Thursday, January 31, 2008

2WW continued.....

We are a few days into our 2 week wait, not a lot to report. I am tired, I am crampy on and off throughout the day, but it does seem to get worse towards the end of the day. Any number of reasons could explain why. I am still feeling calm, unusually calm. I think a large part of that is the nightly PIO injections with a small role played by the reality that it is truly not in my control. I mean as long as I take it easy, take care of myself and follow Dr.'s orders than its out of my hands. I am aware of the passage of time and how it affects this process and when we can test for pregnancy, but I am not dwelling on it. It's like I can't muster the energy to worry, maybe that is a good thing at this point. We shared our struggles with family and many friends over this past year as we have tried to conceive and now as we edge closer to success we feel very fortunate that everyone has been so excited for the possibility of this IVF working. Everyone wants to know when we will know if we are pregnant, and the really good friends are excited yet concerned that I don't get my heart crushed in the event that this does not work. My thoughts on the next step for us should this IVF fail, well they run the gamut. On one hand nothing, no medicine, no procedure has been so difficult to tolerate that it would prevent me or dissuade me from repeating this process again. It's the emotional aspect that affects my thoughts. One minute I think I could not put myself through this again, mostly due to the disappointment but also due to my age. Other times I just cannot bear to end my child-bearing life on a note of failure. Failure is not an option for me, I hate failing. You can see the conundrum here, IVF has no guarantees, it's all risk and if your not a big gambler than the stakes of repeated failure may be too hard for you. I have yet to determine how much of my heart I am willing to gamble.

Saturday, January 26, 2008

The 2WW begins

Ok, so life resumed so sense of normalcy today. I woke up at a normal time and went back to work. Since my job is basically a desk job and my husband is my boss I have a lot of flexibility. I am not tied to my desk all day and can pretty much come and go within reason when it comes to running kids around and picking my daughter up from school. It was nice to be back even if my desk was overflowing with paperwork. It actually didn't take that long to get it under control and I was able to get my "flat billing" out.
I am having quite a bit of cramping on and off in my lower abdomen, mostly it stays on the right side. The same side that has always bothered me since the cornual pregnancy 2 years ago. All tests show that there are no blockages so no one is sure why I have the recurrent pain. I have been taking Tylenol with my RE's ok to manage the pain and sometimes for short measures I use a heating pad set on low on the right side. I don't leave it on for more than 5 minutes and I use the lowest setting so I really don't think I am doing any harm, after all the embryos have yet to implant as of today and I use it in the area where my right ovary is not directly over my uterus.
I am kind of hibernating from people since last Thurs. the day of the retrieval. I talked freely to friends and family about our struggle with infertility, I didn't want to perpetuate the stigma by remaining silent about our struggles. I appreciate the sympathy, empathy, support, concern and curiosity expressed by all, but sometimes I just need to keep it to myself for a bit. Sometimes I just don't want to answer questions, explain or protocol, etc. I don't want to feel alone in our journey and I want to be helpful to others that might experience infertility, and I have a hard enough time feeling like I fit in the infertility box. But, sometimes it has to just be mine. Not even hubby's, not to be selfish, but it's my body going through this whole process and sometimes I have to stake a few moments with it by myself. That is where I am now, trying not to over analyze every twinge, trying not to count the minutes till Feb 7th, trying to feel positive yet not get my hopes so high that I am crushed. Sometimes all of that requires that I hide in my cocoon for a little bit of each day....not only am I maybe, possibly growing a baby, maybe 3 of them, but I am also trying to grow myself some wings. In case I have 3 babies I might need them to fly away for a few minutes for some baby free time....LOL

Transfer day

We showed up at the RE's office this morning for our 8:30am transfer still not knowing if we would actually get to transfer today. Let me tell you, holding your pee from the night before is not fun. I forbid my loving husband from drinking any of his water, I figure if I have to suffer than he can thirst to death for about 30 mins. So the RE takes us to his office and I am feeling pretty lucky at this point, based on the news yesterday. Alas disappointment was waiting. One of our 7 embryos was no longer dividing so that left us with 6, then he proceeds to tell us that 2 more embryos had slow cleavage and were probably not going to divide, so now we were down to 4 embryos and one of them he is not so sure about, it seems to be a little wonky. So we are left with 3 embryos, but he says they are dividing nicely and were very good quality. We had all agreed we would transfer no more than 2 embryos as more than 2 babies was not a risk we were willing to take. After listening to our RE and all his wisdom we agreed with him that our best chance of pregnancy was to transfer those 3 good embryos today. He honestly felt that it was not irresponsible to do so given my age and the low rate of achievable pregnancies for woman in my situation. It was almost a relief, yet disappointing at the same time. The Embryologist will keep an eye on the other 4 embryos in culture for the next 2 - 3 days to determine if they might possibly redeem themselves for cryo, stranger things have happened.
At this point its time to get this show on the road. Hubby gets to sit in the waiting room with my purse and I am taken back to the same pre-op/recovery-room from the day of retrieval where I am instructed to strip once again...oooo but I get to keep my bra on this time. After I change I am led into the OR room again but this time I have to get on the table with my butt hanging off of a wedge shaped pillow. It is placed at the foot of the bed and I scoot to the very end so my butt is up in the air and my feet are resting on the end rails of the bed and my head rests on a flat pillow....get the picture, not exactly the most comfortable position to be in. In the meantime I had a great nurse who talked me through the procedure right along with my RE. He always makes sure I understand what it is going on. So with a full bladder they press on my belly with the ultra-sound wand to make sure my full bladder is out of the way so he can see my uterus. He takes a quick peek to make sure my ovaries are fine, and they are. The nurse really likes me, I get the warm gel and the warm speculum...yep you have to be special to get one of those. I hate to have my cervix messed with so the next part, the part where he uses King Kong q-tips to clean the cervical mucus out of the way was my least favorite part of the procedure. It seems the cervical mucus can get in the way and cause the flexible tube they use to get hung up. Finally after what seemed like forever but was probably no more than 10 mins from the time I walked into the OR my wonderful embryos were brought in and were transferred into my hopefully sticky uterus. The process of the transfer only took about 60 seconds and I didn't even feel the tube and there was no pain involved. I asked the RE to hang a "Home Sweet Home" sign in there so that my embryos might feel more welcome and want to stick around....LOL The embryologist then checked the tube to make sure my embryos were in fact no longer in the tube. My bed was wheeled into the recovery area with my butt still in the air but now covered by a blanket. I was instructed to try and stay in that position for at least 20 mins but an hour if I could manage it without peeing myself. I was able to read my book and the RE was nice enough to let hubby come back and sit with me as long as he wore a pretty cap and some booties. I was afraid I wouldn't last 20 mins I had to pee so bad, but our nurse came back to hang as we were the only patients and she had locked up the front office. The RE checked on me 2 more times before he left and we hung out with our nurse. She was great, she and her husband are going through their own trial with infertility, hubby and I really felt for them as she told their story. Sometimes I don't feel I really belong to that club of infertile woman, I mean I have two beautiful children already. As the RE said numerous times, if I was 10 yrs younger I would not be in his office, I would not need his help. I have age related secondary infertility and sometimes I feel very selfish for wanting one more child. It's not just for me, its for hubby too. We learned the almost all the people that work in the office are or have been patients of my RE, so they all know what it is like to battle infertility and all the physical and emotional ups & downs that go along with it. Anyway, I made it an hour, time actually flew by. I was finally able to pee and was assured that the embryos would not fall out. With instructions to stay off my feet we headed home where I stayed in bed and napped on and off all day. Every commercial, show, website I happen upon is about pregnancy, and multiples, not sure what it means if anything, probably nothing. I am sure I am just extra sensitive right now. We are to continue my PIO shots nightly until a positive pregnancy test or until advised to stop. I took my last dose of the antibiotic this morning. We are scheduled for a pregnancy test on Feb 7th so hopefully we will get positive news at that point. Our chances aren't great, they aren't bad. Its in God's hands now. So for now I lay my hand on my abdomen and say a prayer for sticky eggs and a sticky uterus.

Update on eggs

I slept in today, I only woke up to pee and with the thought that the RE should be calling soon. Ring, ring....Hello....Hi Dr. I had a feeling you were going to be calling soon. What's the news? Good news really. All 7 eggs, surprisingly very good quality. 6 eggs are grade B and 1 is a grade C. He says that is great for someone my age (40). I tell him I tried to make more, but he said he was actually happy with what we got, all 7 are quality mature eggs, all 7 fertilized and all 7 are dividing. In most cases not all the eggs are mature, less fertilize and even less divide, so we are in a good place. My dear hubby and I decided to brave the dreaded PIO shot alone and with only a few Internet videos for instruction, in addition to the verbal instructions we received from the RE's nurse and my Mom (a nurse). We were going to drag my sister (a nurse) into this science experiment as my Mom was working. But we got brave and impatient so what the hell. In case anyone reads this I will explain what worked for me. I got the heating pad warming up on the upper right quadrant of my butt while hubby drew up the 1cc of PIO in the syringe. He used the 22 gauge 1 1/2 inch needle to draw up the PIO, he found it was a little difficult to do as it is thick so you may want to warm it up in your hand or under your arm before you swab the rubber top with the alcohol swab. Once he drew up the PIO we left the needle on and he brought the syringe to me. I put it in the fold of the heating pad and continued to keep it on my rump. After a few minutes I checked to make sure the syringe and oil were only warm and not hot. Hubby then changed the needle to a 22 gauge 1 inch needle as I am thin with very little body fat (don't hate). I had my Mom, sister and RE nurse check to make sure that the needle was long enough, although most people require a 1 1/2 inch needle. Some people use 25 gauge needles, but the 22 gauge only stung a little and I did not feel the oil going in. Hubby rubbed the injection site with the heel of his palm for a minute and then I put the heating pad on the injection site for about 5 minutes. The whole process was short and almost painless, it wasn't worth the anxiety that built up to the point. Several hours later I have only slight tenderness at the site and no lumps that I can feel. I am not jumping for joy that I have to do more of these for who knows how long, but I no longer feel the dread when thinking about them.
We have an 8:30am appt. with the RE in the morning for a possible transfer of 2 of our embryos, possible because the RE will make his decision in the morning after a peek at the embryos to decide whether to transfer tomorrow on day 3 or if he wants to wait and transfer on Tues. day 5. We just want him to transfer on the day that will ensure the best possible outcome for us, which would be a positive pregnancy test.

Friday, January 25, 2008

Retrieval Day

After very little sleep last night we awoke bright and early and made our way to the RE's office. In spite of the traffic we arrived on time and ready to go. Surprisingly enough I was not nervous, maybe a little anxious, but not nervous. I was at the "let's get this over with" stage. I had to fill out some paperwork for the Anesthesiologist and then they took me back, while hubby got to sit in the waiting room with my beloved jewelery in one pocket and his special reading material in his secret pocket. This special reading material was to be used to encourage him to make his deposit for our IVF. I understand he was successful. As for me, they took me back to a pre-op room where was shown a bathroom with lockers for my clothes and given a gown, socks and a lovely lunch-lady hat. After changing the nurse, who by the way was super sweet, started my IV. I have always had them in my hands but they prefer to put them in the arm, actually in the crook of my arm. At first it was uncomfortable but once they flushed it and started the saline I was fine. After a brief discussion with the Anesthesiologist I walked into the OR suite. That was a little weird. I have only had a few surgeries, but each time I was given a sedative first and then wheeled into the room. So anyway I hop on the table, lay down and they proceed to get me set up, strap my arms down (didn't freak me out) and check to see if my legs in the stirrups were comfortable (they kept me covered as it was cold in the room). I started to feel a little woozy and asked if the Anesthesiologist had given me something, I remember his response of yes and that was it for me. I was out, or at least I think I was. I recall hearing a woman screaming and was grateful to learn later it was not me. I awoke fully a little later to the sounds of the same woman moaning. Nurse checked on me repeatedly and told me that while groggy I offered to sing for them but didn't...LOL. I really felt fine at that point, just sleepy. After I assume an hour or so had passed I was allowed to dress and was taken to the exit where hubby was waiting with our van. He had already received my post-op instructions so we were on our way home. I was soooo thirsty so we stopped and got me a drink and some hashbrown cakes. I made some calls to my Mom and son to let them know I was ok. We made it home with no nausea for me. I got changed and took some Tylenol and watched tv for about 30 mins. After that the effects of the anesthesia that still lingered told me it was time to sleep again. I did use a heating pad for my lower abdomen and lower back, alternating between the two. After sleep much of the day and evening I was able to do my son's homeschool stuff for the next day and eat dinner. I was only able to take one dose of the Doxicycline today as I was told to wait till I knew I could keep it down. At this point (12:28pm) I am still having mild to medium cramping and lower back pain. I took some Tylenol PM for pain and to help me sleep. I am supposed to work tomorrow, it's a desk job. Fortunately hubby is the boss so it's up to me if I go in.

Ohhh, I almost forgot the most important part. I was told the other day that we had 12 - 15 follicles which made me feel pretty good. Anyway after procedure and on the way home I tell hubby that no one told me how many eggs were collected. He tells me that RE informed him that they collected 7 eggs.......yep that's it. RE is not sure how many are mature. We never found out exactly how many follicles I had, but if the initial count was correct then almost half of my follicles were empty. How depressing is that. The RE told my hubby I was showing my age at this point. I was too groggy to be disappointed this morning but early this evening I had a minor crying jag with hubby on the phone (he was picking up dinner and kids). Hubby said he feels good about this cycle. And he reminded me that we have enough for 3 -4 transfers and that it only takes one egg, but 7 and that is before we know if they are any good. Although the office called today to ask about the Follistim we were trading in exchange for cryo. So maybe that means we have enough for that option. I know, I know, it only takes one and we really only want one. I just feel weepy, probably due to all the meds, the anesthesia, and a little disappointment at only having 7 eggs. We are supposed to get a call from the office on Sat. to let us know when transfer is, but hubby was told it would probably be Sun.
So there we have it.....7 eggs as of today.

Wednesday, January 23, 2008

Almost there

I had an appt. with the RE on Saturday and all was well, he estimated about 10 eggs. I was a little disappointed but he was ok with that. I was told to continue the meds, Follistim, Menopur and Ganirelix and come back on Monday. Fast forward to Monday morning and more bruises on my tummy. This ultra-sound was extra uncomfortable. Why you ask? Well, it looks more like 12 to 15 eggs, maybe more as my left ovary likes to play hide - and - seek. So my instructions were to take all three meds on Mon. night, Tues. night I was to get 200 units of Follistim at 6pm and 2cc's of HCG at exactly 8pm. So after hubby gave me the tummy shot at 6pm, I rested, cause I'm all crampy and sore. It's the watermelon size ovaries people. I trekked my soon to be sore butt over to my Mom's so she could administer the lovely rump shot of HCG. I always dread it, but she is so good that it almost never hurts, just a little soreness the next day at injection site. I start my antibiotic in the morning....Doxycycline, one in the morning and one in the evening...yippee!!! No shots on Wed. I can have nothing to eat or drink after mid-night cause the big day is Thurs. at 7:30am. Whoa..that is early, but hey why wake up, they are just going to put me back to sleep when I get there. Egg retrieval is upon us and I am excited, scared, relieved in no particular order, it just depends on the time of day. The details of the retrieval are gory so I will save them for after the fact. It should only take about 40 min. and then after being monitored for about an hour I get to come home and snuggle up in my bed for the remainder of the day. Thurs. is also a big day for hubby as he gets to be a participant finally, yep, he gets to love himself into a cup. Crossing my fingers and praying for a positive outcome with no complications...not for him...for me..LOL

Friday, January 18, 2008

I want watermelons not mangos

We had our IVF appt. on Wed, Jan 16th. The RE came in and asked how I was doing on the meds. I explained that aside from tenderness at the injection sites and my abdomen feeling heavy I was doing fine. I said to him that my ovaries felt like mango's, and his response was " mango's aren't good enough, I want watermelons"...LOL Is he crazy? The ultrasound went well, I have 3 - 4 good eggs growing on each ovary, the RE really would like to see a minimum of 12 total, but preferably closer to 18. I have continued on the same meds, Follistim and Menopur at the same dosages, but we started a new one tonight. Ganirelix, it is also injected sub-cu and we chose to inject in my stomach like the other two. Wont be doing that again, the needle is the same length as my other needles, but it is larger and it hurt like a mother. Soooo I think we will be finding a nice squishy fat spot on my butt for tomorrow's injection. The other two meds have to go in my tummy but we have options with this new one, any old fat will do. My tummy looks like a dart board from a drunken tournament and I just can't abuse it anymore than I have to. Our next appt. is Sat. morning and that should give us a better idea of retrieval date. The RE said it's looking like a 25% chance for either Tues. or Thurs. and a 50% chance of Wed. Doesn't really matter to me, I am just ready to get the show on the road. The only problem is each day brings me closer to those dreaded PIO shots and I am shaking in my boots just thinking about them. I watched a few videos online of people demonstrating their techniques. I guess it doesn't look as bad as I imagined but still that's a big needle and a soft squishy place...UGH!!!

Sunday, January 13, 2008

A quick update

Nothing much is going on...unless you count the bruised puncture marks in my abdomen. It's tender and my lower back aches, right about where my ovaries should be. That is if they are still in the correct location and not trying to hide to avoid all these hormones. I have a low grade headache that comes and goes and my ovaries feel busy...LOL. I watched some videos showing PIO injections, so I am getting brave and am considering letting dear hubby learn how to give them. Actually it's for my convenience, if he doesn't learn then I will have to go to my Mom's or sister's to get them done. I think it would be easier for him to learn, that way I can whine and wallow on my own bed with a heating pad after he spears me. I just hope his manliness helps with this endeavor. I mean isn't jabbing an 1 1/2 long needle into the tush of your wife kind of like the hunting men did back in the days of cavemen? It's not like I will be running away ....well I might.

A shot in the dark

January 11, 2008 approximately 6:30pm....we began our injections. Follistim - 360 units, I've had up to 225 units before, let me tell you the amount of medicine makes a difference in the duration and discomfort of the injection. It seems to burn a little more and already after only 2 nights of this my tummy is tender. The Menopur - 1cc, it burned more than I thought it would and it seems to be extremely slow to inject. My husband does a great job with his sticks, he is quick and smooth so I can't complain that its his technique. He seems to think the Menopur is thicker, although it looks thin and watery to me. Needless to say we have survived two nights of these injections and my body seems to be responding already. My lower abdomen feels heavy and kind of busy and tender to the touch, so I figure that on day 2, hormonally its more like day 4 of my past cycles. So far the only annoying side effect I am having is a horrible headache. It surrounds the complete top of my skull, and feels like my head is going to pop off. I've tried Tylenol as that's about all I can take, but it hasn't helped yet. If the headache continues through tomorrow I will call my RE and see if he has any recommendations or if he wants to see me sooner than Wed to check and make sure I am responding to the meds within the normal limits. I'm sure to anyone reading this, it is about as exciting as watch paint dry. The whole point of this blog was for me to document this process for myself, and hopefully my future child. If it answers questions about infertility or IVF for anyone then that's great. Please know that this is my personal experience and not to be construed as medical advice in any way. Only an individuals Doctor is qualified to advise them on any medical conditions that they may be facing.

Friday, January 11, 2008

Baseline

I went for my first official IVF appt today. Back up to last night around midnight...I finally decided to read all the literature that the RE gave, consent forms, information, etc. What do I find....oh crap....we forgot to get our blood tests done. They have to test you and your spouse for HIV, Hepatitis and a few other contagious diseases. The FDA requires this testing before they will allow any of your frozen embryos to be stored. Fortunately it did not affect our schedule and we were able to get the blood work done after the appt.
The appt. itself was almost mundane, I expected a little fanfare, you like some trumpets or a drum roll, but nope. Just strip from the waist down and lay on this table with the warmest paper sheet we offer, put your feet in the stirrups and relax. So I have a tiny cyst on each ovary but RE says its no big deal so we are good to go. We met with the IVF nurse who had to witness our signatures saying that if we don't pay they will claim any conceived children and will auction them off to cover any remaining debt...LOL
Fri, January 11th we begin our meds, I have the joy of receiving 2 shots every evening until my next appt, on Wed, January 16th. We begin our cocktail with 360 units of Follistim and 1cc of Menopur, sounds tasty huh.
I have put in a request for a prescription for some Emala(sp?) creme for my butt before we start the PIO shots, the nurse just laughed at me. Fortunately for her she avoided being slapped due to the fact that she herself is a veteran IVF'r, but she said she would ask the DR. I also asked why a complimentary prescription of Xanax is not included with this IVF protocol as I believe everyone would benefit from me being on it...LOL. As I sure my stress level will continue to rise during this process I figure a little sedation might be good for my little egg friends, you know to kind of dull the roar they hear coming from me periodically. I love me some Tylenol PM, wonder if that is contraindicated, couldn't get an answer about that, I guess I will have to rely on my own super Internet sleuthing to find out.
I really want this IVF to work the 1st time and part of me thinks it will. I have to think that way to get through this, but what if it doesn't, I am so afraid it wont. I mean there are no guarantees, but we did find out that my RE's office has one of the highest success rates in the country. Pretty cool! Maybe he has some cool mojo going on and meets with the embryos prior to transfer. So tonight is my last night of freedom, tomorrow my body becomes a very expensive science project...stay tuned

Tuesday, January 8, 2008

Day 1

I took my last b/c pill last night and already I am spotting. I expect my uterus to be falling out by tomorrow night if the past is any indication of the future. Then onto Thurs. for my baseline appt. with the RE.
Is it ok that I am envious of all these celebrities that are announcing their pregnancies? I mean don't get me wrong, I have two amazing children already, does it make me greedy that I want one more? I am truly happy to read that Halle Berry is preggo and Nicole Kidman too. Like the rest of the world I am well aware that they have both been hoping to conceive their 1st children for a long time. Nicole has to adopted children so this is her 1st bio child. But then I read about Lilly Allen, Jessica Alba and lastly Jamie Lynn Spears and it makes me go....WTF! They are all young, unmarried and weren't planning on being parents for a while. I would bet money that each of the those pregnancies was accompanied by and "Oh S**t" before it sunk in and they accepted it. Here I am 40, old in comparison to them and I have be trying to conceive for over 2 yrs, I know that's not a long time compared to many, but I only have so much time before my eggs expire.
It just kills me to read about young teen girls getting pregnant and thinking that a baby will solve their loneliness, will keep a boyfriend around, will fix whatever is empty inside them. They have no clue how much work a child takes to raise. How it changes every aspect about your life. They just seem so cavalier about the situation. And then there are others like myself who are praying nightly for a child to love and raise, who can't wait to be pregnant and experience all the changes our bodies will go through. I am 40, my body will never be 16,22 or even 30 again and that is fine with me....just give me one healthy baby Lord.

Sunday, January 6, 2008

Happy New Year....and the countdown begins

The new year started out alright. Now if the rest of 2008 would kindly follow suit and stay in step I would be ever so grateful.
Now on to the good stuff, well not good, but scary. I ordered my meds for the IVF and they arrived on Friday. Can I just say that there is nothing joyous about a package filled with 35 1 1/2 inch needles in it. Yep, that's the size, 22 gauge, I might as well have gone to Mickey D's and swiped a handful of their drinking straws as they are roughly the same size and lets face it, the straws are way more colorful and cheerful. As we already have our stash of Follistim and HCG we only had to order the Menapur (sp) and the Ganirelix (sp) and my very favorite PIO (Progesterone in oil). I have my baseline U/S appt on Jan 10th and will be given instructions on when and how much of each med we are to start using. I say we to mean, Me - the recipient of horrible injections in my so very tender stomach and He - being my ever so accurate with a sharp object of a husband. From the little I re-call during my last visit and lets be honest here, I have not looked at the patient info packet they gave me, I will begin with the Follistim and Menapur injections in my stomach for several days. I will be seen every couple of days by the RE or rather my uterus and ovaries will be seen to determine how my eggs are coming along. Once they reach a certain size (Mars seems about right) then I will begin the Ganirelix also in the stomach...fun fun. But that is only the beginning folks. At such time that my eggs measure equal to the planet Neptune I will be given one of my favorite cocktails, the HCG injection in the rear, not to be confused with a shot of tequila, it goes down a little smoother but still stings like tequila and leaves a nice tender bruised spot on my butt, just like when I have had too much tequila, but there is no great buzz to go with it and I have yet to get my husband to add salt and suck a lime when administering it. Not sure how it works after that, but I get to be asleep for it, the retrieval of said planets from my ovaries. Being put to sleep and getting to take the day off from work are the only benefits that I am looking forward to at this point. I will save the excitement I feel about the PIO for another day.

My journey with family & age related secondary infertility