Friday, March 23, 2012

the one in which my head spins

Yesterday was quite the day.

(Warning: long post ahead! Proceed at your own risk.)

I had my local monitoring appointment at 8:00 a.m. My RE was in surgery, so my favorite nurse (Fossil Fran, aka FF) did my ultrasound.

The cyst was still there. That was disappointing to see. Apparently it had shrunk slightly, and the clot in the center was more well-defined. FF offered up the thought that perhaps this means it is clotting and done bleeding, and will shrink away to nothing. Here's to hoping.

On the right ovary, along with the Cyst (yes, it's a pronoun now) were three tiny follicles. Very small. Smaller than my normal follicle size on CD11. Hmmm. Ok.

On the left ovary was one large... thing. At first FF thought it was another cyst, because she saw some echoes in it (not sure what the echoes indicate, but ok). Then she tried another angle with ol' wandy, and in that shot it appeared to be a large follicle. One. The only thing happening on that ovary. She mentioned that there was only one large follicle, and the way she said it made it seem like that's odd. And it is odd for me, and maybe for everyone.

Typical CD11s in the past, I'll have several decent sized follicles, and then end up with only one big 'un at the end.

My lining was triple-striped and beautiful at 9.1mm.

Now an ultrasound alone is just a piece of the puzzle. My blood work was done, and the results would be faxed to my NYC clinic when ready. I can expect my NYC clinic to call me with results anywhere from 2:00 p.m. to 6:00 p.m.

So, let the anxiety commence.

I spent most of the day petrified that my cycle would be canceled because of the Cyst.

I headed in to work, and tried to stay positive. I had a dermatology appointment at noon, so that would be a nice distraction, right?

Except I get in there, and my doc wants to remove a mole from my back. She doesn't like the one little dark spot in the center. So, she slices, dices, and drops it in a jar. And then SHOWS ME. She put it right in my face. Good thing I don't have a sensitive stomach! She then said, "Oh, I hope that didn't make you sick! It's just a mole in a jar!"

Just a mole in a jar??! Oh, that's all? I have a ton of those around my house! No worries, I'm used to looking at moles in jars!

I'm pretty sure it won't be anything serious, as I've had other moles removed in the past and nothing ever came of those. But there's always that chance, right?

After the appointment, I head to Sam's. Buster and I are having my parents and grandparents over for dinner tonight. And I'm stressed. My parents and grandparents have a strained relationship, so that throws some awkwardness into the night. Plus, it's my first time ever hosting a dinner party. I'm a little on edge, to say the least.

I drop a pretty penny at Sam's getting a beef tenderloin, a tub of blue cheese crumbles, and some red grapes. Then I decide that I should just head home at this point, due to lack of storage space in the refrigerator at work.

When I get home, I immediately start in on my to-do list. Cleaning, cooking, etc. Buster and I are both stressed and grumpy, and are snapping at each other left and right. Not fun.

I hadn't heard from my clinic by 5:00, so I email them to make sure they received the faxed results from my RE's office. They respond and say they did receive the fax, and will be calling me shortly.

At 5:30 my phone rings, and it's the study coordinator (who I will refer to as "M"). My stomach is in a tightly-wound knot at this point.

"Everything looks good. You have already ovulated, and we are ready to proceed with your frozen embryo transfer."

Um, what?

It's noteworthy to mention that M has an accent. Not an incredibly thick accent, but a slight accent. Sometimes it takes me just a second to figure out what was just said. This time it took me about 30 seconds.

I asked him to repeat himself.

According to my hormone levels, it appears that I have ovulated. I tried to write down my numbers, but I was in too much shock to do it properly.

The transfer is slated for Tuesday. TUESDAY! Holy shit.

M told me to start up on the Prometrium and Dexamethasone again, as well as continue the baby aspirin. I go back in for blood work on Monday, and after that I will get more details regarding time of transfer.

I then mentioned the fact that this is only CD11 for me. Is it odd that I've ovulated so early? He said that sometimes it just happens this way, and that they don't care when I ovulate, just as long as my hormone levels are where they need to be (which they are). Oh.

And then I ask about the Cyst, since he didn't bring it up. They are not concerned about the Cyst at all. He said it is common with women undergoing IVF, and it will likely just disappear on its own, eventually. Phew. All that worrying for nothing.

After we hung up, I cried. Emotional basketcase? Yep.

I was mentally preparing myself for a transfer on Friday. Tuesday isn't that much earlier than Friday, but enough to throw me off. This is why IVF is rough on a control freak like myself.

All evening long, I was dwelling on this transfer. I was feeling scared. Excited too, but mostly scared.

Over dinner, I asked Buster if he thought it was weird that I'm so freaked out by the transfer happening so soon. He said yes, and that he thinks I should be excited, not scared.

Hmm, perhaps he's right?

As the night progressed, I started feeling more at peace with a Tuesday transfer. I woke up this morning feeling great about it.

Today I decide to email my clinic to get the exact numbers from my blood draw. Here is what they were yesterday, on CD11:

  • Estrogen: 214
  • Progesterone: 2
  • LH: 6

Yeah, I thought the progesterone seemed a bit low, too.

I've been googling all morning. Most charts say that your progesterone should be < 1.5 prior to ovulation. And at 7dpo, it should be > 15. And that a progesterone level of >5 shows ovulation.

Well, shit.

Where does that leave me?? Did I ovulate the morning of my ultrasound/blood work? Have I not ovulated yet? Was that cyst/ovary/thing with echoes in it really just the empty follicle (corpus luteum) that previously housed my ovulated egg?

I'm stressing over this number. M said my levels were good, and that my estrogen was high enough that I can forego the Estrace this cycle.

But what if I really haven't ovulated yet? What happens if the FET is a couple days before it should be? Is that ruining my chances of it being successful?

I've emailed my clinic my concerns, and hope to hear back from them soon. I went from scared, to excited, to where I am now: a nervous wreck.

I want to just let go and have faith in my clinic. But everything I'm reading online makes me think my progesterone levels should be higher.

With all of the evidence presented here (ultrasound, hormone levels, etc), what is your opinion? I'd love to hear it!

I will update once I hear from my clinic regarding the low progesterone.

29 comments:

  1. Ugh, so much info and uncertainty! I feel the same way about ovulation just about every month. The offices seem so non-chalant about it, but obviously you want to be 100% sure about every aspect of your FET cycle! Typically it seems that the docs are always right, but I think you should still feel totally fine with calling again and asking for a more complete explanation of everything. Good luck on Tuesday!!!

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  2. All of my 7dpo progesterone levels are usually around 4 which is a little higher. My doctor assures me that ovulation has taken place. I know that the low levels arent very reassuring but I agree that you have ovulated. Good luck on your transfer!!!!!

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  3. Gah. This has my head spinning, too. I don't really know what to think. I would think that if you had JUST ovulated that day, your progesterone levels still wouldn't have risen that much, but I'm certainly no expert on this. Is it possible for them to keep testing your P4 over the next few days to make sure it's rising? I realize this may be difficult over the weekend, but it's the only thing I can think of that would let you know for sure.

    Good luck. I hope they get back to you soon!

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  4. I'm on a medicated FET cycle that suppressed ovulation so my RE wanted my progesterone low, which means I'm absolutely no help here. I'm really interested in what your clinic says though...

    AND, I just had to say that the "It's just a mole in a jar" line made me laugh out loud. I feel like I really need to find a way to work that into a conversation today.

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    1. Glad I could make you laugh! Were you able to work it in??! I can't imagine how you could easily do that...!

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  5. I have no idea about the progesterone but I am sending you tons of support anyway! I'll be glued to my screen, waiting to hear!

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  6. Good Luck to you, Sweetie! I would be obsessing, too. Sometimes, people get it wrong and it is up to you to MAKE SURE they get it right. This is your life! You don't need a single error to take place here.

    Again, prayers and support in your corner! good luck and God bless

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  7. You are your own best advocate. So although I'm not able to tell you what any of that means- I can tell you that it's good you are being squeaky. Like you said, you want to make sure your chances are the best they possibly can be.

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  8. Excited for Tuesday. Also my re always checked my progesterone a week or two after O bc thats the number that matters, if it was low then, then I started progesterone supplements. Hope that helps ease your mind a bit!

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  9. One cycle when I was doing iui I missed my ovulation because the OPK didn't work. I knew I had ovulated. I went in for an ultrasound and blood to confirm. My RE said I must have ovulated either that morning or the day before because he could still see the follicle, but it was cloudy and my progesterone came back somewhere around 2.

    Still, it's good to ask questions to ease your mind. I would be freaked out by the unexpected soon-ness of a transfer. It's a lot to emotionally prepare for and I have always hated how hard IF is on schedules. I'm excited for you, so don't worry if you're not yet.

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  10. Wow lots of information to take in! Hoping that everything goes smoothly from here on in. Oh, good luck with the dinner this evening. I'm hosting my in-laws on Sunday which I haven't done before and am also feeling a bit anxious.

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    1. Good luck at your dinner party! Hope you blog about it :)

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  11. Oh my! Good luck! So much uncertainty!! I hope this FET is exactly what your body needs to help you and Buster have a precious little miracle in you arms!

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  12. Dont you hate the second guessing?! I wish they would just explain every level and how it relates to their next step. I know the feeling all too well. Goodluck!! Cant wait for Tuesday.You're only able to transfer one right?

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    1. Yep, just transferring one due to study protocol. I've thought about begging and pleading for them to transfer two, but I know other women have asked in the past and been denied. Oh well... :)

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  13. I guess if you had ovulated that day or day before then your P level could be that low. I mean, they take the P test on 7dpo because that's when it peaks (and should be above 10 I'm told).

    Anyway, I'd trust the pros and GET EXCITED!!!!

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  14. Hope you get some answers and some peace of mind. Will be hoping the transfer goes well, whether it's Tuesday or friday. And it's not abnormal to be freaked out it's just part of the process.

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  15. I guess it depends on the unit of measurement used - I thought it was over 10 for natural cycles and over 15 for medicated. My initial thought on reading a level of 2 was that it sounds low. But hey, disclaimer, I'm not a doctor!

    I completely understand why you asked for the numbers, I would do exactly the same. I like to keep my own little notes, and while I know the doctors know what they're doing, they can make mistakes (being told to trigger on my ivf cycle when they had not looked at the E2 results, which came back far too high to trigger confirmed to me that yes, I will continue to ask for numbers) although I do think that for people like us, having the numbers and a broadband connection can lead to much more searching and questioning than I know to be healthy.
    But its essential. I'm glad you emailed the clinic your concerns - would be interested to know what their response is.

    Thanks for swinging by my new place and leaving a comment in the last coupla days too :-)

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    1. I never got a response from my clinic yesterday... but, I am feeling a little more at peace with the low number. I have convinced myself that I really did O that morning or late the night before. Oh the power of self-delusion.

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  16. Wow! Your transfer is coming up fast! I will be thinking of you on Tuesday.

    Progesterone levels usually take a bit to come up after ovulation. Usually 7 dpo. The thing is, you want to transfer your embies around that time, so your hormone levels indicate to me that you ovulated recently and are right on track. The Prometrium will help bring them up to a very nice level, promoting implantation and sustaining a pregnancy. In short, I think you're on track and have a VERY good chance of this working.

    If you're concerned, I would definitely talk this over with Dr. M, even asking about about checking your progesterone levels right before the transfer.

    Fingers are crossed and I'm hoping for very good news soon!

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    1. Thank you, Cristy! I think you are right.

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  17. Deep breaths K xxx Tuesday is going to be a good day for you, they do this every day and know what they need to see, Dr.Google can put the fear of god into you. Hang onto the seat of your pants and trust them. Thinking of you lots and lots xxx

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    1. Thanks Anna! I miss you bunches. Hope you and the kiddos are doing fab!! <3

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  18. I'm sorry this has been so confusing...I sometimes wish we'd have real appts with our docs after monitoring appts to find out what the u/s (and/or numbers) really means. You don't want something to go down that you don't understand or that they might screw up and it's so scary. It does sound to me like your timing on Tues will be very good, but I've never had a FET.

    "It's just a mole in a jar" is hilarious. Um, most of us do not see moles in jars every day! There's no "just" about it!

    Hope your dinner party went well. I always, always get nervous when I'm hosting.

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  19. The level seems low to me, and E2 does spike before Ov so I'd be concerned that number won't be the most accurate either. Can they re-do the b/w before your transfer? Either way, hoping so much this cycle is it for you. Lots of positive thoughts.

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  20. Wow Tuesday! Getting so close! I know it's difficult to not worry. Hopefully it is low because you just ovulated. Keep the faith that they know what they are doing and your body will be ready!

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  21. Honestly... I'd be kinda nervous too. I'm sure they know what they're doing but of course Dr Google makes us crazy with worry.
    I'm sure they'll tell you everything is still good to go :)
    Good luck on Tuesday!!!! Hoping with everything that I have that this is it!!

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