Back from...Paris! And HCG behaving well

My dears,

I can now reveal that the chosen destination for the mystery weekend was..... PARIS!
Yes, the romantic city by definition! Actually I had taken the idea of Paris from my cyber firend Clare who went there a little while ago and then posted a fantastic post called "We'll always have Paris!". And I thought it was just the perfect place. I had been there a couple of times but Mike only went when he was a child so I figured he probably didn't have a fresh memory of it.

I had booked a very nice hotel near the Louvre (hell...it wasn't cheap, but a treat is what we really needed) and because I mentioned it was Mike's birthday they arranged a little present for him!

So all Mike knew was that I was driving, guessed it was somewhere in Ireland and probably a Spa hotel! WRONG! I drove alright, but to the airport! When we got there he was a bit unsettled, not knowing where we were going and all. I had checked in on-line you see, so it was a real surprise until we got to the gate! He loved it though and we had a great time. Weather was great which always helps and we managed to see quite a lot. Yesterday we went up on the Tour Eiffel (how many steps?? didn't count, but my legs are in bits!) and Mike said it was the best birthday present ever! Hopefully I'll have a better one some day...

And we are back to reality now, back to blood tests, back to lack of calls from the hospital...the usual! But the news is good! Today blood test gave an HCG at 101! A fall of 85% in a week!! Brilliant. Now I actually don't know if I have to go back, when I phoned the nurse attempted the card that the ward was closed and to call tomorrow. Ahhah she didn't know I know the game by now, so at least I got the number off of her and I suppose i'll go back again weekly until it goes to zero.

Last thursday I also went to see the berievement midwife. The chat went very well, we both acknowledged that I have now dealt with the loss and moved on. I really want to try and make something out of this experience, I have been doing quite a lot of volounteering when I was back home, so I asked if there was anything I coudl do to help others who went through the same tough time. She gave me a number of an Irish association for miscarriage support, I'll phone the chair-lady this evening! Fran is back on track!

Sorry for not having being able to post on your blogs, I'll catch up in no time! I promise!

Good news and ICLW week

HCG is finally dropping!!! 4 days after the methotrexate shot the values plummeted from 1023 to 681!!! How's that for a birthday present? I don't have to go in on wednesday at this point (it would have been day 7 after the shot) but monday next week to see how it goes! I am sooooooo happy....imagine, being happy about dropping HCG! The World is spinning backwards!

Now for the ICLW newcomers here's a brief recap of my (mis)adventure. Our second fresh ICSI cycle in July gave us a lovely BFP...only to find out at 6w that it was ectopic again. A month ago today I underwent surgery which removed my second tube. The first one was lost to another ecopic pregnancy a year ago after our first fresh ICSI. I'm sure you can all imagine the shock of this...event (can't think of a better word) happening again in both cases after successful IVF procedures. Call me lucky.
Anyway, this time around things didn't quite settled after surgery. A routine HCG test 2 weeks post op showed that the hormones were sky high. This ment either that some cells were left behind after laparoscopic procedure (possible) or that the second embryo implanted also outside the uterus, didn't really developed but was not miscarried either and generated a cellular mass producing HCG (a bit less likely, but we are talking about me here!). Anyway, after a number of bloodtests which never really showed a drop in the levels (stabilised at just over 1000) finally I got a methotrexate shot to put an end to this misery. And this is the reason of the message at the beginning of this post, it's working!!
So I'm now 35, hopefully the levels will continue to drop and I can detox myself in preparation for a new ICSI cycle in the new year.
Meanwhile we are also waiting to hear back about our adoption application which we submitted in June 09. I'll wait until the end of the month and then I give them a call to see what is the current situation, the wait will be incredibly long but hey what do we have to loose?
Thanks for stopping by, I always love to have new readers!

The Ectopic Queen and other updates

What a week! Sorry for not updating, this week work has been crazy, and yesterday I was at a conference I helped organising, I just didn't have a minute.

So on wednesday I went back to the hospital for yet another blood test. I decided to stay in town until the results were ready. I got a scan done too and the uterus looked great, so did the ovaries and...wait, what is that? There was a 1.2 cm mass between my left ovary and the uterus. Could it have been the second embryo in the stump of the tube? She didn't know. It would have been unlikely that the two embryos of the same age had such a different development, but you never know. The blood test was going to tell us more.
I had a nice lunch, bought a book and went back to the hopsital around 3 pm. The beta was ready and it was still above 1000. By the way, I thought the results on friday was 1007...yet again I got it wrong, it was 1078! But on wednesday it was 1023 (I saw it in writing this time!) so a bit lower but not significant according to the doctor. I had a chat with the doctor on duty and decided to go for the methorexate shot. He agreed. More blood tests, more waiting, and finally I got the injections. No big deal if it wasn't for the doctor who put on safety goggles, a plastic apron and gloves up to his elbows!!! I suppose it was for his own safety. The injections were IM, and I was absolutely fine afterwards. I had to go to the conference dinner in the evening and that was ok too.

And yesterday it was my birthday! So now I'm 35. Wow. My 34th started with me being pregnant (but when I found that out I was still 33) and discovered a few days later it was ectopic. Then I had a second ectopic which I hope will resolve with the shot I got when I was still 34! I have to say I look forward to this new year, I hope it'll bring good things. And sure the clock is ticking away but there's nothing I can do about it. Mike, who's not the type that surprises you with presents (normally he asks what I want for my birthday) totally blew me away...when we got home after the conference, there was a big package on my chair in the kitchen, he bought me a clock we had seen two years ago in Spain and never saw anything I liked as much since! He started looking for it over the internet before the summer! Unelievable. And then today when I got to my office, there was a huge bunch of flowers on my chair! I thought it was from the lab but nope...it was again from my lovely husband!! So I sarted saying to him that I hope my surprise would keep up with the high standard he has set...it's only a week away!

Are we there yet?

Ladies and Gentlemen, please welcome the one and only stable HCG person on the planet!

Yes, that would be me. This morning we went to the hospital, got the blood done and the midwife was once again brilliant! She contacted Dr. A before I left so that we can have a plan given that is, once again, friday. Dr. A would have called me with the results and talk to me directly after lunch.
And so she did, she asked how I was (I'm well, but I think I ate something wrong yesterday...) and if I had any bleeding (no, I don't think so, but maybe a slightly slightly coloured mucus?). Anyway the HCG on sunday was 964 and today was 1007. She definitely calls this a plateau. Really no difference. Actually I think we may have reached a turning point! From 885 to 964 in two days and now after five more we are to 1007. I'd say we've gone around the corner. Could it be that it's actually slowley going down?
So what do we do now? She said she's really trying to hold off on the methotrexate because she said "You really cannot start IVF again for two month if you get the shot" I said "No worries! I don't think we'll try again for at least 4 months" but still the values are not going to increase now I think and we can wait a little longer to make a decision. I'm going in on wednesday for yet another blood test and a scan (given that I had two embryos transferred back and that she's very confident they removed the pregnancy with the laparoscopy, could I have picked the lucky ticket for two ectopics for the price of one within the same IVF?) and we decide that day how we progress. If the values haven't dropped I'll definitely insist on the injection. She said the side effect are actually minimal and yes of course I can feel a bit sick with it but it's more likely I won't.

Today a year ago I found out our first ICSI had worked. Can you celebrate a BFP anniversary even if it turned out to be an ectopic? Still I feel in the last year a lot had happened, I got pregnant twice and maybe a third time wasn't far off! This is out of four transfers! Ok I have no babies yet, but I know ladies who never got a second line on those damn sticks, and even though the happiness for us was short lived, it still was one of the happiest moment in my life.

We do have a plan!

Work is crazy at the moment, the academic year has started and I hardly have time to eat! So I didn't manage to update on our meeting with the Super Doctor.

It went very well, of course he said we just have to try again and hopefully our embryos will stick to the right place. We dicussed a lot the stats of another ectopic pregnancy, but he said that if it happens again we'll make a publication out of it! And to basically stay positive and hopefully things will be fine. When we'll be ready to go again I'll be on the same short protocol which worked really well for me. Of course I told him about the HCG being still high and the "wait and see" attitude of Dr. A. He also thinks it's probably good too see if it'll decrease on its own and that there is no real reason to panic as the increase was so minimal. In fact he said that if some cells have in fact been left behind, it may be to my advantage as some scarring of the stump may take place blocking the access even more. I asked him about more surgery before going again (remember? to remove the stumps and the fybroid) but in his opinion could be a bit excessive. So we'll see. Overall it was a great meeting and we came out quite reassured. Then we bumped into the Favourite Doctor and she wanted to know all about how I was, so she brought us into one of the scan rooms and we had a great chat. She thinks this HCG value is high but you never know, she said with me she woudn't be surprised if there was in fact a second ectopic! But obviously I'm feeling well so she's not worried and on friday we'll know in any case. Her husband happens to be an oncologyst and we found out we live very near! I asked her about the methotrexate shot and she said it's very effective but that I can be sick for a few days if I have to get it done. I may loose some hair (hopefully from the legs!) but the dose is so mild I may not even notice. She wants me to stay in touch and le her know how things work out.
Tomorrow it'll be a very early start as I'm teaching at 10 and I have to drive into town beforehand for the blood test! Better going to bed early tonight...

Do we have a plan?

Last night I mange to talk to the doctor again. She was very apologetic for the delay in getting back to me, apparently there were only two doctors on call and it was just crazy. She was very nice over the phone of course, and very reassuring. She said she checked with the other doctor as well and they both felt that the best thing woudl be to talk this morning with the consultant who oversees my case. She said she was going to be on duty all night and that she would call me tomorrow with a plan. She was very sympathetic and knew I just couldn't be left in limbo, and she aslo said that they had received the offial pathology report and that the pregnancy was normal, no sign of trophoblasts (that was my fear, particular cells from the pregnancy that starts replicating out of control) and that although my HCG is a little high, it's no where near the values of a trophoblastic tumor. The fact that I feel well is of course an other indication that this is no emergency to them. She said probably with my knowledge and background I have "been reading a bit too much into the numbers" and I think it's "probably true".

So this morning then I was called twice, once by one of the midwives who deals with all the consultant's cases (we'll call the consultant Dr. A) and she said Dr. A was aware of my results, and that she'll call me tomorrow in person but that she doesn't think there is the need to be worried and that it could be a physiological plateau (basically between 885 and 967 there isn't much of a difference in medical term) and that the best thing is to recheck the HCG ths coming friday and have a better idea which way they are going.
Then the lovely doctor from last night called me (it must have been around 10 am this morning, she must have had some shift!), again she confirmed what the midwife said, she had spoken with Dr. A who thinks this could be completely normal and that given my high HCG before surgery, two weeks was just too early to check. Of course we'll repeat the HCG and that if the value is truly creeping up on friday we'll have a plan in place.

I do feel less worried, I still think these numbers are going in the wrong direction, but hey, can I be wrong for once in this pregnancy please??? Friday is only three days away so it's not a long wait and if they are creeping up this slow it's not going to make a major difference acting today or in a few days time.

And I also got a text from the Favourite Doctor, she had received the report from the clinic and wondered how my HCG was at the last count. So I told her and she said to let her know what the plan was. Today I also have the appointment with the Super Doctor, so many things have happened meanwhile that I'm not ready with all my questions! Maybe I can just listen this time.

Going up

Well who would have guessed...the HCG is not falling at all but climbing nicely.
I actually had the numbers wrong on friday, it wasn't 864 but 885 and two days later is 967. So what this means is that something has been left behind during the surgery and keps growing. We are talking cells here, not an embryo of course.
So I'm waiting now for the doctor to call back. I called the hospital at around 3pm and was told "of course you'll be called back, probably your tests aren't back yet". I call again at 5.30 pm I had heard nothing. After an a nurse or two who kept telling me it was late and that there was nothing they coudl do until tomorrow morning, finally I was put through to the Gyn ward and the nurse there must have remembered my name or something. Anyway, she looked up my chart and told me that in fact my numbers were going in the wrong direction and that she would try to put me through to a doctor. This doctor happened to be the same who spoke with me on friday, she couldn't believe I didn't get called today (ah well) and that she would look at my chart and get back to me with a plan.
So here I am waiting again. I guess the plan would be the get a methotraxate injection and keep the HCG under close monitoring and if that's the case I want to get it done yesterday.
I'll update you as soon as I have news, sorry for not having posted much on your blogs lately.

Another blow

I went in for my "routine" blood test today. Two weeks after surgery. I had POAS last weekend and the line was there but very faint, so I was confident today my HCG should have been very low if not zero. Zero would have been great, moving on, looking forward to the appointment on tuesday an planning what we will do next.

I got a call from the hospital and the HCG is 864...this is still very high. The doctor over the phone asked me if I was feeling well (I am), if I was still bleeding (I'm not), and that they were confident they removed all the material two weeks ago. I still have to go in on sunday for another blood test just to make sure the values are in fact falling and not increasing.

This is neverending...

New findings on alternative therapies and IVF

Being a scientist has some advantages when you deal with IF. First of all I can access most scientific journals with the latest reports, stats and outcomes of new protocols. Then of course the is the "need to know" everything in details. I don't know if I had mentioned in the past that I met another IFer attending my same clinic when I was doing my intralipid and we got talking about our protocols. Well, she new nothing about hers, didn't know what type of protocol she was doing either (mind you she had a failed cycle on her cv, so you'd think she'll be motivated enough to understand WTF happened and could she do anything different) and she was describing to me her meds by the colour of the packaging so tat I could guess...ah well...I'm sure it's not just me that NEEDS to know as much as possible about this journey, but I know that my background gives me some sort of compulsion to learn the scientific inside outs of the process. At our last ET we even had a session with our embryologist!

So, I get by emails regular updates on newly published articles which can be related or not to what I'm actually researching to earn my salary, and mostly they are not. Last friday I got one of those updates and I quickly scan through the headlines and one definitely caught my attention. It titled "In Vitro Fertilization Less Successful With Alternative Fertility Treatments". Now, you can check the link, this is just a "lay" summary of what the real article talks about. So I went to the source and got the origianal paper to get the full picture with my own eyes. This is a 2009 paper, so it's quite fresh on the shelf. I don't think you'd have access to it so if you are interested in the full paper email me and I'll send it to you as pdf. So it seems true, 30% LOWER ongoing pregnancy/live birth rate for people that use alternative therapies (specifically the top three are reflexology, herbal supplements and acupuncture). I actually was shocked. I have gone to acupuncture myself spending a good few bobs on it for the past year and I may actually have lowered my chances?? Alright, I'm a special case, two fresh cycles ended up in a pregnancy which was just in the wrong place. Two FET cycles didn't really work (ok, I had a chemical pregnancy the second time) but I believe the reason is that my body didn't respond well to the medication. So overall I got SOMEWHAT pregnant evey fresh cycle, and overall 75% of the time I had a transfer. I did acupuncture for my first 3 attempts and switched to a milder reiki/acu this last time. Also the number of sessions I had in the first 3 attempts was much higher as I went also during the 2ww. What will I do at my next cycle? Mmh probably not much! A part from the onoing pregnancy rate the paper reports several other data from the two groups of women such as the number of eggs retrieved embryos produced and embryos transferred (correlated to the amount ofdrugs taken); they are statistically the same. There doesn't appear to be a single area where alternative therapies helped. The number of IVF/ICSI cycles is even higher in the group that went for alternative therapies!
I know we are doing everything we can to get a cycle to work, but what if we are doing the wrong thing? The scientist in me, alhough always very open to alternative therapies, may be reverting to pure science...