A list to ponder.

Who knew that I would be so stressed out over my impending progesterone shots? Ugh.

Not a lot of new has been happening since I posted last. I’ve seen the doctor once and everything appears on course. I will see him again this Friday, start my shots on Sunday and transfer the next Friday. The only thing I’ve noticed different is that I shed a few more tears on occasion. And mostly during times that I wouldn’t normally get upset. For example, at work I don’t usually take negative parent conversations personally. I’m going by district policy and I state the facts. No matter how loving I can be, a parent will chew me out. I brush this off for the most part – it’s not like I’ve never verbally abused the poor messenger. But lately I’ve had to try really hard to keep the tears locked up! So I’m blaming the hormones!

During my online research, I came across a blog written by a woman who has had a heck of a time getting and staying pregnant. She has been through a number of unsuccessful IVF cycles, finally had a baby who is now 2, and is in the process of working on baby number 2. I love reading her stuff because it seems we share a lot of thoughts and feelings. Yesterday she had a blog entry titled Things Your RE Won’t Tell You and proceeded to list some things she has experienced. I loved it! I can relate to a few of these. Some things are hard to hear but the cold hard truth hurts sometimes. I thought it would be fun to share the list with some of my own comments: 

1.  IVF has NO guarantees.  Most of you think this is common sense, but for my hubby and me, we really thought that IVF was some kind of magic cure to our problems. *I’ve not had this misconception. My feelings are quite opposite and I think the possibility of having a positive IVF is surreal.

2.  You will become a druggie!  You will feel like some kind of crackhead before your cycle is over.  I remember “shooting up” in my car in a parking lot.  Trying not to let anyone see me for fear of them thinking I really was some kind of drug addict. I also had to put my needles in one of my hubby’s friend’s refrigerators….the first time I met them! *I too “used” in the car once, waiting to pick up Maddie from ballet. I wondered who would pick up Maddie if I was busted with a needle in my belly?!

3.  Your pants are going to be tight.  Between the bloating and the baseball sized knots in your butt, you may feel like you are already 5 months pregnant. *Finally broke down and bought a few pairs of pants from the Salvation Army. My scrubs won’t go over my waist and hips anymore. Boo!!!

4.  PIO sucks!!!  Progesterone in oil really sucks.  In case you were wondering why you would have “baseball size knots” in your butt…..it’s because of the progesterone shots.  These cruel shots also cause symptoms very similar to pregnancy.  Just another thing for your mind to wonder about. *And this is why I stress.

5.  Giving yourself a shot is really not that bad.  Although the shots aren’t the greatest part of an IVF cycle, they really are not bad.  Many women are very intimidated by this part of the cycle, but looking back it won’t be a big deal at all. *She is obviously speaking of the small subcutaneous shots that go in the belly. Really and truly, those weren’t that bad.

6.  Your first IVF is a “trial run”.  I hate to admit this to the newbies out there, but your first IVF cycle is really a “trial run”.  Your doctor is figuring out how your body responds to the meds, what works best for you, etc.  Don’t take me wrong….there are plenty of lucky first timers out there.  But for most of us, the consecutive cycles are typically more successful. *I’m not even going to think about this! I’m going to hope that I am super lucky. I do get a second shot at it for about half the price, but haven’t decided if I will take advantage of it. One day at a time, right?

7.  Home Pregnancy Tests are evil!!!!!!  If there is any way you can keep yourself away from HPT tests, you will be better off for it.  They are pure evil!  If you test too early you will get a negative that is not likely real, if you test later, you will expect it to be accurate.  But nothing is really final until the blood test.  Also, if you do test…..do not use a digital.  They are more expensive and much less sensitive! *I know my will power and assume at this point that I will crack and buy one to use. However, I do think I’d be better off just waiting the two weeks. I’m really bad at reading into signs and symptoms and will be crushed if I receive a false negative.

8.  You will not be allowed to have sex, lift anything, exercise……..  Ok, your RE will tell you these things ahead of time, just thought I would remind you of all the things that you will not be allowed to do. It’s really not that bad, but it can be a big adjustment.  Not all RE’s require these things, so feel lucky if yours doesn’t.  No matter what your RE requires….take it easy.  You don’t want to have any regrets. *Why is it that when I’m told I cannot exercise, it’s a killer and I’m itching to run, but when I get the go ahead, the first thing that comes out of my mouth is “I’m too busy, let’s work out tomorrow.” Mike told me the other day that IVF also stands for I’m Very Frustrated. This from the mouth of a man in the middle of an in-vitro drought. Poor guy!

9.  Suddenly everyone around you will be pregnant.  Throughout your whole infertility journey, you will start to notice every pregnant person anywhere in your vicinity.  Whether it’s a friend, relative or a woman in the mall.  It will seem as if you are the only woman around that is not eating for two.  Feeling jealous or having a hard time being happy for others is normal.  Don’t feel like you are a bad person for this. *I find this most interesting. For me it’s not jealousy or unhappiness. Before I even read this, Mike and I were out on a date and in a crowd of people at a theater, when I leaned over and told him that I spot pregnant women out of nowhere. Crazy that I’m so keen to that observation right now. I even think my neighbor is pregnant although they’ve not mentioned it yet.

10.  The 2 week wait after your transfer will be the longest two weeks of your life!!  That is until you find out you are pregnant and have to wait another 2 weeks to see the heartbeat. *I am no exception to this rule.

11.  You WILL worry through the whole nine months of pregnancy.  There are many milestones that are supposed to ease your mind, but once you have gone through infertility, you will always worry.  Just try to not let the worry take away from the enjoyment of the pregnancy. *I figure it’s taken me so long to get to this point, I might as well slow down, acknowledge the validity and enjoy.

12.  The waiting room at the fertility clinic is the most awkward place.  You would think being in a room full of others like you would make someone feel more comfortable.  But for some reason talking seems to be banned from the waiting room, only looking down at your phone is permitted.  (Maybe this is just my clinic?????)  Never understood why everyone in the waiting room seems so ashamed of being there. *I’ve not experienced this, however, I do sit and wonder about everyone in the room. What point are they in their journey, do they already have a child, how long have they been trying? I’m usually in and out so quick there’s not much time for conversation. But I imagine most people are pretty private.

13.  You will either find yourself lying or telling people about your fertility problems.  Going through IVF is not something that is easy to hide.  You will either find yourself lying to your co-workers about where you are having to go so often…..or you will decide to be open about what is going on.  For us it was a lot easier to just be open.  But I understand that this is not comfortable for some people. *I tried to hide it at first simply because I didn’t want to have to explain why it did not work in the end. I’ve missed so much work I really didn’t have an option. I feel much better having so many friends and family supporting and rooting us on.

14.  You may or may not become an emotional wreck.  Yes you will be on a lot of hormones and that can wreck havoc on your body.  But not all people respond this way.  The drugs have not bothered me too much. In fact the birth control pills gave me more trouble than all the fertility drugs.  If they are messing with you, just try to remind your partner to be patient with you.  You are not always going to be yourself. *I’ve already talked about this. I think I’ve been pretty lucky thus far, but it ain’t over ‘til the bloated lady sings!

15.  The emotional aspects of IVF are much harder than any of the physical part.  Most IVF newbies are a little worried about all the physical aspects of IVF, but in all reality, the mental rollercoaster ride is the hardest thing you will have to overcome. *I definitely second that. It’s almost every day that I experience feelings of joy and excitement one minute, day dreaming of what it will be like, then the very next minute I’m thinking what in the world have I gotten myself into. There’s just way too much thinking going on in my head!

16.  All of the 15 things above will be worth it!!!!!   If you stick it out and are willing to keep working toward a baby, then all these things above will seem like nothing.  The baby you will be holding will make it all worth it.  Looking back on my own journey, all the heartache just seems like a small bump in the road.  Can’t believe after 5 years of trying our little guy is already two! *So they say. And so I hope!!

Taking its toll.

There was a time, around day 7 or 8 of the hormone shots (gonadotropins) that I was pretty much sick of giving myself shots. I remember standing there in my bathroom literally talking myself into going on at least one more night (because tomorrow is always a new day.) But persevered through them and ended up getting great results. So much so that it caused a slight hiccup in the process. My estrogen got too high (7000) and had to level out before putting my ovaries into harm’s way.

Today is probably the most taxing day of IVF so far, and for no particular reason that I can think of. I did get the news that I would need to order more progesterone, but in a different form. This particular medication is compounded so it is not covered by insurance. I was also informed that this type of progesterone will be in the shot form. Since they originally ordered suppositories, I thought I was in the clear, but because this is going to be a FET, I need a stronger dose.

So the plan is to carry on with the estrogen and introduce progesterone 5 days before the transfer. It is my understanding that they are trying to simulate a 2 week pregnancy by the time the eggs are transferred to my uterus. I will have to wait another dreaded 2 weeks to confirm a pregnancy and in the meantime I will continue the progesterone shots.

This will all be worth it... right?

Basketball Team

I tried to stay busy all weekend. It was nerve wracking to think about what had come about in the lab during the weekend. I showed up to my appointment early to beat the traffic. It was crazy how slow the week went by and hard to imagine that I had only had the retrieval Sunday before last.

I saw the doctor in the hallway and he told me we had enough embryos to form a basketball team with rotating players. Eleven little embryos made the cut. Not that I hope to need all 11 but it was nice to know that we have a good amount to use. Mike said we needed to start naming them and Tammy told me she would get started on knitting. Ha! How about we start with two and go from there. The doctor has told us several times that he would only put two in. He explained that three or more would not increase chances of pregnancy, but would only increase chances of multiples. Not only is carrying multiples more risky, but it could take away every ounce of sanity I still have.

Everything looks good on the inside as well. My girlie parts are fresh and ready to prep for carrying a sweet thing. The doctor told me that many women would love to have my ovaries. At 39, I feel that parts of me are already falling apart so him telling me that makes me feel young and energized. Think he did that on purpose?!

I will not be put back on birth control as I initially thought. I started pills last night and applied a patch. Together they will balance my hormones and thicken the lining of my uterus, making a nice comfy spot for a baby. May 4^th is our target date for the transfer. This is great news because the 4^th falls on a Friday so I can bed rest on the weekend and not have to lose more hours at work. It’s all coming together nicely which means that sometime in the next couple of weeks, something will change.

In the meantime, I can start exercising again. I am going to try super hard to work out this water barrel around my waist and eat a bit more vegetables. Out of all the wonderful developments and great news, I did find one downer. This one must be a doozy because it has consumed my thoughts for the past 2 days. Because of the frozen embryo transfer (FET) versus the fresh, I will need to be on progesterone for who knows how long. IM shots (aka, long needles)!!!! How in the world am I going to do that? The subcutaneous shots (aka, tiny needles) were not too bad but it took self pep talks to inflict this pain several times a day. I don’t know that I will be able to pep talk myself into these. I have a few nurse friends and neighbors that I’m thinking of utilizing, but it’s working out a schedule where we are both available that might be tricky. And who (Mike doesn’t count) wants to look at my butt every day??

Don’t borrow sorrow from tomorrow. I will cross that bridge when I get there in about two weeks or so.

Egg Retrieval

The egg retrieval was a cinch. I knew what to expect and therefore refrained myself from singing any songs or making the doctor blush. I was tempted to slap a piece of duct tape on my mouth just to be sure, but ended up using a bit of good old fashioned discipline.

It was early Easter morning and the nurses and doctor were in good spirits (as always) considering that it was a holiday. I passed out chocolate to all that helped me before, during and after the procedure, as some sort of peace offering. I apologized a million times over, but they were so kind. (Really my body under the influence of hormones has had a mind of its own.) Then I found out that my doctor is Jewish and my anesthesiologist is Atheist so I didn't feel AS bad. Nonetheless, I really appreciated their being there to assist me through the process.

Mike and I were laughing in the waiting room because, I kid you not, every stinkin’ commercial on the TV was advertising food. I was NPO and he was sympathy starving. What a pair we made. Got the good o’ IV started then headed to the procedure room. My nerves are a little on edge when I first lay on the hard cold bed. I could get really worked up if I let myself. Slow, deep breaths is key until they say those magical words, “I’m giving you the IV medication now.” “Oh, yes, I feel it in my arm and I’m re…ad………………………………..zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz”

I awoke, once again, to my husband at my side. No singing, no singing, I would remind myself. This time it took a little longer to recuperate from the sedatives. I went home and conked out. The rest of the day was lazy until I had to force myself to get dressed and ready for the evening. Our sweet friends, the Owens, fed us a delicious Easter dinner.

That night I had a tough time going to sleep, wondering about the possibilities. We were told that they retrieved 16 follicles. I thought that was a good number but I also knew that it would go down as time went on. I’ve learned that not all follicles have eggs in them and many eggs are either not alive or insufficient in some way.

I got the call Monday that 14 eggs had survived the fertilization process. Fourteen gives us something to work with during the freezing process. The good doctor called later that evening to confirm 14 eggs and explain that we would lose a few more during the maturing phase. They would grow to blastocysts then be frozen, some on Friday and possibly some on Saturday. I would know by Monday. What the heck, what’s another week of waiting?!

Easter Egg Hunting

My Mike accompanied me to today's doctor appointment. It was good to have him plus a second pair of ears to take mental notes. Sometimes the doctor thinks I can read his mind and sometimes I think he is speaking a foreign language. And I'm in the medical field!

They took my blood then I suffered through a painful ultrasound. I feel like I've have a couple of basketballs in my belly for a couple of days and now I understand why. The doctor is still impressed with my "bajillion" follicles, that are now stacking atop each other. He said they are growing nicely but he still projects that my Estrogen level will be pretty high. His plan remains, he will retrieve this weekend then give my lady parts a break until next cycle.

How about going on a little Easter egg hunt this Sunday? A body going through in-vitro does not wait on anything or anyone. I'm feeling pretty bad for this having fallen on a holiday of all days, but I'm grateful to Dr. Witz and the nurses that will make it happen when it needs to. I plan to bring them some yummies to ease the work load.

I took the Lupron trigger shot last night at exactly 8:30pm in the local Chili's bathroom stall in between our free appetizer and shared entree. Then this morning, my sweet husband woke me up at 8:30am for my second shot. I'm embarrassed to admit that I slept until 8:30a but it was most delicious! And that's it. No more shots... for now. Of course in the morning I'll receive my IV but I won't have to administer it and it surely won't make me feel like the bloating queen.

Tomorrow we find out how many were retrieved and Monday morning we find out how many follicles will decide to fertilize. Exciting stuff! Happy Easter y'all.

Stubborn Estrogen

Just as I had suspected deep down inside, it looks like my estrogen level is climbing back up. I went in to the clinic today for my regular blood draw and ultrasound. It was mostly an uneventful visit with the doctor telling me that I have ovaries of a 30 year old (he tells me that every time) and that I have a bajillion follicles. But he did mention that we are still looking at retrieval this weekend but that there was a good chance that we would need to perform the actual transfer with my next cycle using frozen embryo. Say what?! This news was a little disheartening.

Everyday I get ideas forming in my mind and I try feverishly to form a plan and map out a calendar. I really need to quite doing this! I knew from the beginning that this is a very unpredictable journey and that no matter how many forums and blogs I read, my story will be different from all others. I think my doctor recognized my disappointment and immediately reassured me that this was a great thing. It sounds as though it's quite common in that the estrogen level is too high and oft times postpones the actual egg transfer. The good news is that this is doable. I will simply "recooperate" from all these crazy hormones then start next month with a fresh uterine lining and renewed hope. There is a great risk for OSHH (I think I mentioned this nasty syndrome in a previous post) that could lead to a failed transfer, hospitalization and even death in some cases. Ok, I feel a bit better.

The good doctor told me that in many cases, the transfer of frozen embryos has the same effect, if not better, than fresh embryos. (As fresh as fresh can be after stewing in a petri dish for 3-5 days.) Tonight I'm ok with it. I was also very appreciative that the doctor himself called and talked to me and Mike on the phone, explaining his findings. I'm getting the feeling that this man does not get to go home much. At this point, it looks like he will be spending Easter morning with us retrieving our Easter eggs. I'll have to bring him some candy or something.

Warning: Vain and self-centered venting to follow. I'm trying to be super positive about all this so I thought of two great pluses. I've been a little frustrated that I have this extra 15-20 lbs on me from foolish eating and sheer laziness. Maybe I can get serious these next few weeks, eating healthier and moving my feet. I'm quite aware that I cannot lose that much in a month, but I can practice good eating habits and get some good oxygenated blood to the brain. Also, I have another month to pay for this sweet baby possibly before it even gets here. Oh, one more thought... I have a huge to-do list for the month of April so that will keep my mind busy.

Tonight I poked myself in the belly with Bravelle (3 vials), Menapure (2 vials) and Ganirelix. It just gets more fun with each day.

Small Setback?

Went to see Dr. Witz again today. They like to take my blood and see my ovaries. Apparently I have a bajillion follicles. I texted Mike with this information and he responded with "too much follicing around." Funny guy.

No idea what happened between yesterday evening and this afternoon but my estrogen levels decided to cause some trouble. They've gone from 261 to the 1800s!! I've been trying to learn more about it but the fact that everyone responds to the medications in such different ways makes it super hard to figure out.

The doctor wants to see me yet again tomorrow! I swear he has a crush on me. I've never had a doctor want to see me so often. I very much enjoy the office so I don't mind, but the hardship is getting the day off of work and the time covered by a sub. Everyday I show up, I'm hoping I still have my job and that my co-workers still remember who I am.

As I was saying, I'm trying to do some research to figure out my doctor's job. I'm trying to have faith in him but my mind is racing a mile a minute. Mostly focused on a highly infamous condition known as OHSS (Ovarian Hyperstimulation Syndrome.) Basically, when too many follicles develop in the ovaries, the ovaries become swollen and enlarged. OHSS can cause severe pain and fluid buildup in the lungs and abdomen. Ugh. I just have to pay attention to my body and let the doctor know of any sudden and alarming changes.

I don't know that I could do this if I didn't have a nursing degree. It's scary and nerve wracking all in one! The unpredictability is dreadful. Am I complaining? NO WAY Jose! I'm grateful to be in this situation.

In my researching, I did find the following couple of paragraphs to be quite interesting. I asked Dr. Witz today if, after this is all said and done, would there be a chance we could find out what is causing me to be infertile. He said no then explained that this might put a hiccup in our progress and we would have to figure out a way around it. He is hoping that I'm one of the percentage of women that just simply have unexplained infertility.

Anyway, here is some food for thought if you are interested in my theory.

The difference between a healthy pregnancy and an unsuccessful in vitro fertilization (IVF) attempt may be less than few nanograms of estrogen. New research shows even the tiniest variations in a woman's estrogen levels may help explain why up to 70% of healthy embryos fail to implant themselves in the uterus.

A study in today's online edition of the Proceedings of the National Academy of Sciences suggests that estrogen plays an important role in determining the window of opportunity for an embryo to attach itself to the uterine wall and begin development.

Although a small amount of estrogen is needed to make the uterus receptive to the embryo, researchers found slightly too much of the hormone can alter the necessary genetic process at the implantation site in the uterus and can drastically shorten the fertility window.

I'm usually a pretty patient person, but tonight I'm very anxious to see what tomorrow morning holds for us.

Tonight my cocktail consisted of Bravelle 150 (2 vials), Menapure 150 (2 vials)and Ganarelix (1)

Patience and Such

Many couples find that the intensity and waiting involved with IVF (screenings, testing, and procedures) is almost more than they can bear. Some couples have already waited months and even years to get pregnant. Then, they are immediately disappointed to find that the IVF process involves a time commitment.

As you focus on staying patient during this time, an important IVF success tip is to chill! Make plans to stay active with friends and family. Discover a hobby or a new activity that is relaxing and fun. Try to keep your mind off of any worries or potential setbacks during the IVF journey. And, most importantly, have hope that your doctors will do all they can to help you get pregnant and have a healthy baby.

I read this online today. It's so very true. I've had a tough 7 years going through crazy thoughts and emotions, but thankfully I've not had to experience painful procedures and issues such as PCOS or miscarriages. I'm also grateful for my three step kids that have kept me and my mind busy and active. I just must remain patient!

I've mentioned before that this IVF thing is not something that can be planned. Sure they can give me a calendar but it'll change from day to day. This in and of itself is frustrating but the hardest thing about my scheduling has been my job. I was told that there would be lots of doctor visits but I never imagined the challenge of fitting this crazy thing into my life. It's like a part time job! Luckily I have plenty of days saved up from my almost 2 years at PISD, but I am surely going through it fast. I'm only taking half days off so that helps. But I also am responsible for setting up a sub for my clinic. We've been through stupid STAAR testing and Kindergarten Round Up and will have testing next month as well. I gave my boss a heads up in the beginning but I think she get's a little frustrated with my being gone so much. It is what it is. And it will be worth it.

In choosing my doctor and the best IVF clinic, it ended up that I chose a clinic a little further into Houston. The drive is not one to envy. The appointments are only made between 8-11am everyday but I have to get an early one so that I can make it back to work in time. And guess what? Morning traffic is the bane of my existence. The first couple of trips I ended up with a stinkin' crick in my neck. Coincidence maybe, but I couldn't put up with that going on 3-4 times a week. So now I pop in some soft music or a General Conference talk and voila, I am at ease. We won't even talk about the fuel I burn coming and going.

I question whether or not I should have just waited until the summer. I had three months to wait and then I could have reserved my days off as well as not have to battle the finding a sub. Hind sight is 20/20. I was just super anxious to get started once my decision was made. Ah well, it's a go and we will make the most of it.