Possible Good News, Yet Losing Some Hope

I got my TSH re-test/additional test results back last Friday. My TSH was a 1.530!!! Here are my other results:

T4: 11.4 (normal levels are 4.5 - 12.)
Antithyrodlobulin Ab was < 20 (normal levels are 0-40)
Thyroglobulin: 7.7 (normal levels are 0.5 - 55)

My question is this - if my TSH level came down that much after just being on the medication for two weeks, does that mean that I'm now in danger of having HYPERthyrodisim? LOL. If it's not one thing, it's something else. While I'm trying to stay as positive as I can about being able to start the IVF process, considering all of the obstacles I've faced so far, until that day actually comes, it will be hard to believe that I made it there.

Regarding acupuncture, as much as I have truly enjoyed my past two appointments (last Tuesday's appointment was simply heavenly), I think I'm going to postpone any more until after my IVF cycle if it results in a BFN. $95/session is too expensive for us right now and the impression I'm getting from my acupuncturist is that he can help me more if he does acu for me in conjunction w/ herbs (which I won't be able to do while stimming). So, I plan on taking a good three month break IF my IVF cycle doesn't work. During that time, I will go whole hog w/ the acu and herbs and see if I can get a natural BFP while my body is not all whacked out on meds and artificial manipulation.

As for how I'm feeling as I'm gearing up for yet another baseline appointment on Saturday, I'm starting to lose a bit of hope. I'm not really feeling confident that I actually will be able to cycle again. My cycles typically are about 23 days. These birth control pills (BCPs) have artificially put my body on a 28 day cycle and I have a feeling that my body wants to stick to the shorter cycle (I've been experiencing cramps during times that I shouldn't be experiencing them and I feel like I was having PMS symptoms last week meaning that I should get AF this week (but can't because of the BCPs); therefore, my body won't respond to the stims the way that other ladies who experience regular cycles do. Considering I have been on BCPs for two cycles, I also have a nagging feeling that I will be too repressed or I may have even developed cysts. At this point, I really have absolutely no confidence in my RE at all. Why does Shady Grove put everyone on 21 days of birth control pills prior to their assigned protocols? If my cycles are shorter than other women's cycles and my follies probably start to develop even before I get AF, wouldn't being on 21 days of BCPs confuse my body even more? I'll be especially upset if I can't proceed with this next cycle because he didn't do anything to address my high TSH level prior to when I was supposed to start last cycle. I didn't have any cysts and my other blood levels were good to go, so last cycle could have been my successful one. I really have a feeling that my RE has no clue as to what he's doing. Maybe I'm mistaken and judging unfairly, but he has given me no indication that he knows what he's doing. A phone call to alleviate any of my fears and misguided assumptions would be greatly welcomed, but we all know that won't happen since when has my Shady Grove office ever taken the iniative to show that they care or know what they're doing?

IVF # 1 - Cancelled Due to High TSH

That's right - cancelled not because of high FSH, but TSH!

I saw my wonderful PCP (Dr. Ian Shantz) on Tuesday and expressed my concerns about my TSH level that could be impacting my fertility. (If you remember, my levels have ranged from a 3.4 to a 4.3 and my RE was "keeping an eye on my levels"). So, he ordered a TSH test in conjunction with some other routine bloodwork I ended up getting drawn on Thursday. When I got home from work yesterday (Friday), I received a voice-mail message from Dr. Shantz's associate, Dr. Freas. I was surprised that someone, especially a doctor, had gotten back to me so quickly. Dr. Freas informed me that all of my bloodwork came back fine -- except for the TSH, which shows that I could have an underactive thyroid gland (a/k/a hypothryoidism) and which could have a great role in my infertility problems. I didn't know what the level was and it was too late to call him back, so I pondered whether or not I should bring this concern up with my nurse during today's "Lupron Evaluation" / IVF baseline appointment. After consulting with my wonderful Fertile Thoughts forum ladies, I reluctantly decided to let her know since the general consensus was if my TSH level was too high, it could impact my IVF cycle. And why go into an expensive IVF treatment if my chance for success wasn't as optimal as possible? Yes, it would really stink to have to wait for yet ANOTHER cycle, but what's another month of waiting in the broad scheme of things if it means that I will have a greater chance for that cherished BFP?

So, I went to today's appointment not feeling very optimistic. Here I thought all I had to worry about were cysts and if I had any antral follies, not hormone levels already! While I was getting my blood drawn (they just test for pregnancy, progesterone (p4) and estradiol (e2) during the "Lupron Evaluation"), I mentioned my most recent TSH test. The nurse told me that Shady Grove just changed their TSH IVF cut-off from a 3.9 to a 2.5! That means that I could NEVER have been able to cycle if my levels varied from a 3.4 to a 4.3 in the past! So why didn't they do anything to address my levels back in the beginning of the year? And they would have let me cycle this time because testing for TSH is not part of their standard protocol. Someone dropped the ball. Anyway - since I didn't yet have Thursday's TSH result, my nurse said that they would check my TSH level today, too.

While I was waiting for a call-back from Shady Grove, I contacted Dr. Freas, who turned out to be incredibly informative, supportive, and kind. He told me that my level was either 4.8 or 4.9, which was way too high. He told me of a story of a patient he had who had who was trying to get pregnant and had a level similar to mine. Soon after she started her thyroid medication, her levels stabilized and she got pregnant immediately. He offered to call a prescription of Levoxyl into my pharmacy in case I would be allowed to start my IVF cycle in conjunction with the thryoid medication. However, he did advise that it would probably be best to hold off on cycling until my levels came down to ensure the best possible response to my IVF, not to mention that a high TSH level could cause ovulatory problems, problems w/ implantation, and problems with the development of the baby. He also told me that he was going to go ahead and see if the lab could do a full thyroid work-up with my blood from Thursday (hooray if I don't have to get poked again!) to get a more complete picture of what could be going on to affect my fertility. I can't tell you how much I appreciated Dr. Freas' call and his proactive approach in helping me.

Back to my Shady Grove results -- Lo and behold, they were too high -- 3.19. [Sidenotes of Interest: 1) This is actually the lowest reading I have had so far (and BCPs typically cause levels to be higher) and 2) This reading differs by 1.61 from Thursday's bloodwork! Hmmm.] The doctors told me that I should not proceed with this IVF cycle in order to get my TSH levels under control. I informed the nurse who called me back that my PCP had already sent a prescription for me to take 75 mcg/daily of Levoxyl. She relayed the information to the RE on call who said that was a good plan and that I was to follow-up with my nurse on Monday in order to see what's next. In the meantime, I should discontinue my BCP and baby aspirin.

So, while I am disappointed that I can't join the "varsity" ART league, I feel at peace with waiting until I know that I will be at my best for my IVF cycle.