Second beta

Just got the results from my second beta test this morning: 337! This means a doubling time of 41.19 hours. I will have a third and final beta on Tuesday and then a first u/s next week Friday (5w4d).

At the lab

Should have gone in earlier. Waiting room is packed...

I kept to my own promise not to POAS. Maybe I'll do it just after I get my blood drawn, but HPTs have pretty much always meant disaster for me, so I'm not sure... too afraid to see only one line. No AF yet, but usually that would be 15dpo, so not until tomorrow.

HCG booster shot

First of all, thank you for all your words of encouragement on my previous post, it means a lot to me!

Yesterday morning I had to get my blood drawn for an estradiol level check. This time I went to the clinic's lab and I was so glad I did - blood drawn around 7:30 am, results in by noon, much better turnaround time than the lab around the corner from where I live.

The deal with the estradiol level check is that if it's under 500 pg/ml, you have to get a 1500 IU HCG boosters shot. With IVF#1 it was 1980, with IVF#2 it was >1000, but this time the level was 324 pg/ml. Of course this first freaked me out completely, but then I realized that with the two fresh cycles, my estradiol level at trigger time was near 3000 because of all the stimming. This time there had been a little stimming, but not nearly as much as with a fresh cycle, and my estradiol level the day before triggering was at 304 pg/ml, so I guess it would only be logical that my current level wouldn't be so high either.

So I called a nurse to make an appointment for the shot - she would come by around 6 pm, enough time for me to let my son have his afternoon nap and get the meds at the pharmacy afterward. We came home from our little walk to the pharmacy (with tricycle, uphill, so a normal 10 minute walk now took us almost an hour - the way back went a lot faster, although there were the usual distractions of phone booths, parking meters, garage doors that would or wouldn't open, etc.) just before the nurse arrived about 20 minutes before schedule.

She gave me the shot, but when I looked at the box I was confused - she had used two ampules, but there were still 10 left in the box. Why? In case you screw up? There was only one syringe provided and the two ampules she used (powder and solvent) were sufficient for the 1500 IU, but still, those things make me nervous. I just don't get pharmaceutical companies.

Other than that I have nothing to report, no new symptoms, nothing.

Afraid of losing time

Today, without the distraction of my son (who's at the nanny's), is more difficult than yesterday. It started out OK, but then we arrived at the nanny's and I had intended to tell her about our failed IVF, so she would know why she had to take care of our son so much more than normal two weeks ago, and by doing so, hoping that her hurtful remarks that we should hurry up having a second baby would stop. But it wasn't the moment. Both her kids were there (preteen boy and teenage girl) and it just felt bad. So I just left.

Then I went to the lab to pick up my copy of Wednesday's beta test. While waiting, I saw that the lab technician who had drawn my blood on Wednesday was pregnant (I hadn't noticed on Wednesday). It stung. Somehow I had hoped that my beta would be super low, but still above 2 (so there might have been implantation), but it wasn't: <2.

I felt like crying when I left the lab. Back home I called the RE's office to make an appointment to discuss what went wrong with IVF #2 (not that I think he can enlighten me much on this) and what to expect from FET #1. I had called them yesterday as well, asking if a consult was necessary before the FET. The assistant said that it was up to me, but that she could also just mail me the prescription. Since I didn't think the RE would be able to say much about why IVF#2 failed, I opted to have the prescription mailed. But then hubby and I talked, and we decided it would be good to talk to the RE anyway (discuss why day 2 transfer, why day 2 frozen embryo, maybe even assisted hatching?), so that's why I called to make the appointment today.

Appointment is set for April 7 (earlier not possible). So the assistant said she would put away my file again and not mail me the FET prescription, because the RE would give it to me on April 7. After I'd hung up, my mind started racing again... what if next month's AF would show before the appointment, and I would thus run the risk of having to wait another month with the FET, because the treatment might start on CD01...?

Just the fact of looking into my agenda, thinking, ok, so maybe no FET until May, then if that fails, wait another month before being able to start IVF#3 (which I don't want to do at all right now), and with the long protocol, that would mean ER/ER late July/early August (hopefully just in time before the entire country, including RE and staff, would leave for a month of summer vacation)... which would mean my son would be almost three if and when that IVF attempt would be successful (plus, probably more importantly, I would be 38 by that time), made me cry.

After running around in circles for about an hour, I decided to call the RE's office again. Explained very apologetically what I was thinking/worried about and asked when treatment would start (CD04) and if she could maybe still mail me the subscription. "Comme vous voulez, Madame". OK, well, then, yes, please mail it to me (and I'm sorry for being such a nervous wreck - but I hope you understand a bit an IFer's mindset).

So I feel better about that now - and now that I wrote it all down (and thanks for reading my ramblings until the end), I should really get something done today - after all, this is supposed to be my work day.

French precision

I had to go to the lab this morning to get my blood drawn for an estradiol level check. If it would be below 500 pg/ml I would have to get a HCG booster shot... With IVF#1 my level was well above that (1982), but this time I wasn't so sure, as my boobs are still not sore (which starts freaking me out - to me this is the early sign of pregnancy, I had it with #1, but so far nothing this time). I first thought that if the level would be below 500, the chance of being pregnant would be about zero, but luckily, when I went through old emails I exchanged with a friend, I found out that she did have the hcg booster shot, and she had a successful pregnancy, so that eased my mind a bit.

It was very busy at the lab and the ladies were there usual charming self... I asked them at what time I could call for the results - important as if the level would indeed be below 500, I would have to go to the pharmacy to get the meds and then try to contact a nurse to give me the shot - they told me 3 pm.

So I called around 3:10 pm. "Are you sure the results would be ready at this time?" Yes, I asked this morning and you told me to call at 3... "Well, but normally we don't have the results before 4 pm". You told me to call at 3 pm, and I need to get this stuff sorted if my level is too low... After a few rounds of stupid music she finally came back to me to say that my level was above 1000. So no booster shot needed.

When I picked up my son at the nanny's around 5:30 pm I went by the lab to get the results (on paper this time). When she told me over the phone "over 1000" I assumed they hadn't completely finished testing or something and that the final number would be on the paper. No... the paper also says "> 1000". WFT? They can't give me a freaking number? I mean, it doesn't really matter, because it's over 500, so I don't need the shot, but come on, with IVF#1 they were able to give me an exact number, why not this time? You might wonder why I didn't ask them - well, she gave me the results in an envelope and I didn't open it until I was in the elevator on my way down again. As this was a tiny elevator, my son was freaking out (is afraid in small elevators since we almost got stuck in one a few weeks ago), so I didn't feel like going up again.

I'm really getting a bit fed up with this lab. This morning they also asked me twice what the date of my last period was. I told them, but I also said that it wasn't relevant, since I had a long IVF protocol... I'd prefer to have these IVF-related tests done at the clinic's lab - at least they don't ask stupid questions (like for the vaginal exam where the lab near my house manages to ask why I need this test done - do I have a yeast infection?) and they have their results a lot quicker than this lab. But the downside is that it's 30-45 minutes away by bus and metro while this other one is a 15-minute walk...

Anyway... I guess I'm happy that I didn't need the booster shot. Things seem to go OK inside me, at least as far as the lining is concerned... Still feeling bloated, slightly crampy sometimes, but not as much as last week, having night sweats and crazy dreams (but why don't my boobs hurt? - I googled a bit, apparently some women do have sore boobs with one pregnancy and not with the next. Hmm, ok, I hope I'm one of them then!). One more week until beta.

CD30 - getting pessimistic

Well, everything is basically still as OK as the last few days, but today I asked the RE how many (usable) follicles we can count on, and the answer is seven (...).

Last time (yes, 2.5 years ago) they retrieved 14 (of which eight were fertilized, of which only two were good enough to be transferred). So I'm a bit scared that it won't work this time. I know you only need one great one, and some smaller ones could still mature over the coming two days, but hmm, I'm a bit blue. Oh, and for the records, estradiol level is 2621 pg/ml today.

But the good news is that we do have a date set for ER and it will be Tuesday, so exactly the same cycle length as last time, even though I'm reacting differently to the stimulation and the dose for the last few days is also much higher than for IVF #1. I guess that's due to being 2.5 years older than last time? So tonight and tomorrow night again 225 IU Puregon injections, then triggering Sunday night.

Update: the RE's secretary called to say I should change back to 150 IU Puregon for tonight and tomorrow night (based on my pretty high estrogen level).

CD29 - second u/s

We all had to get up very early this morning so I could make the 7:30 am appointment at the clinic for u/s and blood draw and hubby could catch his 8 am TGV. This meant waking up our son at 6:30 am, which he did not appreciate at all - try to change his diaper and get him dressed while he was throwing a 'I don't want to wake up yet' tantrum, give him a bottle, deliver him to the neighbors (which hubby did, by that time I'd already left) who took him to the nanny... I was about 10 minutes early at the clinic, the female RE was there again and early as well, again just one person in front of me, so my turn was exactly at 7:30.

Lining was great at 8 mm. Then she looked at the follicles and first said ER would either be Saturday or Monday, but after closer inspection decided it would rather be Monday or Tuesday. I didn't ask the exact numbers but apart from a few that are already too big, there seem to be about five on each side which are now around 14 - 16 mm. I'll try to get more details tomorrow.

Got my blood work done right after that and just got the results: estrogen level is now at 1597 pg/ml.

I have to up my dose of Puregon from 150 IU to 225 IU tonight and then come back in for another u/s and blood draw tomorrow. When I asked the RE what time she said she didn't know yet. Told her about this morning with our little one. She told me I should just have asked to come in later, they could have taken me between patients... Secretary just called to confirm the dose for tonight and told me that the RE had mentioned I could come in at 11 am tomorrow (when she's starting her regular schedule)! Yeah, that relieves me of quite some organizational stress as hubby won't be back from his business trip until tomorrow evening. Have to get my blood work done earlier though, so they will have the results the same afternoon.

CD26 - First ultrasound

I had to be at the clinic this morning at 9:30 for the first ultrasound and blood draw to see how the stimming is going. I was early, only one woman in front of me and the RE (a woman whom I hadn't met before) was early too, so everything went pretty fast. I didn't get exact numbers, but the RE murmered something of about five follicles on each side. I don't know if that means 10 in total or 10 usuable in total, because there were some that were already measuring 17 or 18 mm and she told me those would be 'discarded' and the focus would be on the ones now measuring around 13 mm. In any case, I seem to respond quicker to the drugs than two years ago - when after six days of stimming follicles were only measuring around 10 mm. My estradiol level seems to be telling the same story: 545 pg/ml (while two years ago it was 310 on the same cycle day). Don't know if this is a good or bad thing or that it really doesn't matter...

I have to continue with the daily 150 IU Puregon and come back for the next u/s on Thursday morning. This time at 7:30 am - which will be a bit of a logistical nightmare as this is a day our toddler normally doesn't go to the nanny and on top of that hubby will be away on business. So hopefully with the help of my neighbor, who's kids go to the same nanny, and some flexibility on the nanny's part, I will be able to get it all sorted out.

I also had a consult with the anesthesiologist and went by the admission's office for my pre-admission. Everything was fine, but I have to get some additional blood work (coagulation) done, but will do that on Thursday, didn't feel like getting stabbed with the needle twice within a one-hour period.

CD20 - stimming day 1

Started with 150 IU Puregon again today. Six days at home (or actually on ski vacation right now!) and then going in for the first u/s on Monday. Same protocol as last time.

We met with the embryologist last Friday. Not much news, she went over our bloodwork and admin stuff again, same thing the RE did in October.

There was however one thing we wanted to check with her. Hubby's sperm test results in October showed some tiny presence of streptococus, so the RE had prescribed him antibiotics and to redo the test two weeks after the treatment. He did take the antibiotics right away, but could only redo the test a few weeks ago because of my mom's passing and everything. The result was about the same, so he again got a letter from the RE with a prescription for an antibiotics treatment. However, he had just taken one a few weeks ago, this time for dental surgery, so we were a little hesitant to start a third round of antibiotics when the previous two apparently hadn't done their work.

The doc still advised to take the antibiotics, but wait until I had been stimming for about four days, so the meds would still be active just before ER and there would't be strep in the culture used for the IVF. So that's what he'll do now, hopfully that will all work out OK.

CD01

AF showed up this morning which means we're on for IVF#2! Exciting and scary at the same time (I'm already worrying on what to do for babysitting the day of the ER when I have to be at the clinic at 7 am...).

We went to the RE again on Wednesday. This time he was busier than a month ago and we had to wait for an hour to see him for only five minutes. Oh well... Got all the forms signed and took prescriptions home for all the meds for the entire cycle. The sperm test showed hubby apparently has an infection somewhere, so he has been started on antibiotics and has to redo the test in about three weeks, but luckily that doesn't mean we had to hold off cycling for another month.

I thought my recent pap meant I didn't have to go to the lab to get a vaginal test like last time, but unfortunately I was wrong. So I scheduled that in yesterday because I didn't want to run the risk of having my period and then maybe getting the test results in too late for my REs liking. It was OK, sort of. I hate it that they always assume there's something wrong (yeast infection etc), and then you have to explain 'no no, it's just a preventive measure before the start of our IVF cycle'. I still don't understand why the RE can't do it himself.

I went to see a nurse this morning to give me the IM shot of Decapeptyl 3 mg (replacing the Enantone that I had to use two years ago). Stimming starts on CD20. So nothing much going on other than stupid cramps (thank you AF) and hubby a bit afraid of me being very grumpy for the coming three weeks.

Past experience comes in handy

Before we meet again with our RE on October 20th, we have to get some tests done. I had my blood drawn last week, hubby still has to do his, which can be done at basically every medical lab in the city (of which there is one on almost every street corner here in France). But he also has to have his sperm tested again. Which of course he doesn't want do at a random lab, but at the one belonging to the fertility clinic. So he called... and they told him they didn't have space before October 28th, which of course isn't possible for us, as the RE needs to have the results on the 20th.

Luckily, we've done this before. And we know our RE. I remember several occasions where I would be in the waiting room, or in one of the transfer rooms, and he would come in, complaining to the biologists that nothing worked, etc. etc. So, I sent the RE an email, explaining the situation, asking if he could recommend another lab, or maybe find a spot at their own lab for us after all...?

Within an hour I got a call from the RE's secretary, who told me he had gone over to talk to the biologists (haha, I know exactly how that conversation went) and that we should call the lab again, ask for the biologist, tell him we spoke with the RE, say that it's urgent, and get our appointment fixed. If we still would have problems, we shouldn't hesitate to call or email the RE again. So I called. Appointment's set for next week Tuesday.

Pee cup

OK, after all the serious stuff, it's time for a silly post again.

I have to call to the lab today to make an appointment for my monthly blood work (toxoplasmosis) and urine test (glucose and protein). To the right is a photo of the cup my lab hands out when you have to give a urine sample. Its diameter is 1"...

Couldn't they have made it little bit wider?! A bit more girl-friendly perhaps?! I now always take a latex glove before I have to give a sample, I don't have such a perfect aim I'm afraid...

Labs and nurses - the French way

I had to go to the lab on Wednesday to have my estradiol level checked. Here in France, you can't just go to your own clinic to get this done, but you need to go to a 'laboratoire d'analyses médicales' of your choice (there are lots of them). In a way this is convenient, as you can choose one that is close to home or work, but what I hate about it is that these people at the lab have no knowledge at all about your medical/infertility history, and sometimes ask stupid questions, which would never be asked if you could have this all done at your own clinic. Plus, it's not just only for the (simple) blood work, but I also had to go there for a pre-IVF vaginal examination (so they asked if it was for a yeast infection...). On top of that, you always have to call them yourself for the results, they will never call you.

In the case of the estradiol test, if it would be under 500 pg/ml, I would need to get a HCG shot, which had to be administered by a nurse. Again, for this you can't go to your own clinic, but you have to call a nurse yourself, who then comes to your home. This is of course convenient for chronically sick patients who have trouble leaving their home, but I find it adds additional stress because you sometimes have to try to find a nurse at the last minute (you get the test results in the afternoon and need the injection the same day) and you always get their voicemails, so you're never sure when and if they get your message.

So I planned a bit ahead and left a message with a nurse close to where I live (also important, because if you live too far away, it's not worth it for them to come to you as I think they can only charge 3 euros for a home visit) on Tuesday morning, saying I wanted to make an appointment for Wednesday, but I was not sure that I needed one... By 6 pm I still had not received a response, so I left another message. Got a call back within 15 minutes, there was no problem, she would come by the next day between 5 and 6.30pm, I just needed to confirm or cancel Wednesday before 4pm.

In the end, too much stress for nothing, because my estradiol level turned out to be 1982 pg/ml, well above the 500 pg/ml threshold, so I didn't need the hormone shot after all...