IVF/Pregnancy Update

To recap: the fetus had stopped growing at the 8 week mark and we were waiting for me to naturally miscarry. That didn't seem like it was going to happen, so my doctor decided I needed a D&C. I'm lucky that they do this procedure in their Grand Rapids office, so it was much less trauma than if I had to be admitted to the hospital.

I had the D&C on Friday and it all went well. I had the same kind of anesthesia as I did for the egg retrieval, so my recovery wasn't too bad. No nausea or anything like that. I also had to have a Rogam shot as Tim is RH + and I'm RH -. I don't remember much about the procedure (thank God!) but we had requested an ultrasound before hand, just to be certain that the fetus hadn't changed any.

So, we have a couple of weeks for recovery and then we'll talk with Dr. Young to understand the procedure for a frozen embryo transfer. We have 10 lovely frozen embryos to take us through the next steps. I'm actually looking forward to spending the rest of the summer having some fun and enjoying focusing on things not related to getting pregnant or staying pregnant. Time for Tim and me to relax, reconnect and have an adventure or two. It'll be fall before we know it!

News: Some good, some sad

I'll start with the sad news. The visit to the doctor didn't go very well. The embryo is not growing the way it should, so we've stopped the injections and medications. Dr. Young thinks that I should naturally miscarry in the next two weeks. Tim and I are sad and disappointed, and have the attitude that if the pregnancy isn't healthy, then maybe it is for the best. It will be several months before this is resolved and we can try again with our frozen embryos. I'm worried about what the next few weeks will bring -- if I don't miscarry, we'll have to do a D&C -- a much more invasive procedure. Thank you to everyone who's been praying for us, we'll continue to need your prayers as we go through the next several months.

Now, the good news. We have a new family member! For about 6 weeks, we've been discussing getting a second dog. The idea is to get one that Henry likes and that will play with him and become a companion. Henry is so bonded to us that he doesn't know how to play by himself. When we do have a baby, we'll have less time for the dog(s). It'll be good for them to have each other. Plus we need time to do training with a new dog and get him acclimated to the family.

We haven't decided on his name yet -- Tim is leaning toward Lance (short for Lancelot) and I'd like Jack. (I have the idea that Tim will get to prevail on this one. . . but we'll wait and see.) We adopted him from the SPCA (the same place we got Henry). He's a mix again -- about 50 lbs, black and white with a curly tail. Smaller than H, but they were playing together very well in the back yard today. So far, the cats have all gone to ground. I think they are mad at us. Oh well, they'll have to get used to the new doggy.

No fetal pole, yet

At my doctor's office on Thursday, I had my first post positive beta ultrasound. Tim wasn't able to be with me because of his trip. He'll be there next time, though! We saw the implanted embryo. Dr. Young thought he should be able to see the fetal pole (central nervous system -- I think) but wasn't able to find it. We also saw the other embryo, it had implanted, but not grown very much. That one will most likely just be reabsorbed back into the uterine lining. Dr. Young was pretty calm about no fetal pole, just said that all pregnancies were different, and we'd be able to know for sure in 2 weeks. In 2 weeks, if we see the fetal pole and the embryo has grown the way it should, then we're back on track. If it hasn't, then the pregnancy won't be viable.

Of course, I'm worried. But -- our take on this is we don't really have any control over whether it will turn out to be viable or not. It helped that I talked to a friend who had twins via IVF and at her first ultrasound, one fetal pole was visible and the other was not. The second one showed up 2 weeks later and now he's a rambunctious 4 year old. Plus, if the fetus isn't developing like it should, it's better to know now.

So please just keep thinking about us and praying for us. I'll let you know the outcome of ultrasound #2 in 2 weeks!

I can do this . . .

I did it! I gave myself the PIO shot tonight. 1.5 in needle right into the outer, upper quadrant of the buttocks. I tried last night with Tim standing by and totally freaked out. He had to do it in the end because I was almost hyperventilating. Of course, when we are in the same place, I will have him do it. Now, though, I have the confidence that I can do this and traveling won't be quite so worrisome. This means that the shots won't start to rule my life. Whew! big sigh of relief. I now feel the need to take a nap.

YES!

We are (barely 2 weeks) pregnant! My Beta HCG tests on Wednesday and today showed the right and increasing levels of the hormone. The nurses did not say, but my research seems to point out that the level and the fact it doubled for the second test (as it was supposed to) points to one baby.

I'm to continue the shots and estrace until my OB appointment with Dr. Young on 6/26. If all is as it should be, sometime after that they will release me to my regular OB/GYN. I hear tell that the shots could continue for a while -- 6-8 weeks total is not uncommon. The injected progesterone, however, is a good thing for supporting the pregnancy. The issue I face, and will have to figure out as soon as tomorrow, is how to give the shot to myself. All the sub-cue shots were fine. In fact, they became no big deal. This is a 1.5 in needle that has to go in at a 90 degree angle. I tried tonight, but just couldn't watch it going in. I close my eyes when I swing a bat -- how can I actually look at a needle going into my flesh?

Tim is gone tomorrow and won't be back in time for the shot. I could get someone else to help me, but in another week I will travel for work 3 days. As soon as I come back, Tim leaves and is gone for 4 days. I'll have to do the shot for 7 days straight . . . No one said being a mom was going to be easy!

An IVF pregnancy, outside of the progesterone shots, is not any different than an early pregnancy gained in the more conventional way. So, we are announcing it on the blog, but not making any big announcement until we get through the first trimester danger zone.

The other issue right now is that I actually look 4 months pregnant. I've got abdominal fluid build up due to hyper stimulated ovaries. It's totally unfair that I've lost my waist already! We're monitoring it -- it should slowly subside on it's own. Which I really do hope is the case. If it doesn't, they have to aspirate the fluid build up out of the abdomen.

Please keep us in your thoughts and prayers, we've made it this far, and have much more road to travel.

Twins!

Here are the twins...embryos anyway.
50% chance one of them grows into a bambino, 25% chance they both do.
I tried to offer the Doc some Elmers Glue while he was putting the "kids" back in Sarah but he didn't go for it. Now we'll just have to rely on them liking where they are and wanting to stick around and grow. (Sarah won't drink any glue either, even mixed with milk.) Actually, I'm giving Sarah a progesterone shot every night in the keister so that's supposed to help the embryos stick around.

Embryo Transfer

We transferred 2 excellent embryos and have a picture of them, in all their 4 cell glory! We went with 2 on the advice of the doctor. Since my problem is not ovulating, the thought is more than two embryos really ups the chances of multiples. Of course, it would also up the chances of getting pregnant, but not by much. If none implant, I'll wish we had put back more, but that's something to think about a few weeks from now. Two days of bed rest and limited activity and then back to normal. Or as normal with the addition of every other minute thinking "am I pregnant, or not?"

I thought I'd be going stir crazy toward the end of my two days of no activity. The first day of bed rest on Saturday was no problem, I just kept sleeping. Somehow when I lie down, my body thinks it's supposed to sleep. Probably good anyway. I'm still sleepy today and have slept in between reading Barbara Kingsolver's newest book Animal, Vegetable, Miracle. I've read all her books, except this one and it's been waiting on my shelf for some down time. The book is about the year her family spent growing most of their own food and eating locally. Very cool, and something that we've talked about in vague terms. I'm feeling very unworthy, though, as Tim goes to the grocery to get a roasted chicken for dinner, but I'm sure that will pass!

I'm also reading another book -- this one for a book study/small group at church. It's Irresistible Revolution- living as an ordinary radical, by Shane Claiborne. Very difficult to summarize as I'm only in the middle of chapter 5. I'll write more about it as we go and about the group of people that are reading and talking about it together.

On one final note, the radishes are up in the garden! Haven't seen it since Wednesday, so hope all is OK. I'll be able to water it tomorrow.

Egg Retrieval

I'm still feeling a bit loopy (apparently pain meds/anesthesia and I don't get along) but the egg retrieval was a success! The Doctor collected 16 eggs, 2 were immature, one had a broken shell (yes, that's exactly how the nurse described it) so we had 13 to start. 12 were successfully fertilized through ICSI (inter cytoplasmic sperm injection) and we now have 12 embryos growing.

I was very much out of it for the procedure, so I didn't get to watch on the ultrasound. Bummer. Tim says it looked like the needle piercing a dark, fluid filled area that then shrunk as the fluid was aspirated into the test tube. I had anesthesia of a sort by an IV connected to a filled syringe. I also took a Valium that morning (looovely stuff, makes me very relaxed and sleepy). Once I'd confirmed my stats to the Embryologist, they gave me the real stuff. The procedure did hurt, so I remember the doctor telling me to breathe a couple of times. Tim says he asked me if this hurt more or the tattoo, and when I replied, "definitely this!" the nurse ran over to give me more meds. I vaguely remember being transferred to a hospital bed and the next thing I knew, Tim and I were in the recovery room. Apparently he'd done his part just fine and we'd been there for about 45 minutes. They wheeled me out to the car and we went home.

No idea what time we got home, I passed out in bed wearing my clothes and slept until about 4:45. I had some difficulty trying to decipher the instructions for medications I was supposed to take so called the on-call number for the doctor. I'm pretty sure I gave them the wrong phone number to call back, mixing up my two cell numbers. Anyway, finally figured it out. Tim gave me the Progesterone in Oil shot in the butt and I went to bed (this time in my PJs). Except for taking Tylenol a few times last night, I didn't get up until 7:30 this morning. I've also slept on and off most of today.

The Embryo transfer will be tomorrow at 8:30 am. After that I need to spend the whole day lying down. I'm allowed to get up to go to the bathroom, but nothing else. Sunday I'm allowed up, but no lifting, and really nothing else. Monday, back to work and normal schedule. It will be almost 2 weeks after the retrieval before we know for sure if it all worked . . . so keep praying for us like crazy!

More IVF

So I have about 30+ eggs on each ovary, but they are still small -- about 6 mm. 30 eggs is a bit too many, but Julie (nurse) said that they'll manage the meds so that not all of them grow. She didn't seem concerned that they hadn't grown anymore b/c I'd only had 2 days of medication. My follicles on Clomid only went to 8-9mm and I don't know how large the follicles were before any of the meds. They need to get much larger 18-20 mm (I think).

No more Menopur, but I'll keep the Lupron and Follistim. Back to the office on Monday for more blood work and another ultrasound. This time they should have grown some more, so keep your fingers crossed!

I've been reading quite a few fertility blogs and have noticed a few things about how others are seeing the assisted reproduction therapy (ART) journey. Most seem quite obsessed with their "numbers." Hormone levels, sperm count, sperm morphology, blood test results and lot of other measures. We've been told all those things, but haven't been tracking them too closely. Others have all kinds of ways of tracking where they are in a cycle, what hasn't worked and how long they've been TTC (trying to conceive). This obsession worries me. First, I wonder why I'm not quite as obsessed. Normally, I would think I'm the type that would be like this, but I'm not. Second, am I supposed to be obsessed like that? If I'm not, does it mean I'm not as invested and not as likely to get the outcome we want? Frankly, I find the tracking every move, mood and blood test to be very tiring. I had 3 blood tests last week. I'd have to do an Excel spread sheet to keep it all straight, and then I wouldn't know what the numbers actually meant.

My biggest worry is that the follicles are not going to respond to the meds, not grow at all due to some other strange issue. And, if I had only been more demanding of my doctor or compulsive with the data, that this could have been avoided. Oh well, I'm not really up for monitoring all the data. That's what we're paying Michigan Reproductive to do after all!

I've had some crazy headaches the last few days. Today I actually felt like I was going to be sick (as in throw up). I couldn't stand it when Tim took a curve with the car in the parking lot. What a wimp. I'm beginning to see how debilitating migraines can be.

Other side effects: my stomach has little needle tracks in it and a couple of spectacular bruises. Apparently my needle technique could stand some improvement. Up to now, the shots have not been as difficult as I thought they might be.

IVF, Stage 2

We're moving on to the second stage in the IVF. (Stage designations are my own). On Tuesday, I met with Julie, the RN in charge of our case. She looked at my ovaries and measured the lining of my uterus. After a blood pregnancy test, we were cleared to start stimulating the follicles.

Tonight I injected myself with three drugs. A lower dose of the Lupron (to keep my ovaries shielded from any hormones my body might make), Menopur (a mix of LH and FSH) and Follistim (FSH). I do the same amounts tomorrow night and then go in Friday morning for another ultrasound. This time we'll see if the meds are causing any changes to the follicles. Since they have been quite stubborn up to this point, I'm sending them positive thoughts about starting to grow. BUT, they need to all grow at the same rate. We need quite a few to harvest and they need to all be ready at the same time.

I'm glad to drop down on the Lupron dose. I didn't think I was feeling any side affects until about Sunday afternoon. Since then I've been tired, having trouble sleeping and my brain has been fuzzy at work. This isn't my stress insomnia, just more like I keep waking up and can tell I'm not sleeping very deeply. Some pretty good headaches, too, but difficult to tell it those are the drug or allergies. I'm also pretty emotional. I won't let the radio stop on a country stations because, invariably I find my self welling up at some tear-jerker of a song. I've been listening to CDs because even NPR is sometime too much -- I don't want to cry all the way to work!

After meeting with Julie, I had emotions that ranged all over the scale -- excitement to finally be moving on to this point, fear that it won't work, fear that it will and, of course, fear of needles. I'm still dreading the big ones that will have to go in my butt.

The only fly in the ointment is that we don't know exactly when we'll get to the egg retrieval stage, but it will be sometime right around Memorial Day weekend. The nurse said not to plan on going anywhere that weekend, which screws up plans to go to Ohio for the shower/picnic we're throwing for Josh and Allison. Bummer! I'm not counting it out yet, we'll have to see how it looks in the ultrasounds on Friday and next week.

The First Step . . . one of many

We've taken our first big step on the IVF cycle path. Tonight was my first shot. And, it actually went OK. I did flinch a little bit when it came time to stick myself in the stomach, but Tim was there to cheer me on, and it didn't really hurt. Just a little sting. The needle is really small, it's an insulin needle. I have an awesome husband, he did a couple of cheers for me to get me revved up as I got the paraphernalia out. We are incredibly silly at times (well, mostly I'm incredibly silly) and it works for us.

The Lupron that I shot up tonight -- I love saying that -- goes for 14 days. I'll probably be on it a few days longer than that because I think I need to have a period before we move onto the next drug. Since I don't have periods on my own, I'll have to take a drug to induce one. I'm sure the nurse coordinator will let me know what I have to do. She seems pretty good at that.

I had to stop reading about the side affects of Lupron on line. They sound pretty horrific -- mostly things that are like going through menopause and some weird bone pain. What exactly is bone pain? I hope I don't get to find out! Basically, Lupron is supposed to suppress any hormonal signals I actually do have. This is so we can isolate the ovaries and stimulate them with later medications.

Now, I get to take the show on the road. I am going to an event tomorrow night and will have to do my shot at the same time tomorrow evening. I can just imagine someone coming into the bathroom at the restaurant when I'm sticking a needle in my stomach. Should be interesting!

Choose your own adventure . . .

Remember those cool books you had as a kid where you were in control of how the story turned out? I loved them and read lots. Sometimes I think that life should be more like that. If I'm not doing the choosing, somebody or something else is going to do it for me -- right? Well, Tim and I are embarking on our own adventure and choosing something really exciting and a bit scary.

Our families and friends know that we've been trying to become parents (since before the wedding, even!). Clearly, not a whole lot has happened. It seems that I actually need to ovulate in order to become pregnant. It doesn't matter how much "practicing" we do, not much is gonna happen if there isn't an egg for the sperm to meet. We've been working with a great Reproductive Endocrinologist (RE) since a few months after the wedding. Tried a several rounds of drugs, and drug combos. We finally have decided to start a round of IVF (In-Vitro Fertilization). Starting, well, right now! It's about a 2 month protocol and has many, many steps and lots and lots of needles. (I'm really not too sure how I'm going to handle those needles. Apparently I will start out with small ones and by the time I get to the large ones that go in my butt, someone else will have to wield the syringe.)

One big worry for me is how I will manage the travel in my job. I travel a lot, and some of it is not very predictable. I love my career, and we do need it to pay the bills, so balancing is going to be key. I have gotten incredible support from my team at work and from my manager. They've offered to fill in for me and help out however they can. So, thanks to them, I can put that worry aside and focus on other things. We'll keep you posted and Tim can give you his perspective on what it's like to live with a woman taking massive does of injectable hormones!