Roid Monkey

So, on Monday I started rubbing Androgel on my upper arm each morning…and taking two Estrace (orally…phew!) each night. This is the hormone priming step of my IVF protocol. Add these to the Pulmicort inhaler that I use to keep my asthma under control and the progesterone that my corpus luteum is dutifully excreting, and you’ve got quite a steroid soup warming in my innards… I keep checking in the mirror for facial hair, bacne, or increased muscle mass. Aside from my pesky chin hair (excuse me while I find my tweezers…erm…got it!) I haven’t noticed anything.

ImageA sampling of roids in my system. You can read about progesterone, and what makes a steroid a steroid, here.

 

Speaking of progesterone, I’ve relapsed into another of my pre-IUI TTC habits, namely, charting. I keep track of each morning’s BBT (basal body temp) measurement, my CBFM (ClearBlue Fertilility Monitor) reading, any eggwhite sightings, and sexual encounters on a little paper chart on my nightstand. Recording it on the paper chart has a certain old-school charm about it, but can be a bit tricky to analyze and doesn’t quite satisfy my appetite for data.

Enter FertilityFriend. I type in my data to this website and it uses an algorithm that incorporates the data from my temperature, cervical fluid, fertility monitor, and OPK (when I use it) to determine when I ovulated. Actually, there’s a ridiculous amount of other data I could enter, but even a data junkie like me has to draw the line somewhere…

charts aMy paper chart for this month (left), and the FertilityFriend version, with est. ovulation shown as a red vertical line (right).

If you spring for the VIP membership (or if you are a new member, in which case you get a free ‘teaser’ VIP membership), the website will evaluate how well you timed intercourse. C and I apparently did ‘Good’ this month

ImageAnother feature of the VIP membership is that it will overlay up to 7 charts and show you the average BBT pattern. I’m not sure what this would be useful for, but it looks pretty cool:

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The average line (in blue) eliminates some of the noise of individual monthly charts to reveal a general trend of low temps pre-ovulation, followed by progesterone-elevated temps post-ovulation, which drop off just before the next cycle start (bonus benefit of charting – no surprise visits from AF!)

 

And this brings me to my newest dilemma: when to pick up my meds. Obviously, I already have some of them (including the Androgel and Estrace), but there are still ~$1K-worth of meds that Kaiser pharmacy doesn’t carry, which I have to pick up. If it weren’t for traffic, I would have picked them up the day Dr. Y prescribed them. But now that there is a chance – however miniscule – that I might be pregnant, I can’t bring myself to shell out that $1K until I’m sure I’ll need it…

So it’s one more thing on my ‘to do’ list. If FertilityFriend is right about my ovulation date, and if I follow my usual luteal phase of 11 days, then AF should arrive on Monday, and I can swing by the pharmacy after that, with plenty of time before I need those particular stims… On the other hand, maybe I should wait longer – until my baseline ultrasound (next Thursday) to make sure there are any follicles to stimulate with those drugs…yes, I think that makes more sense.

It’s a plan! And thank you, bloggy friends, for inspiring me to think this through, and patiently reading while I do. 🙂 Yet another perk of blogging…it forces me to think before shelling out C’s hard-earned money!

 

p.s. Welcome ICLW visitors! You can read my TTC resume here, but in brief: I’m a 34-year-old chemistry professor with diminished ovarian reserve, who has been TTC for about 15 months, including one missed miscarriage at 9 weeks. After 1 unsuccessful round of IUI, we are moving ahead with our first IVF next month. I use this blog as a form of therapy, and as a repository for interesting chemistry (and biology) that I learn along the way!

Old habits die hard

As you may recall from my last post, the current plan is IVF homework this month; stims and ER next month; detox in July; and FET in August. Not wanting to waste a single egg (what if it’s my only good one left?!), I naturally asked Dr. Y for permission to try ‘the old-fashioned way’ this month. Ever the gentleman, Dr. Y refrained from sharing his thoughts (Why not just enjoy the break? Don’t you realize how low your chance of success is?), and he politely said that would be fine.

So I pulled my BBT thermometer, pen, and a blank chart out of the nightstand drawer, and dug around in the bathroom cupboard for my ClearBlue Fertility Monitor and a stash of test sticks. (Okay, so I may have used the phrase ‘the old-fashioned way’ a tad liberally…) I had skipped all this during our IUI cycle thinking it would be a relief not to have to trouble myself with the morning routine, but I actually ended up regretting it. Throughout the cycle I found myself missing all that precious data! I wanted answers:

  • Would the Menopur injections cause a ‘peak’ reading on the monitor?
  • What about the hCG trigger shot?
  • How long after the trigger shot did my BBT rise?
  • Did the progesterone suppositories cause a higher BBT than usual?

I don’t know! And that bugs me a little bit.

Anyway, I’m back to collecting my precious data this month (and probably will through IVF too, because, why not?!)

And to everyone who wondered how the ClearBlue Fertility Monitor works, the rest of this post is for you. (Wait, nobody is wondering that? In that case, read this hilarious post by Stupid Stork instead…)

Still here?

So, the ClearBlue Fertility Monitor…

Like OPKs, the ClearBlue Fertility Monitor (or CBFM for short) monitors the levels of hormone in my urine. While OPKs detect luteinizing hormone (LH) that surges 24-48 hours prior to ovulation, CBFM detects both LH and estradiol (E2). E2 rises a bit sooner, and a bit more gradually than LH, which means the CBFM can give me more advance warning before ovulation. (This makes it easier to have some semblance of romance in this whole TTC thing. I can say ‘It’s been awhile since we’ve gone out; let’s make Wednesday a date night,” instead of “Wake up! Sexytime! Now! NOW!”)

Each morning starting on CD6, I POAS, cap the little stick, and snap it into the appropriate slot on the monitor. The monitor waits 3 minutes for the stick to develop and then shines a little red light on the stick ‘reading’ the result. For the scientists reading this, I assume the monitor works like a visible absorbance spectrophotometer; I’m looking forward to taking it apart to investigate once I’m sure I don’t need it anymore…

Anyway, after reading the stick, the monitor displays one of three possibilities:

  • Low: low E2 and LH levels. You can have sex today for fun or romance, but you can’t in good conscience use TTC as an excuse.
  • High: high E2 but low LH levels. You can use TTC as a pretty good excuse to have sex today.
  • Peak: LH surge. Ovulation is imminent. Sex today is pretty much required.

The sticks (which you have to purchase separately) look a lot like OPK sticks. But there’s no ‘control’ line – just one line for E2 and one for LH. And the color changes (particularly the E2 color change) are definitely more subtle than for OPKs – hence the need for the monitor to read the result.

I tried, unsuccessfully, to figure out the chemistry (or biochemistry) behind how CBFM works. I imagine that the LH line works using antibodies in a way similar to what I described in this post about how HPTs work, but I don’t know for sure. The mechanism for detecting E2 has to be somewhat different since (a) it’s not a protein hormone, and (b) the E2 line gets lighter as E2 levels increase, instead of darker.

Anyway, here’s a figure showing my monitor & corresponding test sticks for each possible fertility reading:

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Note the cute little egg symbol on the display for ‘peak’ fertility.

I color coded the hormone labels in the figure above to match this diagram I found on the interwebs showing how the menstrual hormones rise and fall at varying stages in a cycle. Note the gradual estradiol rise (blue), peaking a day or two before the LH surge (green):

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Incidentally, while doing a Google image search for LH and estradiol levels, I found the coffee mug above right, which I would want…except that I don’t think I’m gutsy enough to use it in public. They also sell a hat…