Normal Female Karyotype

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A different kind of TWW—for my karyotyping blood work results to come in—is done.

A few weeks ago I had a recurrent miscarriage panel drawn at my RE’s office. It was done more as a formality, IMO. Something Dr. C figured would appease me.

There was some confusion when a new girl in my RE’s office told me my results weren’t in (they were) and never bothered to share them with me or with anyone else—including my RE! I finally tracked down my fave, most competent nurse. She jumped on the ball and called me back within ten minutes with my results that only moments before “weren’t in yet.” Nurse read my results to me over the phone. She might as well have been speaking in hieroglyphics. I politely listened to a slew of medical terms and numbers, then requested the lab results be emailed to me.

For anyone who geeks out on this type of thing, here’s what the panel tested:

  • Anticardiolipins  (3 types: IgG, IgM, and IgA)
  • Beta-2 Glycoprotein  (2 types: IgC and IgM)
  • My thyroid (not totally sure why this was included in the test, since my primary physician draws a full-out thyroid panel for me every 4 months, but, hey, whatevs.)
  • Lupus Anticoagulant comp (This included a whole raft of subtests, none of which I can pronounce, let alone decipher their meanings).

Everything was squarely in the normal range. The Lupus results were a bit on the higher end of the ranges given, but not enough that Dr. C was concerned.

So there we have it. I am “normal.” Well, not normal normal haha…. but my blood clotting abilities are apparently quite stellar. Hooray.

Through a friend’s recommendation, I’ve been reading the website of a reproductive immunologist, Dr. Alan Beer in California, about RI and RM testing. His site is pretty informative and breaks down all the tests he uses in his RI practice in a way that’s (semi) understandable. Among other tests, I noticed that Dr. Beer includes the following in his RM testing, none of which were included in my own panel:

  • Leukocyte Antibody Detection (LAD)
  • Antinuclear antibodies (ANA)
  • Natural Killer (NK)
  • Antiphospholipid Antibodies (APA)

The terms natural killer cells and antiphospholipids are thrown around a lot on IF blogs. But no matter how much I read online, I still have a hard time wrapping my mind around all this stuff.

I’m a total newb at all things RI, so if anyone can tell me whether my panel sucked as far as being comprehensive, please do. I’m not looking for there to be something wrong with me as far as RI goes, but if something major wasn’t tested that should’ve been, I’m def interested in knowing about it.

 

 

‘O’ is for Ovulation

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Well, not for this chick. Not this month. Again.

When it comes to checking for OV, I’m really… let’s say, fastidious. I temp each and every morning at the exact same time. I love nothing more than a good session of sitting down to analyze my charts (man has my idea of a good time changed since my 20s!). I like being able to see progress mapped out in front if me every month. In a trial like IF, any amount of feeling proactive helps.

Back when things were “normal,” I’d begin using OPKs on CD 11 or 12; between CD12 and CD15 I’d usually get a positive result. I’d always test one extra day afterward, just to see whether I’d get another positive. Then I’d stop testing for the month. Like clockwork and just like it should, my temp would spike one to two days after a positive result. It was all very non-exciting and routine, but, what can I say? Seeing that smiley face and knowing that things were working as they should made (and makes) me happy.

And, of course, I lived to share the results with DH. It wasn’t unusual for him to get texts like these from me:

Cryptic, huh?

 

I haven’t used any OPKs since August 2015. There was simply no reason to. After my last AF, though, I happily jumped back on the bandwagon. I hadn’t POAS —on any sticks—in months and was starting to get the itch. Like an addict.

Immediately after AF ended my temp dipped super low. Not too unusual. But at the same time I was getting CM; this was totally puzzling, cause CM should not happen right after AF ends. My temp never spiked after the CM went away. Weird.

On CD11 I began using both Clear Blue Digital and Wondfo.  Day after day after day my tests came up negative. Even using both brands (more on that later), there was definitely no LH surge. Even so, my temp spiked at CD13, just like it normally would.

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Obsessive.

The cycle drew to a close and I knew I had not OV’ed this month. In fact, I don’t think I’ve ovulated at all since the m/c. I’m currently on my fifth period in eight weeks, which must be some kind of world record. Periods that close together just don’t leave enough time for the OV process to happen.

It took until age 28 for my cycles to level out to a nice, predicable pattern. We’ve been TTC since around then, and I’ve relied heavily on those predictable cycles in that time. So you can imagine how much my cycle still being all jacked up following the m/c has me super frustrated. And sad. What the heck, guys? How long does this stuff take?

I desperately want to get back to normal. It can’t happen soon enough. I sure miss those smiley faces. I miss the normality of my routine. I miss that “mundane-ness” of having a regular cycle and OV, no matter how much I might have once complained about those periods. Most of all, I miss knowing that I even have a shot at a BFP.

Why Hello There Again, Gym

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Confession: When it comes to exercise I’ve become the queen slacker of all slackers.

I used to go to the gym (semi) regularly, and supplemented the in-between days by taking long walks with DH and Puppy. I bought an elliptical machine last winter and used it on days when leaving the house seemed too daunting. I also used to meet a friend after work to get a Zumba class in a few days a week. I was what they call, healthy.

Little by little I’ve fallen away from all-things-exercise and found myself teetering on the brink of schlubbery: I moved and no longer have my trusty Zumba buddy nearby. I cancelled my gym membership last spring to “save money.” My elliptical has magically morphed into little more than a very expensive coat rack. And although I do still go for walks, let’s face it: It’s winter. It’s cold. It’s dark. A quick sprint around the block as I drag Puppy along on his leash hardly counts. The toughest reality though is that—on top of my usual ongoing ovary pain—I’ve had near-constant uterine pain and cramping the past several months. Combined uterine and ovary pain make even the thought of working out seem like a date with a torture chamber. (Fun fact: I can now literally trace an outline of the parameters of my uterus, I know it’s location so well.)

Basically, I lost my mojo. 

Over the past few months I’ve noticed my clothes fit just a little bit tighter. (Darn you, washing machine for shrinking all my stuff!) I get winded just a little more easier than I used to (I blame that one on old age—34’s a-comin’!). I’ve felt my energy levels slooooowly dropping (see old age excuse above). I, of course, chalked all this up to stress, IVF, hormones, grief—basically anything I could think of that sounded plausible. I’ve come up with some really great excuses that I could sell to even the most hardened cynic.

Reality: I got lazy.

There’s no way around it. I’ve been loafing, reclining, snoozing, avoiding, rationalizing, blaming, and denying to my little heart’s content.

Time to put a stop to that.

So I rejoined the gym. And I begrudgingly dragged myself there, complaining and mumbling and carrying on the whole way.

And you know what? It wasn’t that bad.

Okay, actually it was that bad. My merciless personal trainer surely had underlying evil intentions that included my walking as if DH and I had spent a wild night between the sheets for a solid week: but functional use of your legs is soooo overrated. Why rely on your uselessly-sore abs to sit up when wriggling off the bed/couch/chair by hoisting all your weight onto your arms is so much more practical?! And would you really want to walk down the stairs on legs muscles that feel like they’re made of gelatin when sliding down step-by-step on your butt is so much sexier? (True stories. Sad, I know.)

I’ve been forcing myself to go to the gym a few times a week, sans said evil personal trainer. And you know what? This crazy thing happened: it’s getting easier! Very slowly, that is, but still easier. I don’t have to safety pin my favorite dress pants closed for work anymore: that’s pretty exciting stuff.

It’s not that I was really overweight to begin with, but I’ve been dogged by these extra few pounds for far too long now (two words: Desk Job). I’m 5’6″ and look my best when I weigh around 130. Imagine my horror when I weighed in at my family doctor’s office (“GP” for my British friends) and she wrote down a number that hovered dangerously in the mid-140’s. Or when said family doctor discreetly and devilishly slipped a graph into my sheath of take-home papers that indicated I was on the cusp of the “heavy” category. Thanks, Dr. S. And to think, your subtlety was almost lost on me.

What does this have to do with infertility?

Well… it’s not really a stretch: I want to do everything in my power to be as healthy as possible, both for natural TTC cycles and upcoming FET cycle. I imagine that being at a good weight is paramount to healthiness. Despite my sometimes ruminating that getting back to my target weight will be moot since I’ll just gain it back during pregnancy, I know in my heart that’s just another of my many tempting excuses. Instead, I try to see it is as a positive: when I gain pregnancy weight, I’ll be able to use my current wardrobe as maternity wear. Silver linings and all.

Will not shedding a handful of unwanted pounds be a deal breaker for taking home a baby one day soon? Probably not. But it is motivation, and this gal will take all the motivation she can get!

And if things go really well, I might even have before-and-after pics to share one day soon.

Peace. ❤

 

 

No Surgery Needed

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The results are in: no surgery needed to correct my arcuate uterus! Dr. C called me today and said that all the REs in the practice reviewed my recent hysteroscopy; between them all there’s over a hundred years’ of experience. They all agreed that my “dent was moderate” (his words), but not enough so that I should get it fixed surgically.

I’m, of course, good with this. I see the situation kinda like a car: you can drive a dented car and still get around just fine. I guess dented uteruses can be seen the same way? Cause we all know how similar cars and uteruses are….

And—since a few of you guys suggested a recurrent miscarriage panel to me—I floated the idea by Dr. C.  To my surprise, he was totally down with it. He said it was definitely worth doing the panel before transfer, and that he’d have nursing call me to schedule the blood test. So a big thank you to those of you who mentioned the idea; otherwise I wouldn’t have known to even ask for it. You guys are total rock stars and I heart you.

Dr. C and I are on the same page with things right now, which is great: There’s nothing worse than fighting your doctor on something you want done but which he/she doesn’t think is needed. Right now I’m, like, in love with my RE. DH understands. We all have our doctor crushes from time to time.

I’m feeling better about things. Now I just need NO MORE SCARES between now and transfer time to maintain my good perspective. I’m guessing the panel will be drawn soon and I’ll hopefully have a very non-updated update to post afterward.

Peace.

Hysteroscopy #2: Arcuate Uterus

Arcuate uterus: that’s the latest term the docs are flinging around these days. Yeah, I know, the title to this post sounds like a sequel to a bad movie. But if all-things-uterus-related are your thang, then, please, read on:


 

Yesterday, after having had something like 4 periods in 5 weeks, Dr. C determined that I’d finally had a “second” period and did my second hysteroscopy. I felt very fortunate that my h/s was scheduled on a day that Dr. C was the surgical clinic doctor and he’d be doing my procedure: there’s just something about having your own RE that makes it so much more comfortable. Well, as comfortable as someone lacing a camera through your cervix and taking an extended video tour of your uterus can be.

The h/s showed that I had no fibroids, polyps, or fetal tissue left in there, so we checked all that good stuff off the list. But then Dr. C was all like, “Hmm, it looks like you have an arcuate uterus. It’s not too bad, but it’s definitely arcuate. See?” He showed me something on the screen that looked (to me) like just a watery blur, explained the condition to me in best-and-worse case scenarios, then wrote it down on a piece of paper. “I know you. You’ll be Googling this the minute you’re out of here. So here’s how to spell it.” Ahh, my doc and I: he knows me so well.

After a bicornuate uterus was ruled out the other month, I’d thought little more of the matter than just my having a weirdly-shaped uterus. But apparently there’s several different medical conditions in which a uterus can be jacked up, and now they’re trying this one on for size.

I, of course, Googled as predicted. I’ll save you the dry, unintelligible, medical definition: here’s an easier explanation that I found online:

A small “dent” in the top of an otherwise normally shaped uterus distinguishes this condition. The Mullerian ducts have fused but have not reabsorbed completely. The problem does not seem to have much effect on normal pregnancy so seldom requires treatment.

arcuate uterine-abnormality

From what I’ve found, an arcuate uterus can be a cause of very little concern:

“…the arcuate uterus probably does not have an impact on reproduction and obstetrical outcomes.”

“… a minor malformation with a benign clinical behavior…”

“According to these results, there is no evidence to support that the arcuate uterus has a different effect on the reproductive outcome in comparison to the subseptate uterus, neither before nor after surgical correction of the anomaly.”

On the other hand, arcuate uterus can have an effect both on fertility and the ability to carry a child to full term. Specifically, it’s suspected of contributing to second trimester miscarriages. Some websites say arcuate uterus is common, others say it only shows up in 3 – 4% of patients scanned.

Fun stuff.

The Plan: So every Monday Dr. C sits down with the other REs in the practice to review cases from the past week that they want to get the others’ opinions on. They’ll make some popcorn, sit back, and engross themselves in re-watching the video taken during my h/s.

Then they’ll tell him what they think I should do. Then he’ll tell me what he thinks I should do.

What Dr. C thinks: For now, wait. If his colleagues suggest that I have my uterus “corrected” then I can have a procedure done to fix it. Will not fixing it affect our upcoming transfer this spring? Maybe. Buuuuuut… maybe not. Dr. C thinks I’ll be okay…. buuuuut he doesn’t want to take a risk of messing up my future chances.

Bottom line: He doesn’t know yet. Therefore, I don’t know yet. The clinic will call me next week with an idea of what to do going forward.

Update to follow.

 

Anniversaries and Would-Be Milestones

I’m not doing good today, ladies. Like, not at all. Today’s been tough:

  • Today is 3-months since we first learned all was not well with our pregnancy.
  • Today is 2-months since the actual miscarriage itself.
  • And, last but not least: Today would have been my 20-week mark. I’d be exactly halfway along in my pregnancy. Instead I’m halfway along nothing. Absolutely nothing.

 

I woke up this morning aware of today’s anniversaries and milestones. I’m not quite sure if “anniversary” is the right term to use, but the odds of all three of these events occurring on the same day? Well, you just can’t write this stuff. Before even getting out of bed I determined that, even though I knew I’d probably feel kinda down today and therefore cut myself some slack, I would not let these thoughts really, truly affect my day.

But then, I made a horrible, terrible mistake: I came to work.

And first thing in the morning, Boss started waving a pic of his newborn grandson in my face. Literally, in my face, exclaiming, “Isn’t he cute?!” This prompted like a 20 minute long convo between Boss and Coworker and Associate Guy about the baby. Not wanting to be a B*, I didn’t shut my office door to drown them out. After several minutes of overhearing baby talk, I left to “go to the bathroom.” All suspect-like, I returned to the office 10 minutes later and they were still going on about the baby! I left yet again, returned, same thing. Seriously, this was the conversation that would not end.

Not even an hour later, Boss approaches me and asks, “Let me get your opinion on something, as a woman. Don’t you think it’s really weird for a mother-in-law to throw her daughter-in-law a baby shower?” Apparently, Boss’ wife has been invited to such a baby shower. Boss tends to get really hung up on little details like this.

And then, guys, I inwardly imploded.

  • First off, my being a woman doesn’t automatically make me some omniscient expert on all-things-baby etiquette. Do you see a baby here? Hmm…..? No? Then don’t ask. Just.don’t.ask.
  • Second, I don’t get it: what’s so wrong with a MIL doing that?! Who cares?! If there’s apparently some unwritten standard that a mother throws the daughter’s baby shower, then I guess I’m out of the drawing for ever having a baby shower that I didn’t organize myself.
  • Third, this man knows I just had a miscarriage. I guess my all but becoming part of the wallpaper when babies and pregnancy gets brought up at work (which they do, way too often) hasn’t worked.

I pointedly mumbled something about how I wouldn’t know and went to the ladies’ room. Again.

Cause like I just said, you can’t write this stuff.


It’s just …. rough … today. I can’t fully articulate why, but I’m so angry that I could kick a kitten. Okay, no, not really, I actually love kittens, but you get my meaning.

I even read blogs on here by others who’re around the same pregnancy week I should be, then find myself fighting off feelings of envy and anger. And that’s so, SO wrong. Cause I love you guys! But, at the same time, please understand what I mean. Cause, in our hearts, we all do this/have done this at some time. That doesn’t make it right; it just makes us human. I actually am happy for others, especially my fellow TTC-ers who’ve come out on the other side. Some days, though, it just straight hurts to see right in front of you what you failed to achieve yourself.


Okay, getting all that ugliness off my chest helped. I can’t let all this stuff fester inside of me. I just know you guys get what I’m going through here. Maybe I just needed to vent. I’m sure that being on day 34 of my period isn’t helping matters. Neither is this relentless stomach virus I’ve had for the past 5 days that shows no sign of slowing down. It’s a regular party over here!

I meant everything I’ve posted before about healing, but grief is a funny thing. Some days you think you’ve moved so far and have done so well, only to realize just how close to the surface it still lingers. It’s a long road back.

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Unmonitored Clomid Cycle

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So there I was, standing at the pharmacy counter to pick up my Synthroid prescription when the idea struck me:

“Can you check to see if I have any Clomid refills left?” I asked the pharmacist on a whim, trying to be casual in my best “how’s-the-weather?” voice.

Without a second glance at me she began clicking around on that computer thing-y which pharmacists peer into like gypsy’s reading from a crystal ball. “Yep. You have two refills until this May,” she replied.

“‘K. Can you fill that for me too?” Again, with the fake nonchalance.

And again, the pharmacist couldn’t care less. She refilled it, ran it through my insurance, and rang me up, while appearing über bored throughout the whole transaction. As intimidating at they look wearing those white coats and—for some unknown reason—always standing on an elevated platform so they can peer down at us mere mortals, I’ve always found pharmacists to be pretty benign and tame in the medical world. Even so, there’s always that little bit of white coat syndrome that makes me just sorta nervous when approaching them.

A few hours past then and I still don’t know what urge struck me to refill my Clomid all these months later: it just seemed like a Good Idea. I’m a resourceful chick, I hate waste, and I knew that the odds of getting questioned about my filling a script from the long-fired Dr. B are low: Dr. B closed his practice in late summer because he has (or had) cancer. He hasn’t reopened since. Dr. C would probably do a headstand in front of me while reciting Shakespeare and wearing a pink tutu before he wrote me a script for Clomid.

Since I’m not planning to waste my money on another IUI and since we’re just marking time until my FET, I figured I have time to kill to do an unmonitored medicated cycle. I’m still kicking it around in my head on whether I’ll use it this cycle or not.

So before anyone crucifies me here, please know that, yes, I realize that REs and Gyns go freakin’ bananas about patients using Clomid unmonitored, but it doesn’t take a rocket scientist to understand why they feel that way… give ya one guess… Second, I know Clomid can cause cysts, but they do go away. Plus, my dosage is only 50 mg, which is the lowest dose I think they prescribe. Third, although chance of multiples when Clomid actually works is about 10%, that figure is actually much lower for women with DOR such as myself. And fourth, its only Clomid—so why not?

So I said all that to say this: Has anyone done an unmonitored Clomid cycle in the past? Any tips, tricks, advice, etc.? How did you time yours?

There’s still a chance I’ll chicken out here, guys.