Monday, August 12, 2013

Days Like Today

There are some days, like today, when this ttc process is so much more difficult than I ever expected.   It's not just the negative pregnancy tests that are difficult.  It's more than that.  There is the ever present financial aspect, the emotional impact from the fluctuating hormones, the physical effects of the hormones (bloating, sensitive breasts, even more sensitive abdomen/cervix/ovaries, zits, pins and needles in hands, etc.) and the stress of whether things are progressing as they should.

I'm finding it so difficult to adapt to any changes in plans.  I am utterly incapable of dealing with any sort of disappointment.  I am totally ill equipped to navigate difficult/confrontational situations.  Today, I just feel unreasonable.

I nearly had a melt down when trying to figure out my gonal-f dosing tonight.  The more overwhelmed I became, the more difficult it became to determine what the second injection should be.  H has been wonderfully patient and supportive and she certainly bears the brunt of my inability to cope with anything.

All of this frustration and worry leaves me feeling like I need to cry, but I can't.

I know it's the hormones because I'm doing this to get pregnant -- to have a baby.  And as this drags on, I have questioned why I am doing it at all.  Maybe I just don't need to have kids, what's the point?

Oh my god, what if it works?

What if it doesn't?

And I don't know the answer.

I feel like I should know exactly what I want at every turn.  This deliberate process of attempting to become pregnant feels like I am burdened with needing to know all of the answers and having no doubts about them.  I've thought on more than one occasion in the last 17 days of injections, "maybe I just don't need this baby".
During every cycle, I say that this is the last one.  Once xyz, is over, I'm not trying again.  It's a disease because of course as soon as I have funds again, the process resets and it's just rinse and repeat.

Over the weekend, my estradiol dropped again from 137 to 120, so they increased my dose to 225.  The follicles grew a little bit, but nothing fell within the "measurable/recordable" totals of 12mm or greater.  I had one 11.5mm and a couple of 10mm follicles hanging about.  Tomorrow morning, I go back for another u/s and more blood work.  Hopefully it will bring good news and plump follicles.

Friday, August 9, 2013

The Pokey Little Follicle

We're having trouble getting the dosing right with the gonal-f.  For about 3 hours on Tuesday, I was convinced that they were going to cancel my cycle.  My estradiol dropped from 130 back to 100 -- decidedly heading in the wrong direction.  I guess this is typical with PCOS -- the numbers can be a little weird until you hit the dose sweet spot.  I'm hoping that is where we are now.  At the last check, my estradiol had climbed back up to 137.  My dose is currently holding at 187.5 and then I head back for more blood work and an ultrasound on Sunday morning.

I have blown through 1800IU of Gonal-F and have been stimulating (getting stabbed!) for 14 days and it's looking like probably another week's worth of meds.

THANK GOD I qualified for the compassionate care plan through the manufacturer. 75% off the out-of- pocket/cash price!!!  So, from Freedom Fertility I was able to get 300IU gonal-f pen for $74.00  each!!!  EACH!!!   And my ovidrel trigger shot?  19.70!!!  ( The last 5 triggers that I bought cost me between 97.00 and 112.00!!!)  Freedom has great customer service and they work directly with the compassionate care people to give you those great rates on meds. I highly encourage you to see if you qualify.  You CANNOT have insurance that covers fertility meds for this program. You must be an out of pocket/cash buyer only.

Here's a little trick: the manufacturer overfills each pen a little bit.  From Freedom Fertility Pharmacy, the price of the medicine is standard per IU, no matter the size of the pen.  So, you should ask your doctor to RX qty3 300 pens instead of qty 1 900pen, so you get three pens worth of overfill instead of only overfill from one pen -- all for the same price!  Then, you get yourself a 1ML syringe and you can draw the leftover meds out of each pen and save yourself some money. Out of my three "empty" pens, I was able to get a combined dose of 150IU or .25ml.  That's a lot of medicine!  So, then I just topped off with one 37.5 (.06ml) click from a new pen to reach my total dose of .31ML or 187.5IU.  Hooray!

Gonal-F conversion from IU to ML (I had my pharmacist double check my conversion below):

900= 1.5ml

450 = .75ml

300 = .5ml

225IU = .375 ml

150= .25ml

112.5 = .1875ml

75 = .125ml

37.5 = .0625ml

Thanks to Andy for the following info based on my dose of 187.5: "I converted IU to ml. Remember that ml is a measure of volume, IU is a measure of effect. There cannot be an IU syringe or scale. There is no standard conversion from iu to ml or mg. It varies from substance to substance. Be very sure here that your conversion is right!

Get a 1 ml syringe, it should be numbered to the 0.1 with marks in between to the 0.01 - draw up 0.3 then one more mark is 0.31 of a ml and go quarter of the way past that to the next mark, and you're good. "