Sunday, January 6, 2008

Oh - and I had another IUI...

Sheesh, what kind of infertility blogger am I? I haven’t even written about IUI #2! So – it went down this past Thursday morning – January 3, 2008. That puts me at 3dpiui today. I was on follistim for 6 nights – 150IU for 2 nights .. 100IU for 2 nights .. and 75IU for 2 nights. Thereabouts. I felt a lot of heaviness and fullness in my ovaries after the first 3 days … and then it sort of … tapered off. Which was very troubling to me. I am worried the increasingly lower dose caused my follies to poop out or something.

Because I triggered on New Year’s Day – one of two days out of the entire year that my RE’s office is closed – I did not have b/w or an u/s on day of trigger – but I was there the day before – New Year’s Eve – and had a nice 16mm and a 14mm that morning along with a respectable E2 level that I can't recall right now. One assumes – since follies grow about 2mm a day – that I had an 18mm and a 16mm at trigger. (Unless of course – all of my follies pooped out. Which is unlikely. But I am still irrationally scared that it happened.)

Anyway – I’m perfectly happy with an 18 and a 16. It was my goal to have an 18 in the lead and hopefully – that WAS the case at time of trigger. I triggered with 10,000 IU of HCG on New Year’s Day – and had one IUI 36 hours later. The IUI itself went without a hitch – was painless and quick. I had J in the room with me … for my first IUI I didn’t … but for this one I figured – he should at least be in the room at the time of possible conception, so he came in and held my hand. It was nice.

I started 50mg progesterone suppositories the morning after the IUI (was supposed to start the night of the day that I had the IUI but oh well. I started the morning after. It won’t make any difference. I’m on one suppository/day.) I started my Lovenox 2dpiui … and I continue to take my daily regimen of: baby aspirin, prenatal, foltex, fish oil, pomegranate capsules and an extra OTC B supplement (because I don’t think my hemo has me on quite enough so I’m supplementing. I’ll pee out what I don’t need so am not worried about it. I’m kind of a rebellious patient actually. Oh well. I can’t help it. I’m smart and I question things and I make some of my own decisions. I am definitely not one of those patients who totally trusts her doctor. Just not in my nature.)

So now … we wait. More waiting. Hey – wasn’t that the theme of this blog’s first couple of posts? Ah, infertility. It’s really all about the wait. Unfortunately – I’m getting impatient… Oh well. Too bad for me. Sigh.

19 comments:

Meghan said...

Glad the IUI went well!

Melisha said...

I also have heterozygous Factor V leiden. I have had three early miscarriages. Thank you for writing this blog, I never imgained someone was struggling with the same things that I am. It brings me comfort to read your entries and it helps me to keep trying. I always thought I would get pregnant so easy and now I can't even imagine being able to get and stay pregnant. So discouraging with such sadness! I am so consumed with this I can barely focus on other things. I am starting my fifth week of Lovenox. I am concerned the dose needs to be higher so I have an appointment with my Hematologist on Thursday along with my RE. I would love to talk more with you!

ONE OUT OF SIX said...

Melisha - I am happy to talk more about this with you as well! I was shocked when I was diagnosed with Factor V and MTHFR. My first 2 losses were many years ago - and so when I had an early loss after my first IUI - I just thought it was bad luck - not part of a pattern. But we did the testing anyway - and there you have it - two blood clotting disorders! Are you TTC? And on Lovenox daily? Let me know .. hang in there hon!

Melisha said...

I am on Lovenox 40 mg once daily. What happens to me is I have this unexplained bleeding 4 days before my period is suppose to start. Which I think is implantation bleeding but can't be for sure? I started Lovenox before my last cycle and this implant bleeding was less but still there. I am thinking I need 40mg Lovenox twice daily. We are trying to conceive and have been for the last eight months. After reading your blog I made an appointment to see a RE, thank you for that. I have only been seeing my OBGYN and a Hematologist that was available in the area. I am hoping Thursday's appointment with the RE will help in explaining the weird bleeding and the right lower quadrant pain I am having with the bleeding. My OBGYN put me on Clomid before the RP panel came back so I just finished my second cycle of that. My OBGYN never said to stop the Clomid since it came back I had Factor V. I have always had normal menstrual cycles so I believe the Clomid is being used to increase Estrogen which will in turn increase my Progesterone levels. I am also wondering if I should be taking a baby aspirin as well. So many doctors so many opinions, I just don't know who to believe. I guess I take the helpful information from each and put it together in hopes to get pregnant.

ONE OUT OF SIX said...

Melisha - I think seeing an RE is smart. But you are right - so many doctors have so many different opinions - and it can be very confusing. It is smart to do your own research - and educate yourself as much as possible so you can be part of a dialogue with your medical team - rather than just accepting everything they say at face value.

Hopefully your RE will test your progesterone post-ovulation as well - this too could have something to do with that early bleeding.

I hope you find answers soon!! Let me know the appointment with RE goes and if you have any other questions - you can always find me here!

Melisha said...

My progesterone level at mid-luteal phase was 13.67. My OBGYN gave me progesterone suppositories but recommended I do Clomid instead. His main reasons being Progesterone suppositories can mask your period and you think you are pregnant and you get excited and then you find out your not and it takes an emotional toll on you after a few months. He also said they are messy and uncomfortable. I have heard of people using both Clomid and progesterone suppositories. Have you heard of this? I made a list of questions out for the RE and that is one of them. I will write you after my appointments on Thursday. Thanks for all your help, you have been great!

Melisha

ONE OUT OF SIX said...

First of all - who cares if the progesterone suppositories are messy?!? Like you give a crap about that if they help you get pregnant!! So that's just weird that he said that. Also - if you're on progesterone - you KNOW that it can delay your period, so you're not going to get excited unless you take pregnancy test and it's positive (he knows such things are readily available at the drug and dollar store, right?) Sorry, but I get riled up when doctors are patronizing to their patients!

Absolutely people use clomid and then use progesterone suppositories after ovulation. My RE puts all of his patients on medicated cycles on progesterone after ovulation - it's just standard procedure.

Good luck to you, I hope your appointment goes well!!

(PS - have you ever considered making the move to an RE? The way I see it - ob/gyn's are experts at delivering babies - but RE's are experts when it comes to MAKING babies in regard to couples with fertility issues. Something to thing about! Again, best of luck!!)

Melisha said...

I have been a little scared to go and see a RE, it makes my infertility issue seem so real and so complex. My OBGYN gave me false hope that my situation could be easily fixed with just a little Clomid. That was before he did the RP panel and found out I had Factor V. Then he said he wouldn't have anything to do with that and told me I would need to see a Hematologist. But what does a Hematologist know about getting pregnant? You could tell he didn't know much because he wanted to know what my OBGYN suggested I take. This is when I knew I had to find someone more specialized and more willing to deal with all my issues and not just pieces and parts. I was very happy I could get an appointment so soon. Another place I called told me it would be three months before I could get in to see someone. Come on that is like an eternity for a person trying to get pregnant. I will certainly ask about taking both the Clomid and the Progesterone suppositories together. Thank you once again for your advice, you have been great!
Melisha

ONE OUT OF SIX said...

Melisha - I have a hematologist too - she is someone my RE referred me to - and refers all of his patients with blood clotting disorders too - so she "knows the drill" so to speak. BEST of luck to you!!

Lynn said...

Hi ladies,

One more to add to the club! I have both heterozygous Factor V Leiden and MTHFR. One chemical pregnancy and one miscarriage at about 10 weeks (HCG levels were never rising at the right amount). 12 more months TTC and finally saw a very good RE that pushed more blood work. I have a family history of clotting disorders, but they are different ones which I had been tested for previously. So hematologist is recommending lovenox when I find out I'm pregnant next time. However, think I might have to go the IUI route soon. Hematolgist seemed a little leary of taking clomid or other hormones - greater risk? Just wondering if either of you heard the same?

ONE OUT OF SIX said...

Lynn - I think the hormones can cause your blood to possibly clot if you have these disorders - but only possibly. Most importantly - are you on a high dose of folic acid and other b vitamins - and a daily baby aspirin? Those are important too. And you could always talk to your hemo, if she is concerned about possibility of clot on the meds, about starting the lovenox earlier, before BFP - either pre-conception - starting early in your cycle - or pre-implantation - starting right after ovulation.

I'm in the pre-implantation camp - I started two days after my IUI.

Fingers crossed!!

Lynn said...

Thanks for your thoughts! I'm going to see the RE next week, so I'll have to see what she says. I think the hemo, while seemingly smart, focuses more on oncology. I plan to get a second opinion from a hemo that focuses more on these issues.

I'm not taking a baby aspirin (funny nobody suggested it yet), but I'm going to start tomorrow. I'm likely to ovulate in the next day or so - maybe it will do something different this month!

My pre-natals have 800 mcg of folic acid, and I eat spinich like Popeye ;)! Not sure about the other b vitamins. Do you know anything in particular here?

It's so encouraging to see others in my boat that are so informed and taking charge of their situations. I cross my fingers for you and hope it's your month!

Glad to hear the Lovenox isn't too scary either.

ONE OUT OF SIX said...

Lynn - for women with MTHFR - up to 4 grams of folic acid (a little more than four times what you're taking in now!) is often recommended - typically a hemo or RE will prescribe a special supplement - brand names are Foltex, Folgard, Metanx - basically they all provide a high dose of folic, along with extra vitamin b6 and vitamin b12. You pee out what you don't need - I'd up your folic and those other b's - it won't hurt - and could a very good thing. Women with MTHFR don't metabolize folic acid correctly - that's part of the reason for the enhanced clotting risk - hence the mega dose. And unfortunately - with the inability to metabolize folic correctly - comes an increased risk of neural tube defects for baby (the mega folic dose helps to lessen this risk as well - just as a "normal" dose of folic lessens this risk for women who don't have MTHFR.) I need to find some good links about these issues and post them on my next blog entry (which I'll hopefully get around to this weekend!)

Glad to help, glad you're seeking information - it's a good thing!!

Melisha said...

Well I had my appointment and have lots to share. My Re seemed great and had a good sense of humor. He was surprised the Hematologist put me on Lovenox for just having heterozygous Factor V. He feels miscarriages as early as mine are not caused by having heterozygous Factor V. If I had additional bleeding disorders or if I had homozygous Factor V then he would put me on the Lovenox 40mg twice daily. He said he wouldn't take me off the Lovenox 40mg because it will not hurt me but he did say I only have to take it from ovulation until my MP starts. When I do get pregnant (thinking positive) I will continue on the Lovenox through the pregnancy. I was very happy to know I can have a break from the Lovenox! He feels my miscarriages are due to an implantation problem. I have been saying this to my OBGYN but not getting anywhere, so you could imagine my excitement to hear this from my RE. RE thinks either there is a problem with the lining of my uterus or it is a hormonal problem. My appointment happened to be great timing, it was day 12 of my cycle. The RE did an ultrasound and my left ovary has a follicle measuring 22cm. He likes it to be 23cm so I am almost there. He perscribed an HCG shot to be taken today to induce ovualtion 36 hours later. On Sunday I am to start the regimen of Lovenox 40 mg once daily, Prometrium 100mg twice daily, 81mg aspirin, and a prenatal vitamin. I continue doing this until Jan. 27and then I take a HPT, if it is positive I continue on this regimen. If it is negative I stop all three and let my MP start. Then on day 10 of my next cycle I will be scheduled to have a Hysterosalpingogram. He says I should not have implant bleeding and if I do he wants to do a uterine lining biopsy. Sorry this is so lengthy I just wanted to share the good news! So I guess all three of us will be entering or have entered this dreaded waiting period between ovulation and either pregnancy or MP. This is the most painful time for me. Best of luck to you both!
Melisha

Melisha said...

Sorry, I meant mm not cm on my follicle size. That is a big difference!!!(LOL)
Melisha

ONE OUT OF SIX said...

Melisha - I like your RE!! He sounds very proactive - and I like that even though he didn't 100 percent agree with your hemo - he didn't poo poo her treatment plan or try to strong arm you into going a different route. And the plan he has in place for you sounds very solid to me. GOOD LUCK!! :-)

Melisha said...

Thanks! Please keep me updated on your situation. Have you had a Hysterosalpingogram? If so, was it as painful as people are telling me? Is the test very informative? Thanks again for all your help!

Melisha

Lynn said...

Thanks so much for the info on the folic acid. You already know a lot more than the hemo I'm seeing ;).

I'm going to another hemo this week, so I'm going to see what else I can learn from him. He seems to have more experience in this field. I'll ask for the folic acid perscription as well.

Melisha - I'm going to see about a hysterosalpingogram when I visit my RE this week. I had a hysterosonogram (this is where they insert a saline solution through a catheter to look at the uterus) aready. If they are any bit alike, I had some cramping, but it was quick and was over once the procedure was done. By the way, I have zero tolerence for pain!

Melisha said...

Lynn,

Thanks, I hope I don't have to have it done but it is good to know it won't be too painful! I wasn't too impressed with the hemo/oncologist my OBGYN sent me to either. Hopefully your second hemo will be better!

Thanks,
Melisha