A funny thing happened on the way to Colorado…

But first, I want to apologize for the radio silence. It started because I was so busy with the start of the school year…

  • We traveled to Chicago Labor Day weekend (8/31-9/2) for a good friend’s wedding. (I got my positive OPK there, so, once again, our plans for natural cycle IUI were foiled…)
  • Fall classes started that Wednesday (9/4).
  • My promotion portfolio was due Friday (9/6).
  • Then on Saturday (9/7), I flew to Indianapolis for a whirlwind trip the American Chemical Society meeting.
  • Then back Monday (9/9) to teach the second week of classes…

And then on Friday (9/13), I found myself…

a little bit.

pregnant.

 

 

As most of you know, I’ve been diagnosed with diminished ovarian reserve (AMH 0.19, FSH 13). I was a poor responder in both menopur + IUI and low-stim + IVF cycles. We were told by three different doctors that our chances of success with my eggs were slim.

We spent the last couple months doing (well, intending to do…) natural cycle IUI and taking a laundry list of supplements in the hope that they might improve egg quality, in preparation for a ‘last ditch’ high-stim IVF cycle at CCRM.

We had our CCRM phone consult a couple weeks ago, and scheduled our one day workup for this coming Tuesday (9/24).

As most of you also know, I’m a religious BBT charter. As a result, I know that I have a short luteal phase (usually only 10 days or so). When I got to 11, 12, 13dpo without a temperature drop (and noticed that my boobs were almost filling the cups of my bra…), I started to hope. Then a week ago Friday, I caved and used an old home pregnancy test I had lying around.

It was positive.

I called Dr. Y’s office and the advice nurse ordered a blood test.

  • Beta #1 (at 13dpo) was 110.

Then on Saturday, the spotting started. Red at first, then brown. On Sunday my BBT dropped half a degree and we just knew that we were miscarrying again. That morning I also realized that I had somehow FORGOTTEN to use the progesterone suppositories that the nurse told me to use when I called on Friday!! (You have no idea how completely out of character it is for me to ‘forget’ instructions from my healthcare provider…especially about something this important!!!) So I cried in bed for over an hour on Sunday, reading and rereading supportive comments on the online forum for my local Resolve support group, sure that I had killed our miracle baby with my thoughtlessness.

 

But I went in on Monday for Beta#2.

  • Beta #2 (at 16dpo) was 380.

I continued spotting for six days, but I kept going in for blood tests.

  • Beta #3 (at 18dpo) was 980.
  • Beta #4 (at 21dpo) was 3512.

Thankfully, the spotting seems to have stopped for now.

 

 

So now I’m feeling a bunch of things:

1) Elated. This is what we’ve been praying for the past 19 months. What we paid about $12K for so far, with nothing to show for it. What we were prepared to shell out another $25-30K more for at CCRM… And somehow we hit the jackpot ‘the old-fashioned way’?!

2) Terrified. Last time we got a BFP (nearly a year and a half ago), we miscarried at 9 weeks after seeing no heartbeat at our 8 week ultrasound. We were sad, but that was just the start of our infertility journey. At the time we were so sure that we would be pregnant again in a month or two. We’ve had a roller coaster year of infertility, a DOR diagnosis, a life-threatening injury, and two failed ART cycles since then. I can only imagine what a miscarriage would be like now that we know what is at stake… We are so far from out of the woods, and I’m really scared.

3) Embarrassed. I know it sounds really stupid, but I feel like a big fat infertility fraud. Like all the wonderful people I’ve met through this journey will resent me. (I could hardly blame them, as I’ve resented my share of pregnant women.) I feel bad for even saying that I feel this way. I’m sure you’re all like “Boo hoo for the poor pregnant girl.” But it’s weird. Infertility has become a part of my identity somehow. If this pregnancy sticks, does that part of me just die?

 

 

So we canceled the trip to Colorado. (Well, for fear of jinxing it, I waited until Beta #2, and used the word “postpone” rather than “cancel” when I called CCRM…)

Our first ultrasound is on Friday.

We are cautiously hopeful…

*******

To our friends IRL, I’m sorry that you’re hearing our news for the first time like this. Given our history and how early it is in the pregnancy (just 5 weeks today), we’re not ready to share far and wide yet… But I didn’t want to leave you hanging! C & I would appreciate your discretion for now.

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Inspiration…and testosterone

Since starting this little blog, I’ve enjoyed finding other bloggers to commiserate with. But in finding bloggy friends, I’ve done my best to avoid blogs of people who were already pregnant. (Exceptions include Vanessa at Yeah Science! – the name of her blog was just too tempting,  and JoJo at An Infertile Road, my very first follower, who got pregnant – on her first IUI! – while I was following her.) I avoided pregnant bloggers because I wanted to shield myself from having to think about pregnant women, a sentiment that Jenny at Dogs Aren’t Kids expressed so well in a recent post.

The problem with this strategy – at least for me – is that it didn’t leave much room for optimism. I loved that there was/is no shortage of support and excellent company in my misery…but I also found myself doubtful that treatment could work for me. I mean, it didn’t seem to have worked for any of my other bloggy friends, so who was I to expect that it would work for me?! (Another problem with this strategy is that it makes me a little bit afraid of actually getting pregnant – like this amazing support system will suddenly vaporize as all my new friends go running for the hills!)

Since my last post, I took advice from Kimberly at No Good Eggs and joined my local Resolve support group. I haven’t been to a meeting yet (the next one is November 19th), but I joined their online forum. On this forum I found inspiration in the form of a Protocol Buddy – someone who followed my weird IVF protocoland had the same baseline AFCand got pregnant! And she writes a blog! I am so encouraged!

Furthermore, this experience gave me the courage to face my fear of pregnant infertility bloggers, and I started reading Jen’s blog, Overworked Ovaries. (Jen’s name and cute avatar kept popping up in the comments section on all my favorite blogs, with hints that her infertility issues might be similar to mine.) I’m about halfway through reading her posts (oldest first), and I find it so exciting to read a story that I know has a happy ending! It’s also great to see that so many of her awesome bloggy friends haven’t abandoned her, but are following along and cheering her on through her pregnancy. And I can’t help but think this is what it’s about! This is what I want!

And I feel hopeful.

*****

Now, let’s talk about testosterone. But first, the disclaimer:

I am NOT an endocrinologist, or any kind of medical professional! This blog does NOT purport to offer medical advice, medical opinions, or recommendations. Please take this for what it is – the ramblings of an infertile woman trying to make sense of her complicated treatment protocol!

*****

Last night I applied my final Androderm patch. The night I applied my first patch, I noted first that it is weird looking. C calls it my third nipple.

ImageI wasn’t exactly sure how to apply it, so I checked the website. Clearly they are not marketing to women trying to get pregnant:

Image

I couldn’t help myself, and decided to check out the website for Estrace cream for comparison:

Image

I’ll leave it to cleverer folks than me to comment…

Anyway, I waited to write about the testosterone-priming until now, partly because I was hoping dreading expecting to observe some side effects. I observed none. This fact makes me a bit skeptical that this low-dose patch would actually do anything for a 200+ lb man with low sex drive. Then again, that’s not why I am taking it.

And why am I taking it?

From what I can tell, the use of androgens (broad term for male sex hormones including testosterone and DHEA) to treat infertility patients is pretty new, and pretty controversial. Most of the papers I read were written by physicians at the same few clinics. But I think the gist goes like this:

  • Recent studies suggest that Diminished Ovarian Reserve is a condition characterized by the reduced ability to make androgens (including testosterone). This correlation seems to be especially strong in younger DOR patients. (Interestingly, several of the papers contrast DOR with PCOS, a condition characterized by overproduction of androgens…)
  • Testosterone is produced in the ovaries, in ‘theca cells’. Testosterone from the theca cells enters the ‘granulosa cells’, where it is converted to estradiol. (You can read more about estradiol in this post.)Image
  • Granulosa cells are the cells that surround the developing follicles and help prep and develop the eggs for ovulation.

The thought is that in theory [insert head tilt and two-handed gesture] since DOR patients can’t make as much testosterone, supplementation (through a gel or patch, or indirectly by taking DHEA – a testosterone precursor), will stimulate the granulosa cells to do their thing and prep those eggs. This is supposed to “enhance follicle recruitment” (more eggs) and “promote follicle growth and development” (better eggs).

At least a few studies seem to support this theory, showing a greater number of large follicles and better overall pregnancy outcomes for DOR patients treated with androgens (versus untreated DOR patients).

*****

I start stims (Clomid 100 mg + Menopur 150 IU) tonight, so I guess we’ll see!