The Saga of Becoming Fruitful

Archive for the ‘2WW’ Category

The 2 Week-Wait is Over

BFN.

Big Fat Negative.

There I finally get to use that acronym. So officially, our first IUI attempt yielded a BFN. The home pregnancy tests were proven correct, that’s the good news.

I went in at about 10:30am for the beta-hCG. After running errands, I got home at about 2:00pm with no messages yet. I knew the clinic closes at 4:00pm, so I wondered if they were going to call me today. At 3:45pm when I still did not receive a call, I initiated the call as I was still hoping…. Anyhow, BFN confirmed by beta-hCG results. Bummer…

If it is BFN, do they really tarry in calling? If it is BFP, could it be that they excitedly call early? I guess I’ll never know.

At least, I can now stop putting in those progesterone plugs. Phew!

You Give and Take Away
Last Sunday, one of the songs at church was Matt Redman’s Blessed Be the Name. I love this song and I was prepared to rock it! Of course, it was upbeat! Before the Coda though, the worship leader interjected “here’s the part of the song that is sometimes difficult to sing” - and I knew it was not just musically, but also figuratively:

You give and take away
You give and take away
My heart will choose to say
Lord, blessed be Your name

I just had to close my eyes to sing that part. Tears were welling in my eyes. A few were unstoppable and fell down. That coda just means a lot to me.

He gives fertility or takes it away.

He gives a pregnancy or allows it to miscarry.

He gives a baby or not.

All of these things, we cannot know. Yet one thing I know, He gives me a hope and a future. And so, my heart will choose to say, indeed, blessed is Your name!

Today is THE Day

beta-hCG test is scheduled for today…

I’m not really excited to go since the home pregnancy test results in the last few days were NEGATIVE, regardless of what HPT I used - First Response Early Result, New Choice (the dollar-store kind) or the First Response Rapid Result. (It is going to be a miracle if I am part of the 7% who gets a false negative even after the 2WW.)

But I guess I have to go to get a confirmation (I will be very pleasantly surprised if I test positive!)…
…so that I can stop using the progesterone plugs
…so that I can “welcome” Miss Flo
…so that I can go back to exercising
…so that we can regroup and rethink Plan B
…so that we can move on to the next step…

I will let you know later today what the final results are…

Choosing A Home Pregnancy Test

There was a time when a woman had to wait until she misses her first period and then go to the doctor to have a pregnancy test.  That pregnancy test required killing a rabbit! But … we’ve come a long way, babe, and we can do our own test in the privacy of our own homes with the home pregnancy testers!  And sparing the rabbit, too!

However, home pregnancy testers (HPT) are NOT created equal.

Basically, some HPTs will give you results earlier (as early as 5 days) than others because they are more sensitive.  Of course, the more sensitive HPTs are typically more expensive. So eventually, it all boils down to:
- you want to know earlier if you are pregnant and pay a little bit more
- you can wait till the end of the 2 week wait and use the regular and cheaper HPTs or maybe, just have the blood test then (without using any HPTs!)

How HPTs Work
HPTs work like litmus paper in the sense that the tester needs to be wetted by the sample - in this case, the woman’s urine. It can be done by 1) urinating on the tester stick, 2) collecting urine sample and dipping the tester stick or 3) collecting urine sample and using a dropper to transfer into the tester stick.
The similarity ends there.  The HPT’s mechanism for determining pregnancy is through the detection of the pregnancy hormone, human Chorionic Gonadrotopin or hCG, in the urine.  The tester sticks are treated specially to be able to do this.

hCG is produced by the woman’s body once conception starts and its amount increases at a rapid rate - typically doubling every 2-3 days during the early pregnancy. The hCG builds up in the woman’s body that eventually, it can be passed in the urine. 

hCG levels peaks between the 8th to 11th week of the pregnancy before it slowly decreases throughout the pregnancy. Here are some guidelines from the American Pregnancy Association:

Most HPTs reportedly can detect as low as 25mIU of hCG in urine. The detection could be as early 4 days prior to or as late as 1 day after the expected period. 

One of the  HPTs that claims detection as early as 5 days prior to the expected period is the First Response Early Result (FRER) Pregnancy Test.  The mechanism it claims to use for increased sensitivity (or earlier detection) is its ability to detect another variant of the pregnancy hormone, hyperglycosylated hCG or hCG-H. hCG-H is reported to be produced even before the primary pregnancy hormone, hCG, is produced.

How Sensitive HPTs Are
Interestingly, the product packaging and inserts of the HPTs rarely claim a minimum analytical sensitivity. Nor do their own websites. There are other websites though that have listed such official sensitivity of different brands as checked versus their manufacturers.

I’m a tables-and-graphs person, so I tend to put more confidence on information that reflects thorough research.  Here’s a study done and published in 2005 showing First Response Early Result (FRER) and Clearblue Easy Earliest Results as having more accurate and higher sensitivity results.

You may say, that’s 2005 data. True.  The other manufacturers may have improved since then. As for me, I think I will stick with FRER until I can find a more recent study showing the new best thing! Moreover, my quick research on the HPT prices did not really give a significant price difference between FRER and the others.   (Except for the dollar store kind, of course!)

Really, it is your money, so you can buy whatever you want.  I was just saying!

Is the Blood Pregnancy Test Redundant?
NO. You still need to get the blood pregnancy test as it is the most sensitive pregnancy test, detecting as low as 5mIU of hCG.  So it confirms or disagrees with the HPT’s results. The blood test is still the most definitive detector of pregnancy.

Moreover, HPTs just tells you whether you are pregnant or not. Yes or No. It does not measure the amount of the hCG in your body.

So, the required beta-HCG is still necessary because that is when the quantitative level of the pregnancy hormones are baselined. Baseline beta-HCGs are later used for comparison to the next day’s beta-HCG levels to see the pregnancy hormones’ increase rate. The beta-HCG levels can give early indications on the pregnancy’s characteristics  - is it viable? potential multiple pregnancies? potential complications?

So There You Have It
If you can’t wait and are looking to get earlier results, the First Response Early Result is the best HPT.

If you are looking for the cheapest alternative, then using the dollar store kind is just as good as the expensive ones after you have missed your period.

Do you differ with my recommendations? Tell me your experience with your HPT!

Bad News, Good News

Bad News…




Good News…
AF has no signs of showing up (yet!).

Meanwhile, I did some research on Home Pregnancy Testers and realized that if I was wanting early results, that the dollar-store HPT won’t cut it. So, I just asked DH to buy me some of those “fancy” ones (Read: more expensive).

I thought it would be good to share what I learned about HPTs to all of you. (Although a lot of you may be badge-bearing veterans of HPTs, I figured there are still some of us who need this info.) Check out the other post on Choosing a Home Pregnancy Test. It includes how HPTs work, why sensitivity is important and if blood tests are still needed.

Have a great week-end!

A Crazy Week-End During 2WW

…is very much welcome! Last weekend was one of those jampacked ones!

Attended 2 children’s party with 1 held at home since it was my nephew’s. Lots of children (yes, I am still good around them), food, games and inflatables. Not to be outdone, us, the adults had our own fun too with “guess my drawing” and got an ice, flip-flops, a drowning Causasian and a lot of sombrero-wearing folks. That was fun! The drawings eventually run out, so we settled for Pictionary. (Note to self: Start researching my own “guess my drawing” for the next party!)

Hosted a church subgroup meeting which was very productive and served dinner with food from my part of the world (which thankfully my guests loved! Anyone heard of “lumpia” and “pancit”?). “(Wo)-Manned” the crafts booth on our church’s “Big Party” (in lieu of Vacation Bible School) and avoided the inflatable water slides which I was egged to go try. I refused, of course, and in my mind I was saying to myself, I’ve got some babies inside of me that I need to “protect”!

I noticed that on all these “eating” occassions, I was drawn to the sour types of food. In one of the birthdays, I ate a lot of the grilled pork which I drowned with vinegar and chili - with rice as a neutralizer, of course! In the “Big Party”, I discovered the big dill pickles and they were delish with the grilled chicken. Ayayay!!! All that talk about food is making my mouth taste vinegary.

Could it be that I am really pregnant because of the change in my taste buds??? Could it be true??? Could it be???

I console myself - at least, my mind is fertile!

My First ICLW During 2WW

Signing up to my first IComLeavWe during the 2WW was a great move! Not only was I focused on doing something I committed to (instead on obsessing on the 2WW), but I was also able to discover a lot of great ladies and their blogs!

Thank you for all your comments and emails! It is still my goal to respond to some of the comments that I have not yet responded to, within the week!  Like one lady said, I hope some of these new acquaintances “stick”. Who knows?  Nevertheless, thank you sooo much for visiting my blog and giving me hugs.

Anyhow, I peacefully await my 2WW. I got for BHCG on Aug 5, Tuesday.  I hope and pray I do not freak out as it draws near.  So, to ease up some of my anxiety, I will “cheat”.  I plan to test daily with the cheap dollar store HPTs starting on Thursday which is 10dpiui. I know, I know … I could get a false negative or a false positive. It’s cheap anyway, so I don’t mind. 

So tune in…

My Doctor…

I recently got a forum message regarding my RE, Dr H. The forum poster #1 was not happy with her and went to another doctor instead. I responded that overall, I was happy with her. Later, another poster #2 added her 2 cents not on Dr H but another Dr in the same center. I’ve culled some excerpts here but if you are interested in the whole context and everything, you can read it at SoulCysters.

Poster #1:

Arpee~ That’s interesting that you like Dr H. She was my RE for over a year and I had a different experience than you, unfortunately. I ended up doing 6 cycles of IUI, 5 on clomid with one BFP (ended in m/c). Even though I only ever got pg with a trigger, she constantly pushed for OPKs (though my records clearly showed a history of high LH and unreliable OPK results). We went in knowing we had relatively severe male factor and yet she did not change her normal protocol for us AT ALL. My m/c was horrifying at that office. DH and I went in to see the h/b at 7wk having had an earlier bleeding scare (so we were relatively ready to hear m/c). She just sighed and said, “Looks like you’ll have to try again with another embryo.” And her staff just walked out like rats on a sinking ship. She told me it would be like a heavy AF and to call after it was over and we’ll do another cycle of clomid. Needless to say, she was totally wrong. When we were told the numbers from DH’s post-wash count, we were never told the total motile. After I got the records, the counts were below 5 million for the last 3 cycles. These are well below the 10 mil threshold most clinics use for IUI. We could have just saved the money for the IVF that we now have to do. They never called when they said they would (which is scary early in pg when you’re waiting for beta and progesterone numbers) and you may have to explain your situation multiple times depending on who answers the phone. Needless to say, I’m over at Dr Y’s office and they are 10 billion times more compassionate and informative. I got (correct) statistics for our situation. I really hope you have a much better experience than I did!

My response:

Hey NerdyGirl,
…when I was looking for an RE, I searched the internet for reviews and got 1+ and 0-. Also, I wanted a woman RE and at that point, it was her and the new lady doctor at the same clinic. So I opted for the “older” one.

Just like I mentioned earlier, I like it that she is a straight shooter. Perhaps because I am so myself. They’ve been good at calling my stats to me, so that aspect is not a problem, either.

Your post and some recent experiences though gave me some things to think about:
1. When she saw that my cysts have shrunk already, she said that we were ready for the next Clomid cycle. Wrong…we were ready for our next Follistim cycle. (I realized doctors don’t typically review the charts before they see you.) (My blog details it more.)

2. She told me to use my leftover Follistim (from my 1st cycle) for my 2nd cycle without warning me about the 28-30 days allowed time in the refrigerator once the vial has been used. Good thing I called them today to ask about it. I should have not even used it for the 2nd cycle. The “good news” is that the med seems to be still working (at least until the 3rd Follistim day monitor) even if they have “expired”. Will see tomorrow if that “good news” continued up to the 6th Follistim day - although I use a new vial tonight that my husband will be picking up from her clinic later today.

3. She made a “deal” with me when we cancelled our 1st cycle (due to OHSS symptoms starting to show) that she will shoulder 600IU of my meds. Now that I am following up, her staff got back to me that what she said was that she was going to shoulder half of my meds - 300 IU. $300 worth - not too big of a deal. But that may be an indication that they do not track what they are promising their patients too well.

So you did 5 clomid and 6IUI cycles with her? Anyway, if things do not really work out with her, I may consider going to a male RE. Being of advanced maternal age and 2 miscarriages, it is possible I will be needing a perinatologist. So I like it the idea that they will be the one who will continue to care for you until you give birth - instead of being passed on to a next doctor, the perinatologist.

Thanks for the info! And I wish you health as you and your DH prepare for your next IVF cycle!

Poster #2:

I have to chime in on that center vs Dr. Y issue. I posted this some of this story on the other Austin OB thread, but I think it has relevance on this thread too.

I went to that clinic in February 2005 from a referral from my old GYN at Women Partners in Health (she’s since moved out of state, so no reason to state her name). I saw Dr. V, and neither DH or I were very impressed with him. My GYN had been seeing me for several years, and we had been trying to get pregnant. She ordered an u/s to “check” for PCOS, and I just happened to have the one cycle that I ovulated in about 3 years during that u/s. So, they ruled out PCOS because I was ovulating. She did the standard fertility workup, and found that my progesterone was low and my estrogen was high. So, I had a hormonal imbalance and she sent me to TFC.

Dr. V met with us, and told me that based on my records from WPinH that I had a hormonal imbalance based on me being overweight. That’s it. Nothing else. He didn’t do any tests, didn’t look at other factors like my overall family medical history, my appearance, etc. He said that I needed to go on BCP to regulate my hormones, I needed to lose 40 pounds, and then, and only then, would he start me on Clomid.

I started seeing a new Family Practitioner in April 2005, and she diagnosed me with PCOS right off the bat from medical history and my appearance (where I carry my weight, hair growth/loss, hormone profile from the GYN tests, etc). Her blood tests and putting me on Met confirmed the diagnosis.

I started seeing Dr. Y in November 2005 on my old FP’s recommendation, and at his office we finally saw the string of pearls cysts on my ovaries during an u/s. I talked to him about starting Clomid, and we elected to wait until after the beginning of the year (DH’s benefits started covering infertility then) and for me to try to lose 5% of my weight. I had an appointment on Feb 28, 2006 to talk to him about starting Clomid, and I got my BFP for DD#1 on Feb 24 from Avandamet alone.

The moral of the story is that I went for 3 long years not being properly diagnosed, and I feel Dr. V at TFC was part of that. I don’t know if I would have had a different experience if I had seen a different doctor at TFC, but if nothing else, the attitude I got at TFC and Dr. V regarding my weight put me off of them entirely. My FP who diagnosed me thought that putting me on BCP when I was TRYING to get pregnant and needing infertility treatment was the dumbest thing she had heard of. She was also not happy that a fertility clinic/reproductive endo office missed the PCOS diagnosis when I exhibit pretty much all the clinical symptoms.

In the interest of “balanced” views here, I am adding excerpts from other forum regarding Dr H and the center she has her practice on:

We used Texas Fertility (Dr H) and really liked them. They are really good about making you feel at home & comfortable asking questions. I was sad when we got ‘promoted’ to a regular ob since everything went so good. Dr V (one of the physicians) was on one of the local news channels recently and is very well known. They also have a class (free) once a month that is super informative. Their statistics were very good when we checked although right this minute I can’t recall where we looked but I think it might have been through the Tx center for Disease Control? Anyway, hope this helps and just fyi….we are 18+ weeks w/ twins!!!
- MedHelp

I am currently going there. We had our 2nd IUI today. About half my class from last year was concieved through them. (IUI’s, IVF and donor eggs) Everyone has been really nice and personable. There office staff is great. They try to squeeze you in when they can and are always patient. I am seeing Dr. S but have also seen Dr V and Dr H for ultrasounds.
- Mothering.com (This one has more related posts, so just go there if you are interest in more.)

I think we all have to take these varying inputs like these with a grain of salt. This is where “different strokes for different folks” is very applicable. None is right or wrong. It’s just that there are some things you are looking for and some doctors you just can’t work with. To each her own, just like the many churches one sees around, they cater to different people.

That is why it is so important and proactive to research and do the rounds when looking for an RE (or any health care specialist for that matter). I would really, really, really think twice in setting up a first meeting if my research had shown consistent negative feedback on a particular doctor or center.

In my case, my research on Dr H’s practice’s SART stats vs other centers makes me feel more comfortable with theirs. So from a numbers standpoint, I like them. I know it is more than the numbers…but so far, my actual experience has been well.

I’m pretty happy right now with Dr H. I have no compelling reason for me to transfer to another RE at this point.

How about you? Have you switched REs in the past and what was your breaking point?

The 2-Week Wait

So I had my 2nd IUI for this cycle this morning…we started with the ultrasound to see if the follicles ovulated and if so, how many of them did that. Looks like I ovulated 1 on the right and 2 on the left.

But… I have no sonogram because I forgot to remind Dr H to print one. I was telling the medical assistant later as I was checking out and guess what she said “You don’t want those. You want the “real” ones in the next 2 weeks.” I told her “this is real as well”. Hmmmpph!!!

So “worst” case, triplets? For me, 1 is alright, 2 is better, 3 is a stretch but I think still good. Well, we will know in 2 weeks.

Did anyone notice that I did not mention the SA results yesterday? Well, I intentionally did not mention that so as not to pressure DH (who reads this blog) on it. We however talked about it later, so now I can tell you about it.

My DH’s last SA was done late 2005 with good counts (71M) and motility (53%). What was below normal was the 4% morphology. When we asked Dr H last Sunday, she was not very concerned about the morphology and that she was after the motile concentration instead.

The post-wash SA yesterday for the first IUI was not very good with 4M motile concentration only. Perhaps it was because DH was nervous that he was only going to give a few millions. Perhaps because he was a bit sick. Perhaps because of the lack of lubrication. (I learned later that he did use s teeny weeny bit ) Anyway, Dr H said that maybe if we “stage” it better tomorrow.

So today, we used the recommended lubricant “Pre” from the lab that did the SA. The frontdesk person in the clinic actually said any non-spermicidal lubricant can be used. Here’s the front and backside of Pre containers:

… and we “staged” it. “Stage” - interesting word… let your imagination work. And we got way much better post-wash SA today at 19M motile concentration! (The desired level is 10M.)

Dr H was feeling good about my girls ovulation and my DH boys’ improved motility concentration.

So, the 2-Week Wait starts today and hopefully ends positive on August 5. Meanwhile, I will use Progesterone VS starting on 7/25 Thursday.

The time starts now!!! (tapping fingers…). So how do you “occupy” yourself in the 2WW? Any suggestions are welcome!

COST: $530 (180 ultrasound, $170 IUI, $180 SA/wash)