Our Infertility

November 26, 2014:
Today is our 3-year wedding anniversary and I can't think of a better way to spend our day than making a huge leap in the attempt to grow our family! We decided to proceed with IUI this treatment cycle and today was insemenation day!
We started the day with an appointment for Tyler to provide his sample. After his appointment, we went out for breakfast and made a stop at the specialty pharmacy for my progesterone suppositories (which I start tomorrow). Then we headed back to CRM for my appointment. The nurse said that Tyler's sample was great with a count of 61.8 million. They require 20 million for an insemenation, so I guess Tyler gets a gold star for his part! The IUI procedure was similar to the hysterosalpingogram (HSG) that I had a year ago. They use a speculum to reach the cervix, then inject the sample through a catheter into the uterus. This was far less painful than my HSG. The nurse did have a hard time getting to my cervix, like other doctors have, and that's why we decided to go with IUI this time.
After the insemenation, I laid flat for 10-15 minutes and then we went on with our day. We did a little shopping for Thanksgiving festivities, and then had an ice cream date at Cold Stone, where we both had our favorites (Tyler: Chocolate Devotion, with double brownie instead of chocolate chips, and Me: Birthday Cake Remix, with carmel instead of sprinkles).
When we got home, we crawled into bed and watched a movie. I had a lot of cramping, which they said to expect, so relaxing was very nice!
Today was a perfect day and hopefully we will be able to share some wonderful news with our next blog post! Please remember that when it's time to share news (good or bad), we will share on our own time. Thank you for understanding and for all of your love, prayers, and support!

November 24, 2014:
Today I had an AWESOME appointment! I have 5 mature follicles that are ready to produce an egg. My uterine lining was also great at 10.3mm. Since we have decided to do IUI (in-uterine insemenation) this time, I spent a lot of time scheduling future appointments. A HUGE thank you to Mary Kurvers for starting my reading class again today. The kids love having you there!
Tonight at 10:30 tonight, Becky will be doing my HCG trigger shot. We will go in on Wednesday for our IUI treatment. Tyler's appointment is at 8:00 and my appointment is at 10:30 (which is why we have to do the trigger shot at 10:30 tonight).
Wednesday is also our 3rd anniversary and I can't think of a better anniversary gift! Please keep us in your thoughts and prayers for a successful treatment!

November 23, 2014:
Today's appointment finally provided us with the hope we have been searching for this cycle! It seems that my body doesn't respond to a dosage lower than 150iu, but will likely overstimulate at that dose as well. Timing is everything right now! My uterine lining was 9.2mm and I had 3 follicles that have matured to 14-16mm. The goal is still 18mm, so we're close. I have to go back in again tomorrow morning (thank you Mary for starting my reading class again!) and hopefully we'll have at least one follicle ready so we can do the HCG trigger shot to induce ovulation. Becky will be working her magic with my HCG injection again, since the location of the injection site makes it difficult to do myself and Tyler would faint before even unwrapping the needle and syringe! We are so blessed to have so many people thinking of us, praying for us, and helping us with so many things during this time. Oh, and I asked about my estradiol from Friday and it was 184! Yay, we're getting there! Now it's time for a nap and then a trip into school to prepare for what will be a whirlwind of a week!

November 21, 2014:
I have become very emotional and will cry about almost anything. I saw a stray cat in the parking ramp when I got to the clinic this morning and bawled for 20 minutes. I cry about happy things, I cry about sad things, I cry about things that I would not usually have any emotion toward. It's a little ridiculous. This is a result of the insane amount of artificial hormones I am injecting daily. Last cycle I injected 900iu of Follistim total. This cycle I have injected over 1,600iu and we're not done yet. It looks like I have freckles on my abdomen. Being emotional, the pain of the injections, and the pile of bills will hopefully be worth it very soon.
Anyway, today was day 18 of my cycle and I needed to have at least one measurable follicle to continue treatment. My uterine lining was 8.2mm, down a little from last time, but still acceptable. My right ovary had one follicle at 11mm and one at 12mm. The left ovary had one follicle at 11mm. They have a long way to go if they continue to grow, but they made it to 11mm which is what we needed today to continue treatment. My estradiol is fluctuating between the 60s and 90s. We need that to get up to at least 200, but 400-800 would be ideal. I will continue 150iu of Follistim (Thanks Ted for picking it up from the ONE specialty pharmacy my insurance will allow me to get it from, that is only open M-F from 9-5, so I had enough to get through the weekend). I have another appointment Sunday at 7am. I am hoping we had some major growth and they didn't shrink back down.

November 18, 2014:
Today my alarm we went off at 3:30am to head down for an ultrasound. Technically, my appointment was scheduled for 9:00, but I was advised to get there at 7:00 and they will get me in early. I didn't get called back right away, but after anxiously waiting, I was called back at 7:45. I am so thankful that they are respectful to my time so I miss as little work as possible.
The appointment didn't go too well. Although my uterine lining has thickened to 9.1mm, both of the follicles that had grew enought to track last appointment, have shrunk back down and are no longer measurable. It was quite disappointing. The nurse said that we will continue injections, but my Follistim dosage was increased to 150iu starting tonight. I go back on Friday and if I don't have significant follicle growth, there is a chance we cancel this cycle. Today is already day 15 of my cycle, so we need to have something happen soon.
I had to fill another Follistim prescription to get me through the next few days, and we are running out of funds very quickly, so soon we may need to stop treatment for a while to save up to continue. I am praying it doesn't get to that point. Please keep us in your thoughts and prayers. I will provide another update on Friday.

November 15, 2014:
Today my mom was able to go with to my appointment so Ty didn't have to miss the any of the last weekend of rifle season. There was a little progress. My uterine lining was the same, 6.2mm, and there were FINALLY 2 measurable follicles. One on the right was 12mm and one on the left was 11mm (the goal is still 18+mm). I'm not sure why it's taking so much longer this time. On the last cycle of Follisitim, they were able to start tracking measureable follicles at day 4 and this cycle I didn't have measurable follicles until today (day 12). My estrodial was 75 at my last appointment, so that means we're headed in the right direction, just very slowly. Hopefully today's estrodial was up passed 100. The goal is to get to at least 200, but preferably higher because each increment of 200 means a mature follicle ready to release an egg. After leaving the clinic, the nurse called to tell me to increase my Follisitim dosage from 75iu to 100iu. Hopefully this will jump start those follies! My next apportionment is Tuesday morning.

November 12, 2014:
I originally had a follow up ultrasound scheduled for Monday, but thanks to the lovely snow, it had to wait until today. The roads were still pretty sucky in Chisago county, but after that they were fine. Traffic was disgusting this morning, I don't know how people do that everyday!
My uterine lining was 6.2mm today, but there weren't any measurable follicles yet. I am supposed to continue my current dosage for injections and then go back Saturday morning to check again. I'm not sure what my estrogen was today, they didn't say when they called, but hopefully that's on track.
Tonight was the first night of conferences at school. I was fortunate to have my only break in conferences correspond with my injection time. Tomorrow is another full day of conferences, so I'm off to bed!

November 6, 2014:
I FINALLY had a cycle start on Tuesday....Wooohoooo! Today was day 3, so it was time for a baseline ultrasound. Tyler was able to take the afternoon off and I had the amazing Paulette come in to teach my afternoon interventions. We wouldn't be able to make this treatment work if it weren't for our employers allowing us to attend appointments at the drop of a hat. We are truly blessed.
So, back to the appointment...My uterine lining was 3.4mm, which is good at this point in my cycle. It shows that it shed properly from the Provera. I had 36 follicles in the right follicle and 42 in the left. Still way too many, but we can't really do anything about that. The good news is they were all "calm," which means they were small. We want them small now and then to grow with the treatment. I started Follistim injections when we got home tonight and will continue to do them daily until I have mature follicles. I go back Monday to monitor follicle growth. The nurse thinks we should have slow gradual growth this time, so we are careful not to overstimulate again.
We asked about doing IUI this month, and it's ultimately our decision to make and they will support whichever decision we make. It's about an additional $500-$600, so we will need to decide if we want to try that now, or continue "the old fashioned way" for a while longer.
We ask that you keep us in your prayers for success this month!

October 23, 2014:
Where to begin...The last cycle was without any treatment due to overstimulation. We were told we could try on our own, but to be careful as there were many follicles that could have produced an egg. Unfortunately the giant "leftover" follicles from last month didn't produce any eggs and didn't even provide enough hormones to start another cycle for me. I was told to call if I didn't start a cycle within 30 days, so I called and had to schedule lab work to see what the problem was. This was disappointing because I have had cycles on my own since August and I thought my body might be regulating itself.
At my lab appointment (2.5 hours round trip for a 2 minute appointment) they did a blood pregnancy test (at home tests were negative) and they checked my progesterone to determine if I would start a cycle on my own or not. Well, the pregnancy test was negative (no surprise there) and the progesterone levels determined that I would not start a cycle on my own, so they prescribed Provera to induce a cycle so we can start the next treatment. Once a cycle has began, I will be back to ultrasounds every 2-3 days to monitor follicle growth. I am going to ask about IUI this time rather than "timed intercourse." IUI stands for  Intrauterine Insemination. They would essentially bypass any obstacles by using a catheter to place Tyler's sample directly into my uterus. Although this is more expensive, it will provide peace of mind and a higher success rate. Hopefully they will consider this treatment this month.

September 24, 2014:
Well, last month was not effective. I was supposed to go in on Tuesday for a pregnancy test, but started a new cycle on Monday. So instead of going to the lab appointment, I went back for another baseline ultrasound to start over again.
The ultrasound tech, nurse, and I were all surprised at what we saw today. I should have had a thinned uterine lining (2-3mm) and my follicles should have been 7-8mm in size. Much to our surprise, my uterine lining was 6mm and I had several HUGE follicles. Seriously, huge. Like 20-46mm in size. I believe there were three in the 40-46mm range, two in the 30-39mm range, and about 5 more that we're 20-30mm. This is due to overstimulation last month. Because it already have giant follicles, they are not doing any treatment this month and said it was our decision to try on our own this month. Tyler and I discussed it, and although there is a high risk of multiples with this many mature follicles, we're going to give it a shot. I will be testing for ovulation and then we will be crossing our fingers, hoping, and praying that it will work out on our own this month.

September 9, 2014:
Today's appointment was AMAZING! This morning my uterine lining was 10mm and I had several measurable follicles. There's were eight between 12-15mm, two at 17mm, one at 18mm, and one at...drum roll please...21mm! The nurse said that my uterine lining is perfect and that I needed to trigger tonight before any of the smaller follicles become too mature and we'd have to cancel the cycle. Becky came over tonight to administer the Novarel trigger injection, since Tyler's doesn't handle needles very well. I was very happy that he offered to hold my hand though! My backside is a little tender now, but it was mostly painless, Becky is a pro!
Now our directions sheet states "timed intercourse," progesterone suppositories, and back in for an appointment in a couple weeks for blood draws. This very well could be the last blog post for a while. I want to thank everyone for their thoughts, prayers, good vibes, and encouragement so far. It's an amazing feeling to know that we are loved by so many, we actually hit over 3,000 page views today! We are truly blessed!
Have a wonderful evening everyone!

September 7, 2014:
We had a blast last night at Brandon and Ellen's wedding, but it made for a tough morning with 2.5 hours of sleep! I was struggling to keep my eyes open on the way down, but managed to get us there safely. We arrived early (like always) so we took a 45 minute nap in the parking ramp before going into the appointment. My uterine lining is staying nice and thick at 9.6mm and two of the follicles on the left side have grown to 16mm and 17mm. There also was another on the left that was 12mm. Unfortunately the one on the right didn't continue to grow, but the two on the left are all that we need! I will continue to administer injections today and tomorrow (75iu today and 150iu tomorrow) and then I will go back Tuesday morning before work for another ultrasound. Hopefully by Tuesday both
large follicles will be 18+mm and Becky can come give me the trigger shot. I am so happy that Dr. Kuneck has found something that works for us and am hopeful that this will be the answer to our prayers!

September 4, 2014:
I went to my ultrasound this morning expecting big, huge, giant follicles...that didn't happen. They seemed to have plateaued again. Of the three that they are tracking, two were still 11mm and one was 12mm. I was happy to hear that I don't have to go in again tomorrow morning, but had to schedule for Saturday morning as I was leaving. This afternoon our nurse called to say that Dr. Kuneck decided to have me increase my Follistim injection dosage and come back Sunday instead of Saturday. So, that meant a refill of my Follistim prescription for another $1,128.79 for a couple days worth of injections. I think it is outrageous that fertility coverage has a different category and set of rules for medical insurance. I feel like it's discrimination against those who are unable to have children the "traditional" way. We are over halfway through my LIFETIME coverage for fertility treatment and are still struggling to find something that will work for us. It is quite discouraging, but we will continue our pursuit! 

September 2, 2014:
The alarm clock went off at 3am this morning so that I could avoid traffic and get to CRM by 7:00 to get the first appointment of the day. I am happy to say that I made it! Shortly after I got there, others started trickling in and I was finally called back at 7:30. I had done my injections all weekend, but wasn't expecting much today, since it is only day 7 of my cycle. Much to my surprise, there's already progress! My uterine lining (which was 2.5mm on friday), was 9.4mm! After that came the follicle measurements. I had one measure able follicle on the right side that was 11mm and TWO measurable follicles on the left at 11mm and 12mm. Of course there were 20-30 more in each ovary, but if these 3 keep growing we'll be very thankful. Although I had 3 get to 11mm last month, it took them 21 days to get that big before they stopped. Today was only day 7 so I am hopeful they will continue to grow (to at least 18mm). The nurse seemed pretty confident, saying that she thinks we'll be ready for the trigger shot on Saturday! The stinky news is that I need to go back for additional ultrasounds on Thursday, Friday, and Saturday. It'll all be worth it someday (hopefully soon!) Please keep us in your prayers! We appreciate your support!

August 29, 2014:
Today was a brand new start...frustrating and exciting at the same time. That means it was time for another baseline ultrasound. My uterine lining was 2.5mm and I had 28 follicles on the right and 35 on the left...too many! I started a new fertility drug today, since Femara didn't work for me. The new one is called Follistim and it's an injectable drug. It was a spendy one with a astronomical price tag of $1,128.79 FOR FIVE INJECTIONS! After driving all around Minneapolis to find "the right" specialty pharmacy, I finally was able to head home. I just completed the first injection and it was only slightly painful. I think the anticipation was worse. I keep telling myself that if my tough 7 year old cousin can handle her injections, I should be able to do it too! Brad and Tracy, if you're reading this tell Rhiana that my injection pen looks just like hers!
Anyway, I go back Tuesday morning (before the first day of school) to see if I am starting to respond to it with any follicle growth. I'm praying this will be our answer! I am looking forward to a stress free weekend of relaxation so that we can get the results we want Tuesday morning!

August 25, 2015:
Today was not a good day. I was very overwhelmed to have an ultrasound on the first day back to work and was devasted by the results. All 3 follicles that were growing have not only decided to stop, but to return back to their unmeasurable size. If that wasn't enough, my uterine lining has thinned and is back down to 3mm. The nurse had no idea what Dr. Kuneck was going to do, so we had to wait for his call. The call came when we were almost home and it wasn't great news. We are going to have to start all over since I didn't respond to the treatment. So now I go back in Friday. I have a lot of anxiety right now and I know it is the worst possible thing for this situation, but I don't know what to do to get rid of it. Any suggestions are welcome.

August 21, 2014:
Well, today was frustrating! It's about a 50 minute to 1 hour drive to the clinic, but I always leave home very early with more than enough time to get there. Today that did not work. I figured there would be some traffic, so I left earlier than normal, giving us almost 2 hours to get there. Thanks to the lovely pouring rain, a stoplight that was out, a stalled vehicle (not mine), the cluster of people trying to get onto 694, and super awesome people who choose not to merge until the last second when their lane ends, I was late...very late....almost an hour late. For anyone who knows me well, I am not late. Ever. I called the clinic to let them know what was going on and I am thankful they were so understanding, especially since it's in their policy to refuse to see you or discontinue care if you are late for appointments.
Anyway, onto the update. The ultrasound was equally as frustrating today. There was NO GROWTH in my follicles today. Another popped up to 11mm, so now there is one 11mm follicle on the right, and two 11mm follicles on the left. My uterine lining has thickened from 4.5mm to over 8 mm, which is great news if my follicles ever decide to grow! I have another ultrasound on Sunday, as long as Dr. Kuneck doesn't decide to scrap this cycle and start over next month when he reviews my chart later today. I am hoping the appointment will remain and that we will FINALLY have at least one 18+mm follicle. I really am looking forward to Tyler joining me on Sunday.
UPDATE:
I just got off the phone with my nurse who provided some more information. Dr. Kuneck is having me take Femara again this cycle. I will start it today and take it today through Monday. He would have liked me to come back in Monday, but since that's our first day back to school, I'll have to go in the afternoon instead of the morning like they typically do. Hopefully there's growth by Sunday! I am so thankful we are being seen at such a wonderful place with such close monitoring!

August 18, 2014:
I went down for another ultrasound today to measure follicle growth. We were hoping to have one at 18mm, but unfortunately I didn't. There was still 20+ follicles on each side, which is not a good thing.  The good news was that there is one in each ovary that is SLOWLY maturing. Each lead follicle was 11mm today. The nurse today did a great job explaining why they are moving forward so slowly; because I have so many follicles, they have to take it slow otherwise I am at risk of a high number of multiples (8+). Don't get me wrong, we'd love twins and would even be okay with triplets, but 8 is a few too many. I have to go back for another ultrasound Thursday morning (cycle day 18) to measure the follicles again. Hopefully the third time will be a charm! I want to thank Bailey for joining me today. It makes it so much easier to have supportive friends/family along when Tyler can't make it.

August 15, 2014:
Today I went for a follow up ultrasound to determine if a follicle was mature enough to release an egg. If there was one, I would administer an HCG trigger shot at home to induce ovulation. Becky was able to join me today so that Tyler didn't need to take the day off work.
Unfortunately there wasn't a mature follicle today. To be considered mature, a follicle would need to be 16-18mm in diameter. The two largest today were 9.7mm on the right and 8.3mm on the left. I have to go back for another ultrasound on Monday to see if there is any change.

August 6, 2014:
Today was baseline ultrasound day! They did a transvaginal ultrasound to measure the lining of the uterus and count follicles in my ovaries to make sure everything was looking good before I start Femara on Friday. It was only mildly uncomfortable due to bring day 3 of my cycle (and a heavy flow day). The ultrasound showed that there were more than the normal amount of follicles in each ovary. I had 22 in the left ovary and 24 in the right (typical is 5-7 in each). This is a common symptom of PCOS and was what they were expecting. Basically, when there are too many follicles, it doesn't allow 1 to mature enough to produce a viable egg. This is why we will be doing the Novarel HCG trigger shot next Friday after I have taken Femara on days 5-9. Despite the high amount of follicles, I will still be starting the Femara and am hopeful the combination of Femara, Novarel, and progesterone suppositories will be effective! The only thing I wish would have been different about today's appointment would have been to have Tyler there with me...Sometimes I regret being so independent!


August 4, 2014:
Although I didn't have an appointment today, I did call to schedule my upcoming ultrasounds. Today was cycle day 1, so I had to call to schedule a baseline ultrasound and a followup ultrasound for day 12. The baseline needs to be done on cycle day 2 or 3. They didn't have any ultrasound appointments available tomorrow, so I will be heading down on Wednesday. Then I will have another ultrasound on Friday, August 15. We are excited to be moving forward and to start the next step in this process!

July 21, 2014:
Today was our initial meeting with Dr. Kuneck. We arrived at the Center for Reproductive Medicine a little early and had some last minute paperwork to fill out. After what seemed like the longest wait of our lives, we were finally greeted by Dr. Kuneck.

We went to his office where he briefly went over what he read in our medical records and then asked us to tell him what we have been through already. WOW! It's not very often that a doctor actually wants to hear what you've gone through instead of simply read charts.

After a lengthy conversation and a very well drawn illustration, Dr. Kuneck told us our plan of action. He is going to treat me for PCOS (Polycystic Ovarian Syndrome) with Metformin again. Dr. Hovinen did this in Cambridge, but since it didn't help to regulate my cycles, I had stopped after a year. Dr. K is also starting me on a drug called Provera. This drug forces a menstrual cycle to begin. I've had this before as well. After a cycle has began, I will start taking a drug called Femara. In the past, I have taken Clomid at this point, but Dr. K would like to try Femara since Clomid hasn't done the trick in the past. I will be going back for a "baseline ultrasound" on day 2 of my cycle. I will also return on day 12 for another ultrasound. If there is a follicle that is mature enough to produce an egg, I will receive a prescription for an HCG trigger shot. This will force ovulation 12-36 hours later. I'll go back a week after that shot and see if it all worked. If it was successful, we'd have a baby 9 months later. If it wasn't successful, we'll do the same thing 3 more times and then move on to IVF.

We learned a lot today and are very happy that we have decided to move forward with this. I know it is going to be a financial stress, but it will all be worth it in the end.