Sunday, February 28, 2010

Day 33: We're Still In It

We were pleasantly surprised to see our Dr. meet us at our 7:30 appt this morning. He walked in saying my Estrodiol numbers from yesterday were a bit high, so he wanted to check me out. Recognized he was being extra methodical, but really wants to be cautious with me. I like cautious.

From the few comments he provided, it sounds like my ultrasound showed him that things were so far so good. I had approximately 9 follicles developing on my left and 15 or so developing on the right. No wonder I feel so fat and bloated. My ovaries are working overtime.

Estrodiol report from this afternoon had my level now at 531, just about double what it was yesterday. Dr. has advised us to reduce our Follistim to 75 units tonight and tomorrow and then down further to 50 units on Tuesday. I'll be back in on Tuesday morning for another set of blood work and ultrasound.

So much of this IVF process is about Faith. Faith in our Dr. figure out the treatment and drug levels right for me. Faith in my body to respond as it should. Faith that one day the baby we've dreamed about for so long will be ours.

Saturday, February 27, 2010

Hormones are Here

The hormones are taking over. I've cried 2x in less than 24 hours and I am on the constant verge of tears.

First set of tears came last night because I was feeling FAT. My jeans are tight, some of my work pants don't even fit. The belly is bulging. I know all of the things you guys are thinking: "It is for a good cause. This is just the start, it is natural to gain weight. Its just the hormones. You are not fat." My head knows these things to be true and to be honest, I don't care. I feel FAT and it makes me sad to sit at the dinner table with my button undone. Being pregnant and getting fat is one thing. Being infertile, doped up on hormones and feeling fat is another.

The second set of tears came tonight when something I had planned just didn't work out. It wasn't a bit deal, I was just frustrated and a typical (hormonally balanced) response would include disappointment. It wouldn't include 15 minutes of crying hysterics.

Day 32: Getting Nervous

Today is Day 3 of the stimulation part of our IVF cycle. I went in this morning for some blood work to check on my response thus far to the meds we've been shooting up. The nurse just called and said my Estrodiol level was already up to 280 (it was less than 25 on Wed) and they want to reduce my dosage of meds and see me tomorrow (Sunday) morning at 7:30 am for blood work again and an ultrasound.

They are concerned about the rapid rise of my Estrodiol and therefore the risks of OHSS (Ovarian hyperstimulation syndrome). Normally a woman produces one egg per month, however in IVF you are taking drugs with the hopes of stimulating multiple eggs. If the drugs stimulate the ovaries too much, the ovaries can suddenly become very swollen and fluid can leak into the belly and chest area. Due to my body weight and my historical ovarian response, my risk for OHSS is quite high and the Dr has always been clear with us on the chance of cancellation depending on my response.

So we'll go in tomorrow and see what's happening. I am so scared that they'll think the risks are too high and decide to cancel my cycle. I'll be DEVASTATED. I am 32 days and 21 shots into this, I can't even comprehend the thought of having to cancel and start again. Fingers crossed my ovaries are working hard, but not too hard...

Wednesday, February 24, 2010

Day 29: Green Light

We got the news this afternoon that my ultrasound and blood work look good and we got the official GREEN LIGHT to proceed to stimulation. YAY! Now we're officially in to our IVF cycle!! Mature follicles. Fertilized eggs. Good quality embryos. Positive pregnancy test. And baby, here we come!

We'll spend the next 8-12 days stimulating my ovaries with the goal of creating a handful of good quality eggs. We'll need to rely on the expertise of our doctor to help us find the right balance between quality and quantity.

Tomorrow our routine will transition to a total of 3 shots per day for me plus the continuation of the low dose aspirin and the prenatal vitamins. They're starting me off on 150 units of Follistim 2x per day, plus a continuation of the Lupron at a reduced dose of 5 units.

The husband has been put on antibiotics for the next 10 days to ward against infection so he's joined me in the drug use.

I am so excited to be finally, finally at the starting line. Here we go!!

Tuesday, February 23, 2010

Day 28: Suppression

I can't believe 28 days have passed. The dreaded suppression phase of this process is 1 day from being over and now the real 'fun' can begin.

Tomorrow I'll go in at 8 am for a suppression test. This will include blood work and an ultrasound. I am not quite sure what they are looking for in these tests, but I hope and pray that everything looks good and we'll have the green light to proceed to stimulation.

Fingers crossed...

Monday, February 22, 2010

Day 27: Getting Better

We've figured out if the Husband jabs the needle into my belly quickly it doesn't hurt so much. Only drawback to this approach is that it typically draws a bit of a blood.

Previous to this jabbing technique he'd be a bit more deliberate (aka slow) with the entry and the withdrawal.

We're 10 shots into this process and learning a few tricks along the way...

Sunday, February 21, 2010

Day 26: Informed Conset

We had our "Informed Consent" meeting with the Dr. on Friday morning. The purpose of the meeting was to sit down with the Dr. and ensure that we're all on the same page and understand the risks prior to entering the stimulation phase of the IVF cycle. I think the meeting is really designed to talk some sense into patients who might want to be the next John & Kate + 8.

Given the fact that we're entering this process very sensibly, the meeting went smoothly and there were no surprises or concerns on either side. Our absolute top priority in this process is a healthy baby and we will be working with the Dr. to maximize our chances for this single goal. We don't know what the next few weeks will entail and how my body will respond to the treatment, but the best case scenario would involve a single, good quality embryo transferred on Day 5.

Birth control is behind us and we just have 3 more days of suppression...we're getting close!

Thursday, February 18, 2010

Day 23: Bills, Bills, Bills

Over the past 3 days - Tuesday, Wednesday, Thursday - I've opened my mailbox to find the following bills:

NW Reproductive: $177.37
NW Reproductive: $435.00
Dynacare Laboratories: $114.00
Dynacare Laboratories: $193.75

Nothing like coming home from a hard day at work only to find bills waiting for you. Hard to believe these costs are ABOVE and BEYOND the 5-figure lump sum we've already paid.

You go in and they tell you that they need to do a "Gram Stain-C" test or a "Anti-Mullerian Hormone" screen and they take blood or they do the procedure and 4 seconds later it is done. You never get an estimate beforehand since it really isn't a discussion whether or not you'll do the test. You only find out weeks later when you get the bill in the mail what it all costs.

The financial burden of this process is sometimes difficult for me to comprehend and accept. But it becomes more and more real as I get used to handing over the credit card to pay the piles of bills. I've always believed money doesn't buy happiness, but I can't but feel we're trying to buy our baby...

Wednesday, February 17, 2010

Day 22: Luck

We're not Chinese, but in honor of Chinese New Year on the 14th, my mom gave us a very meaningful hand painted banner to place above our bedroom door. Chinese people believe they can attract Good Fortune and avert misfortune into by speaking "lucky" words and surrounding themselves with "lucky" objects. Lucky pictures and patterns are pasted on doors, windows and walls the of home to bring good luck and ward off misfortune.

The sentiment of the message she gave us was perfect and every time I head in to our bedroom, I can't help but glance up at the red banner and think of our wish. Although I'm not typically a superstitious person, this process has made me desperate for help from any and all powers that be. We need all the luck, prayers, wishes, and hope we can get.


Tuesday, February 16, 2010

Day 21: Side Effects

Day 4 of Lupron shots, Day 19 of birth control pills. I told the Husband this morning after he gave me my daily shot, "I'm sort of done with this already." Sad part is that I've only just begun...

The drug side effects are kicking in and I have a feeling this list will get longer as I work my way through my chest of drugs over the next 6 weeks.

Side Effect 1: Sweating
Thanks to the Lupron I've begun to experience horrible hot flashes and night sweats. I wake up several times a night soaked in sweat. I've always been a warm weather gal, but sweating in bed is pretty gross. The first night I thought someone cranked the heat up in the house, then I realized it wasn't the air that was hot, it was me.

Side Effect 2: Spotting
Thanks to the birth control, I've been experiencing spotting or 'break through bleeding' for the past 9 days. I finally spoke the nurse about it today and she didn't seem too concerned. I guess it is sometimes a side effect of a low dose birth control pill like the one I am on. I really hope that is all it is and not some type of infection caused by the SHG test a few weeks ago...

Monday, February 15, 2010

Day 20: Lupron Time

It's been about a week since my last blog post. I'm still here, just been busy entertaining family. My parents and my 32-week pregnant sister were in town for a visit. The main purpose of the visit was to help get my sister ready for the baby so I knew going into the visit, it was going to be hard on me. And it was. I could see the excitement in both my parents and my sister, and I couldn't help but fight back tears and repeat to myself over and over again: my turn will come...

With 20 days gone by since we started our IVF cycle, I am so happy that the first phase is almost behind me. Just 4 more days of birth control!! Saturday marked another milestone for our cycle, the start of the Lupron injections. I now have 35 days straight of shots to look forward to...now the real fun begins.

Lupron is used in conjunction with the birth control pills to suppress my reproductive system, basically propelling my body into premature menopause. Fun times. DRs use it in IVF to suppress the pituitary gland and prevent premature ovulation. I am on 0.20 cc or 20 units per day given between 6-8 am along with the birth control and the baby aspirin. The shot is given in the belly about 2 inches away from the belly button. The husband has been playing DR and taking care of all of the details. I just need to stand there and look away and he takes care of the rest:

- Step 1: Wash hands thoroughly
- Step 2: Open up a clean needle/syringe
- Step 3: Open an alcohol wipe and clean the top of the Lupron bottle
- Step 4: Draw back syringe to appropriate dose level
- Step 5: Stick needle into Lupron bottle and push out air into bottle
- Step 6: Turn bottle/needle upside down
- Step 7: Draw back the liquid medicine to appropriate dose level
- Step 8: Remove needle, check for air bubbles
- Step 9: Prepare injection site by cleaning with alcohol wipe
- Step 10: Insert needle, push in medicine, watch wife cringe

The needle used for Lupron is slightly longer than the ones we've used for other medications in the past and for some reason it is a bit 'sticky' meaning it doesn't go in as smoothly as the others. That said, the pain only lasts for a few seconds and we both know that those few uncomfortable seconds (for both of us) is worth the lifetime of happiness we are working toward...

Saturday, February 6, 2010

Day 11: Normal

As mentioned in my Day 2 post, when we went in for our baseline testing I got a whole slew of blood work done. The great thing about our clinic is that they have an online patient portal where you can log on and see all of your test results as they are available. The good news is that the information is available to you, 24/7, pretty much real-time. The bad news is that you are looking at this information without an explanation by a Dr. and seeing a data value without any context is confusing and frustrating. We have an appt scheduled with the Dr. to review the results on the 16th, but that is still over a week away!

So what's a girl do? One word: GOOGLE!

I finally took the time to review the results for all 15 tests that were administered. Since I didn't know what any of the tests meant, I researched what each of the tests were evaluating and then looked for info on what normal data values should be. Good news is that based on all of my very scientific Internet research I am very NORMAL.

The one hormone that I see referred to often in the IVF books I've read and the in all of the literature published by the clinic is FSH (Follicle Stimulating Hormone). FSH levels directly correlate to the number of eggs that you have "on reserve" in your ovaries. The term "ovarian reserve" refers to a woman's current supply of eggs, and is closely associated with reproductive potential. In general, the greater the number of remaining eggs, the better the chance for conception. Conversely, low ovarian reserve greatly diminishes chances for conception. As a woman ages, FSH becomes elevated in an attempt to force the aging ovary to respond, so high levels are bad, low numbers are good.

In the data from the clinic we are working with they say their success rates with IVF are highest (65%) in patients with FSH under 12.0. The good news is that anything under 10.0 is normal and my results were 6.0 mIU/ml!!

So it looks like I have lots of eggs ready to go and anxious to meet up up with The Husband's sperm and make a baby for us.

I am feeling hopeful. With my uterus "looking good" and my ovarian reserve seeming plentiful, we have lots of things working in our favor and our chances of a positive outcome are looking good. Fingers crossed.

Thursday, February 4, 2010

Day 9: "Looks Good"

Two words to describe today's procedures: uneventful & uncomfortable.

I was instructed to have a full bladder before arriving at the clinic. When I checked in they asked me if my bladder was full. Despite the 2 glasses of water I drank before I arrived, I made the mistake of wavering in my answer so they handed me a bottle of water and instructed me to drink more. In the 20 minutes we were waiting I drank the entire bottle of water and quickly went from having a feeling of fullness to feeling pretty uncomfortable. Now with what I'd describe as overly full bladder it was time for the procedure. I undress, waist down, hop up on the table and they begin the trial transfer procedure. The reason they ask for a full bladder is that it straightens out the cervix which makes the entry into the uterus easier. To do the trial transfer they use an ultrasound monitor on your tummy (to see the uterus) and then insert a long plastic catheter watching it enter the uterus on the ultrasound. The pressure on the full bladder from both the top and inside was pretty painful. The good news is that the long catheter slipped right through and the Dr. exclaimed "that was easy" and was done.

Next up was the SHG, which is a test they do using saline and ultrasound guidance (vaginal this time) to take 3D images of the uterus. Lots pushing on the bladder and of cramping during this one, but thankfully the Dr. was kind enough to stop mid-way through and let me empty my bladder. Maybe my clenched fist and distorted face was indication enough that I was miserable. He finished up the procedure and didn't see anything unsual. Everything looked good.

Now I've been having mix feelings about our Dr. since we've first started working with him a few months ago. I have no doubt that he is a very smart, very experienced Dr. In fact, he just got elected as a 2009-2010 Best Doctor in America for his contributions in the field of reproductive medicine. So no doubt, he is one of the best. And one of the best is exactly what we want.

Problem is that he is a bit too reserved for me. During these tests (and others we've done before) he sits quietly (I'd like to think he is REALLY concentrating) and completes the procedure, looking at the monitor, taking measurements, taking screenshots. Then at the end of it all he might say something like, "looks good." Really?!? That is all the info I get? I wish he'd throw me a bone like "wow, this uterus looks amazing" or "these ovaries are wonderful." But no, I get 10-15 minutes of relative silence and then I get "Looks good." I clamor for more information and follow-up with questions, but his answers are just as brief. I always leave the clinic wanting more, information that is.

Anyway, bottom line is that the trial transfer went smoothly and my uterus "looks good" which is great news. I am feeling crampy, bloated and uncomfortable which isn't good, but I know this feeling will pass and left behind will be the reassurance that everything "looks good" as we head deeper into our IVF process.

Wednesday, February 3, 2010

Day 8: Busines as Usual

Today flew by. I was so slammed at work I had very little time to dwell on my infertility struggles. Big day tomorrow, I'll go in to the clinic for two procedures:

1) SHG - A saline ultrasound for the diagnosis of uterine abnormalities. Since the first clinic we were with for 6 months thought I had a funky uterus (which they fixed with surgery) I am curious to get a 2nd opinion from this Dr. before we get to far in this process.

2) Trial Transfer - An practice transfer under ultrasound guidance with the same catheters and techniques that will be used for the actual embryo transfer in a few weeks. During the trial transfer they will take measurements and make notes that they can refer to during our embryo transfer. Since I am a firm believer that practice makes perfect, I am all for this trial procedure.

I also have an acupuncture appointment in the evening so it will be a busy day tomorrow. I'll write up a report with the results (hopefully all good) tomorrow night.

Tuesday, February 2, 2010

Drugs. Drugs. Drugs

I got my shipment of drugs today. They arrived via FedEx overnight and the goods were packed in cold packets as some of them require refrigeration. As I opened the box and examined the contents, for the first time since starting this process I was scared. The thought of all of those drugs (most via injections) entering my body over the next 6 weeks overwhelmed me and tears came to my eyes.









Day 7: Impatience

It hit me as a stood at the bathroom sink this morning taking my 6th birth control pill that I still have a long few weeks to go in the suppression part of our IVF cycle.

The positive, glass half-full part of me says, "yeah! 1 week down, only 3 weeks to go!"

The negative, discouraged part of me is nagging: "geez, you won't be starting the stimulation part of your cycle until March. That is like a month away. 3 more weeks seems like F-O-R-E-V-E-R."

Today the negativity is winning out. 3 weeks seems like an eternity to me right now. 3 long weeks. 23 more days. I am feeling impatient and annoyed that we just can't jump in bed, have sex and make a baby like everyone else.

I am feeling sorry for myself. I know it. (and today, I don't really care).