Project Baby: This form of punctuation ends a statement

What is a period?

I'm currently waiting for mine to start.  We had a conference with our Reproductive Endocrinologist (RE) on 2/13/18.  We gathered to assess our restarting point after taking some time off from Project Baby.  It was great to see him, he's a calm and reassuring presence that gives me confidence in the path we're taking.  Time to exhale and let him guide us through.  I trust him, and that's huge.

He laid out our plan.  4 cycles of IUI and timed intercourse, with medicines to make my body perform.  We can do all 4 back to back, or we can spread them out - it's up to us.  If these 4 don't 'stick' we regroup.

After consult I went straight into line for a blood draw.  I used to hate it, but now I kind of like it.  It makes me feel like I'm contributing something to this process, and that I have some level of control over it.  I've made friends with The Vampires (aka the very nice nursing staff at our clinic).  They are efficient and good -- they hit it every time.  I have the littlest veins of anyone I know, and they like to hide.  To minimize the poking, we go right into my wrist most of the time.  It hurts like a son of a B, but better be poked once in a sensitive spot than 3 times in the wrong spot.

DIY manicure looking pretty good if I do say so myself!

These labs were to see if I had ovulated yet this month (Progesterone level), if I was pregnant (HCG: Human chorionic gonadotropin), how is my thyroid doing (TSH: Thyroid-stimulating hormone), and what are my ovarian reserve (AMH: Anti-Mullerian Hormone) levels.  They have their own lab onsite to process the majority of the tests, so TSH, LH, and HCG came back same-day and I had a call from the nurses that afternoon.  Normal, negative, and negative, so it's time to trigger a period.  Provera to the rescue!

10 days of this and my period should start shortly thereafter.  It gave me a tummy ache so I took it at nighttime before bed - I don't know I'm nauseous if I'm asleep.  Win!

The last test was for my ovarian reserve, and basically gives a general idea of how much time I have left on my Biological Clock.  They send that to the Mayo for processing, so would take 3-4 days for results.  The rule of thumb is that if you don't hear back you're good to go -- no news is good news.  However, I'm more curious than George (the monkey) and like to know my numbers for my own education.  About a week had passed and I hadn't heard anything, so I called the nurse line and left a message.  While waiting for a callback I did some research on what normal levels of AMH are.  Normal AMH levels (1.5 to 4.0 ng/ml) are associated with increased fertility and better response rates to fertility treatments. Low–Normal AMH levels (1.0 to 1.5 ng/ml) are associated with decreased ovarian reserve but chances can still be good for pregnancy outcomes.  Less than 1.0 ng/ml is diminished reserve and that your Clock's alarm is going off.  OK, good to know.  I'm only 33 and all my other labs look good so I was hoping for an overachieving 3 ng/ml.  The call comes, and rolls to voicemail.

My levels are a 0.4 ng/ml.  My heart sank.  After everything we've already been through, everything I've already been through, and I have one more strike against me.  The nurse said that our doctor already reviewed the results and doesn't want to modify our plan - which should be reassuring.  But it was too late and I was already in a tailspin.  Were the next 4 cycles even worth trying?  Why are my numbers so low?  I already lost an ovary, a tube, and now the internet is basically saying I have nothing left in there.  Crushed doesn't begin to convey the heartbreak I was feeling.

I'm still sensitive to this topic - it's only been a few days.  I know that my body responded well to the treatment last time, and it's encouraging that our RE doesn't want to alter the plan yet -- that means this number is workable and didn't scare him like it did me.  I'm not ready to face the idea of never being able to bear a child of my own - I know there is a very real possibility that it might not happen for me but I've been trying to lock that idea and the associated emotions into a closet for now.  I don't want the negative to impact the possible positive outcome we could have this time around.  But it's still there.  Waving at me and creeping into my thoughts during the quiet moments.  It takes my breath away.

Perhaps it's low because I only have one ovary left - it makes sense that I would have lower than 'normal' numbers but for some reason that thought never occurred to me before.  Silly now that I think about it - but I do a pretty good job of tricking myself into forgetting that detail just 2 years later.  So what now?  We forge ahead.  When my period starts this first cycle starts.  I am very hopeful, and relieved that I already know what to expect at each appointment.  We've driven this road before, the path is marked.  I just need to follow along and let Jesus take the wheel.

It's 5:26pm on Sunday and I'm waiting for my period.  Waiting never gets easy.  Period.

xoxo

In a state with no required fertility coverage it takes a village to get it done - if you'd like to donate here's the link:
https://www.gofundme.com/projectbabyc

Project Baby: Backstory

Let's dig in to some of the details - it's clinical, it's personal, but it's real.

It took time and research to find the clinic that felt right for us.  There are several options in the Twin Cities, and tons of information to sort through. I'm not at an ideal body weight, I'll be the first to admit and acknowledge it.  There are some clinics that won't even have a consultation with you unless you meet a certain BMI - which I can understand, but it's still discouraging.  I found our clinic after reading online reviews and their posted statistics.  They have a BMI requirement only when it comes to IVF, due to the sedation required.  I can work with that (actually, I can work around that LOL).

When we first met with our doctor (a reproductive endocrinologist) he started with a litany of blood work on me, and a semen analysis for hubs.  This gave him insight to understand what we're working with.  The great news is that Dave passed his tests with flying colors -- count, motility and morphology were right where it needs to be.  Motility: do his swimmers know how and where to go?  Can they navigate the female reproductive system and make it to the end zone?  Morphology: are they the right shape and size?  There are treatments to correct both, but thankfully and miraculously he was top of the class.  Learning curve level HIGH: sperm are complicated.

Motility explained (credit: https://blog.episona.com/what-is-sperm-motility/)

Morphology explained (credit: http://fertilitysolutions.com.au/so-your-sperm-morphology-is-low-should-you-be-worried/)

My initial tests were normal, I just don't ovulate on my own and therefore have very irregular periods.  It's a hormone imbalance that can be fixed with medication to start my cycle and get us rolling.  This is why we're part of the "unexplained infertility" category -- there is no one thing to blame or fix.  So we just have to pick a course and try it out.

Our RE also conducted other diagnostic tests, including an HSG (Hysterosalpingography).  It's a procedure that injects dye into your uterus to see if it flushes out the fallopian tubes.  This ensures there aren't any blockages that would prevent an egg from passing through to implant in the uterus.  Here's a diagram from http://www.fertilityanswers.com/what-can-an-hsg-say-about-your-fertility/

And here's an example x-ray from http://www.dallasivf.com/fertility-testing/hysterosalpingogram-hsg/

It wasn't painful for me, but they do recommend you take ibuprofen ahead of time in case of cramping.  It was fast, and mine was clear - my remaining tube was wide open and ready to perform!  Success!

As you can read in this post, we did 4 rounds of IUI before taking a break.  I was emotionally and physically drained - and just needed to step away and regroup.  Since then we've moved twice and I've changed jobs - which also changed my health insurance.  

When we first started I worked for a company that offered a lifetime maximum of $10,000 for infertility coverage -- my new job offered $0.  Boop.  Understanding your insurance is a huge part of this process, because it is a financial investment.  Take the time to read your SBC (summary of benefits and coverage) and call your insurance provider to discuss if you have questions.  The clinic we chose does a great job of pulling all the details together as well and providing a printout of exactly what is and isn't covered.  

Ok, those are the historical high points.  Now that you know where we came from, we an get into where we're going.  And here's where we'll start up again.

xoxo

You're invited

This is my personal invitation to you.  To be a part of a very personal adventure.

Pack your bags.  Buckle in.  It's time to go.

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If you're not familiar with the beginning, start here.  If you remember that from 18 months ago, then welcome back.  I'm opening the door to the most vulnerable parts of our lives right now once again.  I'm scared, I'm nervous, but I'm also tired of carrying this burden alone.  I need support, I need love, I need prayers.

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Infertility is a big word.  It can mean many things.  He might have a problem.  She might have a problem.  They both might have a problem.  The problem could be treatable.  The problem could be unknown.  There are tests, scans, drugs.  And there's waiting.  So much waiting.

We are personally working with the ever-so-vague "unexplained infertility".  Meaning: everything looks relatively fine on paper, but there's an X Factor playing a role in prohibiting our ability to get pregnant.  No quick fix, no "easy" button - just a lot of trial and error.

We want children more than anything we've ever wanted - and it's frustrating that it takes so much work to try to make it happen.  There is so much to learn, and the more I know the more I envy the couples that just get lucky.  They don't know how hard this process really is - and I wish I had the luxury to be so oblivious.

I'm on a crusade to pull back the veil that shrouds this process in mystery, and in shame.  I refuse to continue to believe that there is something wrong with us because we need assistance - and I want other people on this journey to know they aren't alone.  This can feel so isolating, and I want to change that.

So, if you care to you are welcome to join me on this path.  Maybe you'll learn something new, maybe you already know these details.  But I'm guessing that more folks than not have no idea - and I'm willing to try to change that with my story.  I'll be chronicling the coming days, weeks, months right here.  Welcome to our life - it's going to be interesting ...

xoxo

In a state with no required fertility coverage it takes a village to get it done - if you'd like to donate here's the link:
https://www.gofundme.com/projectbabyc