be able to do that. I'm scared of what the karyotyping will say, and I'm scared of my OAR results. I'm really scared of another miscarriage.

A picture from a few days ago.

The hardest part right now is not knowing for sure what caused my miscarriages. I don't know if it was a chromosomal abnormality, neural tube defect due to my MTHFR, clotting in the placenta due to my MTHFR, my thyroid, my progesterone, or something else. I don't know.

It also hurts getting on Facebook or seeing a friend somewhere who is pregnant, or has just had a baby. A lot of them have toddlers Audrey's age and told me they were "no where near" trying to get pregnant a year or more ago, and here they are. Pregnant or with a baby. It really feels like a slap in the face. I feel terrible for hurting over that, but I do. I know this is normal, but I just feel like such a failure right now. My body is failing me. My body is failing my husband. My body is failing Audrey. Most of all, my body failed my angel babies.

We are coming up on our due date with Hope now. It's only two months away. That sounds like a long time, but it really isn't. July is going to be a very painful month for me, because my TimeHop is going to be full of memories. July is when I found out I was pregnant with Audrey. I was due with Audrey and Sunny on the same day, two years apart. I'm going to see a ton of pregnancy related things starting then. July 17 is when we miscarried Sunny, July 22 is our due date with Hope. I'm not ready, I will never be ready. I just want both of them back.

Sunday, May 3, 2015

Yahoo!!!!

GREAT NEWS!!!

The morning after I posted this, I got a phone call from Tulsa Fertility Center. We have an appointment! She offered me an appointment for tomorrow - unfortunately, I have a dental cleaning scheduled that has been re-scheduled for months now due to winter weather. So we are going NEXT WEDNESDAY! We will probably spend the night in Tulsa the night before since it is a 10am appointment and we live a few hours away.

I'm super excited! I'll be on cd2 that day most likely, so it would be nice to be able to get a plan into action for that cycle, but who knows. We will see. Either way, I'm feeling even BETTER about it than I was before, so that is awesome!

Let's hope I get some help this time! I think this will be my best shot.