Friday, February 29, 2008

In someone else's basket now

Thanks so much for all the thoughts and prayers, everyone. We got 5 eggs! The ER went really smoothly, and mom has been bringing me hot tea and popcorn as I rest up on the couch.

The IVF lab people said that often a follicle can look nice and mature but turn out to be empty. So, while all those 16 mm follies may have grown enough by this morning to turn out some good eggs, giving us just one short of a dozen, in the end all those follies yielded 5 eggs to fertilize. Honestly, HK and I were a little disappointed we didn't get more, since the odds are that not all eggs will fertilize, and not all those that do fertilize will make it to transfer, and we were hoping for a few to freeze, BUT in the end it only takes ONE, and we are very happy we are starting with 5 times that many.

I feel relieved just to know I am not responsible for my eggs for the next 3 to 5 days - they are in someone else's basket now, and I trust they are taking very good care of them. There is nothing else I can do right now but stay hopeful and pray.

Tomorrow we will get the fert report. I'll keep you posted. Back to the couch now. I am resting easier knowing so many people are supporting us and praying for our little eggs.

Thursday, February 28, 2008

Maybe half a dozen

Okay, we are all set for egg retrieval (ER) tomorrow! At the u/s yesterday, this is what they saw:

Right ovary: 23, 19, 18, 18 (and 16, 14, 12)
Left ovary: 20, 19 (and 16, 16, 16, 16, 12, 12, 11)
Lining: 16
Estradiol: 2518
Progesterone: 1.9, up from 1.4 on Monday

I put the smaller follicles in parentheses because they probably will not be mature at the ER. There was talk about pushing me one more day on stims to give those 16's more time, and my hormone levels are good, but Dr. D decided not to risk it. I am already late in the cycle by one day, there is always a chance my estrogen could spike, and we have enough mature eggs right now to go forward. HK and I are totally fine with our half dozen, and I am getting so crazy on these shots that I am happy to be done!

So last night I did the trigger shot at exactly 8 pm, plus one last injection of Lupron, and today I am blissfully shot free. Ahhh. HK took his antibiotics last night (aww, he had to swallow a couple pills, poor guy! Hmm, do you detect a note of bitterness? Sorry, sweetie.), and I will take the same tonight. No food or drink after midnight, and we have to be there at 7:30 am.

Please pray for everything to go smoothly and for a good fertilization report!

Tuesday, February 26, 2008

My belly

I have been wanting to post, but I haven't had any time to myself lately until today. Lots of good things to report! First, I have finally found a good use for my pot belly: a pincushion. When I do get pregnant (not using "if" here), no one will be able to tell until my third trimester, thanks to the genes from my mom's side of the family. Petite from the waist up, skinny from the thighs down, but kind of like a small beach ball in the middle.

Seriously, people have done a double-take at my stomach and exlaimed, "You're pregnant!" when I definitely was not. But now, that convex accumulation of fatty tissue is the perfect place to inject my fertility meds. Very accessible and thick enough to forclose any chance of hitting an organ with the needles. Nice to have a good use for it at last.

My belly is more bulbous than usual right now, due to my ovaries taking up five times as much room as they usually do. Which leads to the next bit of good news. I had an u/s on Friday and another one yesterday, and those follies are a-growin'! Here's the progress:

Friday 2/22
Follicles on left ovary: 12 mm, 11 mm, 10 mm and 5 small
Follicles on right ovary: 14 mm, 10 mm and 4 small
Lining: 9
Estradiol: 682

Monday 2/25
Follies on left: 18, 16, 15, 15, 12 and 3 small
Follies on right: 19, 15, 14, 14, 11 and 2 small
(look at how that right ovary caught up!)
Lining: 15
Estradiol: 1690

Woo hoo! I got to talk with Dr. D (the RE) yesterday, and he thinks we will get 10 eggs at retrieval -- some mature, some less mature, and some very mature. That sounds great to me and HK.

Today will be my last full day of injects. Tomorrow I will go in for one more u/s and bloodwork, and if all is well, I will give myself the "trigger" shot. The shot contains hCG, or human chorionic gonadotropin, aka the pregnancy hormone. When women pee on a stick to see if they are preggo, those drug store tests are measuring the level of hCG in their urine. hCG is very similar to lutienizing hormone (LH), the hormone that surges right before a woman ovulates. Thus, in the realm of assisted reproduction, hCG is used to trick your body into thinking it's time to pop a follicle and release the egg inside. Controlling the time of ovulation allows you to schedule inseminations and egg retrievals for optimum egg availability.

Ovulation happens 40 to 45 hours after trigger. About 36 hours after my trigger shot, Dr. D will go in with a needle and suck out as many eggs from the follicles as he can, just before they are ovulated. Hopefully, we will get at least one egg that fertilizes and then implants when inserted into my uterus five days later. Then I will gladly welcome any resulting increase in the size of my belly.

As I was telling some friends yesterday, I am getting excited about the IVF, and at the same time I am afraid to get too excited. Trying to keep stress to a minimum. Very thankful for the love, support and prayers of friends and family.

Wednesday, February 20, 2008

Waitin' on the follies

Ultrasound #3 was this morning, and my ovaries still aren't doing much. The scan showed 2 measurable follicles -- one on each side, both measuring 10 mm (a follicle is considered mature at 20 mm). There are also 5 small follies on the right, and 6 small on the left. I found out my estrogen level on Monday was 83, which was not the >100 number we were hoping for.

Because of that, the doctor adjusted my meds a bit starting yesterday, and sure enough, my estrogen was up to 239 today. Yay! So I am hoping to see more good follicles on Friday. Also, the lining of my uterus has thickened from 5 mm to 6 mm. By the time of ovulation, it is usually about 10 mm. A nice, thick, cushy landing pad for those embryos.

Wow, embryo. Just using that word strikes amazement in me. Could that minute, miraculous, cellular-level life form really exist inside me one day? Maybe around March 4th or so?

An online friend of mine had her egg retrieval today. They saw 4 mature follicles at her last scan, but they got 7 eggs today, which is great. Tomorrow morning she will find out how many eggs fertilized, and I am anxious to find out, too, though I am sure my anticipation does not even come close to hers.

This post is not too exciting, but I want to send love and thanks to everyone reading and keeping up with what's happening. It's great to know people are sharing in this with me.

Monday, February 18, 2008

Not much happening

I had my second u/s today, the first one since I started stims (the Follistim injections). None of the follicles are big enough to be measurable yet, but I now have 5 follicles on the right and 7 on the left. That's two more than I had Friday, so I take that as progress.

Now I wait for Nurse Honey to call with the b/w results, to find out if they will adjust the dosage of Follistim. She said it is normal not to see any real activity yet, and that my follicles will not grow until my estrogen level goes up. She said they are expecting my estrogen to be above 100 today, so that is what I will hope to hear when she calls.

Also, tomorrow I will start a new shot, called Menopur, once a day. That's four shots a day now, the maximum I will have to do. It requires setting aside an extra 15 to 20 minutes every morning and night for the injection routine -- get the meds out of the fridge so they aren't so cold, prep the injection site with alcohol, cleanse the vial cap, attach the needle and dial up the dose on the needle pen or prep a disposable syringe and fill it with the right dosage from the vial, squeeze the part of the thigh or belly where I am going to inject, stick in the needle, let go of the squeeze, slowly depress the button, wait a few seconds, and withdraw the needle. Voila! Sometimes a drop of blood comes out, sometimes it doesn't. It's really not that bad. Especially if you have a morbid curiosity about medical stuff, which I do.

My husband ("HK") is going to start observing the injections, so he can get more familiar with the process, since he will eventually have to do some injections for me. Now that is trust, especially for someone with controlling perfectionist tendencies, like me. How many people do you know, whom you would trust enough to let them stick a large gauge needle deep into your muscle and inject you with hormones? Hmm, reminds me of some recent headlines...

Friday, February 15, 2008

Peraphernalia picture

Here is the picture of some of my drugs and drug accessories.

Blog about a blog about a blog

The link above is to a post about a post. I appreciate the blogger's honesty about the "lenses" formed for her in her struggle with infertility and her determination to turn towards tolerance and keep an open mind. She discusses the shift in her reaction -- from sympathy to something closer to bitterness -- to parents complaining about parenting, as her journey toward parenthood became increasingly long and difficult.

I'll admit there is some of this in me, too. There certainly are times of bitterness, jealousy, self-pity, self-doubt. But somehow my hope and my trust that my husband and I will have children, and that this childless time is allowing for growth and strengthening in ourselves and in our marriage that will come in really handy when we do have children, remains the louder voice so far. Of course, we still have a viable option in front of us to get me pregnant -- we haven't done a full IVF round yet, and the IVF meds are covered by insurance (saving us maybe $5000), meaning there is hope we can afford to do it again if it doesn't work. Many, many women have been trying longer than we have, have been through much more, or don't have as many options b/c they don't have insurance or other resources. So I am not passing judgment on the blogger mentioned above (in fact, I chat with her online and think she is very wise and compassionate) or any other woman (or man) facing infertility.

My bitterness comes more from feeling left out and having things not go the way I think they should go. Many of my friends have already had their kids - two or three of them, years ago. My sister, my best friend, has kids that are ages 8 and almost 11. Many of the rest of my friends are not married and (I assume) won't be having babies anytime soon. Who is going to go through having her first baby with me? My original plan was to have babies when my sister and close friends were having babies, so we could all do that together. It hurts to feel left behind, either because I couldn't get married fast enough or couldn't get pregnant fast enough. I had plans about these things, for goodness sake!

What is that saying, "comparison is the thief of joy", or something like that. And why do I feel so entitled to any of this? Part of it is my perfectionism. I see how something goes for someone else, anyone else, even if it's in a movie or a book, and I think of how I want that to go in my life, how to perfect it. Have a baby in the year 2000 b/c my Grammy was born in 1900 and isn't that cool that if it was 1985 then I knew Grammy was 85 years old? I didn't even have a boyfriend in the year 2000. Have all four of my children in my 20's when my body could handle it better. I'm 36 now. Have kids when my sister has kids, so they can be same-age cousins who are friends all their lives b/c I didn't have that (luckily, there is some chance of this on my husband's side of the family, if we hurry up). So I guess a lot of it is about timing for me. I think I know when is the best time for things to happen, and God doesn't agree.

So my struggle is in learning to let go, since I have no control anyway.

This is kind of ramble-y. I need to go eat some breakfast!

Thursday, February 14, 2008

All clear!

Big happenings this week -- all good, too! I was going to wait until tomorrow to post (when I am not at work), but I want to write in the moment, and I am in the moment now.

First, and most relevant to the blog topic: I had my baseline ultrasound ("u/s") this morning, which is where the u/s tech looks at your ovaries to see how many follicles are developing, how big they are and whether you have any big, bad cysts that might cause a problem. I will not go into detail about how they get the best view of the ovaries, but let's just say it's...intimate. So, my report said 5 small follicles on the left, 5 small follicles on the right, and one 11 mm cyst on the left. This cyst is most likely an endometrioma -- a bit of endometrial tissue that has attached to my ovary and caused a cyst to grow. I had a big endometrioma removed a year ago. Thankfully, this cyst is too tiny to matter, and I got the "all clear" to start the next level of meds tomorrow. I am celebrating!!!

After the u/s, I had to get blood drawn so they can check my estrogen level. They moniter that, along with other hormone levels, throughout the process. Later today, the nurse (Nurse Honey -- that's her real name -- she says her parents were hippies) will call me with the test results.
Then, I stopped in the special "all fertility meds" pharmacy and picked up a few more cool-looking vials of fancy meds. I think I will post some pictures tomorrow.

It's been two weeks now of Lupron shots, one a day. Starting tomorrow, I will add to that regimen two injections of Follistim, one in the morning and one at night. Follistim does what the hormone FSH does -- it makes the follicles in the ovaries grow (Follicle Stimulating Hormone). There is supposed to be one egg in each follicle. When a woman ovulates, whichever follicle is the largest releases its egg, and the finger-like ends of the fallopian tubes go pick up the egg and send it through the tube to the uterus. Amazing. Anyway, the dose of Follistim will be adjusted as needed over the next two weeks to grow as many mature follicles full of nice, healthy eggs as we can get. (Then, we will bypass the whole fallopian tube part of it altogether.)

My husband and I had to sign a bunch of forms that I turned in today, giving our consent to the procedures, acknowledging the risks involved, stating what will happen to any frozen embryos in the event that we divorce. Wow. There's a dose of reality for you. Forms aside, I knew this day would be a milestone for me, emotionally. I was holding back until I knew we were okay to go forward, but I am deeply invested in this process now, in my heart and in my hopes.

Okay, other piece of news: I quit my job yesterday! I'll take a few weeks to wrap things up here, take nice break in March, and start my new job on April 1st. I am celebrating!!!

Happy Valentine's Day, everyone.

Tuesday, February 5, 2008

So far, so good

I have had five injections of Lupron now, and so far, I feel fine! Well...I have had some moodiness, but overall, no problems. Before I started the Lupron injections, I went on birth control pills, to begin the process of suppressing my ovaries. Strange to be on BCP when what I want is to get pregnant. I'll take the last one of those tomorrow morning.

Meanwhile, I am almost done with my fourth week of the endo diet. Just over a year ago, because my husband and I had been unsuccessfully trying to get pregnant for over six months and because of my "advanced maternal age" (35), I underwent a procedure called a laparoscopy, where the Reproductive Endocrinologist ("RE") looked inside my abdomen and checked out the exterior of my uterus, fallopian tubes, ovaries, intestines and pelvic wall. The RE found what he called Stage III endometriosis. Read all about the disease here: . He removed adhesions, scar tissue and a large cyst on one ovary. I had almost no symptoms of endometriosis, but I was glad to know the RE had removed it, and I was looking forward to getting pregnant right away. At the time, I read about a diet designed for endo, but it sounded really hard to stick to, and I figured my endo was gone, so I didn't bother with it.

After endometriosis is removed, it returns almost 100% within 10 months to a year.

One year after my lap surgery, we had tried three cycles of intra-uterine insemination (no longer called "artificial") and numerous hormone pills, injections, ultrasounds, RE conferences, ovulation predictor kits, blood tests, and of course a few pregnancy tests, all of which were negative. My husband and I were now down to three options for a baby: IVF, adoption, or continuing to try on our own with no medical intervention in hopes of beating the odds. We chose IVF.

I have been told that IVF effectively takes endo out of the equation. Faced with the emotional, physical and financial toll that IVF would take, I decided I could do better. Maybe IVF helps you GET pregnant when you have endo, but what about staying pregnant? And how about giving this our very best effort, and not just relying on doctors and drugs to make it happen? So, I committed myself to the endo diet in preparation for IVF.

Later, I will post more about what the diet entails. For, now I just want to say that I am thankful that I learned about it, that I have the time and resources to grocery shop and cook within the guidelines, and that I can know that I am taking responsibility for my health. I don't stick to it perfectly, but that's okay. And hey, I've lost 5 pounds.

I appreciate those of you who have left your comments, and thanks everyone for visiting and being a part of this journey.