Got back from CCRM last night and am enjoying being back at home with my dog, not to mention the fact that it is 60 degrees and sunny here in Seattle today. When we left Denver it was snowing and 25, so a big difference. This might be a long post, I want to try and recap everything that went on during the one day workup so that I have it for my records, and in case it helps someone that stumbles across my blog later.
Our day started with a drive from my mom’s house in Denver down to Lone Tree at 6 am. And I couldn’t have coffee due to the doppler ultrasound later in the day so I was a bit (ok, a lot) tired and cranky. We were basically the first people in the parking lot but then others started to show up right after we got there. A few weeks ago a lovely lady named Maureen had commented on my blog and we found out that we would both be at CCRM for our workups on the same day. So as the various couples went into the building I couldn’t help wondering if one of them was Maureen and if we might run into each other. Well, as we were signing in I thought I heard the receptionist address one of the women as Maureen, but I wasn’t quite sure.
After we got checked in we got a huge binder of information and went into a conference room with all of the couples for the orientation. The orientation meeting was good, most of the items that I already knew having gone through IVF twice already, but a few things that helped to understand CCRM – their nurse schedules, contact info, processes, etc. They did go through a whole lot on the details of the IVF cycle as well as the risks. I could tell my husband was a bit uncomfortable as this is probably the first time for him that he’s heard all of this in as much detail as they went into. After the hour long orientation we had a few minutes and I ran into the woman that I thought that might be Maureen, and it was her! By far my favorite part of the day was getting to meet her and talk a little bit about our stories. She is a lovely lady and we have the same doctor and similar protocols, so I’m excited to get to know her more and have a ‘buddy’ at CCRM through this process.
After orientation we met with the business office to sign a bunch of forms and talk about the financial part of this fun process. Apparently our insurance has qualified us for something called the Parent Steps program, which may get us some discounts if we pay them directly and then they pay CCRM. So I need to call them and figure out how all that works. The rest of the process was similar to what we had gone through before and fairly straight forward.
Next we had more forms to sign for the lab – everything for the storage and preservation of embryos, risks, what happens to the embryos (if we get any) if we die or divorce, all the fun stuff. Luckily it went by quickly, but it felt a little bit like signing for a mortgage with all the paperwork.
From there we moved on to our consult with our nurse, L. From the moment we met her I knew she was perfect for me. She was pretty high energy, blunt and straight to the point with a good mix of compassion as well. I feel super comfortable that she will be working with us and advocating for our care. She went through all of the process for our testing – including the genetic testing we are doing as well as the CCS process for testing the embryos.
After all the meetings we moved on to the less fun poking and prodding. First was the baseline ultrasound with the doppler testing for blood flow. It’s been so long since I’ve seen my old friend the dildocam, I think that was when it hit me that we were really doing this again, that dildocam dates and drugs are my future for a while, deep breath to process that reality. Anyway, back to the story. The dildocam showed 20, yes 20, follicles on my right ovary and 7 on my right for a total of 27 follicles! Um, where the hell did those come from? I asked her to measure again, since the most I have ever had is 16 with the last IVF, and the IVF before that my baseline showed 8 follicles total. And apparently that 27 number is correct (more on this later), but I was a bit shocked, to say the least. As far as the doppler, my left side blood flow was normal at 2.88, and my right side blood flow was too high at 3.46, which they said meant I should do absolutely zero caffeine when we start stemming and some sort of electrical acupuncture at some point (apparently I need to figure out more about this as now that I write it down I have no clue what that means).
Next my husband had to go do his thing while I had a bite to eat and read pages from my binder. The results from that haven’t come in yet but hopefully we will get them next week.
Then it was time for the hysteroscopy – which is basically where they put a camera up you to take a better look at the uterus. I was worried about this one as I’ve read varying things about the level of discomfort. Luckily I ran into Maureen again and she had already had hers done, and she told me it wasn’t bad at all. And she was right, it was super quick, no worse than a pap or IUI and I didn’t even have cramping or anything after.
Right after the hysteroscopy we met with Dr. G to go over the tests that had come in during the day.
And this is when he dropped the AMH bomb (which was tested during my day 3’s a week earlier) – apparently my AMH is now 5.5 up from 2.1 and 1.8 before that! I literally responded with the words ‘holy shit that is a normal person level’ when he told us. He said he doesn’t know how my AMH, FSH and AFC could go up by so much over the last two months, but to basically keep on doing what I’m doing – acupuncture, all the supplements list, as something is apparently working. Obviously this doesn’t mean anything about my egg quality (the real problem here) but he said it’s a good sign that everything else is at least going in the right direction. So we’re going to stick with the Estrogen and Testosterone priming instead of birth control in the suppression phase, and then do Follitisim or Gonal-F with Menopur and Saizen (human growth hormone) for stims. Since I’ve been a poor responder in the past he is still going to start me off with a high dosage of stims to start and monitor carefully from there. He also wants to make sure we do the Beta-3 Integrin test – which has to be done 9-11 days after I ovulate (guess I’m back to peeing on sticks again, great). So will be back to Denver in a few weeks to do that and then with the next CD1 we’ll get started.
Last for the day was getting our blood drawn, comprehensive panels for sexually transmitted diseases (required, we had to do this for the last one too), genetic testing, vitamin d, TSH, and a bunch of other stuff that I’m probably forgetting. My husband is deathly afraid of giving blood and gets queasy anywhere near needles, so watching him have to give 6 vials of blood has me laughing pretty hard – mean, I know, but it was pretty funny. I then had to give 9 vials myself – a new record for the number of vials I think I’ve ever done in this process.
So that’s it – somehow I have stumped the doctors with my numbers, which is good, but not enough to actually predict good quality and success, hopefully the protocol, the great staff and lab at CCRM and my doctor will make that happen.
This protocol will be long – suppression, then stemming, then freezing the embryos (please, please let us have embryos), doing CCS – which takes 2-3 weeks, and then a cycle for the FET (again, please, please let there be something to transfer, do you hear me universe?). So if I’m calculating correctly that puts me at sometime in May to start stims and then into the summer before we would transfer. Which seems like forever right now, but I know that it will go quickly, and as long as it works, I won’t care in the end how long it takes. I’ll get my exact calendar after I do my prerequisite mammogram next week, not sure I have enough boobs to squish in the machine, but I’ll let you all know how it goes.
That’s it for now, I’m headed out to the drugstore to buy more OPK pee sticks so I can start peeing on them again in the morning. Come on body, let’s actually ovulate like a normal person this time instead of faking me out multiple times like last month to where I had no clue when I ovulated – think you can handle that?