FlowerWife's New Medicated Cycle Journal - Final Update 8/24 (long)

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FlowerWife
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FlowerWife's New Medicated Cycle Journal - Final Update 8/24 (long)

I am doing another journal for this cycle. Again it's partially for me to keep track of things, and partially for anyone that's going through a medicated cycle that wants to read about someone's experience. I hope someone here (besides me Chat Icon ) finds it useful!!

For ease I copied the history from my last journal and updated it.

ME: 29
DH: 30
TTC: August is month 16
DIAGNOSES: PCOS (Main Symptom is High LH), Clotting Issue PAI-1 4G/5G Polymorphism, Immune Issue Elevated NK Cells, DH and I are also Partial HLA-C Matches, Recurrent Chemical Pregnancies

A Brief Cycle Timeline
5/09 - Went off BCP After 12 Years
7/09 - No AF since stopping BCP, given Provera
8/09 - First Ovulatory Cycle Post-BCP, O on CD32
10/09 - No O or AF Since 8/09, Went to Ob/Gyn, Given Clomid and Provera and No Further Instructions
11/09 - Started Seeing Dr. B, Officially D/x with PCOS, Continued Clomid Cycle from Ob/Gyn with Dr. B Monitoring, No O
12/09 - First Injectable Cycle - Timed Intercourse - Femara/Follistim (150us) - Hyperstim, 10+ mature Follies, Cycle Cancelled, Mild OHSS followed by 3 weeks of BCP
2/10 - Second Injectable Cycle - Timed Intercourse - Slow Stim, Did not respond to Femara/Gonal-F (37.5ius), repeated protocol at 75ius, no response. Switched back to follistim, 21 days of stimming finally got 2 mature follies. Ovidrel Trigger. Progesterone Supps. No AF. At 17DPO had a beta of 5, 2 days later beta of 2 and AF, Chemical Preganancy.
3/10 - Time off from Medicated Cycles (new job), Start Metformin, O CD36, AF CD46.
5/10 - Third Injectable Cycle - Timed Intercourse - Femara/Follistim 75ius also Metformin/Dexamethasone/Vitamin E - 2 Follies, Ovidrel Trigger, Crinone Progesterone, BFP at 12DPO. Beta 42 at 14DPO. Beta 46 at 16DPO, Pregnancy deemed not viable, Beta 41 at 17DPO. M/C and Beta 0 at 23 DPO.
7/1 - Fourth Injectable Cycle - No O or AF Since M/C. Sono and hysteroscopy all-clear. LH Still High, Ganirelix everyday to lower LH and Follistim 75ius starting CD3. Metoformin. Monitoring on CD9 - 1 23mm follie. Ovidrel Trigger CD9. Start Lovenox CD9. IV Intralipids CD10. Crinone CD12. BFN @ 12DPO, Beta BFN @ 13DPO. AF @ 17DPO.

By personal choice of DH and I, all cycles were timed intercourse.

And here we are again.

7.31.10
Going to Dr. B for CD3. Expecting to start ganirelix 25units today and possibly follistim as well. Chat Icon

UPDATE (sorry if this is longish) - went for CD3 this morning. Dr. B walked in the room and literally spent 10 minutes silently reading my chart and computer files trying to figure out what to do with me . Anyway so here is the protocol so far:

-Started Ganirelix today 25ius in the morning
-Also started dexamethasone 75mg
-Start follistim 100ius on Monday
-Monitoring on Friday (although i prob have to go to AFS for it since I prob cant make Woodbury - although I may try to go to work late just so I can see Dr. B Chat Icon ).
-Ovidrel trigger when Im ready, intralipids around ovulation, lovenox and crinone after ovulation.
-Continue Metformin 1500mg

One possible new addition to the protocol which i think is SO weird. He said when i get monitored on Friday he may have me start an injectable called Luveris. Apparently its an LH injectable. so im thinking LH? Chat Icon I have enough LH for like all of Long Island to have a surge, thats why Im on ganirelix and dexamethasone . Anyway he said with all of the antagon that Im on, sometimes around ovulation a little LH is added back to optimally mature the eggs. So he said we will see based on my monitoring on Friday if we need to add it or not. Anyone heard of this or done this before? Ive never even heard of it. But obviously I trust Dr. B as much as I trust my DH so I'll do whatever the man says!!

Also, I talked to Dr. B about in depth, and then DH and I spoke about it, and we decided that we are still going with timed intercourse over IUI this cycle. It's just whats right for us considering the issues.

SO here we go again, please Chat Icon . I'm trying so hard to be positive this cycle. I'm not sure how emotionally I will handle another BFN or m/c.

Current Meds:
-Ganirelix 25ius in the AM
-Dexamethasone 75mg
-Metformin 1500mg

8.2.10
Just a meds update

Current Meds:
-Ganirelix 25ius in the AM
-Follistim 100ius in the PM
-Dexamethasone 75mg
-Metformin 1500mg

8.7.10
Went to AFS yesterday for monitoring. Had A LOT of follies Chat Icon . None were over 11mm, but she def measured at least 10 that were between 9-11mm. Dr. B said my e2 was 600. I forget what e2 means i think the number is good but since this isnt supposed to be an IVF cycle, i am somewhat nervous about hyperstimming. I will switch to IVF if i HAVE to, but I really hope that I don't have to.

Obviously the quantity of growing follies was enough to make dr. b adjust my protocol a bit. Yesterday I dropped the follistim down to 75ius and i will skip tonight and do another inject tomorrow. I am still on the other meds, and he did not add liveris. I also will be scheduling my intralipids infusion for Tuesday night.

Dr. B said to come back and see him on Monday. I am not 100% sure if he meant to see HIM or whether I could just as well go to AFS. But i think I am going to try to take half a day and get out to Woodbury. I cant make it to AFS during monitoring hours anyway on Monday, so I might as well see if I can see him directly.

Thats it for now. Chat Icon I dont hyperstim, but that i get 2-3 nice follies to mature!!

Current Meds:
-Ganirelix 25ius in the AM
-Follistim 75ius every other PM
-Dexamethasone 75mg
-Metformin 1500mg

8.9.10
Saw Dr. B this afternoon. Had several follies still but two main 17mm that are most likely the leads. There were like 2 15's and a few 13's as well as others that weren't measured. Dr. B did seem a little concerned to trigger me that the others will catch up and I'll have too many for a timed intercourse cycle. But i think overall he will be OK with it.

I do have to go back to him tomorrow. I wasn't expecting that. I asked if I could go to AFS for monitoring and he actually said no, that he wanted to be able to see what was going on to "make some decisions" and make sure he was comfortable with me triggering.. So that cramps my schedule a bit. I already lied to get out of work today and now I have to sneak out tomorrow too. I was lucky enough that its a day that Dr. B is AFS in the afternoon, so I was able to make an appointment to see him there. But it's still going to be interesting....

Anyway I'm done stimming and now just coasting til the follies mature.. Still Chat Icon that I dont have to switch to IVF (cause I'll have to think of another set of excuses to get out of work... ).

Current Meds:
-Ganirelix 25ius in the AM
-Dexamethasone 75mg
-Metformin 1500mg

8.10.10

soo todays appointment was eventful!!
had at least two mature 18mm+ follies. had a few others that were measured that i dont remember.
best news of the day was that my lining was a 10!! ive never had a perfect lining and today dr. b said it was perfect
Chat Icon !!
so we had the basic talk about selective reduction since we dont know how many eggs will release.

i ended up doing the trigger shot at the office, sandra did it for me. i did novarel this time. he wanted me to do only half of the novarel since its easier to measure than ovidrel. i did i think 5000units. they say ovidrel is around 6800. so i do have to go back again next week (ive never gone back during the 2WW) to get another sono and he wants to check my ovaries for im not sure what. he did say i may need an HCG booster at that point, where i would get part II of the novarel. im not sure what that all means

anyway so i did trigger today. so let the Chat Icon games begin. i wont lie, i left the office and DH and I had some afternoon delight to kick things off !!

so here we go again. i did intralipids tonight and i start lovenox again in a few minutes.. i really feel a good vibe right now and im really hard this cycle. i feel like my protocol was fairly unorthodox for ovulation induction with timed BD, and I am so thankful for all of the work dr. B put into it. i told him i feel like a science experiment, but i dont mind. whatever it takes.

thanks for reading this far. the support from everyone really helps keep me positive. sometimes its so hard, but i really feel good about this tonight!!

Today's Meds:
-Ganirelix 25is in the AM
-Novarel 5000(iu?) at around 1pm
-Intralipids Infusion
-Lovenox in the PM

Rest of Cycle Meds:
-Start Crinone on Thursday or Friday
-Lovenox in the AM
-Dexamethasone 75mg
-Metformin 1500mg

8.24.10
Went for sono at 6DPO, everything looked OK. My ovaries were super enlarged although Dr. B said it wasnt OHSS. His test for that was amazing - you basically lay down and he jiggles your belly. Then he says if he can do it, you dont have OHSS Chat Icon . He's amazing .

10DPO - Negative HPT
12DPO - Negative HPT
12DPO - Beta result of 2
13DPO - Beta result of 2
Dr. B says its probably an issue with the lab. It could possibly be another chemical PG, but he says he only thinks that due to my history. Either way its another failed cycle Chat Icon .

His recommendation for next cycle is IVF. He says I stim too well for IUI/TI cycles. We always trigger me with follies around 19mm. He says he would like them to be at least 20mm at trigger but because I stim well he doesnt want to risk too many eggs. So we trigger and the eggs could be too immature to fertilize. So he thinks IVF at this point is my best bet because he can control how many go back in and I wouldn't have to worry about crazy multiples or OHSS since he's use a lupron trigger.

I'm thinking I'm probably on board for this although its a really harsh realization. DH is open to it pending my insurance coverage. Unfortunately my paperwork has conflicting info, one place says $10k per calender year for IVF (which would be awesome) and another says that IVF is an exclusion and not covered. I'm super worried that the latter is true although my initial paperwork for this plan says the $10k per year...I tried calling today and got disconnected. Now they are closed so I will have to call back tomorrow.

I'm pretty Chat Icon that this seems to be the end of the road as far as "natural" conception goes. I'm not too worried about the actual IVF process since my protocol now is pretty close to an IVF protocol anyway. I am wondering if I will even need to suppress since I don't O on my own and am naturally pretty suppressed Chat Icon . I have tons of questions and spoke briefly with Dr. B today but he said when I come in for CD3 to set up a consult also so we can talk about all of it together. He also said if I do have the $10k per year coverage that that would get us a couple of cycles which i was surprised about because I thought each cycle was like $15k Chat Icon . But I guess that includes meds and I already know I have decent meds coverage...

Anyway I do have to stop crinone and wait for AF and for my beta to go to 0 assuming it is actually a 2 and that's not a lab error. I hope it is quick and I can go in for CD3 on Saturday or early next week.

I really thought this cycle was it. I was hopeful. And I really wasn't expecting to jump into IVF so soon. But I understand the rationale and I think I would be a good stimmer for IVF (my first injectable cycle I hyperstimmed and had over 10+ mature eggs - at that point Dr. B said it would have been a perfect IVF cycle - hopefully I can repeat and get even more eggs).

A long time ago before I started TTC a family friend that makes a living as a clairvoyant/psychic to the stars told me (without any prompting) that I would have twins. I always thought it would be dumb luck. Recently, he updated that prediction to say it was via IVF. I still thought that he would be wrong. But it's starting to look like he may be right. Only time will tell I suppose.

Anyway so based on what I find out for insurance tomorrow, my next journal may be an IVF one Chat Icon .

Good luck everyone!

Message edited 8/24/2010 8:37:11 PM.

Posted 7/30/10 10:12 PM