Preparation for IUI # 1 - CD3 Appointment Set

Well, I just called to scheduled my CD 3 appointment for my baseline ultrasound and bloodwork. I will go into the office on Monday morning at 7:00 am. (I was a bit peeved at my nurse b/c she's so very abrupt - she better start to become a bit more open and empathetic or I'm going to ask for a new nurse). Anyway, here we go!

More Tests

Today I went to LabCorp for my genetic testing bloodwork. I will be tested to see if I am a carrier of the following:

• SMA (Spinal Muscular Atrophy)
• Cystic Fibrosis

If my bloodwork shows that I am a carrier of either of these, then DH will also undergo testing for these. If both of us are carriers, there is a pretty good chance that our child(ren) could actually inherit these disorders.

The genetic counselor also advised for me to have a a hemoglobin profile done, as well. I'm not really sure what this is, but it it comes back abnormal, I will do more research and post what that means, as well.

IUI # 1 Preparation - February 16, 2009

DH and I went to Shady Grove to sign the IUI consent form and picked up our IUI and injection informational packet and instructional injection DVD. I call the office on CD1 and will learn when I am supposed to go in for my first round of bloodwork and ultrasound and to learn about my protocol. I should be starting this process in about two weeks. Yikes!

IUI # 1 Preparation - February 14, 2009

I received my very first box of medication for my upcoming IUI today. It contained the following items:

• Follistim Cartridges
• Follistim Pen
• Sharps Container
• Ovidrel Trigger Shot
• Prometrium Suppositories
• Disinfectant Wipes

I'm excited to finally get started to see how my body is going to react to the stims.

Other Tests

As I'm getting ready to gear up for my IUI, here are some other interesting little tidbits / bumps in the road:

• I somehow am not immune to the chicken pox virus. I opted to forgo getting immunized since you have to postpone trying to conceive for at least three months after getting vaccinated. I hate tempting fate, but I managed to stay chicken-pox free for the past 36 years; hopefully I will be able to remain that way for several years to come - or at least until after I deliver my baby.
  
• While my karyotype (chromsomal testing) came back normal, the lab did find that I am in the "grey area" for Fragile X. According to The National Fragile X Foundation website: "Fragile X is a family of genetic conditions, which can impact individuals and families in various ways. These genetic conditions are related in that they are all caused by gene changes in the same gene, called the FMR1 gene." My tests showed that I had between "38-46 CGG Repeats." According to the same website: "The grey zone: The most important point about an FMR1 gene with CGG repeat number in the 'grey zone' (between approximately 40 and 55 repeats), is that it cannot be the cause of clinical problems. The gene is perfectly functional. Cognitive impairment in an individual with an FMR1 gene of this size must stem from another source. The only risk associated with a gene of CGG repeat number in the grey zone is that it may be unstable from generation to generation and could eventually expand to a full mutation. Therefore, there is a slight risk of fragile X syndrome in distant descendants. The risk for instability of a gene with less than 50 repeats is quite small."
  
• Our meeting with the genetic counselor confirmed what I learned about Fragile X and where we stand in passing this disorder to our children. However, I am planning on getting tested for other genetic disorders just to eliminate any other possible causes of concern for genetic disorders in the future. I will be tested for SMA, spinal muscular atrophy, and cystic fibrosis. If my test resuts show that I am a carrier of either of these disorders, DH will get tested, too.
  
• My TSH level was a bit elevated during my follow-up CD3 bloodwork evaluation. This could indicate that I have hypothyrodism, but until my RE talks to me about this, I will proceed as though everything is A-OK.
  
• Luckily, my HSG showed that my uterus, lining, and fallopian tubes all look good and are normal. That's one thing to be thankful for in this journey.

The Journey Begins.....

FSH = 31.4. That's how this all began. What in the world is FSH and what does that number mean? Well, in the past three months, I have learned a whole lot. Unfortunately, what I learned was not good when it comes to trying to conceive a child.DH (Dear Husband) and I got married in April 2008 in a lovely wedding ceremony in the Riviera Maya Mexico. I was 35 years old; DH was 31. I waited a long time to find the man of my dreams and it was well worth the wait. I would have waited even longer for him if I had to. We seemed to have had the perfect relationship timeline. We went out on our first date in June 2005; DH proposed to me in January 2007; and we wed in April 2008. We figured that we'd enjoy a few years of marital bliss as a couple before adding any children to the mix. The media had led us to believe that women could have children in their 40s with no problems, so we thought we had plenty of time. However, I always had a sinking suspicion in the back of my mind that I didn't have as much time as every other woman did to have children. That's what led me to tell my OB/GYN at an appointment in October 2008 that after six months of not having been on any birth control, I was not yet pregnant. Since I was then 36 (and she had told me the year before that after 35 a woman's eggs "fall off a cliff," she immediately advised me that it was time to see a Reproductive Endocrinologist and referred me to Shady Grove Fertility Clinic. We met with Dr. Gilbert Mottla of Shady Grove's Annapolis office in November 2008. He didn't seem to be overly concerned since I was still on the "younger" side of seeking specialized help. He prescribed the basic infertilty tests for DH and me (CD3 ultrasound, CD3 and other bloodwork, and an HSG for me) and told us that if the results all come back normal, DH and I could get some OPK test strips and then just have timed intercourse and be on our merry way for another six months.Well on November 10, 2008, I got the call about my CD3 bloodwork results. All of the things they tested for were pretty much normal....except for my FSH level. 31.4. The nurse told me that it was high and advised me to come back in to speak to the doctor about the results. Of course I didn't wait until our next doctor's appointment because I am an immediate gratification kind of girl, so I immediately started googling everything I could learn about FSH. That's when the panic started to set in because my research basically found that having a high FSH level (mind you, anything over 10 is high, let alone 31.4) is a death sentence for eggs. Here is a very simple and unscientific definition of FSH from the highfshinfo.com website:"FSH stands for follicle-stimulating hormone. It is a hormone that is produced by the pituitary gland that, in the female, stimulates the ovaries to develop a follicle (the housing that accompanies the egg prior to ovulation) – each month. It can be thought of metaphorically as the gas pedal which causes the ovaries to ovulate each month. As women age, it becomes more difficult for the ovaries to ovulate as the supply of eggs gets reduced and so the level of FSH rises (in order to push down the gas pedal further) over time. When a woman enters menopause, her ovaries are depleted and the gas pedal stays depressed permanently; that is to say the FSH level remains high. It is also possible for young women to have prematurely high FSH. "I was also led to believe that having a high FSH was probably the worst case scenario that a woman who wanted to get pregnant could ever have. Pretty much anything else would be fixable or workable. But since a woman is born with all of the eggs she will ever have, once she runs out of them, she can not get pregnant. Period. I also read that many doctors suggest that the only way a woman with a high FSH can conceive is by using donor eggs -- which is something that DH and I were not willing to consider -- at least not anytime soon.Luckily, during our follow-up appointment, Dr. Mottla did not tell me that he couldn't treat me. While he did bring up the donor egg schpiel, he also expressed that he would take things as far as we wanted to go to help me get pregnant. He also said that he was not as concerned about FSH numbers as he was about the number of antral follicles -- because if you don't have any follices, you don't have any eggs to fertilize. Unfortunately, my antral follicle count corresponded with my high FSH number -- but at least I had a few! I asked Dr. Mottla what our course of treatment would be and he said that he'd put me on FSH injectible drugs and try an IUI (intrauterine insemination) on me. He told me that he didn't want to put me through an IVF (invitro fertlization) if I couldn't get enough eggs for the procedure. However, after additional research, I learned that IVFs are the better way to go with girls with high FSH, so I'm not sure why he didn't want to go this route with me first. I will do what he suggests as first to see how my body responds to the medications, but if after one or two attempts, the IUIs don't work, I will push to go the IVF route.Anyway, I could go on and on and on about everything I've learned thus far about FSH, but I will spare you any more details for now.