74 Degrees

Let's talk about my thyroid... (try to contain your excitement ;) It was high - 3.62, to be exact. I had no idea it was that high. So, apparently there's different scales to measure your TSH level, and doctors will argue over what's high and what's not, but for the sake of getting pregnant, my clinic said they wanted it around 1.0.  Well obviously 3.62 is not 1, so I had some work to do. They put me on levothyroxine for about a month now and it's been great.

Oh, so the title of the blog.. right. While it's not 74 degrees out at the moment (don't I wish it was), that's the temperature in our apartment. "Okay, so what?" you might say. Before taking this medication, I liked for the temperature to never go over 72. And even that was pushing it. I'd bring it down to 71 or even lower depending on the day. What this meant was that I couldn't tolerate heat. This is one of the classic signs of hypothyroidism.

Let's explore this a little - My basal body temperature (if you're a fellow TTCer, you know you've taken yours every morning for at least a few months), would generally hover around 97.5 in my follicular phase (pre-ovulation) and then 98.1 in my luteal phase (post ovulation). Now that's an average, but I've seen my BBT get as low as 96.7. Yikes. And sometimes it'd get higher than 98.1 but it was usually just for a day or two after I O'd.

I thought for sure this meant that I had a luteal phase defect. I clearly wasn't producing enough progesterone to sustain high temps and therefore I was losing a potential pregnancy each month. But no doctor ever bothered to check my thyroid. And low BBTs are a classic sign of hypothyroidism.

That was until Reprogenesis checked it. And I'm so glad they did because having a high TSH (anything about a 1.5 to 2) can cause miscarriage. Now my BBT has been 98.5 or higher when I wake up. This means that I'm not a giant pool of sweat whenever it creeps above 72 in our apartment.  This makes me happy. And it also makes me feel reassured that these doctors just might know what they're doing. :)

So the moral of my story is, have your doctor check your thyroid! You could be hypo and not even realize it!

IVF Timeline

I've been purposely staying away from blogging for a little bit.  I've felt a little nuts lately with all the planning and preparations that go into doing IVF across the Atlantic. I had a tiff with my coordinator and ended up requesting a new one. That was a huge, unnecessary source of anxiety. Things are much better now, but I have always been one who can only focus on "the now" so needless to say, I couldn't cope.

But things are fine now. We sent our payment yesterday so now it's truly finalized. All of my medication is here and I've been on birth control and levothyroxine since 8/20 (CD3). It's now CD17 which means tomorrow I increase my birth control dosage from 1 to 2 a day - morning and night. Right now I have a little tenderness in my breasts but nothing crazy. I feel like this will be a little intense. Honestly, it shouldn't be anything compared to the "big drugs" so I'm trying not to make much of it. I also start taking prednisone around the same time, which is a steroid that will tell the body not to attack the embryo. Great stuff.

Just in case you're curious about our timeline, here's a breakdown for you:

8/20: Start Desogen (birth control)
8/20: Start Levothyroxine (thyroid medication)
9/05: Increase BCP to 1-0-1 (morning & night)
9/06: Start Prednisone & Folic Acid
9/08: Last BCP - continue other medication
9/12: Expected Period
9/14: (CD3) Start Gonal F
9/16: Leave for Czech Republic
9/17: Arrive in Prague & take bus to Brno
9/18: First U/S - do not take Gonal until after appointment for dosage adjustment
9/18: Possible start date of Cetrotide (a drug that suppresses ovulation)
9/23: Second U/S
9/26: Possible Egg Retrieval
10/01: Possible Egg Transfer

So as we all know, in the world of IF we can plan to our little hearts content, but sometimes the body does what it wants to, which means some of these dates are tentative. Who knows when the actual retrieval will be. I think they like to stim for about 10 days, so it shouldn't be too far off the timeline above. But I've always been a good responder, so I might be ready sooner. We'll see.

And just an update on the apartment - I know I said that we'd be staying at that super modern apartment in Brno, but we're back to staying at the Vienna Apartment. I'm pretty excited. Tomas (the owner) has been absolutely brilliant in his emails and super accommodating. I feel confident about staying at this place and it seems like it's in a good part of town that's close to plenty of stores and such.

Well that's it for now - we leave in less than two weeks. Holy. Crap. I still need to buy a new purse cuz mine's been falling apart and that's the last thing I need while running through an airport. So off I go to the store! Hope you're all doing well!

The Most Unfortunate Place for an Infertile

Today's a big day. Today I took my first birth control pill. I can't believe the irony of how exciting that is. What's more, you should ask me where I got my birth control.

Planned Parenthood.

Oh yes.

I ordered BCP, Prednisone, Folic Acid, and Synthroid from my clinic in Czech. They shipped it over a month ago and, as of yesterday, it hadn't arrived. It's lost somewhere in post office land. This has plagued me with anxiety over the last few weeks. I've stalked our mail man on several occasions. I've gone to our post office several times to see if they have it. Nothing.

Extreme measures had to be taken. Where is an easy place to get birth control? Yep. So I went. Needless to say, it wasn't enjoyable.

I arrived at 12:15 and filled out my paperwork. 30 minutes later I asked to use their restroom so they let me back and handed me a cup. "What's this for?" I asked. "A pregnancy test." "Oh, well I don't need it, I just got my period today." "It's procedure, we have to test you."

I'd be lying if I said that didn't sting a little. What stung worse was when they gave me the results. "You're not pregnant, don't worry."

Oh, wow. Okay. For the first time in 35 cycles of trying, someone else said that to me aloud. Yes, I'm well aware that I'm not pregnant, that's why I'm here at your trashy little establishment!

The nurse came in and we went over my information. I told her why I needed the BCP and she understood. After she left the room I overheard her talking with the doctor and another girl. "So she's here for BCP for her IVF cycle."  "What's IVF?" (um, can you imagine asking this  now?)  "It's in vitro-fertilization (moron!)"  "Well why does she need BC for IVF?"   "To regulate her cycle."

I wanted to burst out of the room and tell that idiot asking all the questions to google once in a while!! I knew what IVF years ago, before I was married, before thinking of babies, before understanding infertility. Ugh, the ignorance!

But I didn't do that. I just sat in the room.. waiting.. humiliated.

I got my prescription and left as fast as I could. Cried in the car, naturally. We managed to convince an RE in the area to write me prescriptions for the rest of the medication I needed. I wish I had just asked him for the BC and saved myself another awful experience.


But here I am, my first day of BCP. I have my medication schedule for the next few weeks. I hope the end of this month goes by fast. I've been occupying myself with buying a few things for the trip. I need a new purse - the straps are falling apart, this is a great excuse. I'm also looking for leggings and some jeans shirts to wear once I start doing injections and become a human pincushion. I can't imagine feeling comfortable in jeans once that starts.

I'm trying to stay positive - I've started saying "when" we get pregnant instead of "if." I have no idea what effect this has, if any, but it can't hurt. I just wished I fully believed it. Maybe it'll be different once we're there. Once I'm pumped full of hormones and they start taking pictures of my ovaries. Maybe then I'll feel hopeful, positive, even confident.

So I wait. Just a little longer.

So Technical - How We Chose Our Clinic

I said a little while ago that I'd start writing more technical posts about IVF and the process so far. I'm incredibly lazy so I haven't gotten around to it, but I'm biting the bullet and writing it today. Here goes..

First I'll tell you how I narrowed down our clinic of choice:

I searched through pages and pages of the Czech Mates posts on the Inspire forums. This is how I first came to hear about IVF abroad. I'd never realized that this was an option. Most of these women go to a clinic in Zlin, Czech Republic for Donor Egg IVF. This didn't apply to me, so I kept Zlin in mind but continued my search. I also noticed some women referencing Fertility Friends and their forums about IVF abroad as well. I read through all of the information I could get my hands on. On FF, I saw more women doing Own Egg IVF and starting snooping around to see which clinics they went to.

Finally, I made a spreadsheet of all potential IVF clinics in Czech. I sorted them by city, success rates, price, services provided, and anything extra that they might do. I narrowed it down to 4 clinics: Reprogenesis, Reprofit, Zlin's Center for Reproductive Medicine, and Gennett. I emailed all of them. (I actually emailed about 10 different clinics, but I'll focus on these 4).

Zlin's replies were fairly quick, but I had a difficult time communicating with coordinator. English was obviously not her first language and, as I like to ask about 1 billion questions, I thought that communication should be key. I also didn't love that Zlin was in the middle of nowhere (think rolling hillside country). If we wanted to do any day trips and get out of our hotel room, we'd have to hop on a bus, taxi, or train and drive about an hour.

Gennet's responses were good, but ended up being quite a bit more expensive than the others. See, all of the clinics asked for basic blood work - FSH, LH, Estradiol, Prolactin, TSH, and sometimes AMH. But Gennett wanted me to have an EKG done and a bunch of other blood work (in preparation for the anesthesia) that would have undoubtedly cost an arm and a leg. Plus, I didn't want to look for a doctor to do all these tests and have to explain why I needed them. Even though they were in Prague and it would've been awesome to stay in that city, it would've been too expensive, so they were out.

Reprofit responded quickly and their replies were easy to understand. I sent them my information (past blood work, IUI results, HSG tests, sperm analysis, etc) and started down the path with them. But I didn't get a warm and fuzzy feeling from their coordinator, and the doctor I was emailing kept missing several questions I would ask. So I put them on the shelf for a bit.

Then there was Reprogenesis. From the get go, they were wonderful. Every single question I asked would be answered the next morning in complete detail. I sent them my information as well and we had a Skype consultation with their doctor. He was great and we had a very good feeling about them.

We narrowed it down to Reprogenesis and Reprofit - they were identically priced with ReproG being slightly more expensive. This was because ReproG used the Embryoscope which added about $800 extra. I did some research and came to the conclusion that the Embryoscope was mainly beneficial for women who had low quality eggs (generally over 35 or DOR) and that didn't apply to me.

So having shaved off that $800 from the cost, we realized that we really preferred ReproG after all. And that's how we chose our clinic.  :)

I drank wine from the bottle last night.

I'm not proud of it, but it happened. And it wasn't as delicious as I'd hoped it be. Better luck next time, I guess.

Okay, I've been depressed. Not your typical "I had a bad day, it rained, I spilled coffee on my skirt, my dog chewed my favorite shoe" kind of depressed. No, more like, "It's noon and you actually want me to get out of bed?? What for?" Yeah, that kind.

Since getting off of Zoloft I've had a horrid time with withdrawal symptoms. Nausea, fatigue, anxiety, depression, random bouts of crying. It's been fun. It's tapered off a bit. I no longer have those crazy "brain zaps" they tell you about. I haven't felt  nauseous lately either. So that's been better.

But the depression.. Oh, the depression. I've been haunted by it. I have a little dark cloud over my head that follows me everywhere. Sometimes I forget that it's there and I can feel normal, but other times, it surrounds me.

I suppose it could have something to do with my Thyroid. I had my bloods stolen the other day and I sent the results to Reprogenesis. Apparently my TSH is super high. They want it to be around .5 to 1.5 for IVF. My TSH was 3.6. Yikes! According to the standard, anything about 2.5 is considered abnormal and potentially hypothyroid. I guess that explains why I have the stamina of an 80 year old lady.

Seriously, this is my very sad daily routine: I leave around 2:30 to go to the store. I head to Whole Foods and search for delicious things, then I drive over to Ulta and stare at the clearance aisle for about 30 minutes but buy nothing. I then head to the Christmas Tree Shop and walk around there for about 45 minutes. I buy whatever wonderfully cheap items they have there and then walk next door to Target where I proceed to purchase whatever items Christmas Tree Shop didn't have. Then I go to pick up my husband from work.

(Also, my day just sounded a lot more pathetic having written it out. Can you believe that this is what I do most days? How sad! What kind of person am I??? :( Ugh..)

As I walk out of Target to the car, I can't wait to collapse into the seat. I'm exhausted. I drive the 5 minutes to DH's workplace and wait in the parking lot to pick him up. But I don't even want to move at this point. We drive another 5 minutes home and I wish he could pick me up out of the car and walk me up the stairs to our apartment. I find my way to the couch and would love nothing more than to fall asleep and wake up 3 hours later.

This is not normal!!!! I am only 28!!!

But now I at least have an answer to why I tire so very, very easily. My TSH is out of control. Fortunately, they're sending me medication to bring it down. Apparently, a high TSH causes miscarriage. I'm glad they checked for it. Wake Forest never bothered to check. Surprise, surprise.

I hope that it'll help with my depression, or at least mask it by giving me super energy. I'll take any kind of help that I can get at this point.

34

34

That would be the number of cycles we've tried. I counted them today. I haven't done that in a while. I stopped when we were hitting 20 because I felt like I was punishing myself. But today, I was curious. So by the time we do IVF, it'll be 36 cycles. That's 3 years worth of trying, yet it's been just over 2 1/2.

AF came today. It's fine. No, it's good. It's a good thing. It means that I can start BCP in a few days. It means that I can get my blood drawn on Wednesday to test my hormone levels and send them off to my clinic. But ... it also means one more thing - I am not a mother. Still.

It's hard not to feel insignificant when you count up the times you've tried to get pregnant and realize that you should easily have two children by now. That stings.

It's hard not to feel insignificant when you drive to the grocery store and can't park in a space because it's reserved for "mothers with children."

It's hard not to feel insignificant when you turn on the news and you hear about the excitement of other women's impending births.

But not yours. Not mine. I am childless.


...*deep breath*


Still, I have hope. Not that I'll one day be a mother, but that God will take these deep, dark, voids filled with pain and tears and wasted days and fill them with a peace that only He can give.

In the midst of the tears I cry today, I feel overwhelmingly thankful. I have a God who watches over me. I could be a lost soul who would never know the goodness and grace of my Heavenly Father, but He chose me from the beginning of time and He works every piece of my life for good.

So I may be scared that this upcoming IVF will fail, but He is not. He knows the outcome. I know that should always be enough for me, but I must admit that my faith waivers. Sometimes I forget that when I say He works everything for our good - that it is also for His glory. So when he allowed Job's family to be killed, it was for His glory. When He allowed Joseph to be taken into slavery, it was for His glory. When allowed Hannah to feel the pain of a barren womb year after year, it was for His glory. But we take comfort in the troubles they faced because we know the beautiful end to their stories, just as God knows the end of ours.

I can't imagine how denying us a child would glorify my Saviour, but I can guarantee that it will. And just the fact that God has a plan for us is humbling. Some people's paths are smooth and easy, with seemingly small hills. Some are clear and obvious. But ours is filled with trees and rocks, blocking our path. The storms we face make it hard to see. It's discouraging. Yet in this struggle God is trying to teach us something.

So for now, that's good enough. The small, quiet moments that I know God is whispering to me. That I know He hasn't forgotten about me. I know He sees my tears today. I know He feels my heart break. And it's in these times that I feel Him the closest to me. For this, I am grateful and humbled and hopeful.

Moving Along

It's been awhile, hasn't it? I've been meaning to write but couldn't quite drag myself to the keyboard. Sure, I've been on the computer, checked the stats of my blog, looked in on some other bloggers I follow, but I haven't taken the time to write down my thoughts.

Why? Well, we all know it fairly well by now: Anxiety. Infertility is riddled with it. Sometimes it's during the TWW. Sometimes it's preparing for a medicated cycle. Sometimes it's just waiting around contemplating what to do next.

I am very anxious. We're down to about two months until our first IVF cycle. Honestly, I'm scared. Scared of what might happen before the cycle... Will we make it there in time? Will I take the right amount of drugs? Will I ovulate early? Will I be sick from the medication? And then of course, what if it doesn't work? How will I handle it? I'm usually a pretty good judge of my reactions. I've known myself for a while. ;) But I honestly do not know how I will cope with a failed cycle. Sure, plenty of warriors have gone before me and completed IVF after IVF, but I don't know if I'm strong enough.

How do you know? Am I cut out for this? I mean, I guess I am cuz I've committed to it this far. We haven't sent them the check yet, but we're all in it. I won't change my mind. I want this. I want to try. I just want it to work.

So, I'm scared. I'm worried. I want to feel hopeful but it's too complicated to feel purely one emotion. I can't be *too* hopeful or *too* scared. I must manage my expectations.

I'm sure it doesn't help that I've been slowly coming off of Zoloft. I've been on 50 mg for almost a year now and I've forgotten why I needed it. It's been really hard. Dr. Vrana (the doctor at Reprogenesis) wants me to stop Zoloft for the cycle anyway so I figured I'd go off of it now before starting BCP and adding that to the mix. But it's been rough. I need some kind of help. I feel like I'm dangling from a cliff.

Okay, so that's my world right now. Here are the logistics:

We've changed our IVF date from October to mid September. We're planning to be there around September 18th. My coordinator at Reprogenesis told me they can modify the timing of the IVF by using birth control pills and I trust them. They've done this a few times.

We've changed apartments too and are staying in this one:   It's similar to the one in my last post, but bigger and looks more like a regular apartment, except super freakin fancy. :)  We'll be there for approximately 16 days and DH will be with me the entire time.

Originally I was gonna fly there alone and then meet up with him a week later, but I realized that this is too emotional to do alone. And I can't imagine having to give myself bum injections. Oh, and I won't have to lift a finger the whole time (which the clinic requires after ET anyway), so that's a plus. And I'm a super newb when it comes to traveling abroad, so it'll help to have someone with me the whole time in case I have a nervous breakdown in the airport.

And that's the plan. I should get my period sometime this weekend which will then be followed up by getting blood drawn for all my hormones (LH, FSH, TSH, Estradiol, and Prolactin). Never thought I'd be excited about a blood draw..

I think I'm gonna start writing more technical posts, too. I really want this blog to benefit someone who is considering doing IVF abroad. I've found a few blogs about it and it really helped to read a personal point of view. So at some point I'll write a list of all the things Reprogenesis has required me to do and questions I've asked. Just not today.

Today I needed to force myself to write. And I did. There it is.