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!