This sums it up pretty well

From Someecards:

Not my secret, but totally could be

Today on PostSecret:

Lap consult scheduled

February 7 we get to make another exciting day trip to Long Island (there really needs to be a sarcasm font) for a consult on my repeat lap.  I am so not looking forward to doing the prep for that again, but I'm really just hoping things go smoothly (as in we do not get another massive blizzard) & we can maybe sneak in surgery by the end of February since I took the 1st week of March off for vacation (no plans, just chillaxin' for hubby's spring break) anyways.  My last lap was almost 4 years ago & they found nothing, but who knows?  I have an infertile friend who was told it was all good only to have a CCRM consult where they took out a ton of endo. 

 

Once I get my period post lap, we can cycle, so in theory I could be stimming in as little as 2 months.  I'm guesstimating based on prior experiences that if that was the case I could end up with retrieval/transfer right around my 35th birthday.  I wonder if I'll get a special gluten free cake that says "Congrats on being AMA now too!"?  

 

I plan on taking FMLA time when the IVF cycle itself starts.  Even though most monitoring can be done locally & they say stress does not affect outcomes, I call bullshit.  And honestly, I have such hatred for my job that anything I can do to lessen cortisol levels will be beneficial to my mental health regardless of pregnancy or not.  My therapist agrees this is a smart idea thankfully so if HR decides to be assholish (I doubt they will be) I have back up. 

 

When we do cycle we will do either a micro Lupron or straight Menopur stim.  Lupron was the only med I've been on (and I've been on a boatload) that ever gave me side effects (I was a zombie; slept 12 hours a day & was still exhausted) so I'm kind of "meh" at the idea.  However, women who are shitty stimmers like myself often do well on such a protocol.  It's kind of similar to what we did for IVF #2 (the only good stim I had) & honestly, I totally trust Dr. B: I know many women who have had way worse issues than us end up with a kid (or more!) working with him.

 

In addition to the stim we will be adding 2 other meds: Prednisone & Lovenox.  Prednisone is a steroid that will supposedly help with my immune issues & make my body not so hostile to an embryo.  It also has the lovely side effect of making you legit psychotic (ever hear of "roid rage"?) & we don't give it to patients @ work unless absolutely necessary because of this.  I've already warned my husband; should be fun.  Heh.  Lovenox is a blood thinner used to help with implantation.  An infertile interwebs friend had some of these drugs left over & was nice enough to mail them to me.  I hope they work as well for me as they did for her.

Immunology bloodwork results

I received a phone call from Dr. B this afternoon.  Yes, he said 4-6 weeks for results & we only did the bloodwork 3 weeks ago.  What’s this, a doctor that calls you himself & does it sooner than the time frame given?  Be still my heart!

For the 1^st time in almost 6 years of TTC I can finally utter these words: we have answers.

Starting off, my husband & I have some haplotype issues.  Specifically, the concerning one is we have a matching HLA type (AA haplotype).  Fascinating yet bizarre.  Genetically, we are quite different (he is Tamil, I am a mix of Portuguese, Hawaiian & Irish) so one would like Darwin’s theory of genetic diversity leading to fitness.  Guess not. 

The good news here though is our chromosomes are normal which I was slightly concerned about since Vid’s parents are second cousins.  Gotta love (or not, in reality; ha!) arranged marriage. 

I also have a high level of anti-nuclear antibodies & an 8.1 extended haplotype as well as TH2 dominance which point to my body attacking foreign bodies, a.k.a. embryos.  Also, based on the T2 he is recommending a repeat lap to check for endo as in his experience there is a huge correlation.  Given my testing positive for so many inflammatory immune things, he said he’d be remiss not to order it.  The dude he recommends is on Long Island so I will have to check with my insurance & pray it’ll just be a matter of an out of network co-pay.

My AMH is on the low end of normal @ .79.  According to all the charts I’ve seen on Dr. Google, that is about average for a 40 year old woman.  I will be 35 in 2 months.  It’s not low enough to be considered DOR but basically the sooner we get pregnant the better (no shit!) because when I am actually 40, we’d most certainly have to venture into donor eggs.  I have no interest (or funds) to do that.

The shocker: I have fucking celiac disease.  My husband, you know, the one who shits like a buffalo & has the gas to match whenever he eats anything with gluten?  Nope.  Totally odd.  He grew up in South India where it’s a rice-based diet & never has GI issues when he visits home & eats the traditional diet.  I’ve been begging him for years to get tested & he never has.  But now we know.  And I, the queen of carbs who has a gut of steel (seriously, I’ve eaten in some very shady road side stands in developing countries with no issue) has fucking celiac.  This was me today upon hearing the news:

I am so sad it’s pathetic.  I don’t want to live in a world without bagels or pizza.  Yes I know there are gluten free options out there but they’ve hella pricey & often taste like ass.  Alas, having a kid is more important @ this point than having a bowl of pasta.  And once I give birth, I am eating ALL THE CARBS in celebration!

Still alive

Hey, so, yeah...it's been a while.  When last I blogged a little over a month ago we had just met with Dr. Braverman to hatch our master plan. Then, lots of things happened:

We ran away for Thanksgiving as tradition dictates (we've done it every year except 1 since we've been together) to Niagara & Toronto.  

Then early this month Vid's mom took a bad turn & ended up in a coma for 4 days which she somehow managed to come out of.  Seriously.  So he's trying to figure out a way to get over there sometime next month for another visit.  

My job has reached the point of intolerability.   I seriously cry when I wake up in the morning several times a week.  My therapist actually suggested I quit if it were financially possible. Yeah, no.  But I am sending out resumes into the ether, hoping to land something less stressful with increased pay.  Should be easy in this economy, right?  LOL!  

And my niece came home last week after 3 months & 3 days in the NICU, with a mic-key button, which is wonderful news but also a challenge obviously.  It remains to be seen what kind of delays, if any, she will have as a result of her premature, traumatic birth.

Then Christmas was yesterday.  It was pretty chill actually.  So.  Much.  Food.

So yeah, lots of things.

Today we did immunology bloodwork.  Thankfully, the company Dr. B uses is actually headquartered nearer to us in Boston so we were able to do it at their main office & therefore didn't have to drive 3 hours to NY.  Yay!  We did what they call the "Fertil panel" (no "e"; fancy!) & should get results in 4-6 weeks.  I had 12 big vials & 16 little vials taken, while Vid had 1 big & 4 little taken.  Guess which one of us closed their eyes & sweat like a pig for the duration of the bloodwork while their spouse kept rubbing their back so they wouldn't pass out?

Yeah.

A meeting with the Pope (kind of)

We took a day trip to NY to meet with His Holiness, Dr. Braverman, yesterday.  We left @ 5 am & thankfully the traffic gods smiled upon us, as wel as the weaher gods.  Afterwards we went shopping @ the giant Indian grocery store nearby & had a nice South Indian lunch (Vid's people) before heading back home.     

 

Overall, it went well. DH was impressed with his office set up (4 monitors = comp sci prof's dream) & his liquor bottle collection, LOL.  He was very approachable with a good sense of humor & also wasn't afraid to use big words with us.  I like big words!

We're starting out with testing for karyotyping & basic immune stuff. He's also testing my AMH. The nurse will call to set things up next week, hopefully locally to us, or @ least nearby in Boston where Reprosource has an office, which is way closer than Long Island.  He says results should be in by around New Year's or so.

For IVF #2 we did "low & slow" with a Clomid kickstart, adding Follistim, Cetrotide & Menopur which by far gave us our best results. Based on this he thinks we need a flare type protocol but is not sure about micro flare Lupron given wh...at a disaster IVF #1 was. He also suggested maybe straight Menopur.

He did a pretty in depth exam/ultrasound & found something interesting: the blood flow in & out of my right ovary is very restricted. He asked if I knew how many eggs were retrieved there vs. left as well as mature eggs out of left vs. right & I said I don't know. I told him I feel it when I ovulate out of lefty but never out of righty. While he doesn't suspect endo it's in the back of his mind & depending on other tests I might have another lap.

When it comes to my weight he does not think it's what's preventing me from becoming pregnant. He does suggest going back on Metformin since it can normalize leptin levels which tend to be higher in obese folks who don't have IR. Leptin affects the release of LH among other things.

For the hubs, based on his sperm frag test & low morph he says to try the FertilAid & see what happens. Clomid might also help with the morph. Ensuring my other half takes his pills will likely be the most challending part of all.  He doesn't think Vid being the product of a cousin marriage is an issue. Also suggested a course of antibiotics prior to cycle which we also did with IVF #2.

More about the war on infertile fat people

 

Over the years I've been blogging you know how passionate I am about advocating for better treatment of those of us with elevated BMIs who are also dealing with infertility.  Too often, otherwise healthy fat folks are told to lose weight & magically we'd get pregnang on our own.  I've posted several articles written based on data gathered from studies on overweight & obese women.  This time, it's the men's turn:

 

A study cited in Renal and Urology News (November 2013) found that "While those who underwent surgery had increased sexual function as well as increased luteinizing hormone, follicle-stimulating hormone, and testosterone, their semen parameters went completely unchanged."

 

So just like the study I wrote about a year ago about women who underwent gastric bypass surgery not having their fertility improved by the surgery, the same apparently goes for men.  Furthermore , just like their female counterparts, infertile men had a libido increase that may be explained by the fact they were given false hope that this surgery would allow them to finally become a parent.  Once again, if the researchers followed them more long term, the level of sexual desire probably decreased with each cycle they didn't impregnate their partner.

 

I'm not minimizing the fact that obesity likely does play a part in some people's infertility.  We all know it's associated with many medical problems besides an inability to conceive.  However, if an overweight or obese person doesn't exhibit any of the associates comorbidities, then why suggest people go through ultra-invasive, extremely risky surgery to correct a problem when there appears to be no evidence it will acheive the desired, supposed affect of improved gamete quality?