Update

Spencer and I went in today for another beta test. The results came in a few hours later. My levels have dropped to 80. So this was a chemical pregnancy. There was something wrong with the embryo and it wouldn't have developed into a healthy baby. I'm am supposed to stop my progesterone and estrogen and come back for more betas until my number drops to 0.  Hopefully we can meet with the doctor soon and get even more answers.

We are completely devastated. We were so happy last week knowing that Frosty had made it through. It's hard to remember how exciting that felt since this week has just been bad news all week long.  I am just so disappointed that having a kid is so difficult for us.

We are going to take a short break and focus on us. I graduate in May and hope to get a promotion at work or find a better paying job at the least. Maybe shortly after that we can attempt another round once stress levels drop off again.

Thank you so much for all of the support. We feel so loved by our friends and family. I'm glad we got to share good news with you last week, but feel bad about taking that excitement away with the news this week.

Waiting game

Normally with an IVF cycle, you have a blood test to confirm pregnancy at nine days past transfer and again at 11 days past transfer.  These two tests are supposed to show an increase of at least 66%, preferably doubling within 72 hours.  This is a sign of a pregnancy progressing normally.  As everyone probably knows by now, our first test came back at 109, which confirmed that I am pregnant.  My second test did not happen until today, five days after the first, because of travel issues over the weekend.  For my numbers to show a 66% increase, I believe they should be around at least 300 now.  The results of this test showed my level at 163.  I had hoped that I heard the nurse incorrectly, but she confirmed the lower-than-desired level.  She said I need to come back in again on Wednesday to see what my levels are at.  She didn't really say that the levels are bad or good, just to retest. So of course, I turn to the internet...

The long and the short of it is that we don't really know what to expect from here on out.  My levels are not doubling like they should be, which could mean many things (most of which are not desired).  There is still a chance my levels go up again on Wednesday and Frosty is just growing a little slower for some reason. That's what we hope to hear on Wednesday and would like everyone to hope and pray for. However, the lower numbers could mean that Frosty had something wrong genetically and won't make it; it could also mean an ectopic pregnancy or that a twin didn't make it (which I am not sure applies to our case since we only transferred one embryo).  I am hopeful that Frosty is just as stubborn as I am and will kick it into high gear and raise those numbers up by Wednesday. However, it's hard not to dwell on the more likely outcome that this round just wasn't successful again, even though it started off well.

This has been very hard news to hear after such excitement last week.  I know everyone was so happy for us.  This news breaks my heart and I hope that I'm over-reacting and it all turns out OK after all.  I just ask for prayers and good thoughts and a Christmas miracle right now.  I plan to do my best over the next few days to provide Frosty with the best home possible and hope for the best.  With any luck, my next post will have a much happier message.

Beta Test: Round II

I’m going to start with what everyone is really waiting for…Frosty made it through! We are pregnant!  It’s still very early and we have a few more hurdles to get through, but we wanted to share the exciting news with everyone.  When I started this blog, I decided that I want to share the good and the bad with y’all.  So hopefully it’s only good news from here on out.

Now for the rest of the update since my last post…

Spencer has been doing a great job with my progesterone shots.  I barely feel them and haven't had any knots in my bum from the oil not absorbing properly.  We even had to do one at the car after his graduation, which was a tad different. The progesterone has definitely had an effect on me though; see the symptoms below, most of them are caused by the progesterone shots.

Today was my beta test to determine if Frosty made it through the two week wait.  A short blood draw in the morning, then a long wait throughout the day for that phone call.  I had to let it go to voicemail because I had interview committee obligations to fulfill throughout the morning.  But once that was done, I looked at my phone and saw the text version of the voicemail.  The key words that stood out to me were congratulations, positive, 109! I was so giddy, but ending a conversation with some coworkers so I kept it inside for a few minutes.  I was shaking by the time I walked out of the library and headed to my car.  I texted Spencer immediately and told him the good news.  I’m pretty sure I’ve cried and been very shaky over the news, as well as absolutely giddy.  It was much easier to function at work the rest of the day compared to when we got the bad news two months ago, even if it was a little hard to focus.

I have another blood test on Saturday to determine if my levels keep rising. The doctor wants to see my level at over 220 to indicate a healthy increase and healthy pregnancy.  So keep the good thoughts and prayers coming please.  We are not completely out of the woods yet, so it’s cautious optimism right now.  After Saturday’s blood test, the next hurdle is the ultrasound to make sure the baby is actually there and it’s not just an empty sac; we might even get to hear the heartbeat then.  I know most women wouldn’t even share this news for another two months, but I don’t care.  I want everyone to be able to celebrate with us now and hopefully at each milestone along the way.  And if, God forbid, we do get bad news eventually, we know we have an excellent support network to mourn with (let’s hope we don’t have to use it though).

Shot/blood draw counter: IIII IIII IIII IIII IIII IIII IIII IIII II

Symptom tracker:  still a little tired (sleepy time is around 8:30/9 pm most nights), nose goes crazy with random smells, taste buds are off making lots of food not as delicious as it used to be, dizzy more often, a little bloated most of the time, hot flashes occasionally, cry more at things that shouldn't really make a grown woman cry (the news gets really iffy sometimes depending on how many heartwarming stories they have to share), slightly crampy (but that's completely normal as Frosty digs in and my uterus makes room for him/her), allergies have been going haywire the last two weeks (I even had to go to my primary care doctor to get antibiotics my sore throat got so bad)

Transfer day: Round II

So apparently I only posted about transfer day on Facebook, not here.

Second time's the charm

On Monday, December 7th, we transferred one little embryo (I'm calling it Frosty).  The transfer went smoothly.

Frosty is back home!

Baby's first picture

I spent the rest of the week sending out good vibes, not stressing about anything, drinking tons of water, and eating healthy.  I had allergy issues because of the crazy Texas weather the first week of December, and after the transfer things hadn't changed too much. I still had a runny nose and dry throat.  Because of the junk going on in the head, I found it hard to notice any possible symptoms during the two week wait.  We also didn't want to test early at home this time, so the blood test on Wednesday December 16th will be a total surprise.

Things are moving right along!

I just came back from my latest sonogram appointment.  The nurse said my lining looked great, measuring about 9 mm and 11 mm on the two different measurements (I think-the screen wasn't really facing me as much as it usually is so those are the numbers I think I saw).  She said we are right on track for a transfer next week.  After looking at the doctor's schedule, she picked 2:45 on Monday, December 7th.  We finally decided to transfer just one embryo this time. There was a lot of debate between ourselves over one or two (my rational side said one, while the hormonal/emotional side said two), but both the doctor and the embryologist suggested just one since they are rated perfect quality.  The embryologist said that if the one embryo doesn't thaw very well and the quality is downgraded, they can quickly thaw another and we can transfer two in that situation.  So this is all exciting news!

I have one more subcutaneous shot of Lupron to give myself tonight and then Spencer takes over with the intramuscular ones in my bum for the progesterone.  Knowing how well it went last time, I don't think I'm as nervous about these this time around.  I don't have to do the patches of estrogen like last time; it's just a pill form of estrogen this time.  I'm happy with this because the sticky from the patches was hard to get off and the patches were just kind of annoying.  I'm not really sure what else to write about right now, so I'll just leave you with what Spencer says is his favorite part of the blog (and something I'd stopped doing):

Shot/blood draw counter: IIII IIII IIII IIII IIII I

Symptom tracker: tired (sleepy time is around 8:30/9 pm most nights), nose goes crazy with random smells, taste buds are off making lots of food not as delicious as it used to be, dizzy more often, a little bloated most of the time, hot flashes occasionally, cry more at things that shouldn't really make a grown woman cry (the news gets really iffy sometimes depending on how many heartwarming stories they have to share)

Round 2

We decided to jump right back in with a second round, this time with our frozen embryos.  We paid our $2500 fee last month when we learned that we could start a frozen cycle almost immediately and it would not interfere with our holiday plans.  The medication was ordered and after a week of not hearing anything about setting up the shipment, I called the insurance company to check on it.  They thought it was just an approval, so it kind of got lost in the shuffle.  They finally got it sorted out, but wanted to charge me $600 for one of the medications (Lupron), so I decided to look elsewhere.  I asked the IVF coordinator to send the entire prescription to the place we used last time, but turns out they only sent the order for the super-expensive medication.  So I just ordered that one, and called back the insurance to order the others instead of messing with the doctor's office again.  After being told the exact opposite about coverage as I heard the day before, and after thirty minutes and five people later, it got sorted out and ordered the rest of my medications (which were all covered by insurance!).

Medications came on Tuesday and my appointment for the first sonogram was yesterday.  They checked my lining, which was 3.6 mm; the nurse said this looked right on track.  After I got dressed again, the nurse went over my calendar and injections.  I start Lupron injections today and continue those for several weeks. I won't start progesterone shots until December and our transfer is early December some time.  I also met with one of the embryologists about our frozen embryos.  We have 4 perfect embryos, so they will just pick one or two of those randomly and thaw.  We have to decide how many to transfer so they know how many to thaw.  

Both the doctor and embryologist said one embryo ought to take just fine, and that two is not necessary, but they'll do it if we want.  The embryologist also said we could thaw one and if it didn't thaw perfectly, we could thaw another and switch to transferring two last minute.  I'm so torn on what to do.  Last time was supposed to work just fine too, so I'm a tad skeptical when they say that one ought to take just fine.  I want to do two to increase our odds, but it also increases our odds of twins drastically. I don't think I'd mind twins, but that would be a lot of change all at once, a lot of extra expenses that I don't know we can afford just yet, and could possibly lead to major complications with the pregnancy.  I'd like to transfer one, but I'm afraid it won't take and we will have to pay again to do another round.  I'm just so torn on what to do; I've done lots of research and there is still no easy decision.  I'm leaning towards just one (two if the one thawed one doesn't look as perfect), but I'm so nervous about that decision.  I just want someone to tell me what to do and take this huge decision out of my hands, while guaranteeing whatever they decide will work out as planned (a girl can dream, right?).

So here are some numbers that I have found in my research and impact my decisions.

Odds:
Our clinic has historically had about 30% success rate with frozen transfers resulting in a baby; the average transfer rate is 1.7, so many people transferred more than one.  The fresh cycle shows a similar average transfer rate and about 42% chance of twins.  Based on my diagnosis, my individualized cumulative odds of success are 48% probability of live birth after one cycle; 69% after two cycles; and 81% after three cycles.  My odds of two cycles with one embryo is 68% probability of live birth and only 3% chance of twins. If I do one cycle with two embryos my probability drops to 57% of live birth and 41% chance of twins.

Risks of transferring one:

• Could not take and we have to try yet again
• Could take and still face complications with the pregnancy
• Could still split into twins

Risks of transferring two:

• Multiple births increase the risk of premature birth and low birth weight in infants. This can affect survival and well-being of newborns. These babies may require special care immediately after birth and at times, can face life-long problems such as developmental disabilities and delays.
• Women who carry multiples may be more likely to need Caesarean sections which may require a longer period of recovery, and at times, can increase the risk of hemorrhage during and after delivery.
• Some who become pregnant with multiples may find one or more cannot survive to term or even a premature birth. This may lead to a medical need to perform fetal reduction.

Beta Test

I'm sure many of you are waiting to hear how the beta test went and if I'm pregnant.  Sadly, it was negative.  It was really rough getting this news just before lunch on Friday.  I'll admit, I cried a bunch and did my best to finish out my work day.  This was one of those days that I'm glad I work in a cubicle and that my coworkers don't often start up conversations.  I wasn't in the mood for talking.  I had texted Spencer, as per our agreement; I don't know how he managed to keep teaching all day long after getting that news.  We have an appointment on Thursday to talk to the doctor about what might have happened and what the steps are going forward.  We still have several more frozen embryos to try again, once we raise the funds we need.  I think our football team is out of the picture, but we could still aim for a baseball team. ;-P

I'm trying to not let this get me too down but it's hard.  This seemed like such a sure thing the way the doctor had described it. I knew our chances were only around 40-50%, but he kept saying how great everything looked, despite our problems.  And I've lucked into having so many issues that have small percentages of people having them, I figured low odds shouldn't be a problem.  Things had been looking up for us, so the universe was finally going to be nice to us. Wrong.  I don't blame the doctor for this not working, he did the best he could and we probably should have taken his advice and done the frozen transfer when he brought it up.  But we were so excited and ready to go. And if it was going to make that much of a difference, why did he wait to bring up the issue until the last possible minute?  He could have mentioned it or had the nurse mention it when I was told to trigger or when we went in for the retrieval.  Or even as the embryos were growing.  Not when we had both taken an entire day off of work for this procedure and were sitting in the office just minutes away from transfer.  Or push a little harder saying your odds of success diminish greatly by proceeding, I highly recommend waiting.  And maybe he didn't think it would really make that much difference and we could proceed with little risk. Maybe he say more on Thursday.  In the meantime, I'm mad and frustrated and disappointed. Mad that we spent about $13k and have nothing to show for it this round but some frozen embryos (and each round after will cost another $3k). Frustrated that I stuck myself with a needle over 30 times and Spencer stabbed me in the butt every night for two weeks with no baby this round.  Disappointed that this is the route we have to take in the first place to make a family and that it didn't work the first time like we had hoped. 

I'm still hopeful that we will be able to do a frozen round soon and that this one will work. We will have to get more loans to afford it though and due to the holidays coming up, it may not be until early next year.  We will know more about scheduling after our appointment on Thursday.  In the meantime, we will do what we can to save money, raise money, and get healthier to give our next shot better odds.  It's definitely been a hard road and part of me regretted going public when I got the bad news. But a bigger part of me is glad I have so many friends and family cheering for us and supporting us. So thank you. Thank you for your prayers and good thoughts. Keep those coming please. Thank you for reading my blog and learning more about this crappy, sucky, roller-coaster of a process.  I'm glad that you know more about what so many women have to go through to have a family.

Knocked up day

Monday, we never got our update from the doctor’s office on how our embryos were progressing, so I called them for the update.  Turns out they’d been waiting to hear back from the doctor on when transfer time would be.  The embryologist said that all 15 of our embryos were progressing well; they want to see 6-8 cells by day three, and all fifteen of ours were at that point. Such great news! They didn’t have a transfer time for me yet, and said they’d call on Tuesday with an arrival time.  Tuesday’s phone call revealed an 11 am transfer time, 10:30 arrival with a full bladder.  I was excited the rest of the day.

Knocked-up Day has finally arrived!! Spencer and I took Zoey to the park in the morning so that she’d be more worn out the rest of the day and not bother me as much. I changed when we got home into clothes that family members had given me.  I had a skirt that Cheryl gave me and a shirt Curtis gave me so that side of my family was represented.  I also wore the “cancer sucks” socks that Paula gave me when David was going through his treatment, so I felt like both of them were with me (I also wore these at retrieval); and to top it off was a sweater Lynnette gave me last Christmas.  I felt like wearing this stuff made the experience a little luckier; Spencer said I looked like Amy Farrah Fowler. 

 

We headed to the doctor’s office.  We got there a little early and checked in.  I was supposed to take two Valium pills when we got there as well as drink lots of water.  Man that stuff kicks in fast! I was so loopy from it.  They took us back and showed up pictures of all of our little embryos.  We have 9 that are excellent right now, so they picked one of those to transfer and the other 8 will be frozen.  Of the other six, three probably won’t really make it to freeze and they will be discarded.  They are going to watch the other three to see if they don’t catch up enough to freeze on day 6. They said because our embryos look so great, they advise against transferring two; that it’s not really necessary and only ups the chances for twins.  Overall, we were very pleased with how many we get to keep and try to build a family with.  Then the doctor came over to talk to us.  He said that because we used the Lupron trigger instead of the hCG trigger (which we did to avoid getting over-stimulated and the complications that come from that), my lining may not be as receptive to the embryo at this time and we could wait and do a frozen transfer for no extra charge (except more meds).  We decided to risk it, mainly because we were so excited for this and didn’t want to wait any longer. We kind of felt like if this were really such a big issue, then the doctor would have put his foot down and said let’s wait or brought it up sooner in the process besides 10 minutes before transfer. Plus we will have 8 frozen embryos we can use in the future if this doesn’t work.  Some further research on Google (I know I shouldn’t!) seems to suggest that Lupron prevents my body from making enough estrogen and progesterone after retrieval, so I have to supplement that with the patches and shots.  While they haven’t done another blood test since right before retrieval, my levels were in the good category then, so I’m hoping that we are doing everything necessary to make this little embryo stick.

Once we decided to go ahead with the transfer, the doctor sent us into the exam room and had me undress from the waist down (nothing new).  Spencer stood next to me to hold my hand and get a better view of the ultrasound screen. The nurse came in to check the bladder fullness; it was great.  The doctor came in a got everything set up.  The speculum was cold (why can’t they warm that thing up?!) and a tad uncomfortable. The nurse used the ultrasound to help the doctor find his way to where he needed to be in my uterus.  Then they called out to the embryologist that they were ready and about 30 seconds later, she came walking through the door with the catheter. She called out my name and birth date to confirm the correct patient, then handed the catheter to the doctor.  He inserted it, released the embryo into its new home, and pulled everything out. Then they tilted back the chair I was in and told me to rest for 10 minutes.  During this time, they came in for me to sign a form saying my name and date of birth were correct when the embryologist called it out.  That was it! I am now considered pregnant until proven otherwise.  Spencer took a few pictures. We asked the nurse to draw some circles on my backside for where the progesterone shots are supposed to go to make sure we were doing it right (and we had gotten pretty close, so yay for us).  I got dressed, went to the restroom, and we schedule our pregnancy test.  We headed home for lunch and an afternoon of binge watching Netflix.  I’m not on strict bed rest, but I’ve been lounging most of the day and plan to go into work late on Thursday, just to give our Baby Wolf time to settle in.  According to the progression charts I’ve seen online, it won’t really implant until Friday/Saturday/Sunday so until then, I’m just going to do my best to encourage it and send it warm, loving thoughts. So excited and nervous at the same time. These next two weeks are going to be so hard to get through.

Update October 8-

Got another call today saying they could freeze two more embryos.  One was AA and one was BC, which is fair/good.  So we had a total of 11 embryos make it to transfer or freezing! Way more than 50% with is what they say is average.  We actually could have us a little football team if they all work out.

We have embryos!

We got the call this morning about how many eggs fertilized.  We started with 17; 16 were good and mixed in with the sperm.  And only one didn’t fertilize! So we have 15 little embryos trying to grow their way into this world!  We are super excited. It’s a huge weight off of my shoulders.  I don’t know why I have to think so negatively, but I was just sure that none of them would fertilize, that we should have done ICSI (where they inject the sperm into the egg), that this was a big waste of money and time and effort.  I guess I’ve just had such bad luck in the last year when it comes to medical issues that I keep expecting the worse so when it doesn’t happen I’m that much happier. I don’t know.  We will get another update on Monday about how many of our embryos are still developing. Here’s to hoping we don’t lose too many. They will also give me a time frame for our transfer on Wednesday.  Oh my gosh this is getting real!

In preparation for transfer, I have to take more hormones. Yay. My favorite so far is the estrogen; mainly because it is just a patch! Haha that’s right! Three patches twice a week. Couldn’t be easier.  The progesterone has been looming over me and Spencer for a while now.  The subcutaneous shots were hard enough to do on my own, I don’t know how I could do an intramuscular (IM) shot on myself.  The doctor prescribed the progesterone in oil, which is given intramuscular. It’s better than the suppositories, but I have been dreading that one and half inch needle for weeks.  I think Spencer has too.  We watched the video on how to give the IM shot and then got everything ready to go.  It took us a while to figure out exactly where the shot goes, but we were finally confident that we figured out exactly which part of my hip to use (FYI, it’s right around my muffin top).  I laid on the bed and was practicing my deep breathing since I was so nervous.  Spencer was nervous too, but powered through like a boss. He found the spot on my hip, cleaned it with alcohol, spread the skin apart, and darted the needle in.  To me it felt like he was barely putting the needle against my skin, like he was testing where to do it.  Turns out, I didn’t feel the shot at all. Nor did I feel any of the medicine going in.  He pulled out the needle, put some gauze on the spot and I laid on the heating pad for a few minutes to disperse the oil.  So in the end, all that worry for nothing.  I’m really proud of Spencer for doing such a great job. I’m sure we won’t get it perfect every night, but at least I’m not as afraid of the IM shot anymore.  I think we could actually do this every night for the next 6 weeks or so (fingers crossed!).

Shot time!

Retrieval Day!

Friday was retrieval day; it’s finally here! I was miserable Thursday night because I was so bloated and my ovaries were twinging a little. I was not allowed to have any water or food after midnight, so I was super thirsty when I woke up.  I also had stress dreams all night where I ate something when I shouldn’t have and my procedure was ruined. I dressed in loose clothing and Spencer drove me to the doctor’s office. We checked in and waited to be called back.  A few minutes later, I was called back and shown back to the pre-op area to get ready.  I changed into a gown and waited while the nurses and doctors got everything prepared. The IV was uncomfortable; the nurse tried it and it didn’t work right.  She had to remove it and asked the anesthesiologist to try.  He got it in, but bruised something or didn’t get it in quite right. All I know is it hurt.  And for some reason, I had some reaction where I went all faint, sweaty, and nauseous.  I threw off the blankets and the nurse gave me a cold washcloth to put on my forehead.  She also had me sniff an alcohol pad to help prevent me from vomiting.  It lasted a few minutes and then I started to feel better.  So weird!  Spencer got to come in and say hello before they walked me back to the OR.

They had me sit on the table and hooked everything up around me.  I lay down and they covered me up. I don’t remember much, just that the meds to put me into deep sedation burned like hell when it hit my arm.  The doctor said it was normal, but I don’t know.  Luckily I was out pretty quick.  I woke up in recovery and was told it all went well.  Spencer got to come back and sit with me, until the nurse seemed to think I was awake enough to get up and change.  After changing, we were sent to consult, where the embryologist came out to speak with us.  They retrieved 17 eggs. I was kind of surprised that it was so low. It seemed like I had way more follicles on the scans, but I guess they weren’t large enough to pull and egg out of.  I dunno.  Still average is about 10-12 eggs, so we are ahead on that point.  One egg was not morphologically normal, and was thrown out.  So 16 eggs to fertilize with Spencer’s donation (which the doctor said had excellent morphology).  We will get a phone call Saturday morning with an update on how many eggs fertilize. This is getting real! 

Transfer is planned for Wednesday; I’m calling this knocked up day.  Like I said, once it gets going, this process goes fast!  We start the progesterone shots tomorrow evening, which Spencer gets to give me. I’m super anxious about these, but trust him.  It will all be worth it in the end.  For now, I’m drinking lots of PowerAde and eating salty foods to keep from getting bloated and keep the water out of my ovaries. I’m crampy and uncomfortable, but it isn’t terrible.  What hurts the most is my hand, which is bruised from the IV and hurts; I’ve spent most of the day with an ice pack on my hand to help keep the pain away.

Rollarcoaster

Oh my so much has happened in the last few days.  This whole process goes in big spurts; lots of waiting and then bam! lots happens all at once.  Now to see if my hormone addled brain can remember everything.

For the most part, Tuesday was a good day; I brought materials to work so that I could build a standing desk. This seemed to help quite a bit with the pain level since I wasn’t sitting all day.  It wasn’t until my evening walk with Zoey that I started to get anxious. We’d spent so much money on this whole process, I didn’t want one little hiccup like getting my medication late to derail everything.  I was looking for the FedEx truck at every corner.  Finally, it came just in time to get home and do my shots at the right time. These were so hard to do; it was a mental challenge to poke those needles into me.  I really hope that is the last set of my shots I have to give myself.  I do not know that I could physically give myself the damn Ganirelix shot again on Wednesday.

Wednesday morning, I had another appointment for blood work and ultrasound.  The blood work went ok. The scan also was fine.  The ovaries are showing lots of large follicles still, but there were some stragglers too, which prompted the nurse doing to the scan to suggest that I might need to do one more day of shots and trigger Thursday with retrieval on Saturday.  This was very upsetting news. I was completely out of Ganirelix and would not be able to order more in time; not to mention that I was tired of giving myself the shots.  I would not know anything for sure until the afternoon phone call.  After the scan, the nurse went over the trigger shot and information for retrieval, just in case it was that night. She showed me how to do the intramuscular shots for the progesterone starting the day after retrieval; those make me nervous.  Before I left the clinic, I received a dose of Ganirelix, just in case I need it.  Either way, I made an appointment for Thursday for more blood work, which could be for pre-op labs or my last scan in case trigger got postponed.

Good news! I got the call to trigger Wednesday night at 8pm and retrieval will be Friday morning.  This turned my day around.  The trigger shot wasn’t terrible, and it was exciting that it was only one shot, not three! My appointment Thursday morning was just for blood work. It was very quick and then I raced back to work to do my second trigger shot. I got to work just in time and did my last shot in the bathroom at work.  So that shot made thirty, 3-0, self-administered shots. I was so excited. No more shots for a whole day!! Haha!  The rest of Thursday was spent chilling and getting some homework done.

Shot/blood draw counter: IIII IIII IIII IIII IIII IIII IIII IIII II

Symptom tracker: ovaries feel like they are each the size of melons (hyperbole I’m sure) and they were twinging by Thursday night, bloated, thirsty, lower back pain, hormonal/stressed out, tired, hungry, acne, some insomnia, sore boobs

Rough day

Sunday morning I had another scan and more blood work done.  Spencer got to come with me this time since it was a weekend.  Blood work went fine.  The scan was fine too. Spencer got to see all of the follicles.  They were measuring a little bigger than Friday at 10-13mm, which the nurse said is excellent progression.  She said that the doctor would make the call for Monday or Tuesday as my next scan and blood work.  The call in the afternoon confirmed that I’d be going in again on Monday.  My estradiol levels were at 2794 and they told me to continue my dosages as usual.

Monday was rough.  My appointment started out ok, or so I thought.  I decided to switch up the arms for the blood draw and go back to the right arm. The nurse couldn’t find a vein.  So we went back to the left arm, where she still couldn’t find a vein.  Sigh. She went and got someone else, who came over and prepped me a little more thoroughly, then found the vein in no time like an old pro.  She bandaged me up and showed me to the exam room.  The scan went fine again.  The nurse said my ovaries are kissing; they are so enlarged they have come together inside me and are way closer to each other than usual.  The follicles were measuring up to about 15mm with many stragglers around the 11mm mark.  The nurse measured about 10 follicles from each side and there were still plenty of smaller ones she ignored.  She said that the doctor would either want me back Tuesday or Wednesday for another scan to see if it’s time to trigger.  If it’s Wednesday, I need more of the Ganarelix; I only have the dosage through Monday night.

The call from the nurse today set off a whirlwind of emotions in me.  My estradiol levels are great, in the 3000s at 3517.  She said that the doctor would like me to come back on Wednesday.  Well crap.  This pushes back the retrieval to Friday, not Thursday like I’d been mentally preparing for.  And I have to order more Ganarelix, so more money and a scramble to locate some.  I need the Ganarelix to be over-nighted or available for pick up.  The nurse gave me the names of a few pharmacies, and I called around.  The first one was going to charge 20 bucks to have it shipped over night, so I said I’d wait and shop around.  I called several pharmacies before finding one that has it and will over-night the medication for free. I called the nurse back and told her where to send the RX. Then I took a break and went for a walk because all of this really upset me.  Pretty sure it was just the hormones and the stress of trying to find the medication I need in such a short window. 

After a few tears, I went back to work. Work in itself is becoming tougher because it hurts to sit down.  My ovaries are so big, they make everything hurt. The ovaries are crampy because they are growing. I’m bloated because of this and the medications.  I’m thirsty all the time, so I down water like no one’s business.  This means my bladder is always full and pushing on much more crowded pelvic cavity.  It feels better to stand but that’s difficult without a standing desk.  I use two boxes to raise my keyboard and mouse then angle my computer screens upwards more.  This works ok, but my feet start to hurt after a few hours of standing.  Driving is worse because I can’t move around and the seat belt pushes on my belly.  I’m also hungry all the time; eating large meals is uncomfortable, so I have to eat a little at a time, but then I feel like all I do all day is eat.  I know most of this is temporary but it’s harder to deal with because of the hormones.  Today I think it was worse because I have to put up with it all for another day. Before this afternoon’s phone call from the nurse, I only had to make it to Tuesday when we trigger, then Thursday for retrieval.  Now I won’t trigger until Wednesday at the earliest and retrieval won’t be until Friday.  I can do this. Suck it up and get through it, is what I keep telling myself.

In the meantime, I haven’t felt like doing homework, so I starting to stress out about falling behind in my classes.  Just a lot of overwhelming feelings right now.  Most of it self-inflicted because of my procrastination.  Here’s to hoping this is all over soon and we get enough eggs to not have to do this again.  I have no idea how some women stand doing this for three or four rounds (let alone fund that many attempts). 

Shot/blood draw counter: IIII IIII IIII IIII IIII IIII II

Symptom tracker: ovaries feel like they are each the size of melons (hyperbole I’m sure), bloated, thirsty, lower back pain, hormonal/stressed out, tired, hungry, acne, some insomnia

The one week mark

The Ganarelix I added on Thursday is not good at all.  The first time I used it I had all kinds of issues.  There was a bunch of air bubbles in it that just didn’t want to come out.  I finally got those out and prepped my tummy for the shot.  The needle gauge is in between the two that I’m already using, so I figured it’d go in easily.  NOPE! I ended up pricking myself twice before I finally got it to go in all the way.  Then it burned! I had a red splotch on my belly for over an hour, which according to Google searches is a normal side effect the first use.  And it continued to burn for a while after the shot too.  I’m glad this wasn’t included since the beginning, but sad that I’ll probably end up using all 5 of my doses of it.

The appointment on Friday went well.  I asked about why my nurse appointment was changed to a doctor’s appointment and the doctor just mentioned that they were going to a conference and wanted to see me one last time so my case was fresher when doing the phone consults over the next week.  So no problem with me, just a routine appointment.  The nurse had trouble drawing blood out of my right arm, so we had to switch to the left arm.  This one worked and I guess I’ll lead with it next visit. The scan went well too. The doctor said that my lining was looking good and measured my follicles again.  They were up to about 10-11mm.  The doctor said I have a good number of follicles and will be very full by the time of retrieval.  Oh boy!

The nurse called earlier in the day and said that my estradiol level is 1176, which is great.  She said to continue doing my same dosages for the next two nights and they’ll see me on Sunday morning for more blood work and a scan.  I should learn more about when my next appointment after that is, Monday or Tuesday, and hopefully get a better idea of how the next week will look with retrieval. It’s getting so close yall! The shots went ok Friday night; the Ganarelix was a little better, but still stung for a bit after it went in. 

Shot/blood draw counter: IIII IIII IIII IIII II (as of Saturday night)

Symptom tracker: Bloated in evening, ilioscaral joint aches, thirsty

Things are speeding up!

Tuesday was my first blood draw after stims had started. I got to the doctor’s office first thing at 7am and had to wait a little while before they called me back.  She drew my blood and that was it.  I made sure to drink lots of water before this appointment so the blood draw would go easily.  I also asked the phlebotomist if it was normal for one side of my belly to hurt more with the shots than the other, thinking about how much more the left side hurt the second night compared to the right side on the first and third nights.  She said that was normal and that I could do all of my shots on my right side if I wanted to.  I’ve decided to give the left side a second chance; that perhaps I was just doing something slightly wrong. 

By the afternoon, the nurse called back with my estradiol level – 406.  She said this was excellent and to keep my dosage the same that night.  She also said that they wanted to see me Wednesday instead of Thursday for my first scan.  I made the appointment with one of the physicians doing the scan since the nurse I spoke with wasn’t available.  It got me really nervous that my scan was moved up and that my numbers were so high already.  My mind started jumping towards having too many follicles growing already and that I was headed for a difficult experience. 

Shots Tuesday night were done at my parents’ house because we went over there for my dad’s birthday dinner.  I tried it in my left side again and it worked okay.  I think I wasn’t darting the needle in quick enough the second night.  I still don’t like the Menopur needle because they are slightly bigger than the Gonal-F pen.

The appointment this morning went a long way towards easing my mind.  I got my blood drawn after I got to the office. Then I was shown to an exam room and got undressed from the waist down.  The doctor came in and asked how I was feeling.  So far my main symptoms have been bloating/gas and a bad back ache, which I told her.  I guess those are normal, because she didn’t really have much to say about that.  Then she proceeded with the ultrasound, measuring my lining and the largest follicles on each ovary.  She said my lining looked great. I have 3-4 follicles on the right ovary measuring about 7-8mm each, plus lots of smaller ones that ought to catch up.  My left ovary had 2 large follicles each measuring 8-9mm, plus many smaller ones.  My cyst is still there, but is small and didn’t seem to worry the doctor.  She said I’m progressing just fine and is exactly what they want to see.  I mentioned to the doctor that I was worried about my exam being moved up and she said it’s normal; they are just trying to figure out when to start the antagonist (Ganirelix in my case; this is what keeps me from ovulating on my own).  That put my mind at ease.

I got the phone call from the nurse later in the afternoon. She said my estradiol level is at 592.  I’m supposed to start the Ganirelix on Thursday.  The part that makes me more nervous again is that she wanted to change my appointment so that a doctor does the scan, not a nurse.  I’m sure it’s nothing, but it seems like maybe I could be kind of high risk if the doctors have to keep doing my scans and not just a nurse.  I’m probably worrying too much.  But I’m actually surprised at how zen I’ve felt about most of this experience.  I expected to be much more anxious about every little detail.

Shot/blood draw counter: IIII IIII I

Symptom tracker: Bloated, slightly crampy, ilioscaral joint (where hip bones meet the back bone) aches, hungry

Pokey pokey

Yesterday morning was an appointment for a blood draw.  They were testing the LH levels in my blood in order to confirm the dosages I should inject myself with starting that night.  We got there just in time for our 8:15 appointment, even with stopping to put a few gallons of gas in the car because I forgot how low it was.  We had to wait for nearly 20 minutes before the nurse came back to grab me. She asked on the way back to the phlebotomy lab if I’d had any water today. I hadn’t because I was in such a rush to get out of the house.  She gave me a water bottle and told me to drink it.  After drinking about half the bottle very quickly, she started to look at my arm to see if she could see a vein.  She poked my arm but didn’t think it was going to produce enough, so she took the tourniquet off to start a new poke. That sped up the flow and she got what she need without poking me again. Yay!  That was everything for the appointment; they will call with the results that afternoon.

First of many early morning appointments

I got the call in the afternoon that my LH level was just above 1, which is what they want to see.  So my paper with the dosages that I’d gotten earlier in the week still reigns true and I was supposed to start those that night.  We had already made plans to go over to Bill and Rachel’s Saturday evening to watch the new season of Dr. Who premiere.  I took everything I needed for the injections over there so I could do them at the right time.  I decided 7pm ought to be a good time for the next few weeks. So around 7, I got everything out. Spencer helped me with the directions and I prepped the injections.  We took everything one step at a time.  I did the Gonal-F first; I just dialed up the dosage and put a needle on the pen.  Then pushed the needle in and pushed the button. The pen did all the work. After I the pen finished the dose, I pulled it out and capped the needle.  That shot didn’t even hurt.  I was kind of excited.  The menopur was more complicated because I had to mix it myself.  I got out the new syringe and put the mixing needle on it.  I used it to draw out 1cc of the sodium chloride solution and inject it into the powder.  I swirled it around and then drew it out of that vial and injected it into the second powder vial.  I took two doses of menopur; so once I was done with the second powder vial, I changed out the mixing needle for the injection needle.  I felt like a lost a little bit of the dose because of my inexperience with the syringe; I think I got enough of it though.  This needle was slightly bigger than the first one, but it still didn’t hurt going in.  Once I started to push the plunger down and insert the menopur, that burned a little.  I read somewhere that it burns because the sodium chloride, but who knows.  This shot wasn’t too bad either.  Once I was done with it, I capped the needle and threw it out in my sharps container.  That was it. I cleaned up all the wrappers and was all done.  Time for ice cream, which is my reward for needle pokes.

My daily medications

 

Today’s injections were a tad different.  Now that I had done it once, I felt more comfortable prepping the injections.  I feel like I did a better job of that.  But the left side of my belly doesn’t like the needles as much.  I felt the needles going in today. L The medicine burned still going in too.  I hope this was just a fluke and they go back to being nice and easy like yesterday.  I was so pumped at how easy it was yesterday, but I’m starting to lose the excitement and confidence since today’s shots were worse.  I guess I’ll know more tomorrow.  Maybe I’ll get some numbing cream or ice my belly first.  I do more shots on Monday, then go back for another blood draw on Tuesday, where I get my new dosages depending on how I’m responding.

And so it begins...

We had our baseline appointment today; the only directions were to arrive with all of our meds and a full bladder.  They started by drawing blood to send to the lab, then put us at a table in the coordinator’s office to wait for everything to be ready, because apparently we were early.  We got moved to an exam room where I was told to undress from the waist down and sit in the exam chair under the orange blanket.  I had to pee so bad this whole time, which I was hoping would be the worst part of the whole process.  The nurse checked my bladder to ensure it was full enough.  Then the doctor finally came in to do a mock transfer.  He put a speculum in to open me up (it was really cold); the nurse used the ultrasound equipment to show the doctor what he was doing as he inserted a few more tools.  After “tickling” the top of my uterus, which felt more like cramping than tickling, we were done.  It was uncomfortable for sure, especially with the cold speculum and the nurse pushing on my full bladder; but it wasn’t unbearable.  The doctor said when we do the real transfer I’ll have some valium so I won’t be as nervous.  Haha, can’t wait! After that, I cleaned up, got dressed, and finally got to pee! 

Then we met with the IVF nurse to go over medications.  She double-checked to make sure we ordered everything we needed.  Then she showed us how to do the injections.  The Gonal-F seems rather easy; I just dial the pen to the dosage required and then poke it into my belly, an inch away from my belly button.  Hold the button for 3 seconds and pull it out.  Recap it and put back in the fridge for the next day.  The menopur seems a little more complicated.  I use one vial of liquid and two vials of powder and have to mix it each night.  I take 1 cc of liquid out of the vial and throw that out.  Then inject the liquid into the first vial of powder, swirl it around until the powder is all dissolved. Then I pull the liquid out of that vial and inject into the next vial. Repeat process and then draw it back into the syringe. I change out the needle and inject this into the same spot as the Gonal-F.  I am supposed to alternate sides each night to keep the bruising and discomfort to a minimum. I’m also supposed to take the meds at the same time every night after 6pm. I think we decided to do 8pm so I will probably be at home each time and so I can have ice cream afterwards. Ice cream is going to by my treat after each poke in this whole process. These are the only meds I’m using for the first few days. I go in on Saturday for more blood work and then they will tell me what to take.  This whole process is planned out tentatively up to the trigger day, but could change as we move along and blood work and scans come back.  Everything is spelled out in detail and the nurse is only a phone call away.  Hard to believe that the time has finally come! I probably won’t write again until the adventure of Saturday and my first injections. 

Here is a shot of my meds from when I unpacked them:

 

What is PCOS?

PCOS, or polycystic ovarian syndrome, is a hormonal imbalance that affects 5-10% of women of childbearing age.  It messes up a woman’s period and causes infertility, as well as changing one’s physical appearance and possibly leading to diabetes or heart disease.  Most women with PCOS have many small cysts on their ovaries, hence the name; these cysts are not usually harmful but cause hormone imbalances. Ovaries of women with PCOS make too many androgens (or male sex hormones).  This causes irregular ovulation, acne, and extra hair growth on the face and body.  Women with PCOS often have a problem using insulin, or insulin resistance; this leads to elevated blood sugar level and increased risk of diabetes.

Symptoms of PCOS begin mildly and only a few at a time. They include acne, weight gain, extra hair on the face and body, thinning hair, irregular periods, fertility problems, and depression.  [I had almost all of these within six months of going off of birth control.]  Diagnosing PCOS involves a health history, physical exam, blood work (to test blood sugar and hormone levels), and a pelvic ultrasound to examine the ovaries.

Regular exercise and healthy foods are the key treatments for PCOS.  Birth control pills can reduce symptoms. Metformin, a diabetes medication, can help regulate your blood sugar levels and help encourage a much more regular menstrual cycle.

Some websites with good information about PCOS that I used after my diagnosis:

• WebMD – Polycystic Ovary Syndrome Topic Overview (http://www.webmd.com/women/tc/polycystic-ovary-syndrome-pcos-topic-overview)

• What is PCOS- PCOS Foundation (http://www.pcosfoundation.org/what-is-pcos)

• Polycystic Ovary syndrome (PCOS) fact sheet (http://womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html)

So what is In Vitro Fertilization?

After talking with the doctor and learning about all of my issues, we decided to proceed with IVF once we got the funds together.  Our post-op appointment was a lot of paperwork signing and questions answering.  Doctor said we have about 46% chance of success with a single embryo transfer and 57% with two (however, this also comes with almost 40% chance of twins compared to about 2% with one embryo).  So we are electing to go with just one for now.  I guess if the embryos don’t look as perfect as we want, we can always bump it up to two at once.  IVF uses medications to stimulate the egg follicles in the ovaries and encourage them to grow.  Some women with PCOS already have lots of follicles, so there is a chance that they will become over-stimulated and develop OHSS (Ovarian Hyper Stimulation Syndrome).  The doctor said that I would have a low chance of hyperstimulation because of the protocol they are going to put me on, but this is something that worries me a bit.  If I were to get OHSS, then we would most likely have to freeze all of the embryos and do a frozen transfer later.  

Basically, they will take me off birth control pills, and four days later start injections.  After 10-12 days of hormone injections and lots of scans and blood work to monitor the growth of my follicles, I will trigger the eggs to release. Before my body actually releases the eggs, they will do the retrieval and fertilize the eggs.  About 5 days later, they transfer the embryo into me.  After that, I have to wait almost two weeks to find out if the embryo implanted or if it was a failed cycle.  Hopefully we get a quite a few eggs.  The odds are that you lose about half of the eggs retrieved between retrieval and transfer/freezing.  Our hope is to get several embryos, transfer one and freeze the rest for future frozen rounds.  The frozen round costs quite a bit less money, so hopefully that’s how we can get baby 2 and 3 if it’s in the cards.

How this crazy journey all began...

Hubby and I have been trying to make a baby for over a year now. I think it’s safe to say that both of us thought it would be quick and easy to get pregnant since we are both rather healthy and young. After nine months of trying and increasingly erratic cycles, I finally went to see the doctor after my period was late but pregnancy tests were still negative.  2 doctors, lots of blood draws, a 24 hour urine test, and two ultrasound scans (one thyroid and one pelvic) later, I finally had some answers: PCOS (polycystic ovarian syndrome).  The pelvic ultrasound also revealed that I had a cyst in my left ovary and my right fallopian tube was blocked.  I decided to have surgery to remove the cyst and fix the tube so that we have a better chance of conceiving.  This surgery was much shorter than planned since once inside he found that I have stage IV endometriosis and closed me up instead of proceeding.  So basically, with both endometriosis and PCOS, IVF is likely our only option for getting pregnant; because of this we got a referral to a fertility specialist to find out what they suggest.

Dr. D is who we picked for our fertility specialist. Our meeting with him in mid June was a whirlwind.  We discussed my background and infertility, then he did another pelvic ultrasound, which was uncomfortable because of my endo. He definitely confirmed PCOS since I have about 30 or more follicles on each ovary.  He also informed us that the cysts were actually endometriosis on the ovary, forming “chocolate cysts”. These are basically pockets of blood in my ovary that have no way to drain, so it’s just nasty old blood trapped in my ovary. Gross!

After the exam, we went back to his office to talk.  Dr. D said I have lots of eggs, so that is good.  In order to remove the endometriosis more permanently, he’d have to take out a chunk of eggs as well, so he wants to wait on that.  He said with the tube blockage, the cysts on my ovaries, and my PCOS, about our only chances for pregnancy is IVF. I have both the hormonal and structural problems that are associated with infertility; luckily, hubby has good sperm.  He recommended the option that requires less egg stimulation since I have so many follicles. The doctor also recommended optimizing my plumbing before starting IVF.  This involves removing my right tube and draining the endo cyst on my right ovary.  This will prevent complications during the IVF procedure and pregnancy.  Apparently my tube drains into my uterus because it cannot go out the normal way into my pelvic cavity.  This can cut my success rate by 25% for IVF/pregnancy.  With the endo cyst, removing eggs could puncture the cyst and cause bacteria-ridden old blood to leak into my ovary, infecting it.  We opted for the surgery, especially since I’ve already met my out-of-pocket max with the insurance which means it’s free.

The surgery went ok. My recovery was a bit tougher than the last time, dealing with a few complications like constipation from the pain meds and my endo flaring up later in the week.  I started birth control pills so that I won’t have a period for a while; the nurse told me I could just skip the sugar pills and go straight to another package, so that’s what I did in order to avoid the endo pain associated with my period.   The next step is to get our IVF scheduled and paid for, but I’ll save that for another post. 

Welcome!

Hi everyone,

I've decided that I want to document our journey with IVF (in vitro fertilization) so that others can understand more about the process.  I feel like this is such a mysterious journey that only the unlucky few have to take.  So many people I've spoken with recently know very little about the process (I was included in that category just six months ago!) and I want to change that.  I hope to provide some education and awareness for IVF, PCOS, and endometriosis with this blog as well as have a lasting record of how we got our future kid.  I've kept a diary of sorts since this all began in February, so I'll probably go back and post some of what I wrote in the past, in addition to documenting everything I can once we start IVF next month.

Thank you for reading and supporting us.  I can't even begin to describe how great it feels to know so many people are rooting for us and care about us.  Please feel free to leave comments and ask questions as we move forward. Nothing is too personal to me anymore, but I might privately answer any questions that may not belong in public.

Love,
S