Wednesday, January 31, 2007
posted by Tinker at 22:02
I talked the RE's clinic into giving me a prescription for three 75IU syringes of Gonal-F today, as the RE decided I needed just one more dose, and I just can't bear to toss out a nearly full pen. In hindsight, I can't believe I'm paying more money and doing extra injections to save this thing that is now sharing a drawer with the potatoes and onions in my fridge, hopefully until sometime near its expiry in 2008.
So my follicle count is the same kind of moving target that baseline estradiol seems to be. I'm beginning to believe that it has a lot to do with the person on the other end of the wand. Today I'm back to 20. It was the same RE today as for baseline, and her count is consistent across those two days; plus she's going to be the one doing the retrieval on Saturday, so she'll be looking for 20. We'll see how well first grade served her on the weekend.Labels: IVF 1
Tuesday, January 30, 2007
posted by Tinker at 09:59
So is it wrong for me to try to extract every last IU of the medication from my fancy pens? I mean, this stuff isn't cheap and we're paying completely out of pocket for everything. And by extract every IU, I don't mean just using the overfill, I mean using another syringe to suck every last drop of fluid out of that pen. Am I a bad girl?
The box says that there are 450IU in 0.75ml. A simple division gives me 60IU in each 0.1ml. From the two pens I've already emptied, I've gathered 0.3ml -- that's 180IU right there! The way things have been progressing, today could be my last day of injections, and I don't have quite enough in the pen I'm currently using to make the full dose. I'd really hate to break into a new pen and have to throw away over 450IU just because I need 75IU. Untouched, I can save that pen for the next cycle, or give it to someone else, right? I've done medical research; I have an inkling what I'm doing. So why am I feeling like I'm doing something wrong?Labels: IVF 1, Trying to Conceive
Monday, January 29, 2007
posted by Tinker at 13:53
I was very lucky this morning as my favorite RE was doing the wandings.
He said that the number of follicles I had could be considered a 'PCOS-like' response, but in my case it was just enthusiasm. My E2 is quite certain to go over 10,000 but he won't be cancelling me. And he said it was accurate to say that OHSS was most likely with a follicle count in the high 20s.
He was very reassuring and part of the reason is probably that my follicle numbers have dropped substantially today. I now have 14 instead of the 23 counted two days ago. They are, however, measuring bigger than average, with the top six ranging from 14mm to 17.5mm, so I have to go for another u/s and blood test two days from now. He's going to leave me on the slightly lower dose of Gonal-F.
Strangely, I'm a bit disappointed. I think I kinda liked the overachiever status I had with 20-ish follicles. Hopefully the reduced number of follicles ultimately means better quality eggs. Fingers crossed. Maybe I can visualize all my follicles as perfectly identical little steaks with AAA stamps on them. I've gotta try, as the bouncers were almost too successful!Labels: IVF 1
Sunday, January 28, 2007
posted by Tinker at 15:09
Well, I've learned a bit the last day or so.
I managed to remember some details of that last cycle (the one where they left me on stims the extra week) wrong. My E2 was 450* when I went for baseline. It was 97 after the extra week of downregulation. So that makes more sense, right? I went digging through some of my older papers and found some scribbles I made: on the first sample timeline I wrote that E2 should be under 100 at baseline; two months later I wrote onto my own schedule that it should be under 73. Yesterday I was told that it should be under 150. I understand that they like it as low as possible, but it appears that the actual cut-off is a moving target. I'm just going to call this one 'close enough' and leave it alone. So this worry about starting too high has been unnecessary.
Whew! One item off the list.
I was also concerned that I would stim too quickly because the biggest follicles at baseline were already measuring 9mm. I took yesterday's measurements and compared them with my previous two injectable cycles and the follicles are now measuring exactly where they should be (or at least, where they have been).
Wow. Two items down.
Your suggestions and support combined with that of some friends on a bulletin board have also been tremendously reassuring. An especially interesting comment is that the number of follicles is a more important determinant of OHSS than estradiol level, and that follicle numbers in the high-20s are the real danger. Curiously, the person who mentioned this to me attends the same clinic I do, though was told this by a different RE there.
So while I've never put a lot of stock in visualizations, I'm going to be trying some over the next few nights. Any partygoers who haven't yet arrived are going to be stopped at the door. No more follicles, or they'll be breaking the fire regulations and the party will be shut down!
*(In Canada we measure E2 in picomols and in the US it is measured in picograms. To convert picomols to picograms, divide by 3.67.)Labels: IVF 1
Saturday, January 27, 2007
posted by Tinker at 10:00
Apparently my follicles are planning a big party on my right ovary and keep inviting friends. I now have 14 over there, plus the 9 still on the left. Today is day 5 of stims and the biggest ones are measuring 13mm, 12mm, 3@11mm, and 10mm. The RE this morning (my clinic has five of them) seemed a little uncertain what to do. She dropped my Gonal-F from 225IU to 187.5IU and left the Luveris at 75IU. I have to go back on Monday for more testing.
That would have been okay, but two things she said disturbed me.
One was that she as much said that I have PCOS (maybe she didn't look closely enough at my chart and assumed that I had it because of the large number of follicles growing together this time around -- she is new and this is the first time this cycle she has checked me). Nobody has ever even remotely considered PCOS a diagnosis for me, as I don't have any of the other symptoms except possibly that I carry my weight around the middle, but if you look at my family (all thin to healthy weight people), we all do, on both sides of the tree, for many generations back. And fertility has been fine up until now.
The second and more disturbing thing is that she said that she doesn't want to see my E2 go over 10,000, as that would surely lead to OHSS. This left me flat. I had mentally prepared myself for a few eventualities (overstimulation, understimulation, poor egg quality), but not cancellation. Not cancellation. That simply has never been an option.Labels: IVF 1
Friday, January 26, 2007
posted by Tinker at 22:46
Oh! I forgot to mention...
Another one of Vancouver's sextuplets has died: report
The Province
Monday, January 22, 2007
There is a report this morning that another one of the Vancouver sextuplets has died.
One of the four boys reportedly died last week. It has not been confirmed whether it is a boy or girl who died most recently. BC Children's Hospital's spokesman has refused to confirm or deny the reports of the chidrens' deaths.
The babies, born two weeks ago and weighing only 1.8 pounds, were hailed as a miracle. The four boys and two girls were born at 25 weeks, just over the half-way mark of an average 40 week pregnancy.
I'm just going to continue shaking my head on this one.Labels: In the News
posted by Tinker at 13:53
Well, I'm not sure what to think today. After having my blood drawn, I asked a nurse what her opinion is on why I've been allowed to stim and she thinks that the higher E2 was only a result of having so much going on on my ovaries (with all the antrals and the fact that they were a bit bigger than average), and that the REs probably don't see it as an issue because there weren't any cysts or the like to be seen.
My E2 today is still elevated at 870 picomols (237 picograms), but I've been told to stay on the same stim dose. The docs do, however, want me to come in for another ultrasound tomorrow morning, just to make sure everything is still okay. Maybe I'll know more then.
As much as I dislike the ultrasounds, it is a bit reassuring that they want to be certain that everything is on track.Labels: IVF 1
Monday, January 22, 2007
posted by Tinker at 20:30
I had my baseline check this morning. It looks like I've got 20 antral follicles (9 on one side, 11 on the other) which makes me happy, but the largest of those follicles are already measuring appropriately for day 7 (about 9mm). The RE said she didn't think that they're producing any estrogen, but my bloodwork results this afternoon came back a bit high at 115 picomols (about 31 picograms for my American friends). On the last injectable cycle I did, I was told that they like to see it under 73 picomols (20 picograms) to start, and mine started around 90-something. They made me stay on suppression for an additional week. Well, this time I've got the go-ahead to start stims tomorrow. I wonder what changed?
--------------------
I talked with my youngest brother yesterday. He bought a second car seat because he wants one for each vehicle (for his 13-month-old) and I asked when he and his wife were planning to start on #2 because I had the impression it might be this spring/summer. Well, they already have, 'casually' he says. I should have asked him outright if she was already pregnant, because they keep that kind of a thing very quiet until the last minute and the second car seat raises a certain amount of suspicion. I suddenly feel an exceeding amount of pressure for this cycle to work because we've been very actively working on number two for well over a year. My SIL got pregnant with her first on the second month of trying, so I would be very surprised if she isn't announcing a pregnancy this spring. It really makes me want to cry sometimes.Labels: IVF 1
Saturday, January 20, 2007
posted by Tinker at 21:44
I find it difficult to really enjoy life to its fullest while trying to get pregnant -- I'm distracted, and my mind isn't all in the moment. Isn't it sad how it impacts us and our families? There are days I get upset with myself for not being grateful and enjoying my perfect little boy, just because I'm thinking about working on the next one....Labels: Rants and Shoot-Em-Up Stories
Wednesday, January 17, 2007
posted by Tinker at 16:28
One of B.C. sextuplets dies in hospital: report
CanWest News Service
January 16, 2007
One of the sextuplets born in British Columbia has died, Vancouver radio station CKNW reported Monday.
The B.C. Women's Hospital did not confirm the news. The parents of the six children are members of the Jehovah's Witness faith and have insisted on privacy.
The Canadian Press reported Monday that sources confirmed the death. One of the sources said the baby who died was a boy.
The six infants were born at 25 weeks gestation and weighed only 750 grams (1.5 pounds).
One baby was born the evening of Jan. 6, with the other five delivered early the next day.
Premature infants born at that stage of development face an 80 per cent survival rate, but still have to overcome major developmental hurdles.
Under pressure from the mounting public interest, the family released a brief statement to the media last week.
It said the mother was "resting and doing well" and the children were in "fair condition," meaning their vital signs were stable and within normal limits.
A hospital spokeswoman said at the time the parents were feeling "overwhelmed" and wished to remain anonymous so they could focus their energy on their family.
I have to begin by saying that I'm all about people having the freedom to choose what works best for them, but in light of the loss of the first of the six babies, I'm left wondering whether these parents were blinded with optimism -- because it certainly shouldn't have been a surprise once they arrived at the hospital to learn that there would be six babies. And did nobody tell them about the frightening health risks to both mom and the babies with such a large multiple gestation? And about the dismal survival rate? And about the huge possibility of long-term disabilities for the surviving children (if any survived)?
The news coverage that I've seen speculates that the six were the result of ART (my guess is a controlled ovarian hyperstimulation cycle). Did their doctor give them the go-ahead either to have sex or to do an IUI with that many mature follicles? How responsible was that? My clinic would have cancelled me or had me convert to IVF if I had produced more than five potentially mature eggs. Was the couple told 'no IUI or sex' and they did it anyhow?
I often read stories of moms of multiples who say that the risks were never clearly laid out for them. Should the clinic doing fertility treatments be responsible for this kind of counselling? The woman's OB/GYN? Or should it be the woman's responsibility to find this information herself?
I feel very sorry for this family having to go through the public scrutiny of their decisions, but they made some extremely risky ones and are already seeing that they can end up on either side of the statistics. Mostly I feel badly for the babies; the decisions their parents made could affect their quality of life forever.Labels: In the News, Rants and Shoot-Em-Up Stories, Trying to Conceive
Monday, January 15, 2007
posted by Tinker at 20:43
I think my little monkey knew things weren't quite right today.
He was snuggly tonight -- he's never snuggly -- and softly stroked my arm repeating 'nice'. It was the highlight of my day. A cuddle and a comforting word (a new one too) from my little man.Labels: Little R
Sunday, January 14, 2007
posted by Tinker at 14:15
When I queried my husband last week whether I should ask his mom to babysit this Monday so that we could go do something special (just the two of us), he managed to worm his way out of a commitment. So I booked a play date for Little R in the morning and some acupuncture for me in the afternoon. Yesterday he asked if I want to go to the optometrist with him on Monday* so that I can have my eyes checked too, making me suspect that he has altogether forgotten that it'll be my birthday.
So in lieu of any special attention from my family, I've been contemplating giving myself a birthday present this year. It's not something I usually do, but I thought it might pick me up a bit. The thing is, I can't think of anything for which I would wish other than spending time with my husband (and son, though we do lots of that already). A spa day might be nice, but that kind of thing is always more fun with someone, especially my husband (talking him into a pedicure the first time was amusing).
I'm thinking I should splurge and buy something. I've always wanted a nice pair of diamond earrings -- some Swarovski crystal or sparkly zirconias would even do -- but that doesn't excite me in the least right now. Beyond that I'm not much for jewelry. I'm not so into music that an iPod or some new CDs would make me happy; and I've recently ordered a couple of books from Amazon. There's nothing special in the way of camera gear I can think of. My house is as furnished as it needs to be (except that bedroom, but I don't consider that a birthday present, it just has to be done). So I'm kinda stuck and looking for inspiration.
* We'll be going to the optometrist on Thursday, in case you're planning your week.Labels: Rants and Shoot-Em-Up Stories
Saturday, January 13, 2007
posted by Tinker at 21:44
Experts Seek Fertility Panel Seat
Government Refuses to Alter Board's Makeup
Juliet O'Neill, CanWest News Service
Friday, January 12, 2007
The government rejected calls yesterday to add fertility patients and experts to the new federal agency charged with policing the use of reproductive technologies capable of creating human life.
The calls came from two Liberal MPs, a veteran fertility doctor, a fertility awareness advocate and a man whose wife was unable to conceive.
They held a news conference to urge the government to assign patients and others closely involved in fertility efforts to fill three vacancies on the 13-member board of the recently appointed Assisted Human Reproduction Canada agency.
Their complaint is "not who is on that board but who is not," said Danny Roth, who adopted a child with his wife after they were unable to conceive a baby.
The government has no intention of filling the three vacancies any time soon and "we feel the board's composition is adequate," countered Eric Waddell, spokesperson for federal Health Minister Tony Clement.
He added the board is free to consult patients and anyone else appropriate to the issues they will be examining.
Beverly Hanck, executive director of the Infertility Awareness Association of Canada, said it is "a matter of freedom and justice" that the thousands of Canadians who seek fertility treatment, fertility doctors and mental health professionals who specialize in the field be represented on the board.
Dr. Arthur Leader, a fertility specialist for three decades, said he doubted any members of the board had ever visited a fertility clinic.
Liberal MP Carolyn Bennett, a family doctor, urged Clement to "walk the talk of patient-centre care." Liberal MP Ruby Dhalla, a chiropractor, said the government had shown insensitivity to prospective parents who shoulder great hardship and cost to have a child. "What is most striking about these long-awaited appointments is that there is a glaring omission of fertility experts, patients and stem-cell scientists," Dhalla said.
In a telephone interview from Toronto, Waddell said the government is satisfied that the 10 members of the board fairly represent a broad range of expertise, perspectives and opinion.
"There is nothing preventing them from consulting with patients on a regular basis, with doctors, with experts in the field," Waddell said. "It's not just a self-contained unit. They are not just going to sit in a room by themselves and make decisions."
The first board meeting of the Vancouver-based agency is in March. Waddell did not rule out expanding the board some time in the future, but it is not in the cards for now.
The board chairman is John Hamm, a family doctor and former premier of Nova Scotia, and the president is Elinor Wilson, recent chief executive officer of the Canadian Public Health Association. The eight others are drawn from academic, legal, medical and faith-based circles.
There are three vacancies and people who could be very useful to discussion and decision-making wanting to fill them. Sure it would be more difficult if the board positions were all full, but they're not. Why are they being refused? Yah, I know... it's 'political', but boy this looks bad.Labels: In the News, Trying to Conceive
Friday, January 12, 2007
posted by Tinker at 21:14
I'm in the doldrums, and I've actually been feeling this way for a while. All I want to think about is getting pregnant. For nearly a month now I've been avoiding replying to emails (important ones too), visiting with friends, even making appointments and booking activities for Little R. It's pathetic and I'm embarassed about myself, but I have no desire to change it either. No, that's not true. I do have a desire to change it, but no motivation to do so.
So this cycle should just hurry up already.Labels: Rants and Shoot-Em-Up Stories
Thursday, January 11, 2007
posted by Tinker at 09:59
So here's the plan:
January 7: started downregulation (nasal spray 5x per day)
January 22: baseline ultrasound and bloodwork; start stims
January 25: bloodwork
January 28: bloodwork and ultrasound
January __: additional tests as required
February 2: trigger
February 4: retrieval
February 7: transfer
My baseline testing should actually be on the 20th, but the clinic's ultrasound slots are already filled. The nurse wanted me to come in on the 23rd, but I asked if it was at all possible to move it ahead.
I'm also doing acupuncture for the first time. I've had two appointments so far and find it quite relaxing. I really like the acupuncturist/TCM doc; she studied under Randine Lewis and is also a doula. She's my age, has a son a month older than mine, and reminds me a whole lot of another friend. I'll be going twice a week until ER/ET. She may be out of town the day I have transfer, but she has recommended someone who can fill in while she's away.
Typically, I'm a sceptic, but I'm feeling good with all of this -- the supplements seem to have given me more energy, and the acupuncture leaves me feeling very peaceful.Labels: IVF 1, Trying to Conceive
Tuesday, January 9, 2007
posted by Tinker at 18:58
I was going to reply to some issues from this morning's post in the comments, but it got too long, so I've decided to make it a fresh post.
When I intuited that I might have fertility troubles all those years ago, a vague notion began forming in the back of my head that if I were to adopt, I'd like to have an African baby. I'm not entirely sure why, but that's the picture I had for my family. In fact, I thought that if I could have biological children, I might adopt my African child anyway.
I don't think I've ever told my husband about the African baby scenario. He's not biased against any culture in any way, but from very early on I sensed that he was happy that he'd found a mate with similar fair colouring to his. Over the years of our relationship I had amended my adoption picture to include a caucasian baby to appease my husband. When I finally brought up the question of whether we might adopt or not, he was very quick to answer that he doesn't want to be raising someone else's children. He didn't want to discuss it. For him, there is no changing his mind, and he would far rather live childless than with a child not of his genes. Certainly I was disappointed, but decided to leave it alone and tackle it again another time.
These days, I'm feeling a tremendous time crunch and am concerned that my eggs might get too old before our family is complete. Out of this grew the question of donor gametes. Perhaps if a child were biologically his, but conceived with donor eggs, he would agree. No such luck. He was again very quick to dismiss the possibility of a baby that is not genetically ours. No discussion. End of story.
I'd really hate for you to take away from this that I'm married to some kind of bigoted patriarch, because that's so very far from the truth. He's got the biggest heart of anyone I've ever met in my life. He runs his own business, but spends at least as much time volunteering for a variety of organizations. He believes it's his job to help other people, just because he can.
Oh, and what do I think? I'm sad that adoption isn't an option, but relieved at the same time for a couple of reasons. One is that once my eggs are too old, that's the end of it all; there's a certain amount of relief in that kind of finality. Two is that Manuela's story has impressed upon me the importance of birth parents to an adoptee, and while her experience is not the experience of all adoptees, I'd probably still be reluctant to take a child from its roots. As for donor eggs (important here too is that we don't have the option of a known donor), if I'm brutally honest, I'm afraid I might always harbour some kind of feeling, perhaps resentment, that the child is his and not mine. I don't know for sure, but the point is moot.Labels: Rants and Shoot-Em-Up Stories
posted by Tinker at 08:48
I had an enlightening though brief conversation with my husband on Saturday. In a prior, equally brief conversation I learned that adoption is out of the question for us. He doesn't want to raise 'other people's children'. This time the question was about donor gametes, and whether there would be a difference in his opinion if it was donor egg or donor sperm. Again, it's all out of the question; if the children are not biologically related to both of us, then we won't be having them.
Oh.
So once the clock is done ticking, that's it for us. Labels: Rants and Shoot-Em-Up Stories, Trying to Conceive
Monday, January 8, 2007
posted by Tinker at 19:09
Canada's first sextuplets were born in Vancouver this weekend. The hospital is being very quiet, undoubtedly because the family doesn't want to be splashed all over the media while caring for their 25-week preemies.
I don't know what more to say....
I'm curious about how and why, but totally respect the desire for privacy. I hope the little ones -- 4 boys, 2 girls, each around two pounds -- pull through.
The full story is here. Labels: In the News, Trying to Conceive
Saturday, January 6, 2007
posted by Tinker at 13:19
I'm feeling like I'm missing something. Would someone tell me why so many bloggers make the names of their meds unreadable/unsearchable? Is it a bad thing for someone to find your story having searched for a med that she herself is probably taking?Labels: Rants and Shoot-Em-Up Stories
Friday, January 5, 2007
posted by Tinker at 21:26
I put together my medical receipts for 2006 today. It won't hurt to have at least those ducks in a row when tax time comes, particularly because Revenue Canada is sure to wonder what I'm up to when a number that is usually only a few hundred dollars is suddenly in the multi-thousands.
My husband, ever the pragmatic guy, immediately asked what this kid (the one who hasn't even discovered Papa's half of his/her genes yet) has cost us. Well, all of last year's fertility treatment and associated meds plus the upcoming IVF will bring us to $12,548.90 and that doesn't include the cardboard shakes, hay pills, or the new pay-parking costs at the clinic -- a far cry from the $250 we spent on Little R, though I could bump that up a bit if I add the 3.5 years worth of prenatal vitamins I took until he was born. Oh, and we're not done yet. This could get really scary.Labels: IVF 1, Little R, Rants and Shoot-Em-Up Stories
Thursday, January 4, 2007
posted by Tinker at 22:02
For some reason I thought December would go on forever; or rather, that January would never arrive. Suddenly I'm only two and a half days away from starting downregulation, 'snurfling' a drug five times a day that was originally designed to help control prostate cancer.
Over the holidays I found myself with a little bit of idle time in a shopping mall, wishing that there was something more I could do about getting pregnant. Yah, I know, the get healthy routine is a good thing to do, but it wasn't the quick fix I needed at that moment. I believe I sighed wistfully and went on with my errands, but I've suddenly been swept up, taking the advice of one of my best online IF friends (Hi LMJ!). I've begun a supplement regimen that includes marginally palatable shakes, a product I thought was only put into anti-wrinkle preparations, plus tablets and capsules that smell like hay bales out on the farm. But now I'm really doing something, and I haven't even cracked a box containing a leaflet with print in a font smaller than mouse toenail clippings. And don't ask me where that simile came from (I blame the hay tablets).
And on the subject of meds, I got a surprise when I picked mine up from the clinic's pharmacy. I'm on different meds! I did just fine on the rFSH alone, but I'm now on the other brand of rFSH together with some rLH that I've never used before. If you're into conspiracies, this switch coincides with the fact that the rLH is free when you buy that company's rFSH -- a deal worked out between the clinic and the manufacturer. Oh, that and the fact that a nurse told me that the doctors have made a conscious decision to use more of that brand of rFSH for everyone.Labels: IVF 1, Rants and Shoot-Em-Up Stories
