The Nerve and a List

So yeah, remember how I said that we called our old doctor's office back around March 20th. They just called and left a message to see what we wanted. Can you believe that?! The nerve of them. Why did they even bother? After a few days what's the point of even returning our call. To top it all off, they were calling to see what we actually wanted since the nurse that took down the message just wrote that we called. Not that we were calling to see if they would prescribe any meds for R as they said during our appoitment, not that we were calling because she hadn't had a normal period since December, not that we were calling because AF was, at that point, 4 days late again. This is the office that took nearly two weeks to get us the results of a stat blood test. GRRRR!!!! I growl at them. I hope the staff at the new doctor's office is a bit more competent.

Here's a list (I live for lists) of the things I'm counting down:

• 47 days since AF arrived to visit R.
• 1 week and 3 days until the RE appointment.
• 25 days until my graduate school applications are due.
• 27 days until my last undergraduate class ever.
  
• 1 month and 1 week until I graduate.
• 2 months, 2 weeks and 1 day until we get to go back to California.
• 3 months and 5 days until our 9 year anniversary.

Man, it's a good thing I don't have a ticker addiction or they would start to consume my blog.

We're making progress

We finally have an appointment with a new doctor. Our midwives don't prescribe any medications for fertility treatment so we had to change providers. Our new RE is, according to a friend who is a patient, really nice and knowledgeable. Our friend is straight so no word about how he is with same sex partners. Our appointment is April 16th. Hopefully we can start TTC again soon after that!
R is late again. Her cycles were like clockwork until about 4 months ago and then something changed. We're not sure what changed, but now her temps don't always behave and it's hard to tell from temps if she's even ovulating anymore. We were temping for months before we started TTC and every month she was ovulating on day 16 or 17 of a 28 day cycle. Our midwife was concerned about her LP being a bit short so she ordered testing and R's LP progesterone levels were really low. Also, R didn't ovulate at all that month.
Any suggestions about what we can do to try and get R's cycles back on track? We will be asking the RE the same question, but wanted to know if there was anything we could do in the meantime.

Holding Pattern

In TTC world: We haven't heard from the old doctor and we don't yet have an appointment with the new doctor.
In school world: I am really too late to apply to any graduate schools for the fall semester. Most of the programs I'm interested in don't accept students for the spring semester so it looks like graduate school in Fall 2008 for me. The question now is what do I do until then? Should I get my teaching certification (1 semester of classes and 1 semester of student teaching)? I took the first semester of classes 2 years ago and stopped. The only reason I stopped is because I wanted to graduate earlier. Now that it looks like I'll have another year to wait what should I do? Where should I live? R is applying for jobs. She's looking all over. She's looking where we live now, where we used to live in the south, and in California. If she gets a job in California then we're hoping they'll help with relocation costs.
Everything feels so up in the air right now. My happy world of plans and lists isn't working. I don't like not knowing where I'll be living in a few months. This is scary. To add TTC on top of this is crazy, but I guess we're crazy. We want a baby before we are 30. We have another 18 months to make that happen.

When will we get to try again?

We're still waiting to hear back from our doctor's office. There are a few RE's in our area. Only one group works with our insurance. We do have some coverage for infertility treatments so we're lucky. Our insurance is pretty good. When R had her heart surgery we were worried, but most of it was covered. Our out of pocket in an Office Setting is $25 per visit then 100% of eligible expenses & Outpatient is 90% of eligible expenses after satisfying $200 deductible. I'm confused after looking over the lists of things they do cover and things they don't cover though. It seems like the lists contradict themselves, especially the first items on each list. What do you think?

Services they cover:

• Diagnosis and treatment of infertility when provided by or under the direction of a Physician.
• Embryo transport.
• Donor ovum and semen and related costs, including collection and preparation.

Services they don't cover:

• Health services and associated expenses for infertility treatments.
• Fees or direct payments to a donor for sperm or ovum donations.
• Monthly fees for maintenance and/or storage of frozen embryos.
• In vitro fertilization, gamete intrafallopian transfer procedures, and zygote intrafallopian transfer procedures, and any related prescription medication treatment.
• Artificial Insemination

It seems like the testing we need to figure out what's going on and the meds needed to fix it will be covered. I think sometimes that we're moving too fast, but at this point we're ready for a little more intervention than our at home attempts.

We were hoping to try this cycle, since our plan was to try every month in 2007 until we get pregnant, but it doesn't look like it will be possible. This may be a watch, test, and learn cycle. I will be out of town the weekend R should ovulate. The next try will be early April. This will be our last chance to have a baby in 2007.

Test Results

R's progesterone level was 0.9 when anything under 5-10 range is considered low. The doc said that with progesterone that low there's no way she ovulated. It was low at CD 24-25 for the past 2 months so she doesn't think that it was just a freak anovulatory cycle since she had two in a row. We've been referred to an RE because our midwife doesn't deal with infertility issues. They wouldn't even prescribe progesterone. It was suggested that we have more testing done.
I'm a bit upset but at least we're finding this out after trying since August and not one year later.
We're definitely not trying this month.

Testing Testing

R will be going in for blood tests tomorrow. I have a long day tomorrow, well most of my days are long days but Monday is always exceptionally long, so I won't be able to go with her. Results will take a while because her midwife is on vacation (skiing, in this weather-it's currently 12 degrees with a wind chill of -6, but again I digress). Hopefully we'll know results next week because we will be insemming around the 15th or 16th of February. Hopefully all her hormone levels look good. There was some concern about progesterone levels and LP length.
We still don't know if we will be driving to visit our donor or if he will be coming up to visit us this month. We'd much prefer that he drove up here. We have 2 dogs & 2 cats that we'd need to make arrangements for. He only has 1 dog and she can come with him. Also, I have a lab that usually lets out around 4pm on Friday, putting us at his house around midnight. Depending on the cycle R might O the same day we're driving down there and we could end up with bad timing for the insem. So far we've gone to see him every time. He's never come to visit us, even before TTC, so we'd get to hit up all the touristy sites. I REFUSE to go the fake Amish farm, maybe we'll go to D.C., Philadelphia, Baltimore, or NYC. They're all within a 1-3 hour drive. It would make for a nice day trip. We haven't done that in a long time.
We used to take day trips all the time. When we didn't have 2 work schedules and 2 school schedules to work around. Now that R's out of school & I'm losing my job maybe we should make that a priority. We still don't know what city we'll be moving to this summer and we should make the most of our time here.

Moments from the Midwife Visit

• We were sitting in complete silence when, all of a sudden, R said, "I bet if they played tapes of children screaming, crying, and whining instead of soothing music while you're waiting it would lower the population of [our hometown]." Which caused me to let out a guffaw just as the midwife came back in the room.
• R's midwife spent a majority of the visit talking to me. This happens to me when I'm with R all the time! People even think that I'm her mother, all the time! I'm younger, so what if I'm 2 inches taller. If we're out to dinner, I get the check. If we're shopping for a major purchase (car, jewelry, etc.) sales people always address me. I just wanted to turn to our midwife and scream, "It's her body, you can talk to her too about when her LMP was!"

In defense of the midwife we saw, she's not R's normal midwife. We did throw her off, when we made the appointment we told the receptionist that we just wanted to have a check-up and make sure everything was OK. When the midwife walked into the room she was under the impression that we had had a positive HPT and were just coming in to confirm a pregnancy because that's how the receptionist had coded our visit. Once we got that cleared up she reviewed our charting and says we're doing a good job. She reassured us that sometimes, OPKs just don't work but as long as 3 other signals line up we shouldn't have anything to worry about (haven't I heard that before...). She was a bit concerned about R's short LP so she's ordered blood work. She's most interested to see how R's progesterone levels are. She did chastise R because she hasn't been taking prenatals. She gave us free samples and will write a script when we get pregnant. She's going to call us with the results from the blood work this month and wished us luck. The last thing she said was that she hopes to see us pregnant soon.
We were very surprised, this is the same practice that friends of ours had problems with a few years ago. All in all, a good visit.

We've decided not to try this month. We didn't want to throw off any testing that the midwife ordered, plus our donor couldn't come visit, and R couldn't get off work so it doesn't seem to be a good month. One month into 2007 and our 2007 plan of attack is out the door. Oops... We will be trying in February, the plans are already made.

As for my job, I still don't know if I'll have one in a few weeks. I am supposed to know on Monday so, hopefully, I'll still have a source of income.

PCOS Sucks

I'm up way too late tonight. I have to work in less than 7 hours & really, I do know better than to stay up this late. I'm gearing up for the most fun of Dr's appointments. Yes, I know that R is the one that will be trying to carry our 1st child, but I'm headed to the OB/GYN tomorrow. My PCOS has gotten out of hand & I need to try some new meds. I've been on Provera for a few years and I'm getting tired of it. I don't think it's supposed to give me two periods per cycle, but it has. I also want to have the "I plan on trying to get pregnant in the next few years" talk. I know it's a little, ok...really, premature since I want to carry our 2nd child & we are still 1 week from our first time out of the gate for our 1st child, but my ovaries have a mind of their own. It may take at least 2 years of beating down on them with hormones before they even decide to release an egg. I figure if I get my cycles under control & get myself ovulating now it will be a lot easier in a few years to get pregnant. I've been doing some research on my own so I can be an informed consumer at the appointment tomorrow. R & I don't have the same doctor but we go to the same practice. She isn't comfortable with a male OB/GYN and sees a midwife instead. I really don't care and didn't really have a choice since I needed a PCOS specialist.