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Archive for August, 2011

Well, as I’m trying to take this whole pregnancy thing day by day (although I think I need a sticker or reminder so I don’t go through x-ray machines, order a deli sandwich, etc…one thing I did twice at the airport and one thing I caught myself and ordered chicken salad instead – seriously I shouldn’t be allowed to be pregnant, I keep forgetting and I’m going to microwave my kid!) – I’m still pregnant!

My second beta (96 hours after my first) was “beautiful” according to Not Nurse Karen (really?  WHERE IS SHE?!) at 1,038.  That is doubling on average every 55 hours, according to Julie who is much better at math than I am.  Since everything is going so well, they’re not going to repeat it and my next appointment is my first prenatal appointment on 9/7 where I’ll have an u/s and then talk with a physician assistant (Dr. Zimon is in surgery that week). They said they’ll measure the gestational sac and look for the yolk. They’ll also try and get a fetal heart rate but I guess at 6 weeks this can go either way (and not to be overly concerned if they can’t find it – ya right, that will flip me out I’m sure of it).

I asked about my measuring my P4 level and Not Nurse Karen said that Dr. Zimon doesn’t typically do that and instead will have me on the Crinone for another 3-4 weeks. Mmm, vaginal suppositories…  But, I shall do as I am told!

Today officially marks 5 weeks and I’m literally walking around in fear most days.  Fear of losing what I’ve worked so hard to get.  It’s not a good feeling and it all comes back to what I’ve said many times – that infertility strips you, absolutely RAPES you, of your innocence.  It’s like the knowing is torture – most women wouldn’t know they’re pregnant right now, nevermind that they’re pretty good and pregnant.  Even women who did know but haven’t experienced infertility would just be walking around in la la land, all positive and full of sunshine, hope, and excitement.  Then there are people like me – who analyze every feeling (or lack of feeling), who can’t go to the bathroom without inspecting the toilet paper closely, who spend hours thinking about what “could” happen and how I would deal with “it” if “it” did happen.  I am trying to take it day by day or, as Julie has told me, with the mantra of for today, I am pregnant but it’s hard.  Really fucking hard.

I didn’t write about this yet but you have to understand what I did to get here.  I mean, you all understand (well, as much as you can) the whole fertility process and 20 negative pregnancy tests, the doctor’s visits, the drugs, the more drugs, the emotional rollercoaster, the split decision to convert to IVF – all of it, all almost two full years of it.  You also know that we transferred two better than perfect embryos – giving us a 50%+ chance of success and you know the outcome on both an HPT and with my first and second betas.  A big positive, right?

But, do you know all the other efforts I’ve made?  Do you know my transfer was on the day of a full moon, which is supposed to increase implantation?  Do you know the day after my transfer I saw a shooting star and wished so hard for me to become pregnant with a sticky bean?  Do you know I ate pineapple daily (and still do) to help with implantation?  Do you know that I gave up all gym activities just to be on the safe side?  Do you know that I considered quitting my job when I found out my RE advises against early pregnancy travel?  Do you know that I wear a fertility bracelet that Erin got for me every day?  I am not kidding when I say I have done all that I can from SO many different angles, but I am SO so scared.  Every day I wake up and think please don’t take this away from me.  This is hard – I dare say harder than going through the treatments. 

Yesterday some of the Crinone progesterone suppository clumped out (sorry if TMI – but this stuff happens and is discussed in here) and I noticed some very dark brown / black spots on it.  I freaked but then settled myself down, knowing that the general rule of thumb is if there isn’t anything red or it’s not coupled with cramps, it’s likely normal (and even in those cases it can be okay).  Later in the day, it was essentially gone and this morning the same.  But, this afternoon some came back so I called Nurse Karen and spoke with her.  (YAY – she’s back!)

She congratulated me a few times and told me how beautiful my betas looked.  She actually said that more than once, so I took that as a good thing.  I told her about the Crinone and the spots and she said that it was likely old blood left over from the retrieval or transfer – that the Crinone is almost like a cement and it can pull stuff with it when it clumps out.  Yummy.  She advised that when I shower in the morning I can do a sweep with my finger and clear stuff out.  Yep, sounds like permission for masturbation to me!  Hahaha, kidding…but really, so many other things have been up there, why not my own digit? 

We talked more about my lack of symptoms – how last week I felt some slight twinges and cramps and then lately absolutely nothing.  How I don’t have morning sickness and wouldn’t consider myself any more tired than normal.  She reassured me that it’s all very normal and still very early for symptoms in some people.

I walked away from the call with Nurse Karen feeling a bit better.  She seemed so upbeat and positive about my beta results and dismissive of my concerns, so I have to go back to that mantra of for today, I’m pregnant.  I just want to get to that 12-15 week mark where I can feel a little “safe”.  But that seems so far away…

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You never know how strong you are…until being strong is the only choice you have. – Unknown

That quote hit home with me a few weeks ago and I’ve been reading it every day since I first saw it.  How true it is was shown last night when, on a whim, I decided to run upstairs and take a home pregnancy test (HPT).  Without Chris knowing, I took the test and almost immediately, I saw this:

I couldn’t believe my eyes!  I asked Chris to come upstairs and he replied with, “you have IMPECCABLE timing today – every time I’ve sat down, you’ve asked for me to get up.  What do you need?”  I told him that he probably should come upstairs and he grumbled something about wanting to eat his cupcake and came upstairs.  I showed him the test and he had a confused look on his face and asked, “Wait, what does THAT mean?  What does two lines mean?” and I told him I was pregnant.  His face was that of utter shock.  We both didn’t speak for a few minutes and all he could manage to say was, “I can’t hug you right now – I don’t know what to think.” 

We finally caught our breath (and / or realized WTF was going on) and decide to call our parents and his sister.  I also let Julie and a couple of friends know.  The rest of evening was a lot of “holy shit” and “OMG” and “let’s not get our hopes up too high”.  I had a hard time falling asleep – so many thoughts were swirling through my mind.

This morning was my beta at 8:00am and then I headed to the airport for a business trip to Chicago.  I called and left a message for Nurse Karen and asked if there was any way to call me with my results before 1:00pm, I’d appreciate it as I’m boarding the plane then and don’t want to miss the call.  At about 12:00pm I got a call from Kate, the other nurse in the office (where is Nurse Karen again?!) and she said “I’m calling you with great news – congratulations, you’re pregnant!”  I just smiled from ear to ear and waited for the number I wanted to hear – she said my beta was 311 and they typically look for betas to be 50-100 so I am really looking to be in good shape.  She asked about my trip and said that she did have to tell me that Dr. Zimon typically advises against early pregnancy air travel.  I told her there was nothing I could really do at this point considering I was sitting at the airport and she reassured me that the risk was very, very small but it is still there.  I asked if there was anything I could do to mitigate the risk and she said no.  That was hard to hear – I don’t want to do ANYTHING to jeopardize what is growing inside me.  We had to coordinate how to get me more Crinone (progesterone supplements), so a box is being shipped to my boss’ office to arrive here in the Chicago suburbs tomorrow (LOL – I am very blessed to have an amazing boss).  My P4 level wasn’t checked with the beta, so I’m going to call tomorrow morning to inquire about that as I wonder if the Crinone is necessary if I’m producing the progesterone on my own.  Don’t get me wrong – I’ll shove whatever is necessary in my vagina to keep this pregnancy viable, but I would have thought they’d check.  Also, as Julie indicated, the P4 can show whether there is a likelihood of twins. 

Oh yes, it is not lost on me that my beta is high and what that can *sometimes* mean.  I’ll take whatever I can get – as long as it’s healthy – be it one or two.  (I may be forced to sell one on the internet if there is more than two…just saying.)

I am cautiously optimistic at this point.  I know that we’re not even remotely at a point of sharing broadly or out of the big risk zone.  I’m trying to keep the perspective of what I thought was the unattainable…can be attained with a lot of strength and perseverance.

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I’m now quasi knocked up!  5 out of the 6 embryos did well, so we had two transferred and three put to freeze.  There were three 8-3+ (best rating you can get – essentially an A+), so two were transferred and one went to freeze.  The other two were 7-3 and 6-3.  Apparently Blue Cross Blue Shield pays for the freezing for up to a year.  That was a pleasant surprise – although for what we pay in COBRA costs, it’s nice to get a handout or two.

My best friend Julie came with me – she’s the one who just gave birth 7 weeks ago to IVF twins.  Ironically, Chris got a trip into Nashua, NH (as a reminder – he’s a pilot and he’s rarely in the Northeast and never when I need him to be) so he landed, grabbed an airport car, and came down with enough time to be with me….except they were running 30-45 minutes behind.  But he was able to be there to hear the quality report and he’s a black and white guy, so that was good enough for him.  I got to see him in his uniform – that’s always nice *wink wink*.  Julie and I sat and laughed a lot prior to – we named the embryos Thelma and Louise. 🙂 She scrubbed up and came in with me and I was blessed to have my actual RE there to do the procedure.

The procedure was nothing to write home about.  Very similar to an IUI but you see everything on the u/s screen and your bladder is full (which was probably the worst part).

And now…we wait!  I’ll know on 8/22.

I spent the rest of the day with Julie and her twins, Erin and Will – my niece and nephew by proxy.  This was my first time holding and interacting with Will as he was still in the NICU when I went and met Erin and when I met them both for the first time – they were only 2 days old.  I’ve now officially fallen in love with both of those kids.  I wanted to smuggle one of them home with me – probably Erin until Will works out his colic… 😉

It was a great day for so many reasons – Julie’s first day out without the kiddos, Chris having a trip where he could actually make it to Boston IVF, the quality report top notch, laughing with my best friend while spread eagle on a table getting my embryos, coming up with the embryo names, and spending an afternoon with the cutest twins I’ve ever known.  I will go to sleep tonight knowing I am so very blessed and hoping that the blessings continue…

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Sometimes I really feel like I’m discussing things that should be in a Farmer’s Almanac and not coming from the likes of my vagina.

I had my egg retrieval yesterday morning – a procedure that kinda sucks but the people at the center were super nice and that made it more tolerable.  After almost two hours in Monday morning rush hour traffic, we checked in and then Chris was sent to do his thing.  I was then brought into the surgery center and placed in a comfortable recliner chair.  A nurse came over and took my vitals and reviewed my medical passport (something I completed online the night before).  Chris then joined me and we hung out for a bit after I changed into my johnny and bathrobe and my big, fluffy red socks I brought from home.  The anethesiologist came over and asked me a bunch of questions – he was a large, LARGE man.  I wouldn’t mess with him…  Then another nurse (who was super sweet) came over and put my IV in with some fluids since I couldn’t eat or drink past midnight.  I then got to meet the RE who was doing the retrieval and she was really nice.  And thank GOD she was a she – I’m not a fan of male doctors, especially when it comes down to my girl parts.  Finally after kissing Chris goodbye, the OR nurse, Bonnie, walked me to the OR with her arm around me.  I’m not typically a huggy person with people I don’t know, but it made me feel really good.  She was a bit cooky, but super sweet.

The room was bright with lots of people.  Some dude Bob was there and I’m not sure what he does?  I think he prepares everything for the doctor.  Bonnie got me situated on the table and some other lady did this tie down thing, which freaked me out at first but then Bonnie made a joke about making sure I don’t escape with my eggs so I laughed and settled in.  The embryologist, who I swear was younger than me, came over and introduced himself and had me confirm who I am.  They put oxygen over my face and then the jumbo anethesiologist came over and put something in my IV (anethesia) and tightened my oxygen and the last thing I remember is Bonnie saying “see you in a bit”.

I was overly emotional after I came to from the anesthesia, but I guess that can happen. The recovery nurse went and got Chris for me and gave me ginger ale and some graham crackers.  The doctor came over to give me my results and I burst out crying again.  They only got 6 eggs – which didn’t help with the emotions, especially after hearing the girl next to me got 16.  I am wondering if it’s because this was a conversion cycle from IUI to IVF?  I guess it only takes one, though, right? I just hoped that we’d get some to fertilize – but was doubtful we’d get any to freeze in case we have to do this again.  The thought of going through this again made me insane.  *sigh*

Chris drove me home and I was *this close* to puking.  I ran upstairs and went to bed and slept on and off for most of the rest of the day.  I was super sore – they said it would be like menstrual cramp sore, but this was worse.  I took some Tylenol and put a heating pad on and stayed like that for most of the evening. 

I got the call late this morning – ALL SIX FERTILIZED!!!  Wooo hoooo!  I was totally shocked and couldn’t believe it.  I guess it’s not quantity, it’s quality? 

I am scheduled for noon on Thursday for the egg transfer.  We have decided to put two embryos back in.  I won’t know quality until I arrive on Thursday, so I’m hoping there’s a few stellar eggs in there for me.  And maybe even a couple to freeze just in case?  Positive thinking…

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Today’s news:

E2: 1,442 (no wonder I’m exhausted)

Follicles: At least 9 – 18.9mm, 18.6mm, 2-18.2mm, 17.9mm, 16.1mm, 14.4mm, 14.1mm, 13.2mm

They are, unfortunately from a timing perspective, having me do another dose of both Gonal-F (225iu) and Ganarelix tonight.  No bloodwork or u/s needed tomorrow (yay for sleep!), but a nurse will call with a specific time for me to do the Ovidrel trigger shot and the scheduled times for my egg retrieval and transfer.

The egg retrieval will be on Monday morning (nothing like cutting it close to when my loving husband leaves) and, if we do a 3-day transfer, it will be on Thursday.

I’m so tired – if this is just a taste of pregnancy, I may spend the entire time asleep.  I am SO very hopeful this is the cycle that does the trick!

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For the girl who struggled to grow 1-2 follicles, I’m now housing a farm of them!!!  I went in this morning for bloodwork and u/s and had one of my favorite u/s techs.  This, my friends, makes me happy.

I got the call from Nurse Karen – going to stim for another night so more Gonal-F (225iu) and Ganirelix and I go back tomorrow morning.  I asked Nurse Karen to guesstimate when I’d trigger and she said probably tomorrow or Saturday, which would make ET on Sunday or Monday.  I’m really hoping for Sunday as my RE is on this weekend so she’d be the one doing everything.  Chris leaves Wednesday morning for work for 8 days so I really want to get the ET over before he leaves to use a fresh sample vs. frozen.  Ahh, the stress!
 
And of course we screwed up the embryo freezing paperwork so I had to run out and meet him at a notary to re-sign everything.  I’ll blame the hormones since I’m usually pretty detail oriented!  I joked that with all the money Boston IVF makes, they should start using electronic signatures and forms. 🙂
 
My E2 is 1,109 and she said there is 8 (not sure where the 10 came from the tech this morning):  17.5, 16.7, 16.1, 15.9, 15.0, 12.8, 12.7, 12.6.  I assume they’re trying to get them a bit bigger (although I meet minimums for the insurance criteria to convert), so we’ll see what tomorrow brings… 

Dr. Zimon and I have been struggling to connect.  She called me this morning in between IVFs and said that she’s had a tough on-call schedule for some reason so all the times I was available she wasn’t, unfortunately.  She wants to give me all the time I need, so we’re going to connect this afternoon.  I have a lot of questions – mostly around benefits / risks with putting in 1 vs. 2 embryos.  Chris has decided (without any information, I must say) he wants to put back in 2 but I’m struggling with the decision.  Our intent was to have one kid even before we knew of this infertility crapola, but I wouldn’t be SO offended by twins.  Although, in the back of my mind, I know what I witnessed Julie go through with carrying twins, bed rest in the hospital, NICU, etc…  I’m exhausted just thinking about it…

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Umm, yes – you read that title correctly.  I just found out that my injectable IUI cycle is being converted to IVF. I was called this afternoon with my bloodwork and u/s results from today and my RE recommended converting as I have 7 measurable follicles (1-15mm, 2-13mm, 1-12mm, 2-11mm, and 1-10mm). We did have the option to continue with IUI and trigger tonight with the IUI procedure on Thursday, but there would be an extreme high risk of multiples and I don’t want my own reality TV show a la Krista and Chris Plus 7.   

Unfortunately, I had to make this decision in literally 20 minutes because I had to go back to Quincy to pick up an antagonist drug to suppress ovulation and had to do that today.  I spoke briefly with Chris (who was literally in the plane) and we agreed to move forward with converting to IVF.  I, of course, called my BFF Julie (the one who just had her IVF twins – my niece and nephew) and asked her opinion and she said if she were me she would absolutely convert this cycle.  So, I called the office back and made it official.

My RE wasn’t available when I went in to get some more drugs and a pound of paperwork, so she is going to call me tonight.  I’m trying to think up all the questions I have – I feel like I’m walking around in a fog.  I am so much of a planner and this wasn’t in the plan this month.  I’m excited and scared – I’ve never done IVF before so I don’t know what to expect (and I feel like an old pro with the IUI stuff).  I did ask the office about costs and apparently you can convert with my insurance as long as I meet the following criteria:

– E2 level over 800
– At least 5 follicles over 13mm

My E2 level is currently 915 and I have 3 follicles over 13mm.  So, the plan is for me to continue the 225iu of Gonal-F tonight and tomorrow night in conjunction with the antagonist injection and then I have bloodwork and u/s scheduled for Thursday morning at 8:00am.  If everything looks good and meets the criteria, I will trigger with the Ovidrel shot Thursday night and have egg retrieval on Saturday morning.  Then, from what I am to understand, there is either a 3 or 5 day transfer period and the egg transfer will be scheduled accordingly.

I guess Chris is getting his IVF wish…and our chances have just increased.  Please make this work and stick.  I’m emotionally exhausted and want off this crazy train.

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