The protocol that worked...

A number of you have asked me about what happened prior to my BFP. I've offered to give a play-by-play and decided that it was easier to do it here since I'm sure it will come up again.

First things first. Disclaimer: I am not a medical doctor. I am not offering medical advice. My results may or may not work for you. I am only offering up the protocol that worked for me. Please view it accordingly.

Appointment 1: Preliminary FSH reading (Dec. 17, 2012)

Blood test result today:

Estradiol (E2): 41

Follicle stimulating hormone (FSH): 35

As per MD, your FSH is elevated. MD recommends birth control pill to lower FSH in order for the follicles to grow.

Medication instructions:

Start/Continue with prenatal vitamins – one tablet everyday

Start birth control pill today, 12/17/12 – 2(two) tablets taken together from 12/17 to 12/23.

Next monitoring on 12/24/12 for blood only at 8am Columbus Circle.

Please email me back if you need me to call in script for birth control pills. Email me name of the pharmacy and telephone number.

Please let me know if you have any questions.

Note: between Dec. 24th and Jan 11th, I did not return, due to a family emergency. I was taking 1 tablet every other day during that time.

Appointment 2: Monitoring and Bloodwork (Jan 11, 2013)

Estrogen <Low
FSH 35

Instructions:
Please take birth control pills to help suppress the FSH level for a
dominant follicle to grow.

Increase birth control pills to 1 tablet every day from today to 1/21/13

Your next appointment is scheduled for 1/22/13 for blood work only.

Have a good day!

Note: I did not return on 1/22 because I had the flu. I continued to take the tablets and returned on 1/27.

Appointment 3: Monitoring and Bloodwork (Jan 27, 2013)- FSH is lower now, time to wean off of OCP

below are your blood results.

E2  31
FSH  4
LH  3
P4  0.2

Please reduce birth control pills 1 tablet every other day ( skip today,
take 1 tomorrow, every other day until 2/3) and return to the office on 2/4
only for blood work . If you have any questions, please feel free to
contact us.

 Appointment 4: Monitoring and Bloodwork (Feb 4, 2013) - FSH is elevated again on 1 tablet every other day
Your lab results from today are as follows:

Estrogen 42
FSH 25
LH 10
Progesterone <low

Please continue with the birth control pill 1 tab every other day until
2/7/13 and return to the clinic on 2/8/13 for blood work only.

Appointment 5: Monitoring and Bloodwork (Feb 8, 2013) - Snowstorm hits NYC, nurses say to stay on one every other day and come on the 11th

Please continue the pill every other day and return on Monday for blood
work, 2/11/13.

Appointment 6: Monitoring and Bloodwork (Feb 11, 2013) - FSH is still a bit elevated, but E2 levels indicate a follie may be growing

 I am writing with the results of your blood work today:

E2      62

FSH    21

LH      11

P4     0.1

The doctor has reviewed your chart and would like you to return for blood
work and sonogram on Thursday, February 14, 2013, any time between 7:00 am
and 1:30 pm. No medications at this time.

Appointment 7: Bloodwork and Sonogram ( (Feb 14, 2013) - Sonogram indicates there are two follies growing on the left ovary - 7mm and 4mm; no meds

FSH    21

Your FSH level is stable. You don't have to take any medications, simply
return to the office on Tuesday 2/19 for blood work and sonogram. If you
have any questions, please feel free to contact us.

Appointment 8: Sonogram (Feb 19, 2013) - Sonogram now shows one follie at 15.5mm

Appointment 9: Bloodwork and Sonogram (Feb 20, 2013) - Sonogram now shows one follie at 18mm 

Blood test result:

Estradiol (E2):277

Luteinizing hormone (LH):41

Progesterone (P4): 0.6

As per MD, your Egg Retrieval is confirmed for 2/22/13, Friday, at 8am/

Please return to office with your husband at 7:30am.
Anika, continue with Ibuprofen/Advil 600mg every 12 hours until tomorrow's
procedure.


And there you have it, folks! My doctor followed a natural IVF cycle protocol, using OCP to suppress my FSH levels and encourage a follicle to grow. Until egg retrieval, OCP were the only meds I took. 36 hours before my retrieval, I took a nasal spray. That was it. When I first embarked on my IVF journey, I thought I would have to give myself shots, but I didn't. This was minimally invasive!

Retrieved an egg today...

This morning, I woke up at 4am! Nerves? I'm not sure. We had an egg retrieval appointment at 8:00. Dh and I got there early and I tried to busy myself in the waiting area.

I went in for the sonogram, first, to make sure the follicle was still there. And it was - measuring a nice, plump 21mm! The doctor (a new woman I've never seen before) said my lining was good, which was comforting. I told her that if the egg fertilized, I want a fresh transfer for this cycle - not frozen.

Next was the procedure room. My instructions for retrieval day were to not wear anything with perfume - no lotion, deodorant, etc. I can survive a morning without deodorant, but I cannot survive a morning without lotion. When I changed into my hospital gown, it looked like I had fallen into a vat of flour. All for a good cause!

I felt more pain at this retrieval than I felt at the one almost exactly a year ago (2/28, I think??) But, they got the egg and Dh made his contribution, so we are just waiting. We should hear by tomorrow at 3pm whether it's viable or not. If it is viable, they will do the embryo transfer on Sunday morning at 11:45.

In the interim, I am taking progesterone suppositories 2x daily and estradiol (2mg per day).

I felt on top of the world after the procedure. I went to the mall and bought a ton of girly clothing. Since my hormones have been regulated, I've felt more like "dressing up" and accessorizing.

I'll follow up tomorrow to let you know the news from the doc!

Keep crossing those fingers!!!

Appointment results from yesterday

So, at my sonogram yesterday, there was a 15.5mm follie. I couldn't believe it! Last Friday, there were two - 4mm and 7mm, natch both on the left ovary. However, I didn't expect 15.5mm. The follie from last year did NOT grow that quickly. This is a good sign.

After my appointment, I got the following mail (truncated):

-----------------------------

Please confirm receipt of email

Hope this email finds you well. Dr. Yang reviewed your test result today and below is your medication instructions.

Blood test result:

Estradiol (E2):245

FSH:8

Luteinizing hormone (LH):11

Progesterone (P4): 0.3

As per MD, your hormone level shows that your LH is elevated. Elevated LH means that you are starting to surge on your own. Possible egg retrieval tomorrow IF the follicle is still there._ Please try to be here at 7am tomorrow for STAT blood and ultrasound.

No Nasal Spray tonight. 

-------------------------------

What a way to scare me!!! I leave the clinic talking about possibly triggering that night and get an email about coming in the very next day (today) for an egg retrieval. This train was moving at 200mph. 

So, DH and I went this morning, but the egg retrieval wasn't necessary. My LH was only 8 today - so no spike. However, my E2 levels were slightly lower - 240. Of course the crazy-lady in me hit the internet right away to see if that was a harbinger, but the sites I read seemed to think it was okay.

I am really hoping that it doesn't signify a decrease in egg quality. I asked the nurse what the E2 drop meant and she said it could mean that the egg is done maturing. 

So, I have to trigger with the nasal spray tonight. $80 nasal spray! $80 nasal spray that I had at home and DH threw away... I digress...

I have another appointment tomorrow morning and they will most likely schedule egg retrieval for Friday morning.

I haven't been to work all week because of school work, but it all works out for my appointments. It also helps that school is right around the corner from the clinic.

Please send vibes for a healthy egg retrieval, if you've got any vibes to spare!!!

If you surrender to the wind...

There is a quote by Toni Morrison that I have just been loving...

"If you surrender to the wind you can ride it" - Toni Morrison

sur·ren·der (s -r n d r). v. sur·ren·dered, sur·ren·der·ing, sur·ren·ders. v.tr. 1. To relinquish possession or control of to another because of demand or compulsion.

In my foolish youth, I saw surrender as such a dirty word! Nik doesn't surrender... she prevails... against the obstacles, against the odds.

However, I am a firm believer that you have everything within you, RIGHT NOW, to be everything you will ever need to be. 

It wasn't until I met DH that I realized there is some strength in surrender. There is some strength in having a bit of vulnerability. 

Life and love are a beautifully-orchestrated dance where sometimes it's just not your turn to lead...

If you surrender, the strength of something else can propel you. If you fight, you are not propelled as far AND you'll be worn out. 

Today I am surrendering. I am surrendering to the legal brief that desires completion. I am surrendering to the clinic making a last-minute decision to not retrieve my egg today, but wait until Friday. I am surrendering to the  desire to just take a minute for myself and to steal a couple of deep breaths and quiet time without feeling guilty.

I will ride it...

LAW

The Cracked Egg

Well, the eggie from the retrieval yesterday didn't make it! DH didn't believe me because I was laughing when I told him. He said he was waiting for me to say "just kidding". I wasn't laughing because I think it's funny. I just think this is going to be an interesting journey and maybe the laugh was more of a nervous laugh than anything.
Either way, back to the drawing board. I am taking OCP every other day (starting today) and I'll go back to the RE on Monday, Mar 12th.
Stay tuned.