Done!

The IUI went well. Our RE said Greg's sperm looked great and was even better than it was the cycle we got pregnant. It hurt like a SOB again, despite taking two extra strength Tylenol, but the pain only lasted for 30 seconds this time, so it was much more tolerable. I did have some cramping and spotting afterward, but it wasn't a big deal.

The one awkward part was when Greg had to collect his sample. Usually we do the IUI first thing in the morning, no one is in the waiting room, and, when Greg goes into one of the exam rooms, there is a stack of magazines there for him. Well, today we went in the afternoon and the waiting room was standing room only. He got called back, (hmmm....I wonder why he got called back all by himself), then, the nurse brought him to the exam room and said, "Do you need some magazines???" He was like, "OMG, can't you just put them in there and not ask!" I am so glad all I had to deal with was 30 seconds of pain! I would have DIED if I had been him.

So, now we wait. Hopefully two eggs + great sperm + getting past the CM = one (or two) healthy babies.

IUI#4 Tomorrow!

Holy crap! I had my CD9 u/s today - and we are already ready to go! My lining is 7mm and triple stripe, and there is one follie on each ovary - one at 20mm and the other at 16.5mm. My RE said the 16.5mm one might be too small, but it's most likely okay, and he doesn't want to risk missing ovulation this time.

So, we triggered and are doing the IUI tomorrow afternoon. I am so relieved to be back in the game, and I'm really glad I skipped the trip!

Second Opinion

We went to see the new RE today. This is pretty much the opposite of our current RE - very to the point, and very experienced. My therapist called him "the grandfather of IF treatment in Austin."

After asking us a bunch of questions, he got right to the point and said he thinks me and clomid do not mix. He said, "There is something dysfunctional going on." Meaning it just doesn't make sense that I am ovulating early and having hot flashes BUT my lining is still okay (apparently hot flashes are associated with a thin lining).

So, now we have to decide what to do. We have four options: More natural IUIs, Fermara IUIs, injectible IUIs, or IVF. The RE was strongly in favor of injectible IUIs as our next step, because the odds of success are so much greater. Of course, Greg and I are very nervous about HOM and we expressed this, and the doctor said we could do a few more natural IUIs and see how that works, or even try Femara, but he wouldn't recommend anymore clomid cycles.

I asked him why injectibles have a higher success rate - he said "We really aren't sure. It is in part because of higher follicle production, but not completely."

However, there is the cost factor: $2000-$2500 per cycle. Ouch. And only Greg's insurance covers it, but I am not on his insurance policy and can't be until January. So, do we wait four more months so we can do them for free, or do we dish out the dough? We can afford it, but it would mean some major lifestyle changes. If we wait, we could continue to do natural or cycle IUIs, or try Femara. But, this RE only gave us 4% odds of natural IUIs working each cycle, and Femara a 8% chance. Injectibles have a 20% success rate.

A few other things I learned:

• I need to cut back on my caffeine intake. My current RE said 200mg a day was okay. The new RE says I should only take in 100mg.
• I also need to cut back on my wine habit. I told the RE that I have 1-2 glasses of wine on most days. He said it would be a good idea to cut back on that, and no drinking after ovulation.
• This RE triggers when the lead follie is 22mm. My current RE triggers at 17mm! But, this RE said it could be because my current RE measures follie size differently.
• He agreed that that cause of the miscarriage was most likely a chromosomal issue.
• He recommends no more than 30-40 minutes of aerobic activity, 3-4 times a week. He said my 30 minutes at a heart rate of 160 bpm four times a week is "probably fine."

For now, Greg and I agree that we are switching REs if this cycle doesn’t work. And, we are leaning towards at least trying Femara. It’s less expensive, and there is a lower risk of HOM compared with injectibles. And, although the RE gave us those pretty crappy odds, Greg and I just can’t stop thinking, if it is just a CM issue, a natural IUI should give us odds similar to a “normal” couple TTC on their own – which would be 20%, not 4%. And if Femara would help up that a little bit more, great. Plus, we did get pregnant on our own without injectibles, so we should be able to do it again!

New Study about IF & Pregnancy in Women with CF

I just found this article and though I would share it. It makes me excited to do another IUI!

CF Meds Are So Expensive

I just refilled three month supplies of albuterol, hypertonic saline, and colistin. Here's my order summary:

Prescriptions	Type	Quantity	Plan pays	Your estimated cost
Colistimethate Sodium Vial 150MG	Refill	1 Rx	$2725.12	$20.00
Albuterol Sulfate Inh Soln 0.083%	Refill	1 Rx	$73.65	$20.00
Hyper-sal Inhalant Solution 7%	Refill	1 Rx	$118.26	$50.00

Almost $3000 for Colistin (and one of those months is an "off" month, so it's really a two-month supply). And, I'm pretty sure that Pulmozyme and Tobi have similar costs, although I don't take those meds, (for now, my doctor has been considering putting me on Pulmozyme). Thank God for insurance!

Decision & Clinic Visit

I decided to cancel the trip. Big thanks to everyone who gave me advice - it was a very hard decision and I didn't make up my mind until the last possible second. I was laying in bed last night, with the Clomid pill in my hand, hemming-and-hawing over it. But I decided to go ahead and take it because, each time someone told me to go on the trip, I felt a little sad, and, each time someone told me to cancel it and do this cycle, I felt relief. So, I took that as a huge sign. I might be able to reschedule it to sometime this fall - luckily plane tickets are cheap and these canceled cycles means we can afford it.

Also, I had CF clinic yesterday. My FEV1 was 112% - down 3% since my last visit, but my doctors were not concerned. The exciting news is that, next month, it will be two years since I cultured pseudomonas! So, fingers crossed that yesterday's culture comes back clear. My doctor said I only cultured "a small amount of Staph" at my last clinic visit in May.

I asked my doctor for a new prescription for my GERD, so he is going to put me on Nexium. Hopefully that will stop the waking up in the middle of the night, gasping for my inhaler, which has been happing every night lately. That cannot be good for my lungs!

I also asked if I could try the lowest dose of Advair again. My CF doctor said that Advair only helps in CF if there is an asthma component and I really only get asthma in the middle of the night and when I go for a run in the cold. But, I figured it would be worth a shot, if I can keep the thrush away this time. I have my probiotic and Orithrush on-hand, so, hopefully it won't happen again.

Two Follies + Great Sperm + Perfect Timing =

Nothing. AF arrived this morning. Onto Cycle 15. It's funny, even though I know my CM is a problem, I can't stop hoping that maybe a few sperm will make it to the egg. I mean, there are so many other women with CF who get PG without assistance - why can't we??? It makes me wonder if there isn't something else wrong, and I'm glad we are getting a second opinion next week.

This also means decision time. I am supposed to go visit my family in Maine next week, which will fall right on CDs 9-13. This means I won't be back in town in time to ensure I don't O before an IUI this cycle. So, do I cancel my trip so we can finally get back in the game, or we risk taking a fourth cycle off?

If I decide to go, I am not going to take Clomid because I don't want to risk wasting another Clomid cycle. But, I may ask my RE if we can do a natural IUI if I haven't O'd by the time I get back.

I think my RE wants me to start clomid on CD 3 now (instead of CD 5), so I have until Thursday evening to decide. I got some good advice from the girls on the Nest, but I am still torn. The idea of taking another cycle off kills me. Especially considering that my FF calendar is currently showing my O dates for November and December as falling right smack on Thanksgiving and Christmas - when we will be out of town for a week. So, if we miss this cycle and those two, we'll only get two IUIs (if we need two) in before January.

Being an engineer, I like to think about the odds - our chance of success is greater than 50% in three IUIs. Meaning, if we miss all those cycles, the odds are we won't be pregnant by the end of the year. This also means there is a good chance I would be at least 34 by the time we had our first kid. Ugh! I hate getting older! I wish we didn't have to worry about the age thing so much.

I'm hoping the therapist can help with this decision. I am really looking forward to my appointment tomorrow!

Oh, and I met with HR today and told them about my CF and IF. I filled out some forms to apply for FMLA. Now I just need to get my doctors to fill out some forms for me, and we will be good to go!

Oh! And, I called the new RE’s office today to ask if it would be okay if I am in the middle of a Clomid cycle with my current RE when I see them next week. The nurse said, “Yes, that happens all the time.” I also mentioned my RE’s lack of monitoring to her. I was really surprised – she said they usually don’t have people come in for an u/s until five days after their last pill! And, when I told her about ovulating on CD10 last cycle, she said, “Oh, that was just Clomid causing a false positive OPK.” (Then I explained to her that O was confirmed via u/s). So, it sounds like this new RE does things pretty much the same as my current RE. And, now that we have our current RE on board with earlier monitoring, I’m not so sure I am going to want to switch. We’ll see next Tuesday. I'm still really looking forward to getting a second opinion.

Check! Check!

I got a referral to a therapist from my RE. I am going to see someone who specializes in IF, m/c, and pregnancy on Wednesday afternoon. I am really looking forward to this.

I also called HR and asked if I could talk to them about FMLA - they told me to stop by tomorrow morning. So, hopefully I will be able to take leave without pay when I run out sick time, instead of completely stressing myself out making up time from all these doctors' appointments!

Broken

Well, I can say with great confindence that this has been the worst weekend of my life. I've been really, really depressed lately, to the point were I just randomly start crying during the day, several times a week. I've felt so hopeless. The miscarriage, the canceled cycles, IF in general, and the fact that my job has been awful is making me miserable. And, add to that CF taking up all of my free time, and I have nothing to be excited about during the week. On the weekends, I am able to disctract myself and I feel better, but, during the week, I am so, so, so depressed. I'm having a hard time concentrating at work, and even being friendly to my coworkers is a struggle, and I've started isolating myself from a lot of my family and friends because all they talk about is children.

And then last night I was pushed over the edge. Greg had been out of town all week, and, when I came home, excited to see him, he just started ranting and raving about everything: the new watering restrictions, the dust the cleaning people missed, how he had to go to my stupid work party, even my driving. Well, that just made me feel like crap because I thought he wasn't happy to see me. And, as I mentioned, I've already been really depressed. So when we got home from the party and he was still being an ass, and I stubbed my toe, I took my keys and threw them with all my strength onto the garage floor and started crying. And I broke the keyless entry to our new car.

So, Greg got even more mad and said, "Great! You just cost us like $100! Way to go!" Finally I yelled at him, "What the hell!!???!! I haven't seen you for a week and you are being such a jerk! I don't understand what your problem is!"

And then he yelled back "You want to know why I'm in a bad mood??!!?? Because my brother's wife is fucking pregnant!!" (Sidenote: They started TTC fairly recently.)

And I just lost it. I doubled over and started sobbing and screaming (literally), "WHY?! WHY?! WHY?! It's so unfair!" And Greg held me, but I couldn't start sobbing. "Why does God hate me?" I asked him, "What did I do to deserve this pain?" And I've been asking myself this all day. The only conclusion I can rationally come to is that God has no control over who has children and who doesn't. Otherwise, why would he let my 16 year old heorin addicted cousin have a baby, but not so many couples in loving, committed, relationships? I know many people do not feel this way and take peace in the idea that God has a reason for putting them through trials, but I just don't believe that myself anymore. This whole IF experienece has really gotten me questioning God, and how much power He really does have over things, or how rarely He decides to intervene.

And, of course, I couldn't stop thinking about was my MIL's excitement back in May when we told her she was finally going to be a grandmother, and how that was ripped away from us. And now we can never get it back. I've never mentioned this before, but I really care about what my IL's think of me because my own parents suck - they are both alcoholics and completely unsupportive about the tough times. If I try to bring up anything to do with CF, they ignore me and change the subject. They don't even want to hear about our IF stuff, unlike my IL's, who are always asking questions and were excited each time we were gearing up to do an IUI. So I was REALLY looking forward to being able to give them their first grandchild.

I cried all night. I didn't sleep at all, and I spent the entire day on the couch, crying. I feel completely beaten down and broken. I don't know how much more of this I can take. But, at the same time, I don't have a choice.

I'm not ready to give up. I mean, if my RE weren't such a freaking tool we'd probably be pregnant by now! All we need to do is get Greg's sperm past my CM - who knew that would be so difficult?? But, it shouldn't be, so I can't give up. Which means I have to continue to go to the job that I hate to pay for IF. And I have to continue to take deep breaths when someone stops by my office and I am on the verge of tears. And I have to suck it up and smile when I am dying inside. The last thing I don't know if I can do. Right now, I feel like I can't.

And that makes me feel weak. I think of the many wonderful women I've met on the infertilility boards, who have been TTC for so much longer, are older, have had multiple losses, have gone through failed IVF cycles, and I see them going strong. I feel like I have no right to feel the way I do. 14 cycles? Pffft - I'm a novice in the IF world!

So, I am caving. On Monday, I am getting a referral for a thearpist. And I am going to apply for FMLA so I don't have to make up work hours missed for the thearapy sessions/doctors appointments and I can keep at least some of my sanity.

Sinus Infection & Second Opinion

Greg and I have been tossing around the idea of seeing another RE since last cycle. And this cycle has made us consider it even more. The only thing that has been holding us back is $$ - our current RE is covered by insurance. The other REs in town are not. Well, we decided today that it is worth spending a few hundred dollars to go in for a consult and get a second opinion, and to find out how much treatment with another RE would cost. I already made the appointment, and we are seeing the new RE in less than three weeks!

What prompted the decision? Randomly, a visit with my ENT. As I've mentioned in previous posts from last fall, my ENT told me about his own experience with IF. He and his wife struggled with it for a decade. Well, today, I went to my ENT because my sinuses have been bothering me. He agreed that I have a sinus infection and said, "Can you take Levaquin?" to which I replied, "If it's okay to take while TTC, I can." And he said, "Oh, well, I will prescribe Ceftin instead."

Then he paused for a moment and asked, "Weren't you TTC last time I saw you?" I admitted to him that I was and that we were seeing an IF specialist, and I expressed my frustration about the lack of monitoring and told him what happened the last two cycles. He thought it was ridiculous and said, "Go see this guy." And wrote down the name of the person we were already considering.

That was enough to push me over the edge. I called Greg and told him about the conversation, and, without hesitating, he said, "Do it!" So, I did :)

I'll Say it Again: You've Got to Be Kidding Me

ARRRRRRGHHHHHHH!!!! I am so freaking pissed off right now. Guess what we learned at the u/s this morning? I already ovulated!!! So the IUI is canceled AGAIN. WTF body??? Screw you. I am here at work trying not to cry.

To top things off, Oing this early most likely means our next IUI might fall right when I am supposed to be in Maine visiting my family at the end of the month, so I may have to cancel that trip. Now I am hoping for another long LP.

My RE was apologetic and said he wants to lower my clomid dose to 50mg and take it CD3-7 instead of CD5-9. He said it looks like my body is "overreacting" to the clomid. He also said he will never assume a false positive OPK again, and he will have me come in right away in the future.

The only silver lining is that we did have good timing with the sex this cycle, and the u/s showed I may have had two follies this time (because he could see a corpus luteum on my left side and fluid on my right side). So we may still have a slight chance.

But still, I cannot believe that it will be at least 4 months in between IUIs. I thought we'd have two IUIs in by now, and we were telling our families that we'd mostly likely be PG again by Sept. But no, I still sitting here with no hope. I fucking hate IF.

What I Learned Today

Clomid can cause false positives on OPKs. So, that is probably, (and hopefully), why it was positive this morning. My RE said he wants to wait until tomorrow for the u/s, as scheduled. So, that's good! Still, I will feel better tomorrow morning when I see that my temp go down to the pre-O range, (it is up right now, but Clomid does that to me). My RE's office probably thinks I'm super paranoid!

You've Got to Be Kidding Me

10 dpo - positive OPK! I have never ovulated this early! I just took my last dose of Clomid last night, for crying out loud. I am chewing my nails, waiting for the RE's office to open so I can call them. Please, please, please don't let this mean it's too late to do an IUI (again)!