Hold on tight......this one's gonna be long and bumpy

Before I get to all the CCRM stuff, I wanted to update on my Longest Monday post. I thought my day was rough until Tuesday rolled around and my perspective took a really hard turn. R (pregnant officemate #2) went in for an u/s on Monday evening and found out that her baby's heartbeat had stopped. Now she is waiting to see if she will miscarry naturally or go in for a D and C. My heart just broke for her and the pain in her face was enough for me to know what she had to say before the words even came out of her mouth. She just wanted to get over "untelling" those that knew. We cried and hugged and talked. At one point she told me that she thought of me Monday night and that she had her first glimpse into what my life might be like with all this stuff. As much as I have been struggling lately at work, I would gladly continue to do it without complaint if it meant she would never have to have this "glimpse". Please keep her in your thoughts and prayers.

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The rest of the week was a whirlwind and then Thursday was here. After all the normal drama that leads up to preparing for a quick trip, we were finally on our way. CCRM or bust. After checking in to our hotel, M and I met up with Polly for a late dinner. Yes, she is as smart and wonderful and kind and beautiful as her blog depicts. This was truly a highlight of my trip.

Friday was all about CCRM. It is an incredible place that reminds me of an upscale hotel lobby with dark woods, granite counters, and a great little glass water feature. It was a bit surreal to be there, looking out the windows to a beautiful view of the mountains. Truly a great place to be. The operations and staff were like a well oiled machine. Everyone knows their role and they did a great job keeping us moving to each "appointment" and explaining how everything worked. Here is what our day looked like:

9:30-10:30: Consultation #1 with our primary nurse. She went through all the ins and outs of how things work at CCRM and then went through what testing Dr. Schoolcraft wanted us to have and what things we needed to do once we got back home.

10:30-11:00: M went off to "do his thing". This is the 4th place he has had to give a sample and it always amazes him as to the number of dvds that are missing from their cases. Ewwww.

11:00-11:30: Baseline u/s and Doppler bloodflow. I actually ended up going early for this so M missed out completely. The baseline u/s was the standard "assume the stirrup position" to have the uterus and ovaries measured as well as an antral follicle count. (I completely appreciated that they had a monitor hung on the wall and angled toward the stirrups so I could follow the play by play of my inner workings without twisting my neck.) AFC was 14. She told me that average is 12-14 for my age. Being in an "average" range for anything IF related thrills me to bits. The Doppler was really pretty cool. There were blue and red blotches on the u/s screen helping her to locate veins and arteries. Whenever she touched one of these, I could hear the sound of my beating heart picked up by the machine. She explained that she was checking to make sure that the blood wasn't moving away from the uterus/ovaries too quickly. After some pretty charts that correlated to my bloodflow popped up on the screen, she made some measurements and said that all was fine. They like to see values under 3 and mine were 2.3 on the left and 2.7 on the right. Bottom line, this means I don't need acupuncture.

11:30-11:45: Hysteroscopy time (camera and gas inside uterus to check for polyps, scar tissue, etc.) New room, same old position. I am still a bit entertained that this was the position I was in when I met Dr. Schoolcraft for the first time. He came in, washed his hands, put on gloves, and went right to work. Even though he didn't yet know the color of my eyes, he said my uterus looked beautiful. LOL.

11:45-12:15: Hang out with M in conference room and wait for Schoolcraft.

12:15-12:30: Regroup with Dr. Schoolcraft. We talked about our previous cycles and our issues most likely being my eggs and endometriosis, but that we shouldn't yet rule out a sperm problem. Not likely, but he wants to make sure that eggs really are the only big culprit for us.

Then came the stare down. The DE speech. The "This is really your best chance for a pregnancy" talk. The "I'm gonna give it to you straight and feel you out." spiel. He didn't fumble with papers or look away once. He said he gives us a 20-30% chance with my eggs (more on this later) and 80% with donor. I didn't even look at M (I was in a staredown after all). "We want to try with my eggs......Now, you suggested that we do an APA screening. What do you think about testing for natural killer cells too?" And just like that we moved on to discuss NK cells, taking DHEA, and better understanding CGH.

Overview: 1) no on NK cells. 2) Yes, he recommends taking 75mg of DHEA daily. He said the studies he has seen are only preliminary, but that some women with elevated FSH/DOR who have taken this 2 months before a cycle have seen higher egg quality in their cycles. He said it is no sure thing, but the initial reports have been promising. 3) Because we have transferred everything that has survived for each of our other IVF cycles, he didn't seem optimistic about CGH really being an option for us - read we probably won't have anything to test anyway. We have only had one 8-cell embryo on day 3 for each of our cycles and neither were stellar quality. He said we could be highly surprised and that if we did get more that looked good on day 3, we could still consider it. He said if we wanted to test them "just to know" if all our embryos are bad to help us move on emotionally, then he would recommend it, but otherwise he would recommend just transferring the best of what we get.

We did discuss protocols a bit, but this is pending the results of my blood test results. He is thinking microdose Lupron flare with the addition of a growth hormone. The growth hormone would be to help the ovaries respond better to the FSH medications, but he said it is sometimes tricky to get because body builders abuse it too much. "Just give me the 'script, doc. Downtown L.A. has to have a shady pharmacy somewhere that can help a girl out."

And then our time was over. He did ask some questions in the hall about where we work and how 2 engineers meet. He did his residency and infertility training at UCLA and wanted to know what it was like to move from Nebraska to L.A. It was nice to see a little of his personal side. Before we left I told him that if he can't get me pregnant, then it will probably never happen. He just smirked and said that their lab is really good.

12:30-1:30: M and I leave to go for lunch. M is not a happy camper at this point. When we did the phone consult, Dr. Schoolcraft gave us a 40% chance. Now that we were in Denver, it was 20-30%. I guess I was focused on other things to really let this absorb and ask why. I can only speculate that it really is just a crapshoot. He didn't kick us out of his office so to me there is still a shot. M is not as convinced right now and doesn't understand why we are dumping boatloads of money for a 20% chance. Long, quiet, unhappy lunch.

1:30-2:30: Consultation #2 with our primary nurse. We talked to her about our "new" odds despite the fact that only new information was positive (AFC, bloodflow u/s, and hysteroscopy). She chatted a bit about it and then moved us on to keeping "positive thoughts". We went through the injection instructions and cycling timelines. BTDT, could teach the class.

2:30-3: Vampire time. 9 vials of blood for me and 4 for M.

3:00-3:10: Business office meeting. IVF is very expensive and here are the cost breakdowns........ BTDT take 2.

3:10-3:30: Consent review meeting. This is where we decide things like who gets our embryos if we divorce or one of us dies. We thought about it hard the first go round. Frozen embryos are now a foreign concept to us. I think our conversation was along these lines, "Who got 'em last time?" "Okay, I'll take 'em again." Record time on all these forms we were told. BTDT take 3.

That was the end of our day at CCRM. I need to go there to cycle before I can move on with any other route. This is my "end of the ART treatment road" grand finale. Schoolcraft could give us 5% and I would still go to him for this last shot just so I know that we went out fighting. M, on the other hand, is not taking the drop from 40% to 20% very well and needs answers before he wants to continue moving forward. He is pretty pissed to say the least. Not being on the same page is usually not one of our bigger issues. I will work to get the answers and hope that he is okay with it.

It could be a little bumpy for awhile, but we are still moving forward. Now we wait for CCRM blood test results, appointments for other tests to be done locally, and for M to be okay with all of this. Nobody said this was going to be easy.

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**As a side note, I just have to say how much I loved meeting up with Polly in between our appointments at CCRM. The feel of RE waiting rooms is usually so doom and gloom where nobody talks. It was so nice to pass through and give hugs and updates before one of us was called back again. Thanks so much Polly for keeping my head in check through all of this. You truly are amazing. I will be thinking good thoughts for you on Monday.**