Day 52: Negative

At 1:00 pm on the nose, we got the call we'd been waiting for. It came earlier than we expected (we were told between 2-5 pm) so we were out on a walk enjoying Lake Washington and the sun. I stopped dead in my tracks on the trail when the phone rang and the familiar 425 number appeared on screen.

"This is blah blah from Northwest Reproductive. I wish I had better news...."

It was in that moment that my throat constricted, my eyes welled with tears and I said: "It's negative, isn't it?"

"Yes, yes. I am sorry to tell you, you are not pregnant."

I don't remember much more of the conversation. I do remember the tears and sobs that came as I hung up the phone. The Husband was standing next to me and could tell the news immediately. He gracefully put his arm around me and led me to a nearby bench where we sat and cried. I am not sure how long we were there, my guess is about 35-40 minutes. Not too many words were exchanged during that period. Just the occasional "I can't believe it" or "where did it go wrong?"

The first and only phone calls I made were to my mom and my sister. I could barely choke the words out, "It didn't work." They were so sad for us, as were all of our friends. It seems that everyone wanted this for us just as much as we did. Today, we were all collectively disappointed by the news.

It's funny. I think deep down I new it was negative. As much as I tried to remain positive over the past 10 days, something in my gut told me this wasn't it. I tried and tried to bury that feeling with lots and lots of positive thoughts. I'd remind myself that the odds were on our side. 65% chance of it working. I'd talk to the Bean (that is what we nicknamed our embryo) everyday and rub my belly, but somehow I knew the Bean wasn't there talking back. The fact that I was scared and not excited to test, was further proof of my doubt.

But regardless of this intuition, I still held out hope and the news still managed to hit me like a ton of bricks. I am devastated. I never thought it was possible to feel this much pain and disappointment. My mind continues to race with thoughts of what happened, what went wrong, what will happen next. My heart continues to grieve for what could have been. My eyes can't seem to stop with the tears.

But despite the pain and sorrow we feel today, I know that life will go on. I know that tomorrow will be a new day. I know that we will try again.

I know that some day I will be a mother.

Day 50: A Moment of Weakness

I stood in the shower tonight and had a moment of weakness thinking, "All I need is a home pregnancy tests and the answer would be mine!"

I went back and forth on the pros and cons of an early test while I stood there. As much as I want to know, I am SO SCARED about the results that I am deathly afraid of testing. I made up my mind before I got out that I've waited this long and another 48 hours for the "official" results wouldn't hurt me.

I must admit even after making that decision, I got out of the shower, dried off and checked under the bathroom cupboard to see if I had any extra pregnancy tests left from previous cycles. Thankfully I don't.

48 hours more. I can hardly wait!

Day 48: Waiting, Waiting, Waiting

I am naturally a very impatient person and this week-long wait is killing me!! My emotions fluctuate from feeling very hopeful and optimistic to feeling domed and disappointed. Tears come easy and my mind is constantly wandering to my belly and what may or may not be growing inside of me. The past few days have been an emotional roller coaster and Saturday cannot come soon enough.

I am excited to hear the results. I am also so very scared. I know that whatever news we hear our lives will be forever changed. This IVF process has changed me and I know the result will forever impact me as well.

I so want it to be real. For all of our hard work and sacrifice to pay off. For the good news to be ours to share. For it to finally be my turn.

Big Day #2 - Transfer

Hello from the couch just a few hours post transfer. I got myself one of those lap desks so that I could efficiently lay down and work from home on my laptop. I am liking this set-up. Today was our transfer day and I am excited to tell you all about it!

I had a rough night last night as I witnessed my already fluid-filled belly expand and get larger and larger. At one point I saw the Husband's eyes bulge when I lifted my shirt and I knew that things were getting worse, not better. I was so scared that I was coming down with hyperstimulation and our transfer today would be cancelled. After a 5 am chat with my sister who is an OBGYN and a morning acupuncture appointment I was feeling more relaxed as they both put my mind at ease that what I was feeling was most likely a mild case since I was still free of any of the serious OHSS symptoms (difficulty breathing, nausea, vomiting, rapid weight gain, etc).

We walked in to our transfer appointment at 1 pm with a fully belly (from lunch), 2 very swollen and full ovaries and a VERY full bladder due to their request for 20 oz of liquid 1 hour before the appt. After both changing into hospital gear (gown for me, scrubs for him) we were set up in a recovery room. After what seemed like forever (remember the full belly!), the Dr. came in with our final embryology report. From the 8 we had on Tuesday, 5 embryos still remained. They had selected the absolute best embryo for our transfer which was considered a Grade 3-4. Being the perfectionist I am, I was bummed that we didn't have a 5 so I asked her why. The Dr. was quick to point out that she rarely sees a 5 and ours was a very good looking embryo. Here is a photo of our embryo. There are three distinct parts to a blastocyst - the two cell types and the fluid cavity. I've done my best here to mark up the two cell types that make our embryo so pretty.



As development of blastocysts progresses, the cells in each of the 2 components divide and the fluid cavity enlarges. With continued blastocyst development the embryo expands, the shell thins, and it hatches out of its shell. Blastocyst implantation into the lining of the uterus can then begin and at that point we're pregnant!!

So next up for me is a fair amount of rest, just giving my body the opportunity to focus as much energy as possible on making our little embryo feel nice and welcomed. We'll get a call tomorrow with the final report of our 4 remaining embryos to see how many we'll have left to freeze based on how they progress over the next 24 hours.

Thanks for everyone's love, support and well wishes. Fingers crossed!

Day 40: Worry Wart

Today was my first day back at work since the Egg Retrieval. Still in a fair amount of pain/discomfort, but I hear it is normal for this stage of the recovery. All day I couldn't help but think and worry about our 10 little embryos. I really hope they are doing well and progressing as they should. At one point I IM'd the Husband expressing my worries and he was quick to respond that they are in very good hands. Perhaps he is right, but I can't help but worry.

We'll know tomorrow morning how many embryos have survived the past few days and if we are set up for Day 3 (Tuesday) or a Day 5 (Thursday) transfer. Our goal would be a Day 5 (Blastocyst) transfer since we know by growing embryos to the blastocyst stage in the laboratory we can deliberately weed out the embryos that do not have the genetic potential for continued growth; therefore leaving us with better quality embryos for transfer.

But we realize it is out of our hands and we can only hope for the best. I'll post an update tomorrow.

The Egg Retrieval

Just a quick update on today. Everything went well and they were able to retrieve 15 eggs! Each one of those eggs are now shacking up with 100,000 of Husband's sperm. I hope they get along.

We'll know by tomorrow afternoon how many were fertilized. I am excited to hear the news.

In the meantime, it is back to the couch for me.

Night.

Day 38: Big Day #1

Today is Big Day #1 - Egg Retrieval! We've been waiting for this day for quite sometime. 37 days to be exact. But in a lot of ways the entire 2 years we've been trying has led up to this day.

My blood work from yesterday morning showed a big jump in my estrodiol level. It is now at 4,500 (up from 2,500) the day before. Each mature follicle will produce ~150-300 units of Estradiol, so based on my current level we'd suspect anywhere from 15-30 eggs to be harvested today.

I am about 75% excited going into today's surgery and 25% scared. The scared % took over last night on my drive home from work. The weight of everything we've gone through and will go through all hit me at once and I began to sob...

Day 37: Fingers Crossed

I was back at the Dr. this morning for yet another round of blood work and an ultrasound. Follicles are looking good and estrodiol is now up to 2527. We got the call this afternoon to proceed with the trigger shot of HCG tonight and our egg retrieval surgery is scheduled for Saturday at 9:30. It will be 100% confirmed after a final round of blood work tomorrow morning.

The only bit of bad news from today's appointment was that my uterine lining was measuring just under 7, which is the same size it was yesterday. It should be growing ~1-2mm per day and with my estrodiol level so high the Dr. is slightly concerned at how my lining is progressing (he would have expected it to be at leat 8-9mm). The uterine lining is important in this whole IVF equation as embryos need to implant in the endometrium and an optimal lining is thick and rich with blood vessels providing nutrients to the embryo. I've had a problem with my lining in every cycle we've done for the past year so this isn't a complete surprise, I guess I was just hopeful it wouldn't be a problem given the drugs I'm on this round.

The biggest risk at this point is that the Dr. will advise us that the conditions aren't ideal for a transfer and we'll be given the option to freeze all of our embryos until my body's had time to create a better lining. Obviously this isn't ideal and I am quite bummed even thinking about this possibility. So I am determine to do what I can to improve things between today and Saturday.

I know that one of the things acupuncture can really help with is blood flow the the uterus which can improve the lining so I made an 'emergency' appt with my acupuncturist this afternoon. She tried a therapy with me called "Electroacupuncture" which is a form of acupuncture in which pairs of acupuncture needles are attached to a device that generates continuous electric pulses between them. So my quest for a baby reached a whole new level today as I laid on the table face down, with needles in my lower back and legs connected to wires and some type of electric machine that generated continuous electric pulses. It hurt a bit and was the strangest feeling. I laid there thinking: OMG this is crazy!!!

I'll go back tomorrow for another set of blood work with a follow-up appointment with the acupuncturist for another round of electroacupuncture. So tomorrow between 8-10 I'll be poked, prodded and electrocuted...all in our crazy pursuit of having a baby.

At the very least I'll be able to look back on this cycle and despite all of the bruising, bloating, crying, and pain, I'll know in my heart that I've gave it all I got.

Day 36: Getting Closer!

We were back at the Drs this morning for another ultrasound and blood draw. My right vein is getting some serious action these past few days and no matter how many times I get pricked, it is still so odd to see blood flowing out of my veins into vials. Estrodiol level is now up to 1528 and I currently have about 16 "big" follicles measuring 14 - 17 mm in size and then 8-10 smaller ones. They want to give the follicles one more day so I'll go back in tomorrow for another check. The nurse said she is 90% positive they'll 'trigger' me tomorrow, which will mean the egg retrieval surgery will most likely be scheduled for sometime on Saturday. Just a few more days, I can't believe it.

I got the sweetest care package today from my older sister. She also struggled with infertility, but was successful in a gonadotropins cycle last year and has a baby due in just 4 weeks. My care package contained magazines to keep me entertained during my recovery and lots of healthy snacks. But the most special gift was a little stuffed sperm. It was a good luck sperm one of her friends gave her during her cycles and she wanted to pass the luck along to me. The good luck charm worked for her, I can only hope it works for me as well!

Day 35: Slow & Steady

We're 6 days into the stimulation process and we had an appt with the Dr. again this morning to check my progress since Sunday. Estrodiol levels are up (as to be expected) at 1074. They also tested my LH (1.63) and Progesterone (.59) levels.

The Dr. spent a fair amount of time measuring each of the follicles to get a sense of development using the ultrasound. So far I have about 15-20 follicles total in development with the bulk of them at developing at a similar rate, which is exactly what he wants. He surprisingly wants to see me back again tomorrow for additional blood work and testing so the methodical monitoring continues. In the meantime, my instructions for tonight and tomorrow morning were to drop my meds dose down to 50 units. The trick here is slow and steady growth of the eggs.

I also had an acupuncture appointment tonight and my Chinese medicine diagnosis is also a good one. She said my energy has been really great over the past few weeks and my tongue and pulse were fantastic today! I'll see her once more before the egg retrieval surgery, then once between egg retrieval and embryo transfer and finally 2x on the day of the embryo transfer.

So I am thrilled to have good reports thus far from both Western and Eastern medicine. Yippee!

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.

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!!

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...

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...

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!

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...

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...

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).

Day 5: Undecided

We got our packet of information from the clinic this weekend. It is a folder which contains a slew of instructions, consent forms and details about our upcoming IVF cycle. We are suppose to read it and be prepared to sign the various release forms in front of a witness (the Dr.) during our Informed Consent meeting on the 17th.

The packet contains a consent form that is 6 pages in length titled "Authorization For Embryo Cryopreservation." Basically, it is all what we want to do with any extra embryos that are created during our IVF cycle. In all of our meetings with the Dr. thus far, he has been very optimistic about the ability for me to stimulate well and therefore generate lots of eggs for fertilization. At one point he quoted 10-15 eggs as what he might expect. Now, not all of those eggs will probably fertilize and become viable embryos, but there is a very good chance that we'll end up with more embryos than than the 1 we plan to put back. Therefore the question is, what do we want to do with those extra embryos?

In the short-term, the answer is simple. We want to save them in case the cycle doesn't work (although we all know that won't be the case) or when the time comes for us to further extend our family.

It is the long-term that raises questions. There may come a time when our family is complete and we may still have frozen embryos in storage. Additionally, the form asks us to provide instructions on the future of our embryos in the event of "special situations" such as divorce, death of a spouse, death of both of us, etc. We're essentially given 4 options for consideration:

1. thawing and discarding the embryos according to clinic protocol
2. cryopreserving and donating the embryos for research purposes
3. cryopreserving and making them available for use by X and X.
4. cryopreserving and donating the embryos for anonymous use by another person or couple

I brought this topic up during dinner tonight with the Husband. He was quick with an opinion. Anything other than option 1 (thaw and discard) didn't seem right to him. He didn't like the idea of an embryo with our genetic make-up out in the world without us.

I, on the other hand, am undecided. The "discarding" language of the first option upsets me slightly and I can't help but hear a flushing noise when I think about it.

Part of me is also very uncomfortable with the idea of donation. The idea that our embryo, with our DNA, could come into this world as part of another family. But at the same time, I know the extreme pain, heartache and yearning that comes from infertility and there is something about the possibility of us helping another couple recognize their dream of a child that I think warrants some thought.

The research option also interests me as I understand that research on embryos has the potential to produce many major medical discovers such as cures for previously untreatable diseases and disorders. However, I am aware of the ethical and religious views on these types of experiments.

So, I am undecided.

I think we'll both sleep on it for a few nights and see where we end up as we know there is really no right or wrong answer. We just need to determine what feels right to us.



Total Pill Count: 6 Total Shot Count: 0

Day 1: Financing & Paperwork

YAY! We’re officially at the starting line. Day 1. For the next 8-10 weeks we’ll be living our lives on truly a day-by-day basis. Every day for the next 60+ days has a task for us to complete (appointments, shots, tests, etc). There is no doubt, this treatment plan will be intesnse, but as a list person, this to-do list regimen is right up my alley.

Today our biggest decision was regarding financing and payment. We met with a financial counseler a few weeks ago at the clinic. She gave us an treatment estimate for 1 IVF cycle with a total of $13,070 + medication which is estimated to add an additional $3,000 - $4,000. So all up, one cycle through the clinic is about $16,000 - $17,000. Unfortunately, for us zero, nada, zilch of these costs are covered by our insurance so all $16-17k will be out of pocket.

Since she knew we were paying out of pocket, the financial counselor also mentioned to us a partnership they have with a company called ARC. The way I understand it ARC has partnerships with clinics nationwide and they offer ‘package’ deals and refund guarantee programs. The good news is that it has been a while since the clinic has renegociated their fee rates so the ARC contracts in place are based on the old, less expensive fees. So I called ARC and found out that we could get what is called a “One Cycle Plus Plan” for a total of $9,437 at a base cost. The plan give us a ‘bundle’ deal of 1 fresh cycle and 1 frozen cycle for a cost lower than the 1 cycle directly through the clinic. Duh, that’s a no brainer. Sign us up! Now there are a slew of costs this bundle deal doesn’t cover (meds, baseline ultrasound, trial transfer, anesthesia, etc.), so I estimate that the total cost is really like $15,000 for one cycle, but we’re still saving about $1-2k and we are still getting the 1 frozen cycle basically ‘free’ with this plan. I also think it was very was nice for the counselor to suggest it since it sounds like less money for the clinic at the end of the day.

So then the tough decision for us was considering what they call a “Refund Guarantee Program.” Basically this is an add on insurance policy. You pay an incremental amount more, but if not successful at the end of the 2 cycles, you’ll get a portion of your money back. We filled out an application and it came back with an add on cost for us of $7,000. So if we added on the refund guarantee we pay $16,400 instead of the $9,400, but if not successful at the end of the 2 cycles, we’d get $11,000 back.

I was a bit discouraged by this figure as a result of my application. Basically this tells me that they think there is a pretty good chance I may fail, and therefore a pretty good chance they’ll need to pay out the refund. Therefore they want to charge us a crapload upfront to help mitigate the risk. The analogy to this would be the auto premium that is charged to an 18 year old male driver of a red sports car. Seriously, am I that much of a risk?!

Anyway, we talked about it and feel like this is NOT A GOOD DEAL. We’d rather keep our $7,000 in the bank. Hope, pray, beg, and think positive thoughts that this will work for us and if for some reason it doesn’t, we’ll decide where to go from there.

So we signed the 7-page contract for the One Cycle Plus Plan and sent in the credit card #. It is a bit painful for me mentally to let go of the money aspect all of this. It is one of the many unnatural parts of this IVF process and in some ways we feel like we are buying our baby. As a bargain shopper (I LOVE a good deal) I can’t help but feel like we’re getting screwed. Why do we have to pay $15,000 of our hard earned savings to get something that 95% of the population gets for ‘free? In fact some people get it for free and don’t even want it.

But, I just need to remember a lesson my parents ingrained in me at a very young age —Life isn’t fair. Unfair is right.

Big day tomorrow with an 8 am appt with the Dr. I’ll send out an update tomorrow night with the details!