Super-Nerd Trigger Calculator

For those of you who aren’t familiar with the HCG (human chorionic gonadotropin) trigger shot, it is a single dose intra-muscular shot given 36 hours before egg retrieval to help mature the eggs.  Because this shot is made of HCG, the pregnancy hormone, it makes at home testing tricky. 

If you test too early on a non-triggered cycle you won’t have any HCG in your system and so you’ll get a BFN.  If you test early during a triggered cycle you may see a line on your pee stick that is just from the lingering trigger and not from a burrowing baby.

This potential false positive scares me.  It scares me enough that I worried about it for other people when we were still trying au natural.  I’d look at other girl’s peesticks and roughly calculate how much HCG should be left and if it might be a false BFP.

If you can’t tell I’m kind of a worrier. 

One of the first things I did when I got my IVF 1.0 calendar was create and excel trigger ½ life calculator based on a 10,000 unit trigger shot and the average ½ life I was able to find on the manufacturers web site.  Of course, since last cycle was cancelled I never used it. 

Today I opened the spreadsheet and realized I’d used overly simple logic and I knew that would bother me.  I had used linear interpolation to estimate the amount of trigger left when the equation is clearly exponential and to a math nerd like me that is very irritating. 

So I rebuilt it.

I plotted the half life, 29 hours (with a confidence interval of +/- 6 hrs) and found the equations for each using a trend line.  Excel is a very smart tool and did all the work for me.  Now I have a fabulous calculator which allows me to enter trigger dosage and number of hours since injection and outputs the low, likely and high residual HCG in my system.



Have I mentioned I’m a huge nerd?

If anyone would like a copy of the file (which also has a beta doubling time calculator) just send me your email address and I’ll send it on over.  If I get bored tomorrow or have any requests I’ll add on a booster shot function.



IVF 1.5 Schedule

Last week I had an hour long consult with Dr. SS’s nurse, we’ll call her Nurse L.  We went over all kinds of stuff in the appointment including the protocol I’m on and the four new meds I’ll be taking.  Somehow I didn’t even realize until midnight that it was a long lupron protocol!

I freaked out, I was on a long lupron protocol for my last IVF (which was cancelled for poor response!)  So of course I didn’t sleep, went over every possibility in my head and finally morning rolled around and I groggily emailed Dr. SS with a long list of questions.

His response helped, but not entirely.  He basically said this: Your blood work came back great, your AMH was higher, your FSH lower and all other numbers were with in normal range.  If we put you on the A/ACP we talked about you’d be at risk for OHSS because we couldn’t use your E2 levels to monitor your progress (this is a downfall of the protocol).

So here is the final protocol / schedule:

8/4 - Start Lupron and Dexamethasone

8/7 - Last BCP (hopefully ever!)

8/8 - Cut lupron dosage in half

8/11 - Baseline E2

8/15 - Start stims (Foll.istim) and via.gra suppositories (4X per day…ick)

8/17 - Start luveris (LH injection) lower stims from 375 IU to 225 IU

8/18 - Intralipid infusion

8/20 - Leave for Vegas!! (also Garth Brooks concert!!!)

8/22 - First US/BW and meet Dr. SS

8/24 or 8/25 - Prob Trigger

8/26 or 8/27 - Prob Egg Retrieval

8/31 or 9/1 - Prob Embryo Transfer

Wish me luck, just one week until I start the dreaded lupron injections again…. IVF 1.5 Here I come.

Welcome ICLWers!

The best way to learn about me is to read my blog, so here are some fun links to follow!

Me and the pups hiking last weekend

I’m Lindsey, I mostly blog about the love of my life Blue, our two pups Panda and Trapper, the bitch we all know as endo, my newest diagnosis of DOR, being an infertile myrtle, and of course  IVF in Vegas baby!

If you’re looking for a roller coaster ride, look no further.  I’m up one day, down low the next, you never know what to expect in this crazy world of IF and since this is my outlet I lay it all on the line.

Also, If you are having trouble commenting on blogs see this post.

Infertoholic

I imagine myself walking into a dingy community center with a piece of paper on the door saying “Infertile’s Anonymous.”   When it’s my turn to talk to the room full of other infertiles this is what comes out…

My name is Lindsey and I’m an Infertoholic

I used to smile, now I pretend to smile.

I used to go to the doctor once a year, now I go once a week.

I used to feel healthy, now I feel sick.

I used to take 1 pill a day, now I inject myself regularly.

I used to eat gluten, now I dream about it.

I used to hope my daughters wouldn’t have Blue’s nose, now I pray they do.

My life revolves around my next infertility fix, whatever it is that day/week.  Maybe it’s a doctor appointment, or lab results, or another wanding?  Maybe it’s Dr. Goo.gle.ing, or acupuncture, or that piece of pizza I have to watch everyone else eat?  Maybe it’s the vitamins, or the injection video I need to watch, or questioning the protocol my doc put me on?

Whatever IT is that day, IT consumes me.  I can’t think about anything else.  If it appears that I’m paying attention it’s because I’m a great pretender. 

Infertility has taken over my life.

I can’t believe my family and friends haven’t forced me into an intervention yet.

Gambling in Vegas

My repeat CD3 hormone panel is back.

AMH – 0.8 

FSH – 8.3 

Estrodiol - <20

All low/normal results for my age, according to the nurse this may mean I don’t have diminished ovarian reserve at all... 

When I originally spoke with Dr. Sher he planned to start me on 600 IUs of Folli.stim for the first 3 days of stims and then to reduce it slightly.  My new protocol (since he got the blood work results) is 375 IUs per day for the first two days then 225 IUs from then on.

I’m feeling pretty optimistic since I talked to her.

The decision is go with option C; go to Vegas planning to transfer and if things aren’t looking great at egg retrieval, head home early and return to Vegas in October.

The only downside is I’ll need several medications that won’t be necessary if we don’t transfer (but they won’t do any harm either) and we’ll have to make some last minute flight / hotel changes.

It will mean a little more money, but that’s what gambling is all about right?  You can’t take home the prize if you don’t pay the ante.

Blue makes me laugh

The last box I needed to check to guarantee IVF in Vegas wouldn’t be cancelled was a sonohystogram.  I explained it to Blue and told him I would appreciate if he came.  I’ve been feeling really alone and I wanted him to be more involved in all of the IVF stuff this time around.

I started to feel really sad when we were sitting in the lobby because it doesn’t seem fair that this is the third sonogram he’s seen and most males never see one until they’re looking at their child.

Then I started crying because I saw a child sized chair.  Luckily this was crocodile tears rather than the sobbing I’ve been doing lately.

Finally we got called in and when I was sitting bottomless on the table Blue looked at me questioningly and asked “so they’re going to put water in your vagina?”  I’m still laughing just thinking about it!  I try so hard to explain this stuff to him but it never seems to sink in. 

The procedure started and I made jokes with the doctor and ultrasound tech because I didn’t have any other choice.  If I didn’t laugh I’d cry, so I chose to laugh.  The procedure went fine, no polyps or fibroids.

On the way home I cried and Blue looked confused.  Finally he said, “but I thought you were feeling better.  You laughed with the doctor.”   

I guess we’ll never completely understand each other….

Whats wrong with me?

I cried myself to sleep last night.  Not a few glistening tear drops either, I bawled, and sobbed so hard I shook the bed and woke up Blue.

Here is a little taste of my internal dialogue...

“God, why would you let me have it in my heart to be a mother and not make it possible?  I’m sorry Jesus, I know you don’t work that way, I’m sorry I haven’t been going to church.  I feel so alone.  I wish I could talk to my family, I wish I could talk to my friends, I wish Blue understood.”  Then repeat that again, over and over for an hour until I finally ran out of tears and energy.

I should be so excited and filled with hope.  We’re leaving in a month for IVF with the doctor I trust the most in the world, we can afford it, my work is giving me the time off paid, everything is working perfectly.

Why do I feel so hopeless?  Why aren’t I smiling ear to ear?

I’m sorry I haven’t responded to any of the comments on my last post, I promise my next post will be informative and not just Debbie Downer. 

Consult with Dr. Sher

A lot happened yesterday.  Here is a quick and dirty list.

• Had my consult with Dr. Sher (we will now call him Dr. Super Smart)
• Decided to go to Vegas for the August 22nd cycle
• Cancelled my meds for the cycle I was supposed to start next week
• Told Dr. BFP we’re through
• Got wanded by an incompetent male to make sure I’m cyst free, and I am
• Told my boss I’d need time off and confirmed it’s all paid!
• Gained a whole new conundrum regarding embryo banking

The consult was incredible, Dr. Super Smart spent an hour and ten minutes going over my entire medical history and filling me in on my options.  He is very confident he can get me pregnant the first round using the A/ACP and intralipids infusion.  We won’t need to use CGH because my haggard ovaries don’t effect the age/quality of my eggs, just the number available.  He thinks for every two blasts we get that at least 1 will be chromosomally normal. 

It was all super positive until he moved on to tell me I need to talk to Blue about how many kids we want because after getting pregnant and then breast feeding my ovaries may be completely done for.

What he suggests is that if we don’t get enough eggs the first time around for two babies that we freeze them all and don’t transfer any.  Come back a month later and do another round where we actually transfer.  He calls this embryo banking.  With this scenario I could take my time between kids and even have my ovaries removed if the pain is bad enough.

I think it’s the smart thing to do, problem is that it means I have to wait a whole extra month and a half to even try to get pregnant.  In the scheme of things that’s really short but to an impatient infertile who is totally sick of waiting it is TORTURE!!

Luckily he said we can wait and see how I respond to meds (he is quadrupling my Foll.i.stim dose) and then decide what package to buy before egg retrieval.  The problem with that plan is that we have to prep for a transfer which means tickets and hotels for 12 days instead of 5, intralipid infusions, and a sonohystogram at home (rather than during egg retrieval for free.)

What do you think I should gamble on in Vegas?

Option A : Trust a single round to produce enough embryos for 2 babies

Option B : Pay up front for 2 egg banking cycles, first transfer in October

Option C : Plan for A but make the call at the last minute if B is necessary

Vindicated

I’ve been having a tough time around my family lately, especially since the cancelled IVF cycle.  I’m really feeling my hope start to wane and it makes it even more difficult to be around babies and their overenthusiastic parents.

My sister and her husband are the epitome of overenthusiastic parents.  I’m pretty sure they actually think my 8 month old nephew poops rainbows.  In a different world, if I weren’t going through IF I might think something similar, unfortunately I live in the real world where IF exists.

My nephew is wonderful and so cute and all the things an 8 month old baby should be, but my sister and her husband make it really hard to be around him.  All they want to do is talk about him, stare at him, push him in your face, etc.  It is emotionally draining.

This weekend we went out to my parent’s cabin, a fabulous lake place where all the worries in the world should float away….  Instead it became another weekend all about the baby.  I was so overwhelmed by Sunday that Blue and I escaped to a friend’s cabin on another lake for a few hours of baby free zone. 

The family we went to visit is like Blue’s second family, and some of my favorite people in the world!  They went through a long battle with infertility 30 years ago and eventually adopted their son who is one of Blue’s best friends.  The mom has been a wonderful sounding board from the start of our IF journey.  She’s been there, done that, and not forgotten how hard it was.

When we went by their house on Sunday it was so peaceful.  I complained for a quick minute about how hard it had been at my parents but after that we just enjoyed one another’s company. 

The next day my whole family decided to go by there to visit and ended up staying several hours.  I had my fill of baby time not very long into the visit and so I strategically avoided my sister and her husband the rest of the day. 

Eventually, when we had a minute alone, the Mom and I sat down and she looked at me with pity and said, “Wow, I didn’t realize it was this bad!”  She went on to explain that she thought my sister was being completely insensitive and she could see how hard it was for me just to be around them.  She said all the things I’ve been thinking, feeling and worrying that I was over-reacting about.  Hearing her say them all back was the best feeling ever, I was vindicated!  Finally someone understood, and it was even someone who had their happy ending and hadn’t struggled with IF in 30 years!

I guess this taught me several lessons, or at least re-affirmed them:

1. You never stop being an infertile after you’ve been through the trenches, you’ll always be a wonderful resource for other’s going through IF because you’ve been there and done that.
2. Some people will never get it and will always be difficult to be around until you have a baby in your arms.
3. You don’t always have to say yes to every family function.  It’s OK to take some time away for your sanity!