IVF Revisited

We did 5 fresh IVF cycles and 7 transfers to get Lucy and Clara here. During the process I researched and read about it as much as possible. I tracked hormone levels, medications, my response, and the results all on my blog. I found other bloggers going through the same thing as well as friends in real life through yoga for fertility to connect with. 

For a while there it felt like my life revolved around the IVF process. In the end it was totally worth it, but I can't say any of the details are still super clear at this point. Time has served it purpose in helping me to forget some of it. 

A few months ago my step-sister Liz started the preliminary processes to begin an IVF cycle. Her husband was married previously and he has two teenaged children. After the birth of his second child he had a vasectomy. This meant he would have to undergo a sperm aspiration surgery, but they knew that going into it. 

Through the initial blood work of hormone levels Liz learned she had DOR or Diminished Ovarian Reserve. Her FSH levels were very high and the drs didn't expect a great response from the meds. 

Despite what they learned they decided they still wanted to go through with the IVF. Abnormal TSH levels and a referral to an endocrinologist created another small bump in the road, but finally at the end of June she was cleared to start stims. 

Once her cycle started we began texting pretty much every day. I helped clarify things for her, explained the purpose of some medications, tried to calm her down when necessary, and cheered her on when her body had a great response. Her egg rerrieval was last Wednesday and they got 17 eggs!! Unfortunately the following day she learned that only 2 fertilized initially and that once fertilized many others degenerated. That day 3 others also fertilized. 

Liz transferred a 7 celled embryo on Saturday (they opted for a single embryo transfer-perhaps because my twins scare her, haha). She's currently in the two week wait. 

During this process I revisited some old blog posts in order to share with her. It immediately put me right back in that place and was such a reminder of the fact that I am a "success story" with infertility. I'm living life as a mommy to beautiful twin girls. That are ours. From our genetics. Grown in my body. 

These facts are amazing and not lost on me. My girls are so perfect and I feel so lucky to have them despite everything we went through to get them here. 

Reliving the process through my step sister reminded me how strong every woman is to go through that. Our babies may not realize it or appreciate it, but we put ourselves through a lot just for the chance to have them. 

So, if you get a second, please send positive and implanting embryo vibes to my step-sister Liz. We all know she could use them! 

Here's hoping I'll have a new little niece or nephew next April to snuggle. 

Thanksgiving success

Our first time hosting Thanksgiving was a complete success. We had my sister, her husband, my mother, my step-father, my little brother, my mom's friend, and my Dad, so 9 people total. This was the first time my parents celebrated Thanksgiving together in 20 years. The turkey came out amazing and wasn't dry at all. All of the food was delicious and I got my appetite back just in time. We did end up forgetting the stuffing on the table, but nobody missed it. Next time we will consult our menu when we put the dishes out on the table. The table looked great, and I got some fun ideas from Pinterest.

I also made a pie. Can you tell what the design is without me telling you?

My sister, her husband and I went black Friday shopping late Thursday night. We went to Wal-Mart (not my favorite place, but my sister's favorite place) and it really wasn't as crazy as I expected. Most people were there to get TV's and I managed to get a good deal on a digital camera for my dad. I also got some DVD's for myself (4/5 seasons of Six Feet Under) cheap. It was so nice to be able to spend time with my sister but not have to be at her house. She and her husband both smoke cigarettes and he loves the T.V to be loud. He also doesn't like bright lights so we often sit in the glow of the T.V. Being at their house means sitting in a smoky, dark and loud environment. It was nice to be able to control things but also spend time with K. 

K and her hubby have been TTC since their wedding in July. When we were in Wal-Mart K had to go to the bathroom. When she came back she said, "I am thankful for my period on Thanksgiving" and I could tell she was super bummed. Although she hasn't been trying for long, I can still feel her disappointment about getting her period instead of a positive pregnancy test. I am feeling better about her trying and the possibility of her getting pregnant first. I think because it didn't happen her first month of trying, I will be OK with it. I really hope we both get pregnant soon so that our babies can have cousins close in age. 

When K came she brought a flash drive with her wedding photos on it. I was able to look through her pictures and am amazed by how ballooned I look from the IVF. Her wedding was July 21 and I had my retrieval the 12th. I look so puffy in all of the photos, and I'm so glad we captured those moments in my life forever. Oh well, no one else knew and no one asked me if I was pregnant at the wedding, so maybe I just see it because I know. 

In other news the bleeding has stopped. I now know it isn't my period, it just isn't the same. I was bleeding heavy on Tuesday and Wednesday and by Thursday it had slowed considerably. Friday and Saturday I had the tiniest bit of spotting and it was brown rather than red or pink like previously. Nothing so far today. W and I have talked a lot about what we want to do and it is difficult. I think the spotting and bleeding will be gone by Monday, but I worry what this has done to my lining. The hardest part it is seems nothing is ever ideal. This month the issue is spotting and bleeding, but next month who knows what it will be. Obviously we want the most ideal situation possible, but I don't think it's ever going to be ideal. We will see what Dr. S's opinion is.

My anxiety has declined tremendously and my nausea is much better. I have an appetite again and know I need to get back to the gym. I'm sad its Sunday, but looking forward to my appointments tomorrow. Hope everyone is relaxing and having a great weekend. 

Changes

Leave it to my body to make up its own mind about things. I can't expect everything to go according to plan, can I?

I woke up to the tiniest bit of spotting. By 9:15 I was bleeding. By 10:00 I was ready to confirm it was my period. By 10:30 I was on the phone with my RE asking him if he still wanted me to come to my appointment tomorrow. Yeah, I made a lot of trips to the bathroom today. 

He said that the bleeding wasn't likely anything to be too concerned about, but that it may change our plans. Yeah, it definitely will. 

I'm bummed that things are going to change. There is a slim to zero chance we will be doing our FET on December 5th. 

On the other hand, I'm glad AF finally showed. I've NEVER skipped my period before, although I've had some cycles in the 40 day range. Today is 48 days since my D&C and hysteroscopy. It is 15 days since my last progesterone pill, so it is hard to say what is going on. 

When I was planning on a December 5th transfer I didn't think it was going to work. I didn't understand why I would skip my period for the first time ever and then transfer embryos something like 60 days later and expect them to hang around. I just wanted to complete this cycle regardless of the outcome. To move on and move forward from the IVF cycle from hell. 

I started Lupron for my original round of IVF last January. I never made it to stims. In July I started stims but never made it to transfer. I am SO READY to complete this IVF cycle already.

The fact that I actually started my period gives me hope and makes me much more optimistic for the success of this FET.  

I still have my appointment at 9:00 tomorrow. I'm hoping we can come up with a new plan that doesn't put us back by much. We had been considering 11/11 CD 1, so today is only 11 days after that. I would really like to complete 1 IVF cycle in 2011. Is that asking too much?

The Two-Minus-One Pregnancy

So someone else shared this story on their blog and I just read the entire story tonight. It is long, but well worth the read. 

The Two-Minus-One Pregnancy

I guess I am the IVF'er who would prefer twins. I can't imagine working so hard and spending so much to get pregnant and then reducing from twins. My opinion is if you can't handle the thought of twins, then do a single embryo transfer. 

What are your thoughts?

Hello again disappointment

The nurse called today and said we will not be able to do the FET this cycle. My RE wants me to come in for another ultrasound when I stop bleeding. He wants to be sure the fluid is gone. I guess if I were to start the estrogen and start building up my lining it could mask the fluid. If the fluid is still there he wants to do a biopsy.

The ultrasound tech is on vacation next week and I don't have an appointment until August 8th.

 I am frustrated to say the least.

Now the debate is whether to wait another 7+ weeks to do the FET (my cycles unmedicated are about 35 days), or whether to start another fresh IVF. I was willing to do the FET this cycle because it would give me closure on our cycle. I didn't have a ton of hope in the fact that the embryos that were frozen were as follows: 1 6-celled embryo graded 4+, 3 4-celled embryos graded 4, and one fertilized egg that hadn't started to divide. It was always very clear they were slow to develop.

So I'm working on a pro's and con's list of IVF and FET.

FET

Pros:

The only cost is the meds (estrogen)

It may work and we could get pregnant for the cost of one IVF cycle

It gives me closure on our cycle and allows me to say we completed an IVF cycle

Cons:

The chances of success aren't great

Our embryos are not as many cells as they should be for day 3 embryos

We have to wait 7+ weeks

The best embryo may not survive the thaw and we would be left with only 4-celled embryos to transfer

IVF

Pros: Doing one cycle prior lets us know that we need to ICSI all eggs and may result in more embryos

We could be transferring fresh embryos in about 7 weeks

The chances of success are higher

We have all the meds we need

We can start this cycle (I think)

Cons:

$$$$

Our embryos could be slow to develop again

Fluid could return since we didn't know what caused it

I really can't make any decisions until the ultrasound to know whether the fluid is gone. Today W and I had a conversation about where to go from here, how much disappointment this has all been, how far we are willing to go with fertility treatments, and how this will all (hopefully) be worth it. Needless to say, the disappointment continues.

Mind and Body

This week has been crazy but great. I have been busy writing reports, attending meetings, and doing therapy with work. In addition, I discovered a great place and realized things about myself personally and started to take control and action. 

On Monday I attended a support group for infertility with W. They mentioned the CNY Healing Arts and Wellness Center which is located next door to the fertility clinic where the support group was. They mentioned fertility yoga, so I decided I would go the following night (Tuesday). After the class I knew I needed to make some changes personally so I could feel good about doing everything in my power for success. 

Well, it was amazing. I can't recommend it highly enough. At first I was a little nervous since I haven't ever actually gone to a yoga class (only done DVD's at home). While it was a little "out there", I loved the instructor and she gave me lots of feedback and made me feel welcome and supported in the class. The class was from 5:50-7:00 and cost $7.00. After the class some of the ladies met for a little support group. That was one of the best experiences I have had so far with my journey through infertility. As much as blogging is a great release and I have "met" some amazing people, talking with people in real-life was just so different. It wasn't led or directed by anyone like the group the previous night, it was just women talking about similar situations and sharing stories and advice. I know I will continue the yoga each week and attend the support group after. The monday night once a month thing, we will see. 

Since I was feeling so great and empowered from the yoga I decided I was going to start acupuncture. I have been in the past for other reasons, but never to this place. It was great. I had been feeling stressed and nervous, but since have been feeling relaxed and in control. I know I will continue through this cycle, just not sure how often since it is expensive. 

This week I have made some realizations about my fate. Just because I pay all the money, do the shots, show up for appointments, and have the procedures does not guarantee success. Physically and mentally I wasn't in a great place recently and this week I have completely turned it around. I started feeling in control of those things I know I can control and have a positive effect over (my mind and body) and have decided to let go and try not to control or understand (too much) the process of IVF.

 I made some dietary changes and have felt great about doing so. I feel positive and much less stressed and am preparing my body the best I can for what it is about to undertake. I hope getting my mind focused in the right direction will help. In effect, I am feeling more positive and optimistic. 

What I do know for certain is that I feel great, I feel in control, and I feel like I am ready emotionally, physically, and mentally to take on IVF in my best possible state. I better be though because we started Lupron tonight! 

Workin' Fool

Today marks two years that I have been working as a Speech-Language Pathologist (SLP) in my current job. I graduated with my master's two years ago and starting working less than a month after. I love my job and am constantly grateful for a rewarding, challenging, and well-paying job. My benefits are great (minus covering IVF), and my surgeries, ultrasounds, appointments, and medications have been (mostly) covered. As a great addition, W starting working this week. I can't even begin to express the huge financial weight that has been lifted off my shoulders. It's not exactly the weight of the world, but you get the idea. I can look forward to working less and letting him make some mortgage payments. The great part is we bought a house we can afford on one income, so when I finally do get my take-home baby, I can work as little or as much as I want (emphasis on the little part).

To be honest, I never thought I would work this long without at least being pregnant. Not that working for 2 years is that long, it's just that it wasn't my plan. Part of why I took my current job was the fact that I make my own hours and schedule and can determine how busy I want to be. Sounds perfect for someone with a young child, doesn't it? You don't have to tell me! Oh well, good thing I like it.

I want to ask for a raise but am not sure how to go about it. We don't have performance reviews and I basically only correspond with my boss (that one who does the business aspects) through email and rare phone calls. I think I may ask for a performance review and would only ask for a small increase, but feel nervous about it. Any suggestions?

On the IF front, I will start Lupron in a little over a week. Time has been going by relatively fast lately between being insanely busy with work and getting ready for our party on Saturday. I am supposed to call the nurse tomorrow to give her an inventory of my remaining meds. I got a cycle's worth of IVF meds for free from fertility lifelines about 7 months ago. We used most of a 900 IU Gonal-F pen last month for the IUI, but have 3 more pens, Menopur, and a Lupron kit (minus one dose). I will need an HCG trigger, more Lupron, and probably another Gonal-F 900 pen. I am pretty sure my insurance will help with the Lupron and know it will for the HCG, but am not sure about the Gonal-F. My insurance does cover IUI's but I'm not sure if they also cover injectables. The Clomid was cheap and covered, so hopefully it will be the same with Gonal-F. I will ask the nurse about donated meds since that is how I got the Lupron last time. We will see. I can't wait to get this cycle started since doing nothing feels crappy. At least when I am doing something, I feel closer to the end goal. No one likes being in limbo, really they only like playing it.

Doesn't that look like fun? 

My only question/debate at this point involves progesterone. Last cycle (with my IUI) I ended up breaking out in hives and I'm pretty sure it was due to the progesterone. I'm not sure why since when I was pregnant I took it 3x's/day for 4 weeks without any problem. This time after about 4-5 days of starting my legs got these itchy bumps that spread and got worse with time. As soon as I stopped the progesterone they went away. I will mention it to the nurse and see what she says. 

IVF here we come...again (sort of)

So we got the green light for an IVF cycle next month. AF arrived promptly on Friday (exactly 2 weeks after day 2 of IUI's) and I called the nurse at my clinic. At first the nurse starting listing everything we would have to do, and then I reminded her that we completed all of those steps in January. In case you don't know, we had started an IVF cycle in Jan after I learned my tubes were blocked in late October. Come to find out, the Lupron helped me to ovulate and when I went for my suppression check (ultrasound) there was a gestational sac. I did Lupron for a little over 2 weeks and that was the end of that IVF. Apparently at least one tube wasn't blocked. 

During our initial conversation the nurse said she would talk to my RE and give me a call back. She called a few hours later and gave me some tentative dates and my protocol. I will be doing the long Lupron protocol and was instructed to use some form of birth control this cycle. Here are the dates: Lupron start date June 16th, ultrasound/start stims July 1, retrieval July 12th. The only date I am going to count on in the Lupron start date. From there, I am going to roll with it. I am excited and nervous to have a plan in place and am now feeling much tighter with money. I want to do some research on ways to improve egg quality since this is a concern of mine. I am hoping there are some supplements are items I can add to my diet that will help. Anyone know of anything?

Around the homestead our garden is doing well. Below is the "map" I worked on this evening which shows everything we planted in our vegetable garden. A lot has come up from seeds, and some we planted as larger, already established plants. I will have to take a "real life" pic since it doesn't look as great as the map. 

I am so happy to have a 3 day weekend to relax. We always say weekends are too short and this one feels like a great amount of time. Only 2 weeks until our party so we are planning and working a lot on stuff around the house. I hope everyone is having a great weekend and getting as much beautiful weather as we are. 

IUI #2 CD 28

Yesterday I gave the HPT another shot. BFN as expected, so I stopped the progesterone. I was bummed on Tuesday, but it didn't really bother me much yesterday. I'm over it and over IUI's to be honest. I am now just waiting on AF and hoping she shows sometime soon. 

I've started working with this new child named Alex, and yesterday was the first time I saw him at home. I had seen him at preschool two times prior. He was just diagnosed last week with Autism and is 4 1/2. He has only been receiving therapy services since December, so he is fairly new to the system. It didn't work out with the last speech therapist and my boss (who is the occupational therapist working with him) recommended I work with him. 

Well, yesterday afternoon ended up turning into an extreme tantrum and I left feeling so upset. The first half hour went fine and although his attention was fleeting, he was pretty under control. Well, then I started talking to his Mom, and he didn't like that. He ended up (after about 20 minutes), screaming at her and hitting her repeatedly. He was so upset by the time I left nothing was going to calm him down or change his behavior. I spent the whole night feeling so sad for this mom who has to deal with this behavior regularly, and upset because I felt in over my head. She said his tantrums occur at least once a day and on some days more often. I am such a firm believer in early intervention and getting involved before behaviors reach this level. I was completely overwhelmed by the situation and spent a lot of time thinking about it. I even had trouble falling asleep last night because of it. The reality is, when you work in people's homes with children and don't have a support and problem solving team around you, it can be overwhelming as to how to deal with a situation. 

I called my boss and talked with him about it last night. He helped me to problem solve the situation. Bob is a great guy and is always really helpful when I find myself in a situation I'm not sure about. He will come to sessions and give me input if I feel I need it, and I always say he constantly thinks outside the box. Bob had been planning to see Alex today so I decided I would join for some of the time and see what their sessions were like.

The mom actually thanked me for coming back today and it went much better. I am now feeling more in control of the situation and know how not to push this child. I guess in life there are many learning experiences, but some are harder to process than others. I will only see this child until the end of the school year, but he made the children I previously thought were difficult look easy. 

Sorry if I lost your attention talking about work, but it was on my mind and was very upsetting to me. In fact, I completely forgot all about the failed IUI and was upset for an entirely different reason yesterday. 

If you stuck with me to this point, thanks. 

I am pretty sure we will be moving on to IVF next cycle. The thing that concerns me most is that I ovulated on Lupron and got pregnant the cycle we were going to do IVF. Since my RE didn't think I was ovulating, he chose to start me on day 21 assuming it wouldn't be an issue. I just don't want to wait until after I ovulate to start Lupron since when I do ovulate it is very late (that month it was on day 25ish). I will ask the nurse about it when AF shows her face (hopefully soon). Since we did all the preliminary stuff for IVF in January, there shouldn't be any additional testing needed. We will see though. 

IUI #2 CD 1 (a new plan)

This morning when my period still hadn't arrived I started to get nervous (since I made an appointment with my RE to talk about our next cycle) and a little excited. I got out my HPT and went for it. When I wiped, there was a little bit of blood on the toilet paper. My response? Someone is laughing and it's not me! Oh well, I knew this cycle didn't work so I was ready to get AF and move on to the next cycle. I was just bummed I wasted the test because I didn't even have to look at the result to know it was negative. 

We had our appointment this afternoon and I left feeling so much better about things. It seems like when  I ask I tend to get what I want. I never complain about getting what I want, that's for sure (just ask my hubby). We talked about the next cycle and my RE gave me a few options and leaned a certain way with his opinion. He said that we could up the dose of Clomid and try that again (although he didn't think it was that great of an idea to try it again), we could do injectables and another IUI, or we could do IVF. We talked the most about doing another IUI using injectables this time. He said it would include more monitoring (blood work and more ultrasounds) and I felt most comfortable trying another IUI given different circumstances. 

 So, we will start Gonal-F on Sunday (CD 3) at 75 IU's/day. I will go in on Tuesday for a baseline ultrasound and to check my hormone levels. I am really happy with our new plan and hoping for some good follies this time. I'm pretty sure if we aren't successful this cycle we will move on to IVF. IUI's are completely covered by my insurance, but IVF isn't at all. I had been thinking I just wanted to move on to IVF, but I felt more comfortable making the decision to do the IUI again given the new plan. 

We also discussed progesterone and Metformin. I asked about the progesterone and he agreed for this cycle I will start a few days after the trigger. He also agreed that it was a good idea to up my dosage of Metformin to 1000 mg/day from 500. I will see how that goes. 

So we have a new plan and I am feeling much more optimistic and excited this month. The only thing is, I didn't find out what time I am supposed to take the Gonal-F. Any ideas?

I take it back

Ok, I guess I kinda overreacted yesterday to the bad news of having a dominant follicle on the wrong side. I was super disappointed and apologize that you had to listen to me complain. 

I talked with the nurse this afternoon and she said we are going to go ahead and trigger tonight and go in for the IUI tomorrow. Rather than doing 2 IUI's as planned this cycle, we will do one tomorrow and then it is up to us to have "relations" the following day. 

My RE is hoping for the phenomenon of transmigration in which my other fallopian tube will hopefully pick up the egg. I am not counting on this, but who knows. 

I am starting to think we should just move on to IVF. The hard part is that we were there 4 months ago. On Jan 5th I started Lupron for our first IVF cycle. I ended up pregnant naturally that cycle so we never continued. It is hard to want to try something less successful, even if it is less invasive and cheaper. I am starting to think IUI's are a waste of time and energy and that I would rather focus on something that is more likely to work. The more blogs I read, the fewer positives I see as a result of IUI's. 

I work so hard all day at being patient (patient while children give me a run for my money, patient when I ask them to do something and they take their sweet time, patient with children who are not as competent as others, etc.), but I am finding I am not feeling as patient in other facets of my life. 

On the plus side I realized after giving the trigger shot that 2 weeks after my first shot in January we got the results that I was pregnant. let's hope we are that lucky again in two weeks!