Trick or Treat

We had our 20 week ultrasound yesterday and everything went great. Most importantly all of baby's organs looked healthy and were in the correct locations - normal heart and brain, intestines inside the abdomen, diaphragm looked complete, kidneys not too bright. It was amazing to see that the fluttering sensation I feel is when the baby kicks off one side of the amniotic sac. We also were able to take a peak between babys leg and are so excited to anounce we are having a little...

Boy!

Now the night before our first ultrasound I had a dream that I delivered a baby boy and had originally thought I was having a boy, but K and all of my family though the baby was a girl so they slowly convinced me otherwise. We were suprised and very happy to find out that baby is a boy (even though we would have been equally happy with a girl). Knowing the baby is a boy just helps make everything a little more real and helps me imagine what our life will be like as a family of 3.

We're still here

Hi loyal blog followers. Thank you for all of your inquiries as to how I've been doing. I am sorry I have been so absent. I kept wanting to update you, but I've been anxious to post... I kept waiting to feel more confident in my pregnancy, and that has taken a lot of time. That's not to say I haven't been enjoying my pregnancy, it's just that infertility and loss makes early pregnancy very difficult. Even after seeing our little baby twice, I was scared that we might lose him/her.

The good news is everything is going well. We had our first OB appointment at 12 weeks and were able to see our baby again during the ultrasound for the nucal transulency measurement, which baby measured great at. I was honestly very suprised (even though I knew baby would almost certainly be ok because I heard the heartbeat on doppler that day) when the ultrasound started and baby looked like a healthy, human baby.

We enjoyed annoucing to our family and friends shortly after our appointment. It was so exciting to be able to share such happy news with everyone. Then last week we made an announcement on facebook, because we have a lot of extended family and friends that we keep in contact with through facebook (and also to inform my classmates, without me having to tell everyone individually when they look at my growing stomach.)

I will try to do a better job in blogging for the rest of this pregnancy. I am 16 weeks today and have my next OB appointment on Monday. Then at 20 weeks (on Halloween) we have our anatomy scan to check all of baby's organs and hopefully to see if baby is a girl or a boy. I think at that point I will finally be able to breath a bit more easily. Each day is better than the next, and I honestly never thought I would be 16 weeks pregnant.

I still read your blogs everyday. My heart breaks with your loss and waiting, and celebrates with your good news. I am rooting for each and every one of you.

I've been outed!

Today at least 10 individuals learned of my pregnancy. Here is how it happened: today was the first day of my otho rotation. I've been worried about ortho because I thought the lima bean might lead me to a. pass out in the OR or b. run out vomiting. But alas, neither of these scenarios happened. I joined my team in the OR partway into a case after orientation, so I hadn't met anyone yet or even had the chance to consider discussing my pregnancy in private. I did scope out the OR for any sources of radiation, and everything seemed safe. We were doing a total knee replacement and were getting ready to put in the replacement joint when one of the residents ask, "You aren't pregnant, are you?" Oh... why yes in fact I am. So I turned bright red (I'm sure) and stuttered out "Actually I am." It turns out the cement they use to fix the joints isn't safe for pregnant individuals, so I was kicked out of the OR and set to clinic, where the remaining resident asked me what happened so I had to inform him (and the 2 nurses and 1 other medical student who were also in the room) that I was pregnant. I was able to rejoin the team for the remaining 2 surgeries of the day, and I feel safer in the OR now that everyone knows I'm pregnant so they will let me know if I ever need to leave, but it's not the way I was planning on sharing my exciting news with the first 10 people outside of the few select individuals who already know. The whole thing does make me worried about our scan this Thursday, because if something is wrong I will either have to tell them or continue to let them think I'm pregnant for the next week. But I will try not to worry myself with that! I'm thinking healthy baby, good heartbeat, appropirate growth thoughts.

2nd ultrasound: 6 weeks 6 days



I slacked on my blogging last week - sorry to keep you waiting. The second ultrasound went well. The baby measured on track and had a heart rate of 137. After the ultrasound I was told that I had graduated from the IVF clinic and should set up an OB appointment. What?! I'm all for being positive, but I can't believe that I'm ready to join the land of appointments only every 4+ weeks.

 

I think there must be a whole lot of fertile people in my city because the earliest I could get a new OB appointment is at 12 weeks 3 days (Sept 9th). This was after I had explained how we did IVF and I was very nervous and wanted to be seen sooner rather than later and the nurse told me they usually see patients between 7-11 weeks. So I am pretty bummed about waiting so long.

 

 

I am still incredibly nervous. I received an email from my resolve group asking when I would be 12 weeks (which is generally when you "graduate" until the pregnancy is completed) and it totally caught me off guard. Me, make it to 12 weeks? I still am taking this pregnancy on a day-to-day basis. I look forward to the future, but I'm always hesitant, waiting for the next scan.

 

In my head 8 weeks is the magical number where I will feel more comfortable (although I'm sure I'll always be scared until I have a baby in my arms). My sister-in-law who had so many miscarriages said that 8 weeks was the latest she had a miscarriage, but she also had a missed miscarriage where the baby died at 8 weeks and didn't know till her 12 weeks scan. I am 7 weeks 5 days today. I'll be 8 weeks on Friday. I feel like I will need an ultrasound after I make it to 8 weeks in order to become more comfortable. I am just so scared of missing something, like in my last pregnancy when I thought everything was ok and it wasn't, or in my sister-in-laws pregnancy where the baby had died but she didn't know.

 

I got really anxious yesterday thinking about how we had to go 4.5 more weeks until our next ultrasound and had a bit of a panic attack. I called the clinic today and after a lot of explaining and insistence, the IVF clinic agreed that I could come in next Thursday (8/15) for another scan at 8 weeks 6 days.  I feel a lot more comfortable with this schedule. This way we will have 2 weeks between our 6w6d scan and 8w6d scan then just 3.5 weeks till the 12w3d scan.

 

I know I will have to get more comfortable with less visits / ultrasounds, and I am sure I will to a degree. It will be a lot easier once I make it to the point where I can feel the baby moving or have a visibly growing belly. But at this early stage of pregnancy I don't have any signs as to the status of our little baby and I worry about him/her.

A birthday wish

It was my birthday yesterday. When K and my sister asked what I wanted for my birthday I told them all I wanted was for my baby to be a healthy and keep growing for 34 more weeks - a very big request I know! Hopefully that birthday wish will be granted, but in the meantime K bought me lovely earings, and my friends gave me thai food, cupcakes, cookies, and a DQ blizzard :)

Our next ultrasound is this Thursday. I am feeling more hopeful due to increased nausea - it is way more intense than it was last pregnancy at this point, which I find reasurring even though I don't feel well. I am hoping that it is a good sign the little one is growing.

In other news I have developed my first reaction to a progesterone injection. I woke up this morning and where K had injected me the night before I had a red, itchy, nodule. Per the advice of my IVF expert friends I have applied cortisone cream and am trying to massage the area. K said that last night oil came out when he pulled out the needle, so I don't know if the oil migrated out of my muscle and into my subcutaneous tissue???

Little Legume

Thank you all for your love, support, and prayers during this nerve wracking time. This morning we had our first ultrasound. The ultrasound tech was amazingly kind and understanding. She must have read my chart because she knew that I would be anxious. She started off by saying we wanted to see a gestation sac and yolk sac today and if we saw a fetal pole that would be extra. As soon as she put the ultrasound probe in she let me know that she saw a great looking yolk sac and a baby with a heartbeat! Baby measured on track for 5w6d and had a heart rate of 93. The Dr told me that the heart rate is on the low side of normal, but ok since we are so early. The baby's heart only started beating recently and the SA node (electrical center that sets the rate of the heart) is still immature. In the first few days the fetal heart rate can be lower than what we would expect in a week. Here are some pictures: 

 



This one shows the fetal pole. Babies heart made him/her wiggle with each beat. I wish we had taken a video!

 

This one shows the baby (arrow) connected to the yolk sac.

There is dispute in my family on the proper legume nickname we should call him/her. K says Snap Pea, my sister says Lima Bean. I think Little Legume is pretty cute :) The ultrasound tech even said baby looked like a cute Bean.

Today we are feeling much more comfortable with this pregnancy. This morning I was on my knees praying in the bathroom when I woke up. We hope the Little Legume continues to grow and flourish. We have a followup ultrasound next Thursday to ensure he/she is growing appropriately and to check the heart rate.

I know a heartbeat still isn't a guarantee, but it was reassuring to see today. I still am scared, but I want to enjoy this pregnancy by focusing on living in the moment.

I hope each and every one of you gets a chance to see a little heart beating inside of you. You each deserve it so much. Sometimes my heart aches when I think of all of you and the pain we all are going through. I don't have any answers but I will continue to root for you, pray for you, and support you until you get a take home baby.


Anxiety

I am  having a hard time remaining calm this pregnancy. After I lost my last pregnancy my whole world came crashing down. I believed that we had made it through the hard stuff; that a pregnancy would equal a baby. But now I know things aren't that simple. And it sucks. I feel like I have been robbed. Robbed of my dreams of how I imagined my children would be conceived, and now robbed of my dreams of enjoying my pregnancy.

I am having hard time even thinking of myself as pregnant.  I logged onto fertilebook and saw a pregnancy announcement from one of K's friends, who I am not that fond of to begin with, and I felt pure jealousy. I couldn't muster up any happiness for them, and it made me feel lousy. I was jealous that they were in a secure enough place in their pregnancy that they could announce it on face.book. Jealous that they were pregnant - at which point I tried to remind myself "you are pregnant too." But I couldn't over come the feeling.

Despite this, I will be destroyed if the ultrasound is bad on Thursday.

I don't want to have to do IVF all over again... But we have no more frozen embryos, so we will have to do IVF again if this pregnancy doesn't result in a live baby in 35 weeks. And if we have to, we will do it all over again. I would go though IVF many times over again for a baby.

I don't want to have to do IVF again... because if I have to go through it again it means we lost another baby. I want this/these baby(ies) that are growing inside of me. I wanted the baby that was growing inside of me 3 months ago. I can't help but wonder what life would be like if we hadn't lost our first baby. We could have been the ones posting on facebook this week.

Midwest Infertility and Adoption Conference

I'm going to be joining Kim from No Good Eggs at Resolve's Midwest Infertility and Adoption Conference in Minnesota in September. The Conference is on Saturday, September 21, 2013 in Golden Valley, MN and covers topics from adoption, to paying for IVF, to donor embryoes:

http://www.resolve.org/Regions/midwest/midwest-family-building-conference.html

I know some of ladies live nearby, so you should think about coming to meet me :)

I am trying to wait patiently for my ultrasound on Thursday. I haven't felt the best the last few days. I've had a lot of headaches and nausea, which I'm trying not to get too excited about, but has been somewhat reassuring. I hope that it is a sign my little baby/babies are growing.

I was praying about my babies the other day while K was driving and when I looked up we were passing a car with the license plates "BFP." Maybe a positive sign?

In sad news, my blogging friend Suzanne just found out she is losing her miracle baby. Please visit her blog to offer her some love and support.

Could it be happening again?

My first beta was great on Friday at 142, but the second beta 72 hours later was only 318.  When I saw the number my heart dropped. I knew it hadn't risen enough. I'm terrified. Last time it rose at a similar rate and the pregnancy wasn't viable. I prayed that it would be obviously good, so that K and I could begin to embrace the pregnancy. It's hard not to compare numbers, but in the blog world most of the women I see get pregnant with IVF have doubling times of 30-48 hours... I was worried the clinic would say it was ok, when I didn't think it was, but the clinic called and left a message. My doctor is worried and wants to do an early ultrasound on the 25th. So, now I'm worried that they agree it is troubling. I came home from work and just broke down. Could we have gone through all of this again just to lose more babies?

2 peas in the pod?

K is out of town for a few days. The morning he was leaving (5.5dp5dt) I wanted to test, because I was hoping it would be positive and then we could have a celebration. With the fresh cycle I told him over the phone, which wasn't as exciting as I had hoped, so I knew at the beginning of the FET that if I found out I was pregnant I wanted to tell him in person this time. Now, back to the morning he was leaving... I tried to be all sneaky, but my pregnancy tests were sealed in an ama.zon box. He heard me rustling, so I had to abandon my plans to test or risk ruining the suprise. All day at work I was thinking about testing. I had trouble concentrating because I wanted to test (not a very good situation when I'm trying to be a good medical student.)

When I got home from work I ran to the bathroom and peed in a cup. I hadn't been refraining from drinnking, so I had to make sure my urine was at least somewhat concentrated before dipping a nice, expensive pregnancy test into it. It looked ok. I reassured mysself that if it was negative I was testing fairly early using mid-afternoon urine. I dipped the test in and set it on the counter. As if she were a guardian of the pregnancy test, my cat jumped up on the counter and stood watch over the test for the full 3 minutes. I left my cat with the test and when I walked back in a few minutes later this is what I saw:

 

Two beautiful lines.

I haven't told K yet, because he doesn't get back till tomorrow night or Friday, but I couldn't wait to share with all of you. Thank you for all of your prayers and well wishes with this cycle. Whenever I recieve an email alerting me of your comments it makes my day. You girls are the best :)

I have thought about things and going forward I am going to believe my babies are healthy and strong and that everything will be ok. I've been imaging 2 healthy embryos growing and 2 healthy babies being born in ~9 months. 1st beta is Friday morning.

Joy and Sorrow

Hi everyone. I know I haven't been a very good blogger during this FET, and I apologize for my lack of posting. I guess it's because of what happened with the fresh cycle. My hope and fear are both present on a daily basis. Losing my pregnancy was one of the saddest moments of my life. But grief doesn't exist in just a moment. I experience the loss every day. I will never not be sad by this loss, but I'm also never just sad. Being pregnant was such a great joy, and I am happy I was able to have those few weeks of blissful pregnancy:

Your joy is your sorrow unmasked.
And the selfsame well from which your laughter rises was oftentimes filled with your tears.
And how else can it be?
The deeper that sorrow carves into your being, the more joy you can contain.
Is not the cup that holds your wine the very cup that was burned in the potter's oven?
And is not the lute that soothes your spirit, the very wood that was hollowed with knives?
When you are joyous, look deep into your heart and you shall find it is only that which has given you sorrow that is giving you joy.
When you are sorrowful look again in your heart, and you shall see that in truth you are weeping for that which has been your delight.

Some of you say, "Joy is greater thar sorrow," and others say, "Nay, sorrow is the greater."
But I say unto you, they are inseparable.
Together they come, and when one sits, alone with you at your board, remember that the other is asleep upon your bed.

Verily you are suspended like scales between your sorrow and your joy.
Only when you are empty are you at standstill and balanced.
When the treasure-keeper lifts you to weigh his gold and his silver, needs must your joy or your sorrow rise or fall.
- Kahlil Gibran

I know that joy and sorrow are inseparable. When I grieve I grieve for the beautiful connection I had with the people I loved and who loved me, who are now gone. I am fortunate to have had such love in my life.

I'm 4dp5dt and go back and forth between thinking this FET failed and that I am pregnant (in which I am fearful I might lose the baby/babies). Neither of which is a very good frame of mind. I am trying to just accept whatever happens, and accept life on a day to day basis. This journey has taught me that despite my desires, I can't control my fate when it comes to infertility. The only thing I can change is my outlook:

Life never stays the same, and refusing to accept uncertainty and chance is setting up a battle that is not only un-winnable but also unnecessary. Accepting that life is about change helps you see more clearly what you do have control over and to take action.

Transfer 2.0

Yesterday we had our transfer for our FET. This time my bladder was so full I thought it might burst. I told K it's like being at a movie theater near the end of a really good movie after drinking a giant soda and really needing to pee but not wanting to so that you don't miss the end of the movie.

In good news both our blasts surived the thaw and were transfered successfully. The Dr said it was a picture perfect transfer, which I am very grateful for. My blood hcg draw is next Friday. I am pretty busy till then so hopefully the time will pass quickly. However, K will be out of town next Tuesday-Friday so if I get an urge to pee on a stick, no one will be there to stop me.

I don't know how to feel about everything. I am trying to embrace these 2 blasts, and I know I am already attached to them, but I'm scared that I might get pregnant and lose 1 or both of them. I want so badly for them to grow into 2 perfect babies.

FET schedule

I have a FET schedule! I already started etrogen twice daily on 6/15. On 6/27 I go to estrogen thrice daily. On 6/28 I have my lining check and if everything looks good then I will start my progesterone shots. The transfer of my two little blasts is 7/3 - just in time for them to see their first fire works show from my uterus :)

Freaking out

My previous post seemed very calm and collected but now I am freaking out. I was googling IVF, balanced translocation, and PGD and it really freaked me out. It seems the theoretical 50% unbalanced, 25% normal, 25% balanced ratio is purely theoretical and there can be a lot more abnormal than normal. I found a website where women posted their eggs retrieved, # fertilized, # PGD, # normal, # transferred, and result and the statistics did not look good. The sample size wasn't that large, probably 30 women, but it seemed that a lot ended up with no normal embryos, and although some did end up with 1 or 2, there were very few BFPs.

I know I am jumping ahead here and freaking myself out unnecessarily, since we don't know if K is a carrier or not... but I am really upset. I just want a baby. I'm trying to reassure myself that both his siblings with the translocation have children. I am just terrified of the number of miscarriages it took them to achieve those children. Also, they didn't have any female factor (or male factor in his sister's case)  involved. It has taken us so long just to get pregnant the first time, I don't want to lose any more babies. Ugh. I feel at every step of this journey we keep getting bad news after bad news: I didn't ovulate, then I didn't ovulate on clomid, then K had low sperm counts, then K had 0 morphology and we needed to do IVF,  then we got pregnant just to lose the baby, and now maybe we have a chromosomal factor on top of everything else.

I hope that our 2 frozen embryos are normal and that everything will work out ok. Please keep us in your thoughts and prayers as we move forward with this FET.

Unbalanced

No, this post is not about balancing life and infertility, which is a constant stuggle and a topic I could write several posts about (and am working on writing!), but rather genetics.

I think I have mentioned that my husband and I are not "out" about our infertility. However, after our miscarriage we looked to his family for support. I was talking to my sister-in-law last night, who has had several miscarriages in the past but now has 3 children, when she stated: "don't you know about the genetic mutation that runs in the family?" Why no, in fact I did not know.

It turns out K's older brother and one of his older sisters have been tested (after several miscarriages each) and are carriers of the same large balanced translocation. This can happen randomly, but considering they both have an identical translocation, it is likely genetic, which means one of K's parents is a carrier of the balanced translocation as well, which would mean K has a 50% chance of being a carrier.

The good and bad news is that the translocation is very large, so unbalanced embryos have genetics incompatible with life. K's sister-in-law shared that she has had 9 miscarriages and they all happened before 8 weeks (except in one of her early pregnacies where she learned at a 12 weeks ultrasound that she had a missed abortion and the embryo had stopped growing around 8 weeks.) It's unfortunate that the mutation causes miscarriages, but "good" in that the miscarriages occur early and since it is incompatible with life, it doesn't cause children to be born with serious health conditions or problems.

K's sister-in-law also shared that she and K's brother were patients at the same RE clinic we are patients at. They were going to do IVF, but had to wait 5 months due to scheduling, and concieved their second child with IUI + femara while waiting.

Overall, I am not sure what to think about all of this information. Our 2 blasts that we have left can't be tested since they are already frozen. I am planning on transferring them both in July (btw I got my period today on my own) and hoping for the best. However, now that I know about the translocation, I will be very hesitant to embrace the pregancy (if I get pregnant) till we get past 8 weeks.  Moving forward with future IVFs we will have 2 options, we can test K for the translocation or we can do PGD on the embryos. We have the shared risk program with this round of IVF and I don't know if K being a carrier of the balanced translocation would exclude us (which would really, really suck if it did).

There is still a 50% chance K isn't a carrier of the translocation, but I am afraid he is given what happened to bean sprout. Bean sprout could have had a random genetic mutation by chance, but what happened with my pregnancy sounds a lot like what happened to K's sister-in-law with many of her miscarriages.

Other considerations: if K is a carrier of the balanced translocation 50% of his sperm will be unbalanced and create embryos incompatible with life, 25% will be completely normal and make normal balanced embryos, and 25% will have the balanced translocation resulting in embryos that are balanced (like K's brother and sister) but will be carriers of the translocation. Here is a picture:


If K is a carrier, in our cause all of the "unbalanced" would result in early miscarriages.

I'm trying to reassure myself that our IVF resulted in 3 good blasts. Even if K is a carrier only 50% of the embryos created with his sperm should result in unbalanced embryos. Thus, at least 1 of the embryos should be normal. However, we do have the confounder of ICSI. So I hope that the scientist who picked which sperm to inject into my eggs picked the right ones!

Super Sweet

I'm excited to announce that I have been nominated for my very first blogging award :) Aislinn over at Baby Makin' nominated me. Thank you Aislinn! I love reading your blog.

And to all my other readers - 11 now! :) I love the support I get from you ladies. Most days I come home from work and take a break by catching up on your blogs. Reading about your journeys and struggles really inspires me, and I am rooting for you every step of the way. I feel that you are the only friends I have who really understand what I am going through. So thank you to all of you!


Super Sweet Questions:

1. Cookies or cake? For my birthday I always have Dairy Queen icecream cake. It is my favorite. But K makes some awesome chocolate chip coconut cookies that I love. If I eat cookies I perfer them in either dough form or straight out of the oven.

2. Chocolate or vanilla? Dark chocolate :) I eat way too much of Brook.side's dark chocolate covered pomegranate.

3. Favorite sweet treat? This is  a tough one. At the top of my list are: under-cooked brownies (that are still gooey), oreo balls (ground oreo mixed with cream cheese covered in almond bark, and I don't even like oreos), better-than-sex cake, and butterfinger icecream.

4. When do you crave sweet things the most? After lunch and dinner. Once I have something savory I always have room for something sweet.

5. Sweet nickname?  My father-in-law calls me his "Dee-dle daughter," which I think is the sweetest thing ever :)
 
 

Back on for 2

Thanks to your comments and texts I was encouraged to email Dr. D. I let him know that I respected his opinion, but still desired to transfer 2 embryos, and asked if he could bring up my case at the next RE team meeting. He sent me an email this morning that the team decided it would be OK for me to transfer 2 embryos. I met with my therapist this evening and we discussed transferring 1 vs 2, and I believe transferring 2 will be the path of least regret. No one can't predict the future on this difficult infertility journey, so the best I can do is listen to my gut and chose the option that I believe will give me the least regret in the long run.

Today is my and K's 3 year anniversary. I am so lucky to have him. He makes this whole journey worthwhile and I don't think I could make it through all this heart ache without him. We went out to dinner and discussed transferring 1 vs 2 embryos. His main concern is the finances involved with potential twins. Money is fairly low on my list of concerns at this point, but I understand where he is coming from and tried to address his concerns. I did remind him that transferring 2 embryos can result in 0, 1, 2, or 3 babies. Transferring 2 embryos is no guarantee of twins (although I wish it was!) He said that he is OK with transferring 2 if that is what i really want. We did finish the dinner by reminiscing on all of our favorite wedding and honey moon memories, so it wasn't all infertility talk :)

Single Embryo transfer

Well after I wrote out all of my reasons why we wanted to transfer both of our remaining embryos I found out today that Dr. D only wants to transfer one. He said that he doesn't think I qualify for transfering 2 since the first transfer was "succesful" in that I did get pregnant. He gave his reasons for wanting to transfer 1 and I gave my reasons for wanting to transfer 2.

He is fairly confident that I will get pregnant again with a single embryo transfer and doesn't want to expose me or my potential babies to the increase risk of twins. I understand these risks and understand that a singleton pregnancy is perferred. I am scared of the potential adverse outcomes of twins; no one wants to increase their potential children's risks of cerebral palsy, necrotizing enterocolitis, and periventricular leukomalacia, or have a NICU stay and the potential of taking home only 1 or neither baby, or 2 sick babies.  K changed his mind about transferring 2 when Dr. D mentioned the risks to me with twins. K doesn't want anything bad to happen to me. He would rather take the potentially longer but safer route. I understand what he is saying, but at the same time I worry about the damage that happens to me the longer I go in this journey. Yes, I am not physically injured, but this process has taken a huge emotional tole on me. I feel like I am living a life of waiting. I can't enjoy the present. Likely this has made me more willing to take risks in the hope of achieving a baby quicker. Dr. D says he thinks I am too caught up in the process to look at things objectively. He thinks I want to adress this too agressively, which may cause unecessary harm. I understand what he is saying, and I agreed to only transfer 1, but I am still not happy about it. I can't predict the future. I know that if I did get pregnant with twins and something went wrong I would feel horrible about it.

We did also discuss my reasons for wanting to transfer 2, and I did get fairly upset because our priorities aren't the same. Dr. D thinks the chances of transfering 2 and ending up with twins is greater than the chances of transferring 1 and have another nonviable pregnancy (however, he isn't the one who has to go through the potential loss, and he did say that there is a possibility that 1 or both of our remaining embryos could be chromosomally abnormal). He agreed that they do not like having only a single blast left for a future transfer because thaw rate is not 100%, but he says if that happens the worst thing that happens is that the cycle is cancelled (which would be a big deal to me!) and I would be set back 3 months (but that is a long time when you have been waiting so long and want a baby so badly!).

I did agree to only transfering 1 by the end of the appointment, although I did so begrudgingly. He did say if I still realy wanted to transfer 2 he could bring it up at the next patient plan meeting, where all the REs discuss the how to treat a patient, but I declined. I could still change my mind if I want to, but I believe the other REs would agree with his plan to only transfer 1.

The timeline for the FET is a bit longer than I would have liked. Since I never had regular periods in the past, I likely will need provera to induce my next period, after which I would start estrace for the FET. However, Dr. D wants me to wait to start my 10 days course of provera till June 23, which would mean I wouldn't get my period till July 5th or so. Then I would need to take at least 19 days of estrace, so tentative transfer July 23. I am a bit worried because the last day of embryos transfers for this entire up-time is July 26, so if we had any set backs (i.e. period takes longer than the usual 3 days after provera to start, or my lining doesn't thicken and I need extra days of estrace) then the whole FET may be cancelled until August. I wish that they would let me start the provera at least a few days earlier.  My miscarriage started May 10th, so June 20 will be 5 weeks from then, and July 5th would be 8 weeks after the miscairrage. The only hope I have of starting earlier is that they said if I got my period on my own in June, we could discuss beginning the FET at that time. I hope that my body recovers and even though I don't normally ovulate or cycle, maybe the pregnancy will have reset my hormones and I may cycle on my own.

The aftermath

So tomorrow is my follow-up appointment with Dr. D to check on how I am doing and discuss moving on to my FET.

The misoprostol for the missed abortion was an anxiety filled event, but I am still happy with my choice, and luckily I had several friends who gave me advice, listened to me worry, and helped me anticipate what would happen. I took 4 pills vaginally Friday morning after the bad ultrasound - passed 2 clots with cramping, but no bleeding. Then 4 more pills Saturday morning - nada. At this point I called the resident at the hospital and begged to try one more dose to try and avoid the D&C, which he obliged, so I took 4 more pills Saturday night and only passed about 4 clots with no real bleeding. I was rather distraught that the whole process hadn't worked and scheduled a D&C for Friday, with the hopes that maybe things would still occur naturally before then. Thankfully on Monday I started to bleed bright red blood and a lot of clots, which lasted through Friday (4 days total), so despite my efforts for this to take place on the weekend, I was bleeding a lot at work. However, by this point I was mostly just relieved that the bleeding had started because I knew that I had not bled enough over the weekend.

I have taken 3 hpts over the last 10 days and my hcg is definately decreasing. With the first test the test line was as dark as the control, and now with the most recent test the test line is light enough that I would consider it positive (if I really wanted it to be positive, like 12 dpo), but is fairly light. I am hoping that in a few more days it will be negative.

My body seems to be a bit whacky hormonally. My face is breaking out :( and I just want to eat junkfood.

K and I have talked about what to do next. We are wanting to move forward and do the FET during our clinics next up-time, which I think would be in July, but we will find out for sure tomorrow. At this point we are leaning toward transfering both of the frozen blasts that we have. There are several reasons why we are considering this:

1) We want to maximize our chances that the transfer will results in a BFP and pregnancy. We would be overjoyed with either 1 or 2 babies. I know that are increased risks with twins, but I feel comfortable with the statistics given the quality of medical care in my area.

2) We only have 2 frozen blasts. Even if we plan to transfer 2, there is a chance that only 1 will survive the thaw.

3) If we only transfer 1, in the future we will have to do a FET with only 1 blast (Our shared-risk covers FETs for all frozen embryos, so we wouldn't start another fresh cycle till after transfering all of our frozen blasts). If it didn't thaw correctly we would have nothing to transfer, which would be really upsetting/frustrating and set us back several more months because we need to start another fresh cycle.

4) We paid for IVF out of pocket. Luckily we qualified for a shared risk program. If I don't get pregnant and carry past the 1st trimester with at least 1 of the 2 blasts we have left then we get our money back. We could then rejoin the shared risk program and retry IVF. Hopefully the next time my protocol can be maximized to result in even more eggs/embryos and we could consider doing PGD at that point if necessary. Obviously I would much rather get pregnant with this FET then redo IVF all over again, but even if I get pregnant I feel like my family won't be complete without several children, so I will need to do IVF again. If I have to redo IVF this year, then at least most of the costs will be covered, and hopefully we can get enough eggs/embryos that we wouldn't have to do it a 3rd time in the future. Transfering 2 embryos now will either result in pregnancy which will hopefully result in a baby or no pregnancy, at which point I would know that I need to do IVF again now, before I potentially relocate in a year for residency.

5) I am not sure about this last point and still need to research/think about it more. Just going off of my gut feeling, I feel that if I get pregnant with twins and one of them is chromosomaly abnormal and fails to grow after implanting but the other baby is healthy and continues to grow, the loss would be easier on me then having 2 separate pregnacies with 1 ending in a baby and 1 ending in a miscarriage, which could happen in either order. However, I do have a fear that if one is chromosomally abnormal then the loss could affect the other baby and I could lose them both. That is probably my greatest fear and the primary reason why I would consider transfering them seperately. My reassurance against this concern is that I have not seen this happen commonly on the blogs I read. I have seen many instances where one twin stops growing or dissapears from one early ultrasound to the next, but the other twin has always been ok.

My other question for my appointment tomorrow is whether or not I should take Metformin for my FET. I was put on it originally when I failed clomid and started femara and was left on it for IVF because they said it could help with egg quality, but I stopped it with the miscarriage because I couldn't motivate myself to take any medicine. I restarted it last night, but need to find out if there is a benefit to taking it with the FET? I will let you know how my appointment goes tomorrow.

Bitter

I have been having a lot of feelings that I am not proud of.

Normally, I am very compassionate and empathetic. Part of the reason I didn't like OB/GYN, for example, is because my patient's suffering touched me so deeply. I brought that sadness home with me whenever something went wrong. 

But lately, instead of feeling sympathetic when I hear of other people's loss/struggles, I feel bitter, because I compare it to my own and find their's lacking/easier. I know this sounds ridiculous and not very nice, and really it is not even an appropriate/possible thing to do. When I take a step back, I know I can't compare my own pain to someone else's pain, but in the moment I can't help but feel that I have been wronged, that I have had it worse. I don't feel bad for the person who is suffering, I feel bad for myself.

For example, I had a classmate who was upset that his great-grandpa is sick and might die. I should sympathize with him, I know how much it hurts to lose someone. But instead I am pissed off that he still has his parents, and grandparents, and a great-grandparent(!) gosh darn it. Or similarly, I have a sick pregnant patient, but instead of being sorry she is sick, I think "well at least she has a baby."

And when I think like this I know that if the majority of people around the world looked at my situation they would say how can she be so pissed/complain so much/feel so wronged when she has such a great husband, a good education, a stable career, a roof over her head, her health, etc. So many people in world have had horrible, terrible, gut wrenching tragedy and injustices afflict them. When I truly think about it, I know that the majority of the people in the world have it worse off than me... Why am I so caught up in my own grief?  Why do I feel like I have had it worse? I know I have so many great things in my life, but I can't see past the things that are bad.

When I think of my mom, I think of her suffering. I relive all of the bad things that happened in her last few months. I see her sick in bed. But she was only sick for 1 year of the 23 that I had with her. And her last few months had many happy moments. I don't know why the horrible memories are the ones that come to my mind, often unsolicited. I wish I knew how to move past those memories so I could remember the good times.

I do believe in God, but I can't find any peace. I don't have any religious solution to my suffering. After a tragic event, the religious people in my life generally say things like struggles help bring you closer to God or suffering helps you learn to rely on God. But right now that answer just makes me angry. Am I so distant from God, that I need so many struggles in my life to bring me closer to God? Am I that bad of a person, or am I that bad on relying on God, that I need so many reminders that I need to rely on God instead of my own understanding? And even if it was even partly true, would God let the people I love die just to teach me a lesson?

 

So now you all know that I am not being a very good person right now. I feel very woe-is-me, and I am embarrassed by my feelings. Losing Beansprout has triggered a lot of feelings of losing my parents. I need to figure out a way to move past my grief, or at least not to be completely consumed by it. I don't want the bad things that have happened in my life to make me a bitter person. I still want to be kind and loving and compassionate. 

Bean Sprout

K was nervous in the weeks leading up to the ultrasound, but I wasn't. I really thought that this was it. I looked through the calendar and planned out our future. Bean Sprout was due on Christmas Day - she was going to be our Christmas miracle baby. Even though I know Christmas isn't a very good birthday, I figured I could try to have her a few days early or late by sure willpower, and the good part would be that our family would all be on break so they could come meet her. I had pre-emptively made my schedule for next year easy from November on, so I would have a lot of time off the spend with Bean Sprout. I looked at how far along I would be in each rotation, imagining my belly growing. K and I talked about names. Each Wednesday I would look up the week's developments and tell K: "This week Bean Sprout has a heart beat" "Today Bean Sprout is growing arms and legs" etc.

I knew things could go wrong, but I felt that they wouldn't. I thought we had made it through the hard part: 1.5 years ttc, IVF, a positve beta.

We went in for our ultrasound early so I could talk to the billing office to find out if my favorite OB would be in-plan. One of the nice ultrasound techs, who did a lot of my follicle scans, called me back. The TV monitor over the bed was tilted wrong, like when you are trying to watch a show on your computer and need to move the screen up or down to get the colors right. I thought about asking her to fix it, but I figured I would wait till we got Bean Sprout on screen - I couldn't wait to see her. She put the ultrasound wand in and I saw the sac right away. But as she scanned through it I didn't see a baby the size I expected to at 7w1d. There was a big yolk sack, and something small to the side. I looked up and saw her shake her head. She scanned through again and said "I am sorry." Bean Sprout had stopped growing. The yolk sac was dispraportionately large, the fetal pole tiny, and there was no heart beat. Laster, Dr. D said that the large yolk sac is associated with chromosomal abnormalities.

I sobbed the rest of the day and have been crying on and off since then.  I don't understand how this could happen. We've been waiting for this for long. It hurts so much.

I knew Mother's Day would be hard, having lost my Mother this last year, but I thought it would be easier having a baby growing inside me - becoming a mother myself. I felt like my Mom was watching down on me, trying to send me a gift to help me get through, but now I know that was a story I made up. I wanted to fill the holes in my heart from losing my mother, and father, and all my grandparents, but I've only succeeded in making another hole. I have lost another person that I love - because even though Bean Sprout was only a few weeks old, I loved her as soon as I saw the picture of the blast they were putting back inside of me. I had hopes and dreams and fears for her.

It is Mother's Day and I'm waiting for Bean Sprout's body to finally exit my womb. I took two doses of Misoprostol this weekend with no success so far. I just took the last dose a few hours ago. I am hoping this works, because if not I will have to get a D&C, which I am trying to avoid.

I'm sitting here wondering if Christmas will be sad forever now?

Bad news

Went for the ultrasound today... there was no heartbeat. Bean sprout had stopped growing. More later.

To my blogging friends

I'm sorry I haven't posted in awhile. I don't mean to leave you girls hanging or make you worry. Things have been uneventful in terms of the pregnancy (It still feels unreal to say that). I feel like I am waiting for the ultrasound to confirm that Bean Sprout is ok. Luckily, I have had no spotting and very little cramping. I have had very little symptoms, which I am both thankful for but nervous about. Our first Ultrasound is this Thursday.

I also don't know what I should post about. I spent a year and a half trying to get pregnant and now I finally am, but I feel guilty talking about it on my blog. I know several of you ladies went through IVF right around the same time as me, but didn't get pregnant. I can't imagine how hard it would be for you to read my blog. I am so sorry about what you have been through. It breaks my heart that several of you, who have become my blogging and IRL friends, didn't get pregnant / did get pregnant but had a miscairage / had your IVF cycle delayed. I am still reading your blogs and rooting for you. I want to comment, but I hesitate because I don't want to cause you any more pain than you are already going through. I just want you to know I am thinking of you.

OB GYN

*Warning this post might piss you off and/or make you cry. It deals with unintentional pregnancies and pregnancy loss. I just need to get this stuff off my chest.*

I have been on my OB GYN rotation for several weeks and it has been really hard on me. At one point I thought maybe I would like to do OB GYN so that I could go on to be a RE, but I realized after only 2 weeks I could never surrive the 4 year general OB GYN residency I would have to do before specializing in OB GYN. In OB I saw a slew of women who were pregnant but didn't care about their unborn children. They did drugs, didn't take necessary prescription medications, and didn't take care of their chronic medical conditions that could harm their unborn children. One of the nurses said "If they loved their (unborn) babies ...xyz" and the doctor replied "well the problem is a lot of the women we see in this clinic don't love their babies." 

I saw women with a diagnosis in their medical charts of "unwanted fertility" (each time I saw this I silently raged), because these women keep getting pregnant, not wanting to get pregnant, because they failed to use birth control but continued to have unprotected sex.

At this point I was thoroughly pissed off. I think of all you wonderful ladies who would do anything to have a baby and would make wonderful mothers, but don't have your babies yet. I wish I could pull out a magical wand and put all these unloved babies into your loving wombs instead.

Then I saw several traumatic events that broke my heart. While on labor and delivery I had a patient come in in labor with a pre-viability pregnancy (but close) . She wanted her baby so badly. I could relate to her. We couldn't stop her delivery and we delivered her tiny baby, who was alive for about an hour before passing away. I was crying in the delivery room with the patient.

A few days later in procedure clinic I had a patient come in from her anatomy scan where they discovered her baby had died several weeks earlier. We had to perform a D&E. I won't go into details on this, but it was incredibly upsetting. Right after this procedure we had an add on D&C for an 8 week missed abortion. 

I elected not to take participate in or shadow at either of the local clinics that perform elective abortions. For this I am very grateful because I imagine that that would have damaged me even more.

I am really distressed and down. I know from reading IF blogs how miscarriages and losses are much more common than is discussed in society, but seeing so much first hand has really affected me. I had always thought I would be so happy when I got pregnant, and I am, but I am much more terrified then I ever thought I would be... I am praying for all of you ladies who recently found out you are pregnant that everything goes smoothly and your babies grow healthfully and for all you ladies that are still waiting that you get your BFPs soon.

Overjoyed and Terrified

Sorry to keep you all waiting. I've been waiting to write this post till I talked to one of my friends who reads this blog in person, I wanted to tell her the news before she read it. My beta from 9dp5dt was 137 and beta #2 was 238, which the doctor said was an adequate increase. Apparently, even though people talk of doubling, the cut off is more like a 66% increase in 48 hours. I am a bit nervous with 74% increase, because I have seen other women doing IVF who have had their betas triples or quadruple in 48 hours, but I am trusting my doctors when they say everything looks good.

I am in shock that I got a positive beta. I never peed on anything and I fully intended to wait till I got home from work to listen to the message with K. However, about an hour after I gave my blood at the lab I got a page from Dr. D (we work in the same hospital) that said, "Congratulations Dee! I am sorry, I couldn't wait. -Dr. D," which sent my heart into my throat, so I logged into my record and saw my first beta number. So I called K right away and told him, since I didn't want him worrying the whole day when I already knew the outcome.

I am so thankful for all of your support through this process. I don't think I could have made it this far without your friendships, support, and guidance. I know things are still very early in this pregnancy, but I hope that everything will work out.

I am simultaneously overjoyed and terrified. I feel really attached to bean sprout (as we have been referring to him/her) and I don't want anything bad to happen to him/her. (I call bean sprout a her and K calls bean sprout a him). Every time I get a cramp or pain in my abdomen/pelvis I panic. I still look at the toilet paper every time I go pee, praying not to see blood. I am calling to schedule my 7 week ultrasound today and I pray that we will see a heartbeat. I am trying to stay calm and excited.

7dp5dt

I'm 7dp5dt and doing well. I keep on going back and forth on whether I am going to test before my beta. My clinic tests on 10dp5dt so I am scheduled for my blood draw this Thursday morning, and they will call and leave a message with the result. Part of me is really anxious to test at home, because I really want to see a positive - and I want to see that positive right now! We have been waiting so long to see one. But on the other hand I know I would be devestated to see a negative, which has kept me from testing before today because I didn't want to see a negative because I tested too early. I feel like now at 7do5dt if I tested and it was negative, then there would be very little chance of it being positive with my beta.

In the past I always tested alone, with the hopes that I could suprise K with a positive, but I have decided this cycle I really want to find out at the same time as K if we are pregnant or not. I told K I wanted to test at home today with him, but he wants to wait. He thinks nothing good will come of me testing: that if it is positive there is still a chanec the beta will be low, which will devestate me, or if it is negative, I will be devestated, but there is a possibility that me beta could be positive. Plus, he says, I have waited so long already, so waiting 3 extra says for a more definitive answer would be better. I understand where he is coming from, and I really want us to find out together, so at this point I am planning on waiting till my beta (but it still is so hard, when I know that I could test right now and maybe find out I am pregnant). Even though the clinic will call in the morning with the message I will wait till we both get home from work to listen to it. Also, I don't want to find out at work where I won't be able to celebrate or mourn openly.

I am feeling pretty good. Most of the symptoms I have I had before the ET even took place or within the first 2 days after ET, so they are definately attributable to the hormones and progesterone/estrogen. My bloating and abdominal pain is finally gone - thank goodness! But I am still chugging a lot of gatorade just in case.

Break Down

I just had my first official IVF break down.

I got a letter in the mail today summarizing our embryo results. It says that they froze 2 blastocysts and discarded 4, which is very different from what I was told. 2 were ready to freeze right after transfer, and the other 4 continued to be cultured overnight, and the next day they told me they froze 2 more. I even relistened to the message I got the day after transfer and it clearly says "Good news! We were able to freeze 2 more blastocysts from the embryos we continued to culture." I called the RE lab right away and told them I had been told 2 were froze on day 5 and 2 were froze on day 6, but the lady I talked to said she doesn't know what happened the person who left the message must have read the report incorrectly and we only have 2 blastocysts frozen.

I am really upset. I know I am lucky to have 2 blastocysts, but I had been told we had 4, so its devestating to suddenly have half of our potential future children not exist anymore.

Frozen Embryos

After a dissapointing morning at work, were a physician told me that he was "against ART because if a woman can't get pregnant the universe is probably telling her something" and how he is "upset that RE's think they help people" (If only I were brave enough to respond to his comments, but I still had to work with him for several hours, and I'm not witty, so I just kept quite and gave him a look), things took a turn when I got a call from my Dr's office. They were able to freeze 2 more blastocysts! So now we have 4 frozen embryos. I know I was a little down that we only had 7 eggs fertilize but I am soo soo happy that 5 made it to blastocysts and were a high enough quality to freeze/transfer. It makes me hopeful that they are a good batch :)

I started feeling nauseous, having some lower abdominal pain and bloating, and just feeling sort of blah yesterday. Is it normal to feel this way after the ER/ET/all the hormones? I know these could be signs of early/mild OHSS so I am trying to rest and drink a lot of gatorade, but then I also wonder if it's just the cummulative effect of all the estrogen and progesterone I am taking. I haven't decided if I should call my clinic. I haven't gained any weight, which I know is the main sign of OHSS.

Last night I gave myself my first PIO shot by myself! K got stuck at work and wasn't going to get home in time so I sucked it up and did it. It didn't hurt, but when I pulled the needle out a little stream of blood started dripping down my hip/butt. On closer inspection afterwards I realized I had injected the PIO fairly close to a site where K had injected some over the last week. I don't know if that contributed to the bleeding or if I just nicked a capillary on the way in or out, but the bleeding was the only notable difference from when K does it. I might have to give it to myself again tonight, because my Resolve group meets tonight and my injection time is during our meeting. Unless, of course, I find a lucky friend who wants to do it for me :)

Transfer!

I just got home from our transfer. Everything went smoothly, and luckily I knew what to expect from my friends who have already been through this. They transfered 1 embryo - an "excellent" expanding blast. We also have 2 "good" blasocysts that they are freezing today and 4 others that they will continue to culture till tomorrow and freeze them if they can *grow little embryos grow!*. We have cute pictures of all of them :)

I listened to circle + bloom before the procedure, which was very relaxing, and in a few minutes I am going to go get a massage. After the transfer K and I got to hang out in the room for 10 minutes and it was nice. We were laughing and debating which of our characteristics our children will have. Then I stopped at the co-op on my way home to pick us up a piece of coconut cake to celebrate. It is 75 degrees here today - beautiful and sunny. I can't imagine a more perfect day then today: eating coconut cake with K in the sun with a little embryo getting comfy in my uterus :)

No vacuuming allowed

I forgot to mention my favorite part of IVF: my 10 lb weight lifting restriction that started after 6 days of stimming and continues for a week or two after retrieval. My nurse was giving examples of what was too much weight. For example, a vacuum creates 25  lbs of suction, so she said no vacuuming! And a wet pile of laundry weight 20 lbs, so no laundry :) All of this was said in front of my husband, which was great!

Egg Retrieval and Fertilization Report

The retrieval went well. I think the IV was the worst part. And not even actually the IV - The anesthesiologist said I had small veins in my hands so he put the tourniquet on really really tight and then slapped the back of my hand several time to make the veins pops out. The needle actually going in didn't hurt at all compared to the slapping lol.

At 9:30 I went pee then walked into the OR. I remember sitting on the bed, getting warm blankets put on me, feeling pressure as anesthesia went into my IV, taking a few breaths of oxygen, and then I was out. I woke up ~25 minutes later and was pretty much ready to go (although I had to wait around for 30 minutes). The pain was fairly minimal. In fact, I was feeling a lot of pressure before retrieval, and  the pain afterwards was almost better than the pressure I had before. I went home and K and I watched Brave and Wreck-it-Ralph :) I feel so lucky that retrieval went so well. I took 2 tylenol 3's when i got home per my nurses intstuctions and a few hours later I was itchy all over. I also developed the hiccups. The hiccups were horrible, so I don't plan on taking any more tylenol 3.

I just got the fertilization report this afternoon. We had 11 eggs retrieved, all of which were mature. They were able to ICSI all 11, and as of today 7 fertilized successfully and are growing in the lab. They are doing well enough that we are tentatively scheduled for a 5 day transfer on Monday. I get to call on Saturday to find out what time on Monday, as they only schedule the OR 2 days ahead of time. Then my pregnancy test is scheduled for 4/18 - only 2 weeks from today!

I was hoping for more eggs (and more embryos) given my age, but I know the Dr.'s were conservative in stimming me so that I didn't get OHSS. (I only used half of the meds prescribed to me, so I have enough follistim and menopur to do IVF again without buying anymore meds!) I am trying to stay clam and have faith. I hope that the quality of the eggs and embryos is good.  If we are lucky we might have a few to freeze.

I really really hope that I will be pregnant in 2 weeks.

IVF Day 9

Sorry I only have time for a quick up-date. Went in yesterday for another follicle check and found out I was done stimming!

Right: 21, 18, 18, 17, 17, 14, 13, 13, 12

Left: 18, 16, 14, 13, 11

Lining:  8.8

We did our trigger last night - 10,000 beta-hcg. I was terrified of the needle since it looked so big, but it hurt less than the ones I do in my abdomen. K did a really good job. Retrieval is tomorrow morning!

IVF Day 8

Today's ultrasound showed good progress:

Right Ovary: 16, 15, 15, 14, 14, 13, 11, 11, 11, 10, 10

Left Ovary: 13, 13, 13, 12, 9

Lining:  7.6, trilaminar

Dr. D said I responded very well over the weekend! My follicles grew quicker than he expected (but not too fast). So I have to go back tomorrow for another ultrasound. Normally the follicle checks are first thing in the morning but apparently a lot of women in the clinic are close to triggering. They had already added on 7 patient tomorrow, so my appointment isn't till the afternoon. The plan is to possibly trigger tomorrow or Tuesday, which would make retrieval Wednesday or Thursday and transfer Monday or Tuesday (if we make it to 5 day). Right after my ultrasound Dr. D came quickly in the room and said sort of nervously, "you responded quicker than I expected so you are going to need to go home right away and take your Antagon." Luckily, I had it in the car since K and I went to our hometown for Friday/Saturday and I brought it with just in case, so K ran out and grabbed it and I gave it to myself in the clinic.

I was happy Dr. D was there. I asked him about culturing 14 embryos and how this was different than the original paperwork I had. He said the clinic had just changed their recommendation based on their newest research and statistics. In fact, they had just printed the new paperwork Thursday night, so I was one of the first to get the new recommendation.

Obviously, I am responding well to my low dose of meds and the number of embryos they want to culture is based on their new research so all of my worrying Friday was unnecessary. I am feeling hopeful and excited.

The circle + bloom meditations are going well. The only problem is that they get me so relaxed I sometimes find myself nodding off while listening to them. Especially when I listen to them right before bed. However, this is a good sign because normally I have a really hard time falling asleep. I lay in bed and my mind runs a mile a minute with worries.

IVF Day 6

I had my test at 9 am this morning so I went to the clinic to get my ultrasound at 7:30 so I would have time to make it to my test. I didn't know what we were expecting to see after 5 days of stims. The US showed 6 follicles in the 8-10 mm range on the right and 3 in the 8-10 mm range on the left. There were 11 smaller than 8 mm on the right and 5 smaller on the left that weren't measured. We went to wait in the consult room (yes, K came with me!) but then the nurse came in and said the Dr. wanted me to get blood drawn. At our original consultation Dr. D had said that my protocol would have no blood draws (they didn't need to measure estradiol), so I immediately became concerned that something must be wrong if he now wanted blood (I even had the thought that they were going to cancel my cycle and got very upset). However, by the time I got the blood drawn it was 8:35 so I had to leave and go to my test. I think my test went well, but I won't know my score for awhile. I then returned to the clinic. I met with Dr. D, who told me my E2 was 131 (which seems low to me compared to some other numbers I've seen) but that he was happy with that level and the US results. He said in someone my age it is a balance between overstimming and understimming.

Dr. D wants to keep my doses the same and have another ultrasound and blood draw on Sunday morning. I am a little concerned that my dosages are so low, but I am trying to trust in my Doctors and their knowledge. I don't know of any other women who have undergone IVF at 24 with a high antral follicle count to compare my dosing to (Or even if I should be comparing my dosage, because it will just cause me to stress more). I know the goal of IVF is to get me 1 healthy baby, but I have this additional hope that it will also give me siblings for my 1 healthy baby. I know I should be focusing on getting my first baby before I think about the siblings, and I would go through IVF more than once if I needed to to get siblings, but I have always wanted a big family - like 5 children big :) IVF is expensive and emotional so I want to get as many babies out of this cycle as I can.

Another thing that threw me off is we discussed how many embryos they will culture. The paperwork we signed today says they want to culture all of them if there are 14 or less or culture 10 and freeze the rest at the pronuclear stage if there are 15 or more. In our original discussion they have used 8 as the cut off. I don't know why it has increased. I wonder if it increased based off of their reccommendations for getting us the healthiest blastocyst or because we agreed to the warantee? I signed the paperwork but I am sort of wondering if I should ask about the number we will culture at our next appointment. But then again I am trying to trust my doctors and worry less. I know I don't know much about IVF, especially compared to my Doctors, but it is hard not to second guess them and worry when I have so much riding on this one cycle.

IVF Day 5

I can't believe I have made it to day 5 already. Time has really been flying! I got off of work at noon today to study, so I went and got a massage. Yes, i know, a massage does not equal studying, but it was so so much better than studying :) Now I have to spend the rest of the night studying... boo!

My stomach is a bit sore when I injected the menopur. It feels bruised, but it doesn't look bruised. I think it might just be that when I pinched together my skin for the injection I squeezed a bit too hard, but then again it could be from the medicine itself. I guess I will find out tomorrow when I see if my next menopur injection site is sore or not.

I will share my ultrasound update as soon as I can tomorrow!

IVF Day 4

Thank you everyone for your comments and support. It means a lot to know you are reading my blog and cheering me on. Only a few people know that I am in the process of IVF, so it means a lot to see words of encouragement.

Things are going really well so far. I am still really excited - I am having trouble studying for my test in fact, because I am so excited I just want to read blogs and search things on google. However, I have a test right after my follicle check appointment on Friday so I really need to get studying!

I got to add the Menopur to my regimine tonight and decrease my Follistim dose. The shots went well except at one point K came over and was watching me inject myself, which made me nervous, and I started to stick myself, then panicked and pulled it back out, before thrusting it in again. So I stuck myself three times tonight :)

IVF Day 3

My second injection went quite a bit better than my first. It didn't seem to hurt as much as the first and I was more comfortable injecting myself. I am actually excited each day to give myself my shot because I know it is bringing me one step closer to my dream of having children. I am feeling very positive and hopeful right now, as I think I should, because it just might help me get pregnant. I just hope the menopur and antagon shots are similar.

Yesterday's headache resolved 2 hours after 2 tylenols, dr pepper, and dark chocolate :) I woke up today without a headache - yay! But I am starting to feel a little one developing. Maybe I should attempt to stop it in its tracks with more chocolate? lol. In other news, I am feels some twinges and fullness in my lower abdomen, which I am guessing is either because 1) I am hyper-aware of my lower abdomen and am probably just noticing normal intestinal movement or 2) I am bloated, possibly from my medications.

Tomorrow I start double injections and only 3 days until my follicle check! I have been visualizing growing a good number of high quality eggs. I hope that there are a lot developing, but mostly that is because I hope we get enough embryos that we can freeze some to create siblings for our baby later.

IVF Day 2

I woke up with a headache :( Is it a side effect from the Follistim? And unfortunately I don't own tylenol. I've been an ibuprofen girl my whole life - I just love it so much! But, my Doctor said I can't take any ibuprofen during IVF, only tylenol. So I had to run to the store on my way to work and get some tylenol. After taking it (and a Diet Dr. Pepper) my headache is mostly better from a 5/10 to a 2/10.

The injection last night went pretty well. I was inspired by Emily and have declared that my husband shall seranade me with "shots shots shots shots shots..." each evening. Last night he seemed a little tentative, but I hope his enthusuasim will improve. The actual shot went pretty well. The needle didn't hurt, but the medicine stung a bit going in and for maybe 20 minutes afterward. I am using the follistim pen. Once I pushed the needle in to my pinched stomach I injected the medicine at a moderate pace and then left the needle in for about 10 seconds before taking it out. When I pulled the needle out one clear drop came out of the injection site, is that normal? Should I inject the medicine slower/quicker or leave the needle in longer? I realize it might not be that much medicine, but since it costs so much I was to get every last drops worth :)

I have enjoyed the circle + bloom meditations that I have listened to so far... other than at one point when I was deep in meditation, my husband came and stood with his face 2 inches away from mine for a minute and i didn't respond so he poked me, which brought me out of my peaceful state to see his face right infront of me and I hadn't realized he was there because I was so relaxed... I think I might have screamed lol.

I found myself in surgery today with a room of pregnant ladies... I'm taking it as a positive sign.

CD 1 and Treatment Day 1

My type A personality is very pleased that CD1 is also treatment day 1, but presumably that happens for most people doing IVF (at least on my protocol) since they had me stop birth control 3 days before starting injections. I told my husband that if we are lucky this will be my last period of 2013 :) Wouldn't that be nice?

In about 1.5 hours I will give myself my first Follistim injection! I am really excited and feel like this cycle is going to go by really quickly. I downloaded circle and bloom's ivf meditations to my ipod and plan on listening to it everyday. There were 3 to listen to before starting injections that I didn't know about so I need to listen to those really quickly before 7:30 pm.

Making My Return!

I’m sorry I haven’t posted in so long! I’ve been on my surgery rotation for the last 5 weeks and it almost completely took over my life. I was getting up at 4 am and not getting home till 7 pm most days.  My life consisted of: work, eat dinner K made me, sleep, repeat. Luckily, I only have 1 week left.  

On the plus side, surgery did a good job of keeping me busy while I waited for the time to pass till IVF starts. I took my last birth control pill on Thursday 3/21 and will start my injections tomorrow. I have a nice progression of shots planned: 1 for a few days, then 2 for a few days, then 3 for a few days. My first US appointment to check how things are developing is on Friday 3/29.

At our baseline US last week my lining was 3.9mm and we had 26 antral follicles – 11 on the left and 15 on the right.

The Plan, Resolve, and Depression

Yesterday I called the IVF clinic and told the nurse that I had gotten my period (which definitely is a period now). At first she tried to tell me that I had gotten my period one day too early for this upcoming IVF cycle and would have to wait till my period next month. However, when I was at the clinic the other week they told me I could start IVF if I got my period between Feb 7-March 28, and that is even written on the paper they gave me, so I was a bit persistent that the nurse check with the doctor. I tried to be nice and told her that that didn't sound like what the doctor had told me. K says I get pushy at the clinic, but it's only because I don't want to have any regrets that I didn't advocate enough for myself enough during this process, so I always am vocal about my needs and desires with the clinic. She eventually called me back and told me that the doctor said I can start taking the birth control and that K and I should take our antibiotic at the same time, which we did last night. So I have now officially started IVF, although it feels like I am still waiting. My first US is 1 month from today - March 14, and then we will decide what day I will stop taking the birth control. The nurse told me I will tentatively stop March 20, which will be 35 days of birth control and then would start stimming March 23rd. They ordered all my meds and I will pick them up from the hospital the day of my baseline US.

Last night I also went to my first Resolve group meeting. I had seen a flyer advertising the group at my IVF clinic and I thought it would be good to talk to other ladies going through infertility. I have been very quiet about everything I have been going through with my friends and family. At first I was talking to one of my very close friends about my frustrations when K and I started ttc, but as troubles kept arising she kept telling me that everything would work out and that everything was in God's plan, which I know she was only saying to try and make me feel better, but it just made me feel worse, so I stopped talking about my struggles with her. Recently I have been feeling more and more emotional and can tell that K is hurting because I'm so upset all the time, so I have been trying to find new outlets of support and emotional well-being.

Shortly after my Mom was diagnosed with cancer I started on anti-depressants. However, I stopped them when K and I started ttc. I have been wondering recently if I should go back onto them, especially after listening to Mo on the Bitter Infertiles podcast talk repeatedly about the importance of treating depression when ttc. I don't know why I am resistant to go back on them, other than the fact that they were soooo horrible to stop. I felt jittery and irritated for about 3 weeks coming off of them. I scheduled an appointment with my OB/GYN next week because I need to get a pap smear and my TSH checked for IVF, but I am thinking about discussing starting anti-depressants with her. I also emailed 2 counselors in the area asking them if they had experience with patients dealing with infertility, but neither has responded yet... I sort of feel like I shouldn't be depressed. I have so many wonderful things in my life - a great husband, the financial means to proceed with IVF (although I would much rather have my parent's alive then to be able to afford IVF with their life insurance policies), a good education, and a job that lets me help people. But at the same time I feel so angry that I have had to go through infertility and losing my Mom (after losing my Dad) in the same year. I feel isolated because I don't know anyone else who has no parents and has no children (that she wants desperately to have.)

Which brings me back to the Resolve group. There were 5 great ladies there who I really enjoyed talking to, and 2 of the ladies are going through IVF/FET at my clinic and were able to give me a lot of information and advice. The group meets once per month, which will be great for me. I kind of wish they met even more often!

Suprise!

*Possible TMI warning*

When I went to the bathroom after getting home from work tonight I had a suprise waiting for me. It seems I am bleeding on only CD17. I totally wasn't expecting a period at this point. I wiped and was like "hmm is that blood?!" I had already thrown my work clothes on the floor and was going to put on pjs, so I picked those back up and looked and apparently I had bleed through my underwear and even through my pants, which luckily were only scrubs. I am thinking quantity wise that it is enough to count as CD1, but it was more dark, old blood and I didn't see any bright red blood... I am supposed to take my antibiotics and begin my pre-IVF birth control when I get my period this month (which wasn't supposed to be for 2 more weeks!). So I am unsure if I should go ahead and take all of that tonight. I might wait till the morning, when I can call the clinic and see how the bleeding progresses... which if it does I am thrown off but totally happy if it means we can move forward with IVF quicker!

Twiddling my Thumbs

To keep myself busy over the next 1.5 months my goal is to lose 5 pounds. I want to get my body ready for pregnancy *fingers crossed* so I want to eat healthy and be at a healthy weight. I am not overweight per se. My BMI is 24.5ish, but I weigh close to the most I've ever weighed. My plan is to re-direct my obsessive tendencies at healthy eating and weight loss. Brilliant right? :)

IVF is a go!

So we had our IVF appointment today and it looks like we are cleared to move forward with IVF! The plan is for me to wait till CD21 this cycle and then take provera for 10 days to induce my period (since I most likely won’t ovulate this cycle or get my period at an appropriate time since I am not taking Femara). Once I get my period I will call the clinic and start taking the pre-IVF birth control and K and I will both take an antibiotic. Once I have been on the birth control for ~2 weeks I will go in to make sure I don’t have any cysts. I will continue on the birth control for a total of 19-30 days so that my cycle syncs up with several other women who will be doing IVF with me. Then I will stop the birth control and begin stimulating with Follistim and Menpur. I don’t remember the exact protocol the doctor wants to use, but I will be getting a copy of it at my next appointment. After reviewing my previous ultrasounds (antral follicle count over 30) and history of irregular periods he feels that I do have PCOS, so given my PCOS and age (24) he feels I am high risk of OHSS. He is going to try to prevent OHSS by using a certain protocol the clinic has been using on PCOS patients with good results. It involves using a GH antagonist after any follicle is greater than 12 mm and then using a GH agonist to trigger when the follicles are >18 mm instead of beta-hcg. After retrieval we will do ICSI due to K’s poor count/motility/morphology and I will start Progesterone injections. The plan is to do a 3 day transfer of 2 embryos if we have 6 or less fertilized eggs, and do a day 5 transfer of 1 blastocyst if we have 7 or more fertilized eggs.

So the general schedule looks like:

Start Provera: Feb 16

Periodand begin pre-IVF birth control: ~Feb 28

Begin Stimulating: ~March 31

Retrieval: ~ April 13

I really liked the Dr. even though I will be working with several of the Dr.s in the clinic depending on who is on call. We were in the clinic for over 4 hours and they were very thorough. We were able to meet with a financial advisor and we qualify for the warranty, which means we can pay a lump sum which will cover IVF and as many FETs as it takes to get pregnant and carry that pregnancy into the 2^nd trimester or we get our money back. I am hopeful we will get pregnant, I just don’t know how many rounds of IVF or FETs we will need so it’s nice being able to just pay this once. (If we don't get pregnant and have no frozen embryos to transfer we get our money back and can choose to reapply for the warranty and do IVF again). For those interested the lump sum is $16,000 of which $14,500 is refundable for someone my age. The $16,000 covers everything but meds and our initial consultations/tests, which we already had done.

The Dr. said our chances of success are:

74% if we have 1 great quality 5 day blastocyst to transfer

60% if we have 2 fair-poor quality 5 day blastocysts to transfer

56% if we transfer 2 3-day embryos

I am ready to get started. I know there are a lot of “ifs” still left to play out: A lot of ifs about timing, the protocol working correctly, getting a good number of eggs, fertilizing a good number of eggs, have the eggs develop and grow healthily, and not developing OHSS (if I do develop it they will freeze everything and have me do a FET). I really hope that everything works out and that everything goes smoothly (although I’m sure it won’t since nothing seems smooth to a woman who really wants to get pregnant and is hopped up on a lot of hormones and drugs). Honestly, I won’t care as long as I can get my baby in the end!

CD1

It's cycle day one again. Not really a suprise given those morphology results I got in the mail yesterday. This is just another reminder that IVF is probably our best option.

SA results

So... We just a letter in the mail regarding K's most recent SA. His count was increased (20 million/mL, 50 million total) but percent motile was down (18%, 9 million total motile sperm). This time they checked morphology, because for some reason they hadn't checked morphology for either of the other 2 SAs that he has done (They pointed out that we did pay for them to check morphology when we did the IUI in November, and they charged us for it, but "for some reason didn't perform it" hmmm). The letters from our hospital with lab results are always formatted poorly so I am trying to look for an actual normal morphology percentage and I can't find one. The morphology section (Tygerburg criteria) is broken down into:

strictly normal HS (0),
acrosome defect (1),
moderately amorphous (19),
severely amorphous (71),
abnormal head size (0),
pyriform defect (7.5),
borderline head shape (1.5),
and other defect (0).

All those number do add up to 100, so perhaps they are percentages... which means we have 0% normal sperm?? I am glad we only did 1 IUI if that is the case. Although I wish they would have checked this earlier so we didn't waste a whole year trying to get me to ovulate, when K's sperm are such that they probably can't naturally fertilize any egg I would produce. I assume this means we will do ICSI with our IVf. I only wonder/hope if the results are so bad that we won't be able to use his sperm? Time to begin googling...

Do you girls think I should contact HR or my Dr and complain about the whole morphology issue? Since I saw we were charged for it in November and the packet said they check morphology for all IUIs, I assumed they checked morphology then and as the clinic generally says "No news is good news." I assumed morphology had been checked and was ok. If we knew we had 0% morphology in November we could have start IVF several months ago... ugh! As K said "So everything we have done so far had no chance of working?" It seems we have wasted a year with a lot of ups and downs, hope and despair, for naught. And although some of it was unavoidable we could have avoided the hope and despair of November, December, and January if they had completed what they were supposed to do. As it is I have only found out about this in the letter. The doctor called and told K his count/motility % and never mentioned the morphology. On top of it all, I just checked the bill, and I think they charged us for morphology again, even though it was supposed to not be charged since we already paid for it in November.