Easter and Graduation

We had our last appointment with Dr. Br.averman this past Monday. 

We left Friday evening and spent the weekend with my sister K in Albany. She and I dyed Easter eggs Saturday while the boys hung out. We all took a long walk with little Ben strapped to W's chest in a carrier (he really wanted to carry him) in the beautiful sunshine.

On Saturday afternoon we met my Dad and his gf at a sports bar to watch the NCAA basketball game. Syracuse played Marquette. We were rooting for Syracuse and my Dad was rooting for Marquette since this is his alma mater. W had a good time egging on my dad when Syracuse won. Baby Ben came as well and slept the entire time.

Sunday morning I woke up to find that my sister hid all the Easter eggs for me and W to find. I hid them last year, but since she has baby Ben she was up first and hid them. I had gotten a bunch of candy and put together easter baskets for K, my BiL D, and W. K cooked a delicious breakfast. My Dad, and my BiL's parents came over for dinner on Sunday night and we had a pretty delicious feast.

Baby Ben wearing the adorable hat I bought him

I spent a lot of time over the weekend snuggling with little Ben and thinking about how it's going to be with 2 little ones. K and I gave him a bath and he loved it. He's a pretty easy-going little guy (so far) and still super cute. He's really tiny and loves to be held and snuggled. He's getting more alert and starting to look around more. We saw him roll over from his belly to his back once. It was pretty impressive since he's only 5 weeks old.

On Sunday night we headed down to our "second home" AKA our friends apartment in Queens. We got in pretty late and had to do my shots on the road. I got a little annoyed with W when he left the car door open when my pants were down, showing off my lovely butt to anyone who wanted to look. The worst part was I yelled at him to shut the door more quickly and he didn't hear me so opened the door back up to once again display my butt. 

Monday morning we got up, got ready, and headed out for a breakfast of delicious NYC bagels. We arrived just in time and I wrapped up the little gift we brought (2 bottles of Finger Lakes wine) for Dr. B in the car.

We didn't wait too long to be called back but waited for quite a bit once we were in the room. I was so disappointed when the nurse told me that "wandy" wanted to see me again. They had me undress from the waist down and we waited and waited. It was getting hot and my legs and butt were sticking to the paper on the table, but eventually Dr. B came in. He wasn't in his usual super sarcastic mood, but it was also Monday morning after a holiday weekend.

He put "wandy" in and neither W or I saw anything right away. This worried me a little because I expected them to immediately come into view. Well, he moved "wandy" a little and there they were. He hovered over one of them to try to find a heartbeat. He waited about 10 seconds and then turned the volume up. Still nothing. He was looking at the screen making some confused/focused face (or what it seemed like to me) and I started to panic. My heart was beating so fast and we still didn't hear any little heartbeat. I looked at W with a look of terror. Finally I just asked him, "Is there a heartbeat?" He apologized and said that yes, but that the computer took a minute to really pick it up. He said he turned it up so we could hear it. Then, we heard that amazing sound and I was so relieved.

Both babies looked great and are starting to measure a bit different. The ultrasound tech told me they would at my last appointment. Baby A (the baby on the bottom) was measuring about 4 days ahead at 12w3d. He/she really looked like it wanted to take a cozy little nap. Its heartbeat was something like 166. Baby B was once again our mover and shaker. That baby measured right on target at 11w6d. It had a heartbeat of 178. It was flailing its little arms and legs and moving around quite a bit. W was so happy to see them moving. He loves the photos. He keeps looking at them and smiling.

As Dr. B started to remove "wandy" I asked if we were going to get any pictures. He said he knew there was something he forgot, and went back to take a few.

Baby B waving

I love this picture of their little heads. Baby B was snuggled in too deep to get a good pic of them together. 

Baby A

Babies looking like aliens

Dr. B said he definitely didn't need to see us again and asked if we had any questions. I asked about all of my meds. I was instructed to stop PIO shots, Neupogen shots, and Estrogen patches (SOOO happy!!!) When I asked about Lovenox he looked back through my chart and said he would like to see me stay on it throughout the pregnancy but reduced from twice to once/day. This is mainly due to the fact that I have Leiden Factor V. He told me Metformin should be something I continue through pregnancy and beyond since I have a metabolic disorder, PCOS. He said to take baby aspirin throughout pregnancy and "until the day before". I think W and I were both a little confused so didn't really ask. He then told us we were supposed to ask "until the day before what?" He told us the day before I die. I said I may not have warning, but if I'm given 24 hours to live that I will certainly stop. He joked that I will be celebrating when they give me 24 hours to live because that means I can stop my baby aspirin.

We gave him his gift and card and thanked him again. I had wanted to give him a hug but didn't think that would be a good idea since I was naked from the waist down. I had also wanted to get my picture taken with him, but again for the same reason I couldn't. Oh well.

W hummed the graduation song as we walked to our car, super happy and amazed. We grabbed all of my meds I would no longer use and brought them back into the office to donate them. The office gave us a lot of donated meds while I was doing my IVF cycle so I was happy to return the favor.

We headed into NYC for an amazing day with beautiful weather. We did a lot of walking and didn't do anything super special, but had a great day. It was 62 degrees and sunny, the warmest we have felt since early fall. We ate some delicious pizza and enjoyed the sights. It really was a perfect day.

Now that I am done with Dr. B I feel a little lost. I have to call my ob's office and schedule my next appointment. We have decided to skip the NT scan since I've had so many extra ultrasounds. I'm guessing I won't need to be seen for quite a few weeks.

W and his mother are both dying to tell the world, but I don't think I'm there yet. W is pushing for next week since we will be 13 weeks, but I'm not sure. I have a little belly but it's not hugely noticeable. I'm still fitting into my jeans and wearing my regular clothes. My pants can no longer travel through the dryer, but if I let them air dry they still fit fine. I guess I just need to make the adjustment to no longer going to/needing a fertility doctor and clinic. It might take a little time. It's all I've known up until now.

We are so excited about having twins and talk about the babies all the time. The truth is though, I am in complete denial that it's happening inside my body. I can't even begin to wrap my head around the fact that I have 2 babies growing inside of me right now. Maybe when I begin to feel them move it will seem more real but for now it might as well be happening in someone else's body. 

11 Weeks

Today marks 11 weeks. I am so amazed and grateful to have made it to this point. The babies were both doing great last Friday when I had an ultrasound. They were wiggling and dancing like crazy. Baby B was having a little dance party while A did a few flips and turns. Both had strong heartbeats and measured right on track.

The ultrasound was at the hospital where I will deliver as the ob's office didn't have any availability on such short notice. The receptionist was super friendly and excited for me about having twins. A woman came to get me to bring me down to the ultrasound. She introduced herself and told us (me and my MiL) that she was a student and that she would be performing the ultrasound. She told me to lie down and pull up my shirt. I was amazed and super excited to have graduated from "Wandy". I don't think I'll miss her any.

The student took a while doing the ultrasound, but I can't complain because it just gave us more time to watch the babies. She took some measurements and I noticed the crown rump length wasn't the same for both babies. This made me worry a bit because they have always measured exactly the same week and day on every other ultrasound. She looked around quite a bit more and then called in her supervisor.

The supervisor then basically repeated the same thing, talking the student through it all. This meant an even longer ultrasound! She was very friendly and shared lots of laughs and giggles with us when the dance party got going. She took the measurements again and told me both were measuring exactly the same. The other thing I was surprised to find out was that they are not next to each other, but instead one is on top of the other. She also told me they always label Baby A as the one closest to the cervix. I guess there is a system to labeling them. Maybe it changes as they get bigger?

From the ultrasound we headed down to the ob's office. We waited a really long time to be seen and were even called in once only to find out it was the wrong Elizabeth. Once we were seen they took my weight and blood pressure again (I lost a pound), then asked me a bunch of questions. I met with a different doctor since the one I saw last time had been in a car accident and was taking a bit of time off. They thankfully told me she is okay, but just needs a bit of time to recover. This new doctor was also very nice and accommodating to all of Dr. B's recommendations. She was reassuring and we talked a little more about the NT scan. She said we could do another ultrasound prior to my appointment with Dr. B and I scheduled it before I left.

Later that day I got a call from the office asking why I needed another ultrasound. I guess because everything looked so great they didn't think it would be medically necessary. I explained the situation and she then understood better. She just left it as she wasn't sure whether my insurance would cover it or not. W and I have talked about it and I also talked with the insurance company. They said it would likely be covered, but really it doesn't make much sense to have 2 ultrasound 4 days apart since the one locally is scheduled for Thursday and the one with Dr. B is scheduled for next Monday. I think we will cancel it and look forward to our ultrasound with Dr. B.

W was really bummed that he couldn't be at the ultrasound last week. He is trying to save his paid time off from work so decided it would be best not to go. He was so disappointed when he heard how cute they were being. Last Friday was the day I really fell in love with those little jumping beans. I've been in love with the concept of a baby for so long, but seeing them move and flip was just so amazing.

Two Weekends ago we got together with our good friends who have a 2 month old. The wife is one of my fertility buddies, T so they know we are pregnant. Her husband was so amazing and accommodating to make so many food choices. It was quite the "Mexican fiesta"! From there W and I went to the store to buy a new t.v. We had been talking about it since we bought out new sectional around Christmas. The huge amazing couch didn't work with the 32 inch t.v. We had to squint to see the print when making a selection on Net.flix. So, we purchased a 55 inch with part of our tax return. W is pretty thrilled with our new purchase, especially since it's correlates with March Madness.

This weekend we had some good friends J and C over for dinner with their 2 1/2 year old E. She was so excited to see us and be at our house, she didn't stop bouncing around the whole time. She played with some of the toys I have for work and we took this great picture.
We also told them that we are pregnant. They were so excited and C starting squealing and they both gave us huge hugs. It was really fun to share our excitement with some good friends. C was too funny because she said she always pays attention to what I eat and drink. She had noticed I skipped out on the goat cheese that evening prior to dinner.

Now to do the boring pregnancy update thing. Feel free to skip but I just want to document for myself. 

The babies are about close to 2 inches long each. Their heads are half the length of their bodies and they are growing hair follicles and finger and toenails this week. The most critical part of their organ systems have developed and they have reproductive organs (that we won't know about until they are born.)

My belly continues to grow and it's getting harder to hide. This morning when I took my weekly photo I tried to smile despite how chubby I felt like I looked. Luckily I can dress really casually to work so have been wearing sweatshirts and looser clothing. I swear a co-worker stared right at my belly as I took my jacket off when I arrived at a meeting last week. I think I'm just being sensitive, but I'm sure I look like I ate too many donuts to most of the families I work with.

The nausea and food aversions have definitely improved. I'm better able to eat a wider variety but feel like I get full really quickly. I still have moments where I don't feel too great and it's generally when I try to do too much. My body is good and telling me when to slow down and W is great and picking up the slack. I started getting round ligament pain this past week. There was one time when I stood up too quickly from sitting cross legged on the floor and had to immediately sit back down I was in so much pain. Today it was more constant and even when I was just sitting in a chair. I asked at my ob appointment last week and thats what she said it was. Unfortunately, she also said it's only going to get worse.

My mood is better and more stable, especially since I am avoiding sugar. I noticed it was giving me headaches and mood swings so it helps to just stay constant with my mood and blood sugar levels throughout the day.

I'm still on all of the same meds. I emailed Dr. Br.averman earlier last week to see if things were going to change before out appointment at 12 weeks. He told me to remain on everything. I'm hoping 12 weeks brings at least a huge reduction in what I am taking.

All in all, I'm just so happy to be at this point. I love these little ones so much already and can't wait to see them again next week with W. 

First OB Appointment

Yesterday afternoon was our first OB appointment. They called me back and had my hubby wait in the exam room while a nurse took my blood pressure, pulse, weight, and a list of my medications. She was definitely frazzled with all of my medications, but what can I do? I'm sure it's not everyday that the list includes so many. My blood pressure was, amazingly, really good. My pulse was a bit elevated.

I then waited with W in the exam room. The same nurse came in, frazzled again, and started to talk about labs and cultures and my insurance. She asked me to look something up about my insurance so I started as we waited. Another nurse then came in and explained that we didn't need to worry about anything and that they had it figured out. She asked whether it was our first pregnancy and we told her "sort of." We told her we had 3 previous losses and she was super sympathetic and understanding. She reassured us that if we had any questions or concerns at any time that we should feel free to call.

When Dr. Hi.ll came in she had her laptop and asked about our complete history. We gave her the run-down and joked about how she was writing a novel. It was hard to re-hash it all and I was practically in tears by the time I got to the end of it. It's a long story that contains a lot more downs than ups. It's not too often that I go through the entire history with someone, so it was hard. 

She was so happy and excited for us that things finally worked out. We told her about how we are still working with Dr. Br.averman, and she was more than happy to coordinate care with him. She seemed happy to take a back seat in the decision making until it was her turn. We told her we will meet with him again at 12 weeks and he will make a plan for the rest of the pregnancy. She said with those recommendations we can move forward. She said she could probably learn a thing or two from reading his notes in the files that were sent over. I was so pleased with how open she was to working with him and following his recommendations. It was such a breath of fresh air from working with my local fertility clinic.

She then explained that she would do a pap smear, pelvic exam, and some cultures so left the room while I undressed and got ready. It was weird to have W in the room while a pap smear was done, but we joked about things so he was fine with it. He's been in the room for at lot at this point so he's not easily phased. The doctor warned me that I was going to have quite a bit of bleeding from the pap. Her gloves in the garbage were covered in blood, as was the table when I got up. The nurse gave me a pad and the doctor repeatedly reassured me that the bleeding was from my cervix, not my uterus.

I gave a urine sample and then we headed down to the ultrasound room. I was so happy we were getting an ultrasound, but disappointed when they referred to the machine as a "dinosaur". The machine did not provide crisp images of our little ones, but we saw them and it was great. They measured on target but the machine did not allow us to hear their heartbeats. Dr. H promised that for our next appointment we would get an ultrasound with the better machine.

She asked us about genetic testing and we said we wanted to do the NT scan (mainly for an extra ultrasound). I told her that Dr. B wanted me to be seen weekly and she gladly agreed, saying we had been through so much and was happy to do that. I asked some other questions and she was honest and straightforward with her answers.

By the time we left the office we had been there almost an hour and a half. We were long past the time that the office normally closes, but I was so happy the doctor spent so much time with us and never made us feel rushed. The other office staff did not look as happy as W and I were. We made an appointment for next week for an ultrasound and to meet with the doctor again.

Overall, it was a fantastic appointment. We felt like the doctor was compassionate and bright, as well as open to working with Dr. B, which is very important to us.

In other news, I got my doppler this week and have used it quite a bit. The first 4 or so times I tried it the first day I didn't have any success. Finally, on my 5th attempt I found a heartbeat. It was amazing! The next morning I tried it again and am pretty sure I found 2 different heartbeats. They were in different spots, but it is impossible to know for sure. Since then, I can easily find the first one within seconds of trying. The other one is more difficult, but I can find it with some persistence. The doppler has been amazing and I love listening to the sound of my little babies. It was such a great purchase!

8 Weeks

I'm almost through week 8. I oscillate between feeling really positive and confident about things to worrying a whole bunch. Early in the week we watched the first episode of the Walking Dead. That night I had a horrible dream that the babies died. I also dreamt I was chasing my cat around the supermarket because he got free from a bag I was carrying him in. I have a lot of crazy dreams, but this was one of the worst. I woke up feeling horrible and scared. When I told my sister about my dream she said she had bad dreams when she was pregnant and watched that show. We won't be watching it again any time soon. 

I finally made a decision about an OB and made an appointment this week. When I saw Dr. Br.averman on Monday he said he wanted me to be seen this week or next. I was so overwhelmed by the decision of who to choose I put it off until later in the week. 

I first started with the hospital I knew I wanted to deliver at. I chose that one because they have the highest level NICU. I really hope we don't need it, but it's good to have "in my back pocket" as my general physician said. I got recommendations from 2 friends and my general physician about who to use. Then I called and made an appointment. They didn't have anything this week so I made an appointment for next Thursday afternoon. They offered me one Tuesday morning, but the afternoon is much better so that W can be there. I'm really nervous about the idea of not getting and ultrasound. I have no idea whether I will not not, but I'm not sure I can go too much longer without one. It's so easy to get spoiled with weekly ultrasounds. 

After my bad dream this week I decided I wanted to buy a doppler. I ordered one online and am hoping it comes this week. I really hope it doesn't cause me more stress since I bought it for reassurance. I realize it doesn't always pick up a heartbeat, so I promise I'll try not to stress if that happens.

This week the babies are the size of raspberries or about 3/4 of an inch. The fingers and toes are still webbed but starting to differentiate. Upper lips, the tip of little noses, ears, and eyelids are developing. The babies even have distinguished wrists and elbows that they can flex.  

My belly is definitely getting bigger. I still don't think it's noticeable to anyone else, but it feels more firm and has a different shape. I'm still fitting into my jeans but joked the dryer really shrunk my one pair this week. I put them on one morning and had to really stretch them out before they felt comfortable. I may not be putting them in the dryer again. I'm sure it's the dryer's fault, not the fact that I'm getting any bigger, right?

My symptoms are about the same. The nausea fluctuates from day to day and hour to hour. I'm still exhausted and love my sleep and naps.

The meat aversion has improved slightly and I had meat at 2 different meals this week. One was a soup that had chicken in it and I had a few bites with the chicken and then last night I ate corned beef. I know it's not great a great choice, but it's a once a year occasion. I've noticed anything with nitrates in it seems to give me headaches so that wasn't so much fun last night. 

I'm still getting up a few times a night to pee although I tend to resist and then not sleep as well. The bathroom really isn't that far and I try to keep my eyes closed as I pee so that I can fall back asleep easily. 

I've had some heartburn this week and eating Tums seem to help a bunch. 

My ovaries still feel huge and are really painful if I move fast or suddenly. Last night I rotated in bed and was in so much pain on both sides. 

My back has also started hurting a little bit this week and I'm not sure why. Good thing my hubby is a physical therapist. He said he was going to look into some exercises for me. I also want to start doing prenatal yoga but there isn't any place that close and the only one I found offers it on Thursday evening. Not sure how well that will work. W and I talked about ordering a DVD. We took the dogs for a walk today since it was so beautiful. I have honestly been too scared to do anything but am realizing it's really important to at least walk as much as possible.

I haven't really had any cravings. Every time I open the fridge and see pickles though they look absolutely delicious. It's the only thing that looks good all the time (even in the early morning). I don't think that's really anything new though. Just typing this makes me want to eat one. It just seems so cliche. 

I don't have a ton of patience these days. I feel badly as I work with young children and really should be more patient, but I'm struggling lately. I also don't have a ton of patience with W but he's pretty understanding. He appreciates that I recognize it and apologize after.

I'm still on Metformin 2000 mg/day, Neupogen 35 units each evening, Lovenox 40 mg in the morning and evening, 3 estrogen patches every other day, 2 cc's progesterone in oil every night, baby aspirin and Foltanx in the morning, and a prenatal vitamin. Last time I asked Dr. Br.averman he said just to continue everything. Not sure when I will stop them but I'm nervous just thinking about it.  

Last night we stopped at the mall and looked at a few baby things. We haven't bought anything other than the onesie and outfit in NYC but it was kinda fun to look at things and start thinking. W and I both woke up this morning and talked about dreams we both had where we were lost. I think it pretty much sums up how we are both feeling. The twin thing is sinking in more and more and I'm starting to get excited and feel attached to them. I've been really guarded this whole time but I feel myself letting my guard down more and more. I just hope things continue to go well. 

Resistance

I started stimulation on Sunday night and had my first monitoring appointment on Wednesday. I'm doing my monitoring locally but will be headed down to Long Island on Monday.

When I checked in at the front desk another woman was also checking in. I looked up to see Dr. K (RE and owner of the clinic) as he was saying hi to the other woman. I was so thrown by seeing him I didn't respond at all. That's just an indication of how frequently I see him around the office. I usually only see him at retrieval and transfer. The nurses serve as the buffer between patients and the RE and there's even minimal contact there. I guess that's what happens when your clinic does close to 3000 cycles a year. 

 I decided not to request any specific NP, but got stuck with Mrs. Bitch-Face anyway. I was so glad W came with me because as she had her back to us and was complaining or being ridiculous, W was making faces. it was good that I was able to smile about it rather than get pissed off. She obviously just doesn't like it when she's not able to make the decisions. 

The scan was fine and there were lots of tiny little follicles. I later got an email from the nurse Sandra at Dr. B's saying they were changing my protocol, completely taking me off Gonal-F. The plan switched me from 150 Gonal-F and 75 Menopur each night to just Menopur 225 nightly. 

As a result  of my being slightly concerned,  I emailed both the nurse and Dr. B to ask the reason for the switch. Dr. B quickly responded saying "It was due to the low LH levels that respond better to pure Menopur cycles." I then asked him the importance of LH during an IVF cycle and what the levels should ideally be and he said, "We like to see it over 2 and it is a necessary building block for estrogen production and follicular growth. We see this commonly when there is some resistance to FSH only stimulation."

I know at my last appointment with Dr. B the nurse mentioned something about resistance to Gonal-F. I didn't understand it at that point but I guess it makes more sense now. I wonder if it's from taking it so much, similar to antibiotic resistance. 

It gives me so much more confidence to have contact with my doctor. Regardless of how busy he is, he takes the time to respond to my questions. The nurse has also been much better about responding to my questions and emails. Last night Dr. B responded at 11:15, long past the point that I was in bed.    Things definitely feel different this time around, but only time will tell if there is a true difference. 

Beyond Frustrated (Rant)

Today was not a great day. Going back to work after lots of time off is never easy. With how busy I am right now it's been particularly hard. There are some days where I go home and wonder if I really want kids. They are exhausting and can really drain all of your patience quickly. I hear it's different with your own kids and I really hope that's true. 

I'm also in the process of planning/hosting my sister's baby shower. She's always said her MiL was crazy, but now I fully believe it. We are doing the shower at her in-law's house and her MiL had only offered to do the cake. I assumed that's all she wanted to do and didn't feel comfortable asking her to do much more. I guess she was complaining that she wasn't feeling involved so I sent her an email. I then found out that my very friendly and nice email made her even more upset. In the end we got it all smoothed out, but it required an hour and a half conversation on the phone. Sometimes I just don't understand why adults can't act their age. I'm not really interested in making things more complicated and difficult than they already are going to be. This isn't the easiest thing for me to do to begin with. 

The biggest thing that has been bothering me this week is the nurse at Dr. B's. When I was in the office last Friday she told me she would send me a calendar that afternoon. By Monday I still hadn't received it. When I called Monday to pay my balance I asked the receptionist about it. Later that day I finally received the calendar. With the calendar was a message asking me to inventory my meds and then let her know what I would be needing. Tuesday morning I responded with my list of meds and also had a list of pertinent questions. When I still hadn't gotten any kind of reply this morning I emailed her again. I again told her my list of meds, asked her to call the others into the pharmacy, and asked my questions. I got zero reply today. I'm willing to be patient and I don't always expect an immediate response, but I don't think I'm being unreasonable in feeling annoyed by it all. We are paying a lot of money and I expect a reply in a somewhat timely fashion. I'm relying on her to call in my meds in order to start this cycle and I'm supposed to start on Monday. I plan to call the office tomorrow morning and am considering asking to be assigned to the nurse I had last cycle. She was much more responsive. I don't want to feel like I have to do someone's job for them. I shouldn't have to try so hard to get some answers to my questions and my prescriptions called in. 

I was hungry this afternoon when I was out running errands. I decided I would buy some pickles to eat since they looked delicious. When I got into the car I really wanted one so opened up the jar. It then spilled everywhere, so now my car smells like dill pickles, yummy!

Sorry for all the bitching, I just needed to get it all out. Okay, I think I'm done. 

IVF #4 CD 12- The Final Stretch

Today W joined me for my appointment. The NP measured my right side first and I thought for sure we would trigger tonight. Then she went over to my underachieving left side and the follicles were a bit smaller. On the left side I had 2x13 mm, 2x14 mm, 3x15 mm, and 2x16 mm. On the right there were: 1x11 mm, 1x13 mm, 1x14 mm, 3x16 mm, 2x17 mm, and 2x19 mm. Obviously not all of these are going to be mature at retrieval, but I'm happy with how things are progressing.

Since my clinic was only going to be open for a half day today the NP said it was important I call her ASAP to let her know if we would trigger tonight or not. She gave me her cell phone number and told me to call when I knew. I asked her if she would trigger me tonight and she said she would probably hold off another day, especially since we are planning to freeze everything. She also said it was important to find out from Dr. Br.averman on what day he wants the embryos frozen. I assumed it would be day 5, but she said sometimes the preference is on day 1. I will put in an email to Dr. B to see what he has to say. 

Once I got in the car I emailed the nurse at Dr. B's office and told her I needed to know about triggering ASAP although I was pretty sure I knew the answer. She got back to me fairly quickly and said we were going to hold off another day. I called my clinic and scheduled another appointment for tomorrow.

Based on how I felt this weekend I knew there was going to be a big jump in my estradiol levels. My sense of smell became out of control and I started feeling much more uncomfortable. I'm officially to the walking super slow phase of this cycle. Today my estradiol was 4537, up from 1094 on Friday. We are definitely planning a Lupron trigger and freeze all based on my levels today. They kept my Gonal-F the same and reduced my Menopur to 1 vial.

I finished my crap-tastic book for book club over the weekend. I can't believe people like to read stuff like that, but oh well. It's just not for me. Promptly upon completion I shopped in the Kindle store for a new read. I came across a book called The Light Between Oceans. So far it is amazing. It was so refreshing to start reading a book with good writing! Our book club meets tomorrow and I don't think I'm going to have a whole lot of input. 

We (and by we I mostly mean W) crafted some Halloween decorations for our porch. We made some ghosts and a spider web and put out orange lights for the porch lights. Today we went to the pumpkin patch and got a bunch of pumpkins. I have a thing about white pumpkins since I had them for decoration at our wedding. They didn't have any good big white ones but I got a few small ones. 

We have a freeze warning for tonight and so we covered our raised flower bed full of dahlias with some old sheets, and boy is it attractive! I'm going to be so sad to see my flowers go, they have been so beautiful for months. 

In other news I heard that one of the girls I went to graduate school with is really sick. She is on a ventilator in the hospital in very critical condition. Some friends started a page on Facebook for updates about her. It sounds like last night was really bad. She is in my thoughts and I'm asking that anyone else keep her in your thoughts too. They think she may have an extremely rare neurological condition that has no known cure. I really hope she pulls through. Something like that really puts things in perspective.

IVF #4 CD 4- Baby Snuggles

I'm feeling a bit better today with the dexamethasone side effects. I think I need to stay away from coffee and I will probably fare much better. It's okay because I've wanted is less lately anyway.

 It was rainy all day today so we didn't do a whole lot. We went out for lunch and then stopped and saw our friend's new baby. Little D turned a week old yesterday and was absolutely precious. Baby snuggles can cure any rainy day blues.

My first monitoring appointment is tomorrow. I'm hoping we see some good little follicles. 

Sickness

I work with little kids that are walking cesspools for germs. I have 19 children on my caseload right now and I think about 80-85% of them have some kind of cold or another. 

I douse myself in hand sanitizer each time I get back in my car. Heck, I should buy stock in Purell I use it so much. 

Today I start dexamethasone. Each time I've taken it I've noticed I either get sick or get something else. I think it was last time that a giant wart popped up on one of my toes within the first week of taking it. Another time I got a really bad stomach bug. 

So, wish me luck in not getting sick. If it's only a cold I guess it's not that bad. I better start bulking up on my Vitamin C and make sure I get enough sleep. That one is a big tougher with early morning appointments. 

AF showed up this morning and tonight is my first night of stims. I always laugh in the beginning when I am looking forward to starting something that I know in the end isn't that much fun. Oh well, it's good to be back up and going. 

I'm Going to be an Aunt to....

A little boy!! That's right, my sister has a teeny-tiny penis growing inside her right now. I had boy feelings all morning about it and then missed 2 calls from her while I was in a therapy session. Since she didn't leave a message I figured I was probably right. She actually is pretty excited and sounded happy. He is going to be one crazy little guy, but I can't wait to meet him! February is a long way away...

Good thing it's a boy too because when I quickly laid a few pieces of the quilt together it had boy written all over it. I picked green and blue because I know my sister likes blue but doesn't like orange or yellow. I made lots more progress today on it. 

W said the fact that they are having a boy immediately gave him hope that we will get our little one soon. He wasn't sure why, but he suddenly got a dose of confidence about everything tonight. Maybe it's because my sister and I both like the same girl name. Maybe because it means we may still get to use the name. 

I got my list of meds for this cycle and there are no big surprises. I will be on dexamethasone which I haven't used in a while. My clinic stopped prescribing it to patients. The dose is also higher than I previously used. I'm a little nervous about starting at a higher dose for the Gonal-F than previously, but I will trust their judgement. High estrogen has always been my problem so we will so how that all goes. I guess if we are using Lupron and freezing everything that is less of a worry. 

I have all the Menopur I need and think I can buy a Gonal-F pen off of a friend for cheaper than at the pharmacy. It's still definitely not cheap though : ( I need to refill the dexamethasone and get another dose or two of Ganirelix and then I should be all set. 

It was pretty cool here today. It wasn't a nice fall cool where you can wear a few layers and be comfortable. Instead, it was a much colder version where I felt like I needed to be sipping hot coffee all day. Our house was pretty chilly tonight and the hubs was strongly resisting turning on the heat. I guess we should probably take the A.C unit out of the bedroom window first.  

Back in Gear

I went for my baseline on Wednesday. I spoke with the nurse at Dr. Br.averman's office (Sandra) and she gave me a schedule. The plan? Start stims on Monday and then my first monitoring appointment will be Thursday. Is this really happening again??? AAHHHH

New and Confusing Information

Yesterday was my follow-up with Dr. Br.averman. Of course the office was running behind so we waited for over an hour past our appointment before they called. 

At first Dr. B said everything was essentially normal. But I could hear him flipping through pages and pages of paperwork. Then he got to the HLA (Human Leukocyte Antigen) matching portion of the testing.

Here is information I found on HLA matching from Dr. B's website in order to explain it and be more clear:

"A fundamental part of HLA function is the presence of MHC molecules on all cells in the body. While there must be great similarity between these HLA genes with the donor and recipient during a transplant, this does not hold true when considering an embryo. There are reasons an embryo must have significant differences than the mother in order for a pregnancy to be successful and not result in miscarriage. Evolution has resulted in significant variation in the shape and sizes of MHC molecules (It is the MHC molecules that pick up virus and bacteria and present it to the immune system for eradication). The variation of the MCH molecules prevents a virus or bacteria from mutating and then evading the immune system in every person they infect, preventing an entire population form getting wiped out during an outbreak. Nature has a reason therefore to try and reject an embryo in couples with similar HLA genes as this would eliminate the ability to diversify.

Other HLA molecules on the embryo's surface, however, play an important role in beginning the process of immune tolerance. One theory is that a difference between the HLA genes of the mother and the embryo is important as it draws the immune system to the site of implantation due to the detection of something foreign. From here, the embryo begins to interact with the maternal immune system to turn off its attacking aspects and use it to its own advantage. Advantages include mild inflammation that can assist with implantation as well as the production of antibodies to protect the fetus."

 So, apparently W and I have a lot of matches. He said anything over 5 was considered significant. We have 6 that we know of for now. The test wasn't complete and the DQ Alpha portion of it was missing. This means there are another possible 2 matches that we will find out about once we complete the testing.

The HLA system is located on chromosome 6. As Dr. B said, this is the chromosome that "polices the immune system". If things are too similar, then the immune system attacks the embryo. He thought this was a possible reason for the way things have turned out in the past.

He also said that I had a PAI 1 4G gene mutation which is consistent with PCOS. I also have 1 copy of Factor V and 1 copy of MTHFR. All of these create a cumulative effect relating to blood clotting. He said this can be easily remedied with the use of Lovenox.

As far as the HLA matching goes, I guess his plan of action is to use Neupogen. This is a drug that is administered as a shot like anything else in a IVF cycle. The way that it works is it puts the immune system to rest in order to shield the embryo from the immune system. It's a drug commonly used during chemotherapy and is experimental for use in IVF cycles. Dr. B said he's had a lot of success using it for this type of problem. 

He said we don't need IVF and that IUI's would be an option. For now we will do IVF since we already have a cycle paid for. In the future, we could have him manage the immune portion and do IUI's. They are covered by my insurance so it's definitely something to consider if need be. It's that whole missing a tube thing that deters me. 

We talked about this upcoming IVF cycle. At first I could tell he didn't want to manage it due to the logistics. He was trying to back out of it but I put more pressure on him and he said he would keep to his word. I know its complicated and difficult, but I can't keep doing the same exact thing that my clinic has me doing. It's not working!

We talked about a the protocol again and meds. We will start on Gonal-F at a higher dose and then step it down shortly after. The reason to do this is that the higher dose recruits more eggs to begin with and then once they start growing they don't need as high of a dose. We may or may not add LH depending on my levels and his preference was Menopur over Luveris. After a few days we will add in Ganirelix and will trigger with Lupron. The plan for now is to freeze all embryos. It is likely my estrogen will get super high again and it's not a favorable environment for embryos. Also, the hormone management is extremely difficult with a Lupron trigger and I guess it would be easier to wait. I'm not thrilled about this option, but it's OK. I'm happy to try something different. 

So the plan for now is I need to get doctor's orders to my current office to get a sono before coming off birth control pills. I'm waiting for them to send this over so I can schedule my appointment. Then I will get a scan. As long as everything looks good I will stop bcp's and we will start this cycle. I should get a protocol written out from Dr. B and get assigned to a nurse soon.

So the biggest question is, how am I feeling about all of this information? I'm SO HAPPY I trusted my gut and pursued another opinion. I'm glad I found Dr. B and that we went through with all of the immune testing. I definitely had my doubts about whether it would all be worth it. I now 100% believe it was! Just doing what CNY told me "keep trying, it's a numbers game" was not going to work for me. There is something bigger going on. 

I'm kinda sad to find out to the hubs and I are apparently just too compatible. At least we know that if we ever need an organ transplant we don't need to go far. I'm hopeful for changes and armed with a whole bunch of new knowledge, ready to move forward and get this show on the road! 

A Forced but Badly Needed Break

When I woke up this morning I felt awful. I was nauseous and had a headache. I had to be at my clinic early for beta #2.  

I started spotting in the morning and had pretty bad cramps last night, so I knew I wasn't going to see an increase in my levels. I waited almost all day before calling them. There were some severe storms in the area and I guess their system was down most of the day.

by 11:00 I was bleeding full force so when I first talked to the nurse I told her it was CD 1. She scheduled me an appointment for Thursday as a baseline so that I could start a FET and told me she would call me with the test results once they came in. 

My HCG level dropped to 14. That's only down 5.5 points in 5 days, WTF??!! I had also requested my TSH levels be checked again and they were fine. When she told me my HCG number she said I wasn't going to be able to do the FET this month. We need to wait until my levels go below 5 to be considered negative. I have a repeat beta scheduled for next Monday and my follow-up (WTF) appointment with my RE that Friday.

I'm not sure how I feel about a break. Part of me wants to just keep going, but I realize I probably need a break. We have done 4 transfers (2 fresh and 2 frozen) since December. I've been on some kind of hormone for over a year.... isn't that crazy?! I have either been cycling, trying to cycle and getting cancelled, or on BCP's. I don't even know what a unmedicated cycle would look like for me at this point. I guess there's only one way to find out.

Fertilized

I got the call as I was making my breakfast this morning. I had a feeling that would happen as soon as I started cooking. The result? Some burned bacon. I didn't enjoy it, but the dogs sure did. 

Of the 19 eggs retrieved 14 were injected with W's little guys. Of those, 8 had fertilized. They said there were still 5 that could fertilize, but we will see. As of right now we have 8 little combinations of me and W growing away. I was a little bummed initially by this number, but then realized that it's completely out of my hands at this point. If it's meant to be this time around it will. No worrying or feeling disappointed is going to change anything. I have to stay positive!

The nurse asked how I was feeling and I told her that I had gained 3 pounds overnight. She quickly talked to the NP and they said they wanted to see me today. I made an appointment at 11:15 to go in. The told me my transfer was scheduled for Tuesday at 11:15 and then asked if I planned to do acupuncture. When I said yes they transferred the call. 

I spoke to the receptionist at the Healing Arts Center and she said I was all set for an appointment after my transfer. I then asked if it would be my favorite acupuncturist, D and they said he wasn't working on Tuesday. There was only the guy I didn't like. I promptly cancelled the appointment and was a bit disappointed. 

On my drive into my appointment D called himself to ask how I was doing. I told him I had gained some weight overnight and that the office wanted to see me. He asked if I was interested in coming in to see him relaxing for a little bit. He told me to tell the receptionists that I was there for a consultation so I wouldn't have to pay. I told him I would be over after my appointment. He also said he would be willing to come in Tuesday for me so that I didn't have to see the guy I didn't like. 

I got to my RE's office and the receptionist was super concerned. She asked if I was OK and whether I wanted to lie down somewhere. I told her I was OK but just that they wanted to see me. She said she would get me right up. The waiting room was packed but I didn't end up waiting very long. 

They drew my blood and took my vitals and then instructed me to undress from the waist down. A NP I didn't recognize came in and did my ultrasound. My ovaries were pretty much the entire ultrasound screen when she measured them. It was crazy! There was a small amount of fluid in my abdomen, but everything looked pretty much OK. She told me that I need to take it easy and just relax for the next few days. If my conditioned worsened I was supposed to let them know and if I was in a lot of pain I was instructed to go to the ER. She sent me on my way with some pain medication and reiterated that I needed to take it easy. 

I asked about adding progesterone in oil to the Crinone this time and she said I could do whatever I felt comfortable with. She gave me some progesterone and syringes along with some instructions. 

I headed over to acupuncture and saw D for about 40 minutes. I took a little nap and felt some much less bloated after. He only did points on my stomach but I think it really helped. He told me if I was feeling uncomfortable again on Monday to call him and he would do the same. I felt so much better after some relaxation time. 

On my drive home I got a call from my clinic. I was nervous that something was wrong, but they were just calling to see if I would be willing to change my transfer time to 1:30 since Dr. K has a surgery that will likely run longer than they initially thought. This works much better for me because one of the children I work with is getting evaluated for Autism on Tuesday. I was so disappointed I wasn't going to be able to be there but now it looks like I will.

So, we have 8 little embryos growing and my transfer is Tuesday. I do have OHSS but it seems like with rest and relaxation I should be fine. I started my progesterone and Lovenox tonight and will add in Estrace later tonight. I hope our little ones continue to grow and that we have at least one good embryo to transfer on Tuesday. They won't call with any more updates so for now I just need to leave it up to the pros. 

The DJ Better Put On a Slow Song

I had another appointment this afternoon for intralipid therapy, blood work, and an ultrasound. The NP and I joked about how many more follicles have joined the party and that they're really growing up. I guess they aren't grown up enough yet, and it's time to slow this party down a bit. 

Due to the afternoon appointment, I don't know what my estradiol levels are. Shannon anticipated they would be higher than the 4691 that they were on Saturday. So, she gave me Cetrotide and told me to do that alone tonight. No Lupron, no Gonal-F, no Luveris. 

I've been feeling a lot of action in my ovaries and I swear they were pissed after I did the Cetrotide. They were like, who the hell put on a slow song, this party was just getting started!

There were a LOT of follicles today. I had 20 measurable ones but I'm sure there were some more. Whether those will all make it to be eggs or not, who the heck knows. A bunch were still a bit small and immature so I guess we are cutting the underage ones off from any more of the good stuff in hopes they leave the party and don't cause issues for everyone. 

I'm a bit disappointed that my retrieval has been pushed back and that I have to go in SUPER early tomorrow, but I just do what they tell me like the good little patient that I am. I think I'm bummed about two more days of work more than anything else. 

I'm not worrying about everything like the past and it feels good to relinquish some control. Not that I ever was in control anyway! I'm just riding the wave of IVF fun.

Truckin'

After feeling disappointed on Wednesday after my appointment, things have really picked up. I went in Friday and there were 10 measurable follicles on each ovary. My estradiol had risen to 2469. They reduced my dose of Gonal-F to 75 IU's and kept the others the same. Then they ruined my Saturday plans by telling me they wanted to see me again the next morning. I was really looking forward to going with some friends to a giant garage sale, but I missed out. 

This morning the NP told me she was going to get carpal tunnel measuring all of my follicles, but my estrogen made some huge leaps and was at 4691 in a little more than 24 hours. For some reason my estradiol levels want me to be immature about things, so it always seem to include the number 69 somewhere in there. They told me only to do Lupron tonight and skip all stims and then 75 of Gonal-F and 37.5 of Luveris tomorrow. I return Monday for blood work, an ultrasound, and intralipids.

When the nurse first entered the room this morning to draw my blood she mentioned that I would probably trigger tonight. This threw me a bit because I had been anticipating a Wednesday retrieval and told people I was taking that day off. When the NP did the scan she said she wanted me to get the full potential of this cycle and didn't want to trigger me too soon. I still have quite a few smaller follicles that I hope catch up. 

I will be taking Dostinex again to help prevent OHSS. This time I'm not as freaked out about things, I'm just trying to do my best to trust them. Coasting helped last time to reduce my levels and I didn't end up having any issues despite high estrogen levels. I am thankful I am such a high responder and that I can save some bucks on already expensive meds. Of course I ordered more that I don't think I will be using. 

We made some purchases today for our upcoming bathroom remodel. We bought an amazing sink and some tiles so I'm starting to get excited. I'm not excited about showering at the Y while our own shower is out of commission. 

I've been feeling really full and uncomfortable the past few days. I've also been pretty exhausted and making sure I get plenty of sleep. The headaches have been much better this time around which I am thankful for.  A new issue is that my contacts have been driving me crazy. I asked about it today and she said it could be a side effect of the meds or it could be that things are so wet in other places that it is drawing the moisture from other places. Great, my va-jay-jay is sucking the moisture from my eyes. How awesome of a mental picture is that? 

To Add a Little Excitement and Drama

I was picking up clothes from the bathroom floor (we are such neat freaks!) in order to start laundry this morning and made a not so great discovery. 

On Thursday when I started my stims I asked W to grab what we needed from the fridge (Gonal-F). We have some old pens in there as well and he brought those up along with the new box which was in an opaque bag. We talked about the old ones (3 pens) and decided it was best to throw them out since it had definitely been more than 30 days since they had been opened. I started to mix the Luveris, measured my Lupron, and took the Gonal-F pen that was on the vanity and used it. 

I continued to take all of my meds for the past 3 days without thinking anything of it. I had seen the old pens in the garbage and ignored the opaque bag on the floor since I assumed it only had needle tips in it. 

That brings us back to this morning. I was picking up the clothes and I found the opaque red bag. Don't get me wrong, it's not that our laundry pile was so large it was buried, but it had ignored it, assuming what was in there wasn't an absolute necessity to deal with immediately. I opened the bag to get the extra tips out, and what do I find? I completely unopened box of Gonal-F! I immediately called W upstairs and we realized that instead of throwing out the pen that was so full, I had accidently been using it. We did the math and figured out this pen was first opened during IVF #1 in July!! Oh Shit! 

When we were talking about throwing them away, W didn't throw them all away, only 2 of the 3. He tossed the bag with the new one aside and put the old one up on the counter. Distraction set it when I started to measure out my meds and I grabbed the old one assuming it was the new one he took out. Man, is his support in this process a mixed blessing. Last IVF I got upset because he wasn't involved enough. This time I realize his company in the room is enough and that the meds need to be all my responsibility. That way I have no one or nothing to blame if things don't go as planned. 

So I spent a bit of time this morning googling expired and opened Gonal-F and am not sure what to think. If it hadn't been opened I wouldn't be freaking out. But, it's likely not as potent as it should be, if potent at all. I emailed the NP at the clinic and am waiting to hear back. I really hope this doesn't mess things up. There's never a dull moment with IVF, huh? I guess I just assumed by the 3rd time around I would have it all figured out. Well, not so much. 

It's safe to say the first tears have been shed this cycle. Maybe that means the FSH is working after all?

Still Here and the Real 200

I'm still here, but there was just nothing earth shattering to report. I have been feeling exhausted this week paired with fighting off some cold/sinus thing. I had an appointment on Monday and was sufficiently suppressed. I had hoped I would start stims that day, but I was cleared to start Thursday. I didn't ask exactly why but just realized that, once again, I can't control this process.  

This week crawled by. We woke up to snow on Monday and a lot of the schools were closed. It was not a pleasant sight. Then it was cold all week and extra grey. Sometimes living in Upstate NY has serious drawbacks. Like when you don't see the sun for a week straight. Or when you have to worry about your flowers growing outside because there is snow and frost most nights at the end of April. This week was filled with lots of report writing, meetings, and we joined back up at the gym and went all but one day. I'm sure all of these things played into the fact that I have been exhausted. 

This cycle I am still doing 150 of Gonal-F but we switched from Menopur to Luveris. Instead of doing 75 like last time I am doing 37.5. I'm not exactly sure what the difference between Menopur and Luveris is, I'm just trying to go with it. I finally made the jump to request a specific NP and I plan to each monitoring appointment this cycle. At my clinic there are a ton of nurses and at least 4 different NP's. Some seem more aggressive than others and I'm glad I did request Shannan. When I went after the FET I got a NP who said they were going to start me on a super small dose of stims. I don't want OHSS, but I do want a decent number of eggs. Shannan was super friendly and helpful answering any of my questions. She also booked my appointments for Mon, Wed, and Fri of next week at my preferred times. I'm scared to think of how exhausted I will be next week with 6:45 appointments 3 days. 

Dont' forget to enter my GIVEAWAY!! I will pick a winner on Sunday. 

So when I went through all of my posts I realized that I had only published 199 posts and that 1 was a draft. So, this is actually my true 200th post. In keeping with the theme I did for 100 posts I will add some pics so you can better understand and know me.

Fall is my favorite season especially living in the northeast. I just love the colors and how beautiful it makes everything. This is why we chose to get married in the fall.

We bought our house 2 1/2 years ago after living in a tiny cabin in the woods behind my parents' house. We looked at SO MANY houses before we found the right one. It was like trying on wedding dresses, I just knew when we found "the one". 

We have a four year old nephew named Owen.

I kind have a thing about decorating our dining room table seasonally.

I miss Mexico and being on vacation.