Sad and Disappointed

This morning I went in for labs to get my estradiol levels checked to make sure we can continue with our cycle as planned.  I was told that if my levels aren't high enough, it's possible that they might cancel the cycle at this point.  Despite hearing this, I never really thought this would happen.

I waited and waited for my doctor's office to give me a call this afternoon with my lab results.  3:00 rolled around and I still hadn't heard from them.  I sent them a message via the patient portal and my nurse quickly responded with, "I'm visiting with Dr. Brabec about your results.  I'll call you soon."  When I saw that, I had the feeling the results weren't good.  She called me a few minutes later and told me that my levels were really low.  I guess they're supposed to be between 100 and 400 and mine were at 40.  She said she thought my body was "over-suppressed" from the Lupron and that I would probably require a lower dose.  She then told me that if we were to continue with this cycle, I probably wouldn't have very many eggs for the retrieval.

So, basically, they want to stop everything now and start over.  Not only do I have to stop taking all my shots, but I also have to go back on birth control.  I can't begin to tell you how sad and disappointed I am.  I really thought I would be having my retrieval surgery next week.  Now I'm being told, it may not happen until the last week of November.  I understand that if my body isn't reacting properly, this is the best thing to do right now, but it just sucks.  A LOT.

They're supposed to call me again tomorrow so we can get things figured out.  We'll see what happens...

My Tummy is a Pin Cushion

I've been taking Lupron for over a week now and it's been a piece of cake.  Truly, the needles are tiny and you don't feel a thing when it's going in.

Today I added Gonal-F and Menopur to my daily injections.  Not only did it take 20+ minutes to mix everything up, but I also feel like my tummy is now a pin cushion.  I did the Gonal-F first and right away noticed a difference in the needle.  It's not that much bigger than the Lupron needle, but it is bigger, and surprisingly, I could tell.  It bled a little.  Next, I did the Menopur.  I'd heard from a friend that this one burns going in.  And that was definitely an accurate statement.  Ouch!  Finally, I ended with the Lupron, because I knew that one was easy.  And it hurt too!  I tried to use three different injection sites, but I'm wondering if I was too close to my first injection one.

Anyway, this is what I get to do for the next 10 days.  Could be worse...

Meds

Here's what $2,000+ worth of fertility meds looks like...in case you were wondering.  The Gonal-F (the four tall boxes in the back) alone cost $1200.  Yikes!

Japanese Customs

Our culture doesn't really do anything to acknowledge the tragedy of a miscarriage.  It's often a very private matter that women (and their husbands) have to go through alone.  Often times, people don't know.  When they do, they don't know what to say.

The Japanese culture is quite different.  In Japan, when a pregnant woman loses her child, she can go to Jizo to make an offering.  People bring baby toys and gifts to the Jizo statue who is then supposed to help your "mizuko" (miscarried child) find a second way into being...either by returning to you in the form of another baby or finding another family.

The Japanese also have something called a Nanairo-no-yadorigi tree, which has symbolic ties to fertility and pregnancy.  You can write a wish on a piece of paper and twist it around a tree branch to help you conceive and protect an unborn child.  The custom is that when the wish is granted, you return to the tree and find and untie the paper.

I think these traditions are beautiful.  And it kind of makes me want to get a tree (just a little indoor one from Home Depot or something) and do something like this.  I think it would be neat.

Legalities

Earlier this year, I read a book called "Sing You Home" for my Book Club.  It's a Jodi Picoult book about an infertile couple who turn to IVF but end up getting divorced when they lose the baby late into the woman's pregnancy.  After the divorce, they end up in a law suit over the leftover frozen embryos.  Needless to say, the book was pretty deep.

Today my husband and I had an appointment.  During our appointment, I had the usual labs and an ultrasound done, but we also had to officially fill out all the paperwork for our IVF.  Within the 25 pages that we had to sign and initial, was a clause that addressed what was to be done with the embyros if either of us died or if we got divorced.  It made me think of "Sing You Home" and how real these types of issues can be.  Our options were to check a box that said "Destroy the embryos" while the other box said "A court decree, Last Will and Testament, and/or settlement agreement will be presented to the clinic directing use."  We chose the latter, as I can't imagine destroying the embyros (another very heavy topic that we'll save for another day).

Again, it's just crazy to think that these are the types of things you have to discuss and determine before going through with this.

Lupron Injections

I started my Lupron injections Friday evening.  This is the first round of all the shots I will be giving myself.  I'd heard it's not a bad shot, but of course, I was still a little nervous doing it the first time.  Because I'm a huge dork, I had my husband video tape me giving myself the shot.  I'll see if I can upload the video later, though it wasn't very eventful.  This shot was a piece of cake.  The needle is just a little insulin needle.  Very tiny.  It went in very easily, and I didn't feel a thing (from the needle nor the injection of the Lupron).  I can totally do this!

The fertility drug (Gonal-F, Follistim, or Menopur) I've heard will be much worse.  One of my friends, S, who used the Menopur said it really burns as the liquid is going in.  Not too excited about that one.  And I'm REALLY not excited about the intramuscular Progesterone in Oil shots that I will have to be doing for the last part of my IVF cycle and beginning part of my pregnancy.  My friend T said she's had to get these in the butt and that they hurt like hell.  I'm suddenly reminded of a steroid shot I had to get in my butt a couple years ago when I had a bad case of hives.  IT HURT!  I can't believe I'm going to have to do that everyday for weeks (maybe months)!  Obviously, it'll be worth it, but after watching a video online and seeing the size of that needle, I'm getting a little anxious.  I think that will be one that the hubby has to do!

Sonohysterogram

I got my sonohysterogram (SHG) yesterday and HOLY MOTHER OF PEARL...it sucked!  I was in no way prepared for how painful this procedure was.  Earlier this year I got a hysterosalpingogram (HSG).  I was told that the SHG would be pretty similar to the HSG.  All these similar acronyms...are you confused yet???  Needless to say, the SHG was way worst than the HSG.  This procedure had me sobbing on the table.  I literally had tears streaming down my face throughout the whole thing.  I had the worst pelvic pain as they were filling my uterus and I felt nauseous and like I was about to pass out.  I feel like they may have had some difficulties because it lasted way longer than I had expected too.  The doctor said something about finding a polyp and that she was going to "try to take care of it" to avoid surgery.  I don't really know what that means.  Did she remove the polyp?  If so, how did she do it?  Did she blast it away with the saline at a high pressure or did she scrape it away with something?  All I know is whatever she did...it was incredibly painful.

Afterwards, both my doctor and nurse said, "This is the worst part of the whole thing.  You're put under for the retrieval.  The transfer is nothing.  And even when you have a baby....at least you can get an epidural!"  So, I guess at least that's good news...

On my way out, I had to stop at the pharmacy that's located at my doctor's office to pick up my first round of injections.  The pharmacist behind the counter could see that I had just been through something traumatizing (my eyes were all bloodshot and my face was red and puffy from crying).  She walked around the counter and, without saying anything, gave me a big hug.  It was a simple gesture, but I really needed it.

Our IVF Timeline

It's official, we've started our IVF cycle.  I'm really amazed at how optimistic I'm being about all this.  I keep finding myself saying "WHEN we have our baby..." instead of "IF this works..."  I really do believe this is going to happen.  It might be something to do with our clinic's 83% success rate with couples our age undergoing IVF with ICSI (intracytoplasmic sperm injection).  That's amazing odds!  We're working with some of the best doctor's in the country and I trust them 100%.

One thing I really like about RRC (Reproductive Resource Center) is that they have a patient portal that you can use for correspondence with your doctors and nurses.  They upload all your lab results there so you have them at your fingertips.  It's pretty cool, especially for someone like me who doesn't like to use the phone.  If I have a question, I can just shoot a quick message through the portal and I typically get a same day response.  Love it!

We got our calendar sent to us through the portal this past week.  Here's our timeline for everything:

Sept 24 - (hubby and myself) - Initial general consult, IVF consult (they don't typically do this on the same day, but I guess we're special), pelvic exam/PAP, ultrasound, labs (for both of us)

Oct 1 - Called to report the start of my period, went in for labs (just me)

Oct 2 - Started birth control pills as part of the suppression phase, also began daily low-dose aspirin (supposed to improve ovarian responsiveness, uterine and ovarian blood flow, and implantation and pregnancy rates)

Oct 11 - Go in for a Sonohysterogram (procedure where they infuse the uterus with saline via catheter and do an ultrasound to check for any abnormalities)

Oct 19 - Begin Lupron injections (also part of the suppression phase), also start taking dexamethasone (a low-dose steroid tablet (may improve egg quality)

Oct 23 - (hubby and myself) - Go in to sign and complete paperwork with a notary and make payment, also ultrasound and labs (for me), last day of birth control pills, start Z-pak (hubby and myself - to prevent infections in the reproductive tract)

Oct 28 - Begin Gonadotropin injections (used to stimulate the growth of the follicles in the ovary)

Oct 30 - Go in for labs (just me)

Nov 2 - Go in for labs and ultrasound

Nov 5 - Go in for labs and ultrasound (at that time they will determine the specific date of the retrieval...based on my scans)

Nov 6(ish) - take Ovidrel injection 34-36 hours before retrieval (to complete the maturation process of the eggs)

Nov 7, 8, or 9 - Retrieval day (done in the hospital) - I'll be put under with anesthesia while they retrieve the eggs through a needle guided by ultrasound, hubby will be required to provide a sperm sample to be used for the fertilization process.  Begin progesterone injections (to help support early pregnancy).

Nov 12, 13, or 14 (five days after the retrieval) - Embryo transfer - My embryos will be 5 days old at this point and will be considered blastocysts.  They will take one or two of the best looking ones to transfer back into my uterus.  They will give me a valium to help relax me during the procedure which is done through a catheter.  I'm on strict bed-rest for the next two days (no working, no cooking/cleaning, etc).

8 days later...I'll go into the lab to take pregnancy test (blood tests can confirm pregnancy faster and more accurately than home pregnancy tests).  This will (hopefully) take place right before Thanksgiving!

Everything Happens for a Reason

I had my 10 year class reunion this past weekend.  Not gonna lie...I didn't want to go.  I'm from a small town where everyone knows everyone's business.  When I left, I didn't really bother looking back.  My parents moved away after I graduated, so there was never any reason to go back and visit.  And as far as my classmates go,  I don't really keep in contact with anyone outside of Facebook.

I had very little desire to go back and see everyone.  In fact the only thing that really pushed me to go was the fact that my best friend from elementary school, "T", was going to be there.  Her mom passed away this summer and I had to miss the funeral because I was out of the state.  Needless to say, I felt bad about it all and when I saw that she had RSVPed on Facebook, I decided I would go.

So, my husband and I left town Friday evening.  We had made arrangements to stay at my sister's house (who lives about 40 minutes away from my hometown).  We got there around 9:00 and stayed up until midnight or so drinking wine and chatting.  I'm close with my sister and it didn't take long for me to spill to her that we're going to be doing IVF.  She was very supportive (and excited).

The next day, the reunion "fun" began.  There was a parade in the morning and our class got to go through on a float.  Oh joy.  It was pretty lame and kind of put me in a bad mood because my friend who I was expecting to see didn't show up.  I spent the afternoon with my family.  Then that night we had a dinner followed by a party at the lake.  We had been at the dinner for about an hour when T showed up.  She told me that she was on her way when she found herself turning left instead of right and ended up at her grandma's house.  She sat and talked with her grandma, saying she didn't really feel like going to the reunion.  Luckily, Grandma told her to get back in the car and GO!  It's a good thing she did.  We spent the night catching up.  A few hours into our conversation, the topic of children came up.  I told her we'd been trying for a long time with no luck.  It was then that she asked me if I had considered IVF.  I told her that we were actually just getting started with IVF.  She then confessed, in a hushed voice, that she was 7 weeks pregnant with twins...conceived through IVF.  I couldn't believe it.  Our topic of discussion then, of course, turned into injections and retrievals and transfers.  She told be it took them 3 cycles to get a positive pregnancy test, but mentioned that she thought the stress of her mom dying probably played a big part in why the first two cycles didn't take.  She encouraged me to stay positive and as stress-free as possible (hard to do when you teach 23 six year olds).  

Anyway, by the end of the night, I felt so glad that I went.  Not only did I have a great time catching up with an old friend, but I found a new support system...someone I can talk to about it all.  I just goes to show you...everything happens for a reason.

IVF

Last Monday, the hubby and I went to our appointment at the infertility clinic.  The doctor we requested (Dr. Riggs) had a family emergency, so we ended up having to meet with a different doctor (Dr. Brabec).  Our appointment lasted about two and a half hours and consisted of a pelvic exam/pap, trans-vaginal ultrasound, labs (for both the hubby and myself), and a consultation.

We went over the semen analysis that my husband had done a couple months ago.  Dr. Brabec pretty much said our only option to conceive would be IVF using ICSI (intracytoplasmic sperm injection).  She said with the SA numbers as low as they were, there wasn't much point in trying IUI (intraueterine insemination) and that she recommended starting right away with IVF.  She said usually couples come back on another date to have their IVF consult, but since we were already there, she was able to get the IVF coordinator to come in a talk with us.  She gave us a huge folder of info and talked us through everything.  Then another woman came in to discuss the financial aspect of it all.  When it's all said and done, it's going to cost us around $15,000.

We went to dinner afterwards and discussed it.  We definitely want to move forward as soon as possible.  We don't have the money to pay for it all upfront, so we're looking into a loan.  Hopefully we can get all that squared away without any major hiccups.