More Test Results Back...

So we got the last two test results back from the blood they took at our re-consultation. They were looking at Vitamin D levels and AMH levels. My vitamin D level was normal-well ok-low normal...but that makes sense for living in a perpetually cloudy state! For all those unfamiliar with AMH (because I sure as heck was), it is an acronym for "Anti-Mullerian Hormone". Quite a mouthful that one. AMH is a blood test that measures ovarian reserve. Here's a description from a website:

"AMH stands for Anti-Mullerian Hormone. It is also called MIS (Mullerian Inhibiting Substance) . Since AMH is produced directly by the ovarian follicles, AMH levels correlate with the number of antral follicles in the ovaries . It has been documented that women with lower AMH have lower antral follicular counts and produce a lower number of oocytes compared with women with higher levels".

Apparently, specialists have begun looking at AMH over FSH because it (AMH) does not change depending on where you are in your cycle (whereas you have to test FSH on cycle day 3). Anything around 1ng/ml to 3 ng/ml is considered a normal result. Numbers lower than 1ng/ml are sub-optimal. Anything above 3-3.5 ng/ml is considered high (usually associated with PCOS) and places the woman at risk for hyperstimulation.

So...my AMH level was..... 9.5 ng/ml! Gee-think I have poly-cystic ovaries? Basically...I have A LOT of antral follicles. Which makes sense since I don't ovulate on my own-I guess I'm kind of hoarding my follicles, in a sense.

Ok. I'd rather have a higher result than a lower result without a doubt...but the risk for over-stimulation is greater than typical. Also, I don't believe AMH speaks to egg quality. So I can say I have a ton of eggs, but who the heck knows of the quality. Is there a test for quality? I just hope with all those follicles dotting my ovaries, something will work and we get our one healthy baby.

I'm definitely getting scared though. Well, nervous is probably a better descriptor. Nervous and anxious to just get. on. with. it. I hate waiting. I hate not knowing. I hate inaction. But I'm not looking forward to all the feelings (the old feelings that I thought I had buried after our previous treatments) if our first cycle is unsuccessful. I'm trying to stay realistic. I know there's a good chance that it won't happen for us right away. But a part of me still hopes we will be the "one cycle and done" family. I can't help it. And I am probably setting myself up for a hard fall. Ahhh....it's just a viscous cycle! I need a crystal ball so I can look into the future to see what happens. I just want to know!

Oh...as for my cousin update/preg-dar update: results are inconclusive. No announcement was made at the family Christmas party, but I did watch said cousin all night and she was drinking water, rather than partaking in the ample amounts of alcohol provided. When I mentioned this to my sister-she looked at me like I was OFF MY ROCKER and asked why I was visually stalking this cousin. *Sigh* She just doesn't get it....which is probably a good thing.

Keeping My Fingers Crossed....

...That my period either comes *right after* my consultation (so I don't have to wait too long for a baseline appointment) or that my cycle day one is on *the day* of my consultation so I can have my baseline then.

As with anything fertility related, timing is everything. For an infertile, timing is also important in order to *order the medicine on time*. For me, my insurance dictates that I get my injections through Freedom Pharmacy. They are AWESOME. I have always had awesome experiences with them. They specialize in fertility medication. My doctor puts in a call to them and they deliver my meds, to my door, the next day. Super reliable.

So the problem isn't Freedom Pharmacy...the problem is that if I am on cycle day two, three or four on the day of my consultation, my doctor may not be able to order the medicine in time to begin treatments on that cycle. Which would be more waiting. Which is tough for a woman with PCOS who doesn't know if her next period will come in 21 days or in 81 days.

So I am determined not to worry about when AF comes (even though I really really REALLY want it to come on the day of my appointment or right after) because, well, there's nothing I can do about it. I guess it's one of those things that I have to let go and try not to worry about.  I know a few weeks doesn't make a difference, regarding when we start treatments. But man...now that we made the decision to begin treatments again-I want to start like YESTERDAY. Ugh. I have an instant gratification issue. Might be my fatal flaw....and certainly not a good trait to have with fertility issues. Waiting, waiting, waiting....

Edited to add: EXACTLY THREE WEEKS TILL OUR APPOINTMENT!!!!!!!!

Still Pondering...

Happy October! I cannot believe I haven't yet blogged this month. Major fail. We have been pretty busy though. I had my best friend's bachelorette wine tour one weekend and then the next weekend Dan and I had a date night and went to see one of our favorite comedians. Then my sister and her boyfriend were in town so we did a lot of family stuff. It's been a good month so far :) I love fall around here and am looking forward to the Halloween festivities and my friend's wedding at the end of the month!

So Dan and I have still been pondering the whole IUI vs. IVF thing. And again, I feel so lucky that they have such awesome technology available that there is even a choice....and that we have good insurance that will allow us to go with what we feel best for our situation. Finding that silver lining...

But the decision is still kind of hard. I still feel like we should try the most minimally invasive protocol first (I think that comes from the school psychologist in me, who is required by law and best practice, to decide a child's program based on the "least restrictive environment". Kind of the same principle), but the idea of skipping to IVF is beyond tempting. It feels like every other day, we're changing our minds about how to proceed. Part of me has just resigned myself to the fact that we won't make an actual decision until we are in the moment. I *tend* to be impulsive and will probably go with how I am feeling on the day. And maybe that's ok too. Maybe how that's how it is supposed to be-a decision from the heart. And Dan....he's pretty laid back, not to mention super supportive. He will back up whatever decision I make, as he's ok with both. Love him <3

So for now, after talking, I think we decided that **if**(still a very questionable "if" at the moment) we do IUI first, then we will only do one cycle (two at the VERY most) before moving on to the big guns. However,  I think we are getting comfortable knowing that, at our consultation, we might change our minds based on what the doctor recommends.  Fortunately, our specialist is very good about letting patients decide their protocol-within reason and with a whole lot of guidance. So we shall see.....

In other infertility news...My friend from work just started her maternity leave early due to swelling in her legs and feet. She really struggled to get pregnant and tried for over a year, with a few miscarriages during that time. Right now, Bree is 39 weeks pregnant-and expecting a baby girl! So YAY for another miracle baby who might never have come to be without modern technology. Although, I'm a little ashamed to admit because I know how she struggled, I was a little jealous of Bree. And that's how I KNOW that I am ready to have another little monkey in the house :)

 Just a silly picture :)

 With her future hubby? That's Cameron, a good friend's son...he's adorable. Cute couple, huh?

 Not a great pic of Alex...but wanted to show off her awesome mohawk hat...it's goes half way down her back!

Appointment Change :)

So I received a call today from my fertility center. They had a cancellation for Tuesday, December 6 at 9am :) My original appointment was scheduled for the end of December-the 29th to be exact. So, of course, I took the new appointment. Yeah, it may only be three weeks and change earlier, but three weeks is three weeks. It's three weeks that I don't have to wait! I'll take it. And who knows? Maybe another cancellation will come up for even earlier. So as of now...my appointment is 10 weeks from tomorrow! Seems like a long time, but we have soooo much going on this fall that I think the time will fly.

I'm also debating about our protocol. I had success with conceiving Alex on our first Gonal F and IUI cycle. I cannot go back to Clomid because of the side effects it gives me. Basically, I had vision changes while on it (one of the more serious-and rare-side effects) and was told that I can never go on it again. So that leaves injections/IUI or going straight to IVF.

I never before considered going straight to IVF, but my new insurance is fantastic and will pay for three IVF cycles. So in some ways, I'd like to just go for the big guns. But then, in other ways, I feel like I should begin with the most minimally invasive procedure, in our case-IUI.

I guess I'm also nervous about going right to IVF because it's like "what now?" if the IVF fails. It's kind of the "end all be all". I would be so nervous that the three cycles would not take and then we would be paying out of pocket. I guess I would just fear that it would feel like we were running out of options-whereas doing IUI first-I would know that we have IVF in our back pocket, if needs be. Make sense?

So it's oh so very tempting to just start with IVF, but I don't know that it is the wisest decision. We'll probably stick to the original plan of injections with IUI. Either way-Thank God for this technology! Thank God that I even have a choice amongst which procedures to start with. Twenty-five years ago, I wouldn't have been as lucky.

 This is how she likes going down the slide

 She got braver and tried the bigger, covered slide

And finally...Alex got really brave and went down the spiral big kid slide. Look at her long 19 month legs ;p She doesn't take after me, that's for sure!