Thursday, August 19, 2010

consult. ultrasound. beta. repeat.

Had my repeat repeat repeat beta this morning.  I had kinda decided that even if it went up I didn't want the MTX yet because it just freaks me out right now and I'm worried about how my body will respond. I'm sure it will be fine, but I don't know. It's probably just the desire for alcohol...
While we were waiting for the blood results to come back, we had our consult with Dr. Z and then he decided he wanted to do an ultrasound just to see what he could see.

So the consult was...well...sorta devastating.  He wants to try again obviously.  But we didn't do that shared risk program cuz of insurance, so I'd be shocked if he didn't want to try again.  He walked B and I through our entire last cycle, right down to each of our 17 eggs' little journeys. 

He started with my estrogen levels.  Before we did the retrieval, he'd like to see between 200-300.  Mine was 144. At retrieval, he'd like to see about 200 per follicle retrieved. I had 17 follicles retrieved.  My estrogen was at do the math. No good.  So he said that this basically means we only really had 7 mature eggs out of the 17.  If that. 

He went on to walk us through the Day 1 to Day 5 embryo debaucle of 2010.  The "Awesome! to Damnit. to Oh Yay! to WTF? to NOOOOOO!" debaucle.  He said that at the transfer, he was extremely pessimistic about our odds.  I knew that.  He said that with the egg quality (and estrogen levels) at day 1 he was surprised at day 3 when things were looking good.  At day 5, he said it made sense based on what he saw at day 1.  But if we did the transfer at Day 3, there would have been a very low chance that they'd pick the "right" embryos as so many looked falsely good.  He kinda explained that embryos run on battery power for energy for the first three days, then when they have to transform into blastocysts, they have to create their own energy to keep developing.  That's when we saw the truth about my eggs. They couldn't make the cut. Sad.

So he said that he'd like to up my stimming protocol the next time.  Two injections per day.  He for sure wants me to do acupuncture to try and help stimulate blood flow to my ovaries, he thinks that's definitely a factor.  But unfortunatley, he thinks that my endometriosis is the biggest factor. He thinks it has infiltrated my ovaries and is affecting my egg quality pretty significantly.  And he doesn't suggest another lap because messing with my ovaries is a bad, bad idea.  It can absolutely affect blood flow and there's too high of a chance to impact my ovarian function.

It was a sad appointment.  But we're going to try again.  Just when.

That's when the next bit comes into play.  He called me in to do an impromptu ultrasound. He said that if my lining is thin then that's not a good sign, that's what he wanted to look for.  As soon as that lovely wand was in place, I could see something in my uterus. I thought maybe it was really thick lining, that maybe that was good.  Then he said to the nurse that it looks like a sac.  An empty sac.

So I got confused.  He then reminded me that we had earlier talked about how ectopics can present as a "pseudo sac" or something in your uterus but actually be in your tube.  This is bad beacause some people get tricked and do a D&C to clear out the uterus and then think all is well.  And then BAM. You're in the hospital with a ruptured tube because as Dr. Z put it, "It was still festering in there".  **shutter**

He actually said this could be really good news though and that the numbers might tell us that it's not an ectopic. His gut reaction now is that it's not an ectopic, but an intrauterine miscarriage.

I asked what a normal pregnancy looks like at this stage.  He said "much bigger. with a yolk sac". I got sad.

Then he removed his wand from my lady business, let me regain my dignity, and waited for me outside.  When I walked out he said the numbers came back.  My beta was 617. It went from 400 on Tuesday to 617 today.  I definitely wasn't expecting that. I really thought it would be 420 or something.

So he said it could still be an ectopic with that pseudo thing.  Or it could still be a miscarriage. He didn't want to do the MTX today. I have to go back on Monday.  I'm an F'ing regular. F!

Today hasn't been a good day. I've been up since 3am. I was at work til 8pm. B and I are disagreeing and arguing right now...about kinda everything. We're just both so devastated and stressed and trying to be positive and hating ourselves at the same time. It's gross.  That's the word for it. The whole thing is gross. 

Get me off this f'ing ride, man. Seriously. Dr. Z said it could take months. Hopefully  not, but it could. And when my number gets back down to zero someday, then we have to wait 6 weeks.


  1. OMG, when will it ever end. This is torture and it isn't right. Freakin endo and bad stinkin eggs. I am so sick of thinkin about it. This sucks for you!!!

  2. So sorry for this depressing appointment. I hope that it is not a tubal and everything progresses on it's own.