Test results - Phase 1

When I first started investigating infertility, I noticed ALLLLL these tests that people were either posting about or asking about. In the interest of other OCD peeps that likes to compare everything under the sun, I've listed mine below.

Estradiol: 30.3

FSH: 12.4

LH: 4.7

Progesterone: 3.84

Prolactin: 1st test - 12.0; 2nd test - 14.8

X-Prolactine?: 6.9

TSH: 1st test - 3.77; 2nd test - 2.38

X-TSH:2.1

AMH: 1.7

The first prolactin and tsh actually has an E before it, but the X ones were on the same day. Not sure what that is about...

From what I understand, my FSH is troublesome. :-( We have to use surrogacy because I had surgery a few years ago that removed most of my uterine lining. It has grown back in many areas (causing me problems), but still tons of damage and the doctors do not believe I can carry a pregnancy. 

I really hope we can use my eggs, but only time will tell. Don't get me wrong, I would love any child equally, but I would really love to see a child that is a mesh between my husband's genetics and my own. My father died when I was young (accident), but both he and my mother come from an intelligent, attractive bloodline. 

Course some of us are a bit loopy, so if we can't use my eggs then I can focus on the fact that the child won't get that. 

Ahhhhhh - the ups and downs. 

Blog designs

I really need to pump up the design on this blog. Not exactly sure why except that every time I look at I think "ew yuck". Being in IT, this should be easy-peasy for me. It's not. My patience is about 0 of late. Very sad. I should be ashamed as, oh about a zillion years ago, I used to design websites. (Then I moved on to less creative, but very technical things.)

*shakes fist*

Damn you interwebs!!!

On that same note, anyone know how I can read other blogs on my iPhone? You'd save me a couple of hours of internet search that ends up on Pinterest.

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UPDATE: Ok, I prettied it up a bit. That'll do for now.

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UPDATE 2: I figured out how to read blogs I am following on my phone - free and easy. (Was totally over-thinking it.) Turns out the app, Flipboard, has a Google Reader RSS option in it. Now all my blogs that I am subscribed to are listed all neat and pretty for my on-the-go pleasure. Yay!

Book learnin'

Started reading IVF: A Patient's Guide, by Rebecca Matthews PhD. In Chapter 1 I have already found at least 1 error (possibly two)* and that is a little frustrating. Also the constant mentioning of how crappy my chances are since I am older is a bit depressing, but all in all, still like the book. I like that's it's written from a factual standpoint, which even with the depressing crap, I can appreciate. Give it to me straight doc. I'll give my full review once I am complete.


If you are similar and like data / academic reading, then run to your nearest college and see if the library will let you have access to the periodical: Fertility and Sterility. Fascinating stuff in there! If your local college library (or local library???) doesn't have it available, then I suggest buddying up with some professor types. They can usually access the articles free of charge online. Otherwise, the individual articles are pretty expensive. I think the first one I looked at was $35. FOR ONE ARTICLE!!! Fortunately I have the hook-up. :-)

 Do you have any favorite books or articles that you found helpful? How about websites. Feel free to share them in the comment section.

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*Error(s): Page 6 lists the SART data from 2008 with regards to pregnancy success rates. The rows labeled "Percentage of pregnancies with twins" and "Percentage of pregnancies with triplets or more" are inverted. I knew this instantly because I have combed over SART statistics and went back to verify after reading this. If someone did not know this, then the erroneous percentages for triplets could be QUITE shocking.
The second possible error rate is on page 9 in the sentence "...the triplet rate should be low (less than 10% and closer to 5%)...". While technically this is correct, in my observation of triplet rates, I noticed numbers that hovered more between 1-3.5%. Unless my memory is wrong OR I am completely misreading something. (Not unheard of.) 

Tickets procured!

Well it's official. We are off to make a baby in India this summer! (I'm already imagining making a "Made in India" one-see.) Plane and train tickets purchased; doctor appts are set and confirmed.

There is a surprisingly great and diverse blog community that have traveled the same route (ie. surrogacy in India.) If you are interested, you can look at my blog links and see the current ones I am reading. Lots of on the edge stuff for ya. Be forewarned: one blog will lead you to 20 more. Eventually you will loop back around, but come prepared with tissues.

It's our first IVF cycle and I'm trying to do everything possible to make sure it is a success. Cut out all alcohol (I miss you dear wine...), cut waaaayyyyyy back on the caffeine (= need for naps), showers instead of baths (this makes me very sad) and tons of other stuff I probably don't need to worry about but am anyway. I even forwent oysters the other night. Amazing how many things we take for-granted. Hopefully it will pay off. I'm taking prenatal vitamins and baby aspirin. Next month I start acupuncture.

Here we go. 1,2,3 JUMP!

Monday's meeting - better than expected

Just getting around to updating on Monday's meeting with our [wonderful] doctor here in Atlanta. I'm feeling lazy, but I don't want to procrastinate in writing this so - presto! - I'm going to just copy what I wrote to my mom yesterday.

The doctor said she "had" to tell me that the one bad test (FSH) does statistically lower our chances, but that all the doctors still felt I was a very viable candidate when viewed with my other test scores. (Sound like I'm in school.)  Technically my FSH isn't really even THAT bad, but slightly higher than they would prefer. They wanted it under 11 and it was 12.4. At a level of 20, they advise against a woman proceeding with her own eggs. <9 is optimal. It can fluxuate from month to month (and always fluxs during your menstrual cycle), but they try to look at it from a perspective of your highest reading at the beginning of your cycle (day 2 or 3). Stress and such may be a contributing factor for your body producing higher levels (they just aren't really sure what all may be factors). 

That made me feel better because I'm guessing with their sharp increase of success rate in older women for 2010 (over previous years and higher than the national average) I was worried that they would consider me as too risky a candidate. It says a lot that they would still be confident with me as a lot plays into their SART scores. Having a higher success rate for women 38and up will certainly get them mentioned in Top 10 lists for magazines and such. So it was nice that she was still really confident regarding my chances. 

I asked her about what the nurse said regarding freezing embryos now, and she said that she didn't feel it was an immediate concern. If we found a surrogate and were able to do a cycle in a few months and THAT one wasn't successful, THEN she would advise that we consider it. She is such a nice and professional doctor; I wish all my doctors were as great as her. 

After doing some research with published papers, I noticed that my scores are a bit of an odditity. Specifically, that most women that have higher FSH scores usually have bad other scores. They even have a lot of cases where women with normal FSH scores are falsely masking a problem, but the other scores shed light on what is called "falsely suppressed FSH."  In my case (an AMH score in the normal range but an FSH that is elevated) only 5% of all cases are like that. Therefore, there is not enough research to give good statistics that the higher FSH will be a problem. Add to the fact that I had the cryoablation (also an extremely small sample size of women that go the IVF route) and I guess it is anyone's guess. I halfway wonder if the missing uterine lining has an effect on pituitary gland trying to create more FSH. I should have asked the doctor the other day, but I forgot. 

My mom cracked me up with the beginning line to her response:Well, it sounded like you were talking in a different language there, but I got the gist, that you weren't perfect, but good to go.

Moms are awesome like that. It totally made me realize how much info I have learned in such a short time. Now that I think about it, that gives me a much needed confidence boost in a time where I definitely need all the help I can get.

Someone needs to write a paper

An idea appeared in my head that will probably be only interesting to a tiny, tiny subset of people in the entire world. Even in the tiny subset of women that do IVF, it will only be of interest to less than about 1% of those females. And some fertility doctors. And maybe some researchers. BUT THAT'S IT. And only if it isn't a medically ridiculous theory to begin with. (I only play a doctor in my brain.)

Screw it. Here it goes anyway. You can say you saw it here first. I'll be anonymously famous!

I'm wondering if cryoablation, or any uterine lining issue, would cause the pituitary gland to mistakenly produce slightly elevated levels of FSH. 

Feel free to chime in if you have any medical knowledge on the subject!

Trying to get research data on that would be a doozie. You'd need solid baseline before and then calculate proceeding ones with the norm for the age range. Oh yea, and you'd need to find enough women who were having it done.

I'd ask my doc, but I think that would officially put me in the "she asks weird questions" category.

We're going to have a meeting about the meeting and get back to you.

The nurse called today and initially told me what I thought she would: "The doctors had their meeting and your doctor wants to schedule a consult with you to discuss the results. Wait what? Earliest we have available is next week. How will that work for you?" GAAAAAHHHHHH!

Seriously? I have long thought that doctors operate in a different world where test results are just little things on pieces of paper that get moved around and talked about while sipping tea. No rush. Take your time. One lump or two?  It's not like we are waiting for each minute to tick by. The internet feeding our fear like a hypochondriac on WebMD. This confirmed my tea theory and it took me all of second to decide that I was NOT going to wait another 6 days.

"So what does it all mean? Are we still ok to use my eggs?" Nurse: "oh yes, it just means the doctor will probably want to give you more fertility meds and you should think about freezing some embryos now. It could take months before we find a gestational carrier." And there it was. We were still a go with my eggs and of course, my husbands gametes. (Is it weird that I don't want to post the S word?) I didn't have the heart to tell her we were going to India instead.

Now we just wait for our meeting about their meeting about our test results. Where they tell me "TIME IS OF THE ESSENCE!!!" As if I didn't already know that. Hopefully I will have a zillion more questions by then. Wait....that's my hopeful? I may need to schedule a meeting with my hubby to discuss this...

And the answer is...

....
....
....

Yes, exactly.
No answer.

Doc's office did not call today like they were suppose to. Left a message, but they have a dreadful phone answering system that often cycles me around till I land in someone's voice mail.

Bad ending to a super-bad day. At least my hubby is wonderful.

Stats! need stats, stat!

Where we are right now: we knew from the beginning that we would have to go the IVF/surrogacy route (more on that later), but late last year we were given some hope that I may be able to carry a baby. Several tests and renewed hope/worries, we were told a few weeks ago "that ain't gonna happen". Ok fine. Back to square one. What we were not prepared for was the cost... After much research I had to inform my husband that the possibility this could easily go over 6 figures, was very real. Not to mention costs if something medically went wrong with the gestational carrier (new code word for surrogate) and she doesn't have insurance. I'm guessing most won't.  (All of this lead to my idea of surrogacy in India, but I will save that post for a later day.)

Here is a tiny shred of info about us: 
My stats - 40 years old, Caucasian, good BMI of around 22, generally a healthy eater, exercise semi-regular, semi-weird health issues over the years with nothing serious.
DH - 40 years old, Indian, mid-range BMI for male, generally a healthy eater, exercise semi-regular, no known health issues.

Current state of basic tests:
His tests showed good count, with a little slowness.
My tests showed an AMH of 1.7 (normal range), FSH of 12.4 (GAH!), and 16 follicles (yay). (Stay tuned for my rant on confusing AMH numbers...)

I honestly expected a much lower FSH and the news hit me hard. The news of 16 follicles earlier that day was probably the one thing that didn't make me crumble in a pile of tears. Just kinda stone-faced for a few hours. I'm hoping that the HUGE amount of stress I have been dealing with lately (tremendous stress at job, followed by loss of job, car accident, worrying about money, worrying about this whole IVF/Surrogacy thing, blah blah blah) may have had some affect and that with proper stress reducers, followed by a few lifestyle changes (no alcohol, cut way back on caffeine, muti-vitamins, baby aspirin, avoid toxins, etc) that this will help.

The logical side of me worries because I saw a blurb on the interwebs that some doctors believe your highest FSH is where you are at no matter if it fluctuates later, but the hopeful side of me reminds me that all of this is not known yet and thus doctors can not have an absolute certainty of what may or may not help. Besides, the article very vaguely stated "some doctors believe..." with no facts or numbers to back it up. Plus, I tend to be the girl that doctors say how unique my situation is. With everything. Want proof?  My normal AMH combined with my FSH puts me at less than 5% of cases of a study that was about AMH and FSH numbers combined. When looking at SART reasons for infertility, my medical issue of why I can't carry a baby has me at less 2% of the population that goes to infertility clinics. Essentially, it means I really don't have a lot of stats I can lean on at the moment to gauge what our success will be.

Our US doctor will be calling me later to either "discuss the results from last week" or "schedule an appointment to discuss the results from last week". Not sure which since the lady on the phone (when I was driving no less), gave me the info and I honestly did not hear much after "FSH 12.4" and "doctor team will discuss internally at their meeting on Monday". We are in the process of talking with several clinics in India as well and will see how that goes. On SART, our clinic had an over 30% success rate with women my age last reporting period (2010). This statistically significant enough that it will make them stand-out, but it also makes me wonder if they skew what they advise. As in "you really need to use donor eggs" instead of what might be a perfectly normal range of odds for my age.

Sigh. I told you I over-think things.

Unnecessary title explanation...

I suppose I could classified as one of those people that tends to over-think mundane things. On one hand I believe it often gives me great insight, on the other it plaques me with time-consuming obsessive thoughts on the meaning of, well, hell, most things. Mundane or not. That said, very late last night I decided to write this blog and 5-10 minutes later I decided on the name.

While I could (and will to some small degree) laminate on what went into the name, the short answer is that it was very late,  it seemed catchy, and I finally got around to reading "A Passage to India" a few months ago. That's kinda it in a nut shell. Somewhere in my tired mind it made sense given that my husband and I have a complex relationship of west meet east, even before the idea of Indian surrogacy entered the picture. You see *cue dramatic music* my husband is from India and I am from the US. That gives us a unique perspective into our upcoming journey. One I feel may help others - even those who are not in the same situation.  

I haven't read extensive literary essays on the meaning of "A Passage to India" (nor do I plan to), so I can only base the title on what I took from the book. Without going into a day long book review, the end result is that it is about the struggles that occur between cultures, great sacrifice, injustice, and acceptance. Other things as well, but that will suffice for now. Maybe I will manage to weave all of the different meanings into this story where it is fitting. Maybe not. Now that I think about it, I don't even want to laminate "to some small degree". For now, I'll try not to over-think it, for there are far too many prevalent things to over-think at the moment. 

Welcome aboard. Please fasten your seat belts - turbulence is expected.