New Day, New Approach

Sorry, its been awhile since my last entry.  After getting a negative result I had to crawl into a hole for a few days and sort out my thoughts.  I am now in the process of getting out of that hole and moving forward.  But man what a ride!  I can definitely say this first full IVF cycle has opened up a new world of emotions.  Happy, sad, mad, angry, back to happy, hot, cold, well mostly hot, crying, laughing, and that was all just one hour of a day during IVF.  Needless to say, I am ready to try it all over again.  

So we met with the doctor on Monday because he wanted to have a re-group meeting to see where to go from here.  Wait, back up a second.  The day I found out the negative result the doctor called me that evening and we spoke for about 45 minutes.  And through my tears I was still able to ask him some important questions that had been on my mind.  I said, here's a thought.  In September we were canceled because the birth control pills messed up my cycle, and basically we thought I wasn't even on the right days to stimulate, after we had already stimulated with drugs for 6 days.  But the cycle after September we did an ultrasound just to see what was going on and there were something like 9 follicles present.  Then the cycle after that, we did another ultrasound and I had something like 5-6 follicles.  Then the December IVF cycle we started with 4-5 follicles, but only ended up with 2 by the time it was time to harvest them.   Sooo, here's a thought, what if......the drugs you gave me in September stimulated and woke up follicles for the next cycle which is why I showed 9 follicles and concurrently 6 follicles.  The doctor stopped talking on the phone and said, "No one has ever asked me that, or thought of that."  He also said he hadn't read anything or any studies about this, but that it didn't mean they weren't out there.  So fast forward to our Monday meeting.

The doctor says, well here is what I would like to discuss.  And I stopped him cold.  I said, "don't even start going there with the donor egg conversation, because I have NOT given up on my own egg supply yet and I don't want you to either."  He looked at me and said OK.  I said here is what I would like to do.  I want to be an experiment of sorts for you.  I want to make a wager that if we walk into the ultrasound room right now and look at my follicles that I will have 6 or more.  I then reminded him again of my theory of taking the stimulating drugs for a couple days the month before you plan to do IVF and how I believe it is waking up follicles for the concurrent cycle.  He said ok, let's do an ultrasound and if you have more that 6 follicles right now for this cycle, your theory may be correct, since you just were on the stimulating drugs from this most recent attempt.  So I marched into the ultrasound room, Very confident I might add.  The nurse coordinator came in and asked what our new plan was and opened the chart to see the notes from the doctor about what we had just discussed in his office.  Funny thing was, he didn't write down a single thing!!!!!!  She looked at me and started laughing and said, NO REALLY, what is the plan for you guys?  I just looked at her and said, well... we have a little wager on a theory that I have, and if my theory proves correct, this will be unlike any other plan you have probably had here.  

Paper skirt on and here we go!!!!  And how many follicles did I have you ask????  6!!!!!!  Yes, that's right 6 follicles!  So the doctor looks at me and says, ok we are going to test your theory.  I will do IVF on you again in January with your eggs.  And here is what we will do.  I am going to give you 3 days worth of stimulating drugs right now and you will inject them for the next 3 days.  Then we will proceed in January with an IVF cycle and see if we get more follicles and hopefully more eggs.  He said if your theory proves correct, he will definitely take it into consideration when treating "poor responders" like myself in the future.  I said, "well when you make it big with your research, name the study after me.  And also I want half of the profits!!"  Ha ha!!

He said he has never tried this before, and probably hasn't heard of anyone else trying it for a couple of reasons.  The biggest reason being that anytime you give a woman the stimulating drugs, the CDC considers it to be an IVF attempt.  (And everything has to be reported to them.)  Well in our case we aren't attempting anything this cycle, just trying to wake up more follicles for next cycle.  So to the CDC it looks like a failed IVF.  And this looks bad for the clinic and the doctors overall success rates.  Especially since my age group (under 35), has the highest success rate, doctors want good numbers, not failed ones.  Another reason this might have not been attempted by many or any is because the drugs are so expensive.

So for experimentation purposes, they gave me some "sample" drugs for free, and I am not in the December IVF group, and no money has exchanged hands.  So I guess you could say I am an "under the table" experiment of sorts?  And I am totally ok with that.  

We started the drugs Monday after our appointment and have done them twice a day since then.  Tonight will be my last injection for the experimental portion.  Then I will just go on like normal until my cycle starts in January, and then we will start up again with the full IVF. 

I am feeling very excited.  I like that our doctor genuinely listens to my ideas, and doesn't just act like a know-it-all doctor.  I am excited for the possibility that I might have an idea that might help other people in my situation.  I am even more excited if my theory gets us pregnant.  Maybe I should go to medical school? I know I have mentioned it before, but naaaah, I'll just keep advising the medical community one brilliant idea at a time.  Ok, maybe I am getting ahead of myself, but hey at least phase 1 of my theory has proved to be true twice now.  That has to say something.

I don't think I will have much to report until we start up again in January.  In the meantime, I hope everyone has a Merry Christmas, Winter Solstice, Hanukkah, or what ever you celebrate, and a Happy New Year!  All the best things are coming in 2012, I can just feel it!  

Oh, and please please keep those positive thoughts going, cause I know the more people we have thinking good thoughts for us the better!  That theory has to be true!

Jenny

73 Needle injections

12 blood draws 31 vials

3 IV needles

Not sure what to say...

I went in for a blood test to see if I was pregnant this morning and got the results back this evening about 6pm......

I am not pregnant.
I'm very sad.

I don't really have anything else to say.

Jenny

The deal has been made

Today was one of the days we have been looking forward to for a really long time! The transfer!!!  We arrived at the clinic around 730am and were escorted back to the back where the 2 gurney beds are with the wrap around curtains.  I was told to once again put on the lovely open-back gown and hop on the gurney.  I was told I was to have a full bladder because it makes the uterus easier to view.  Soooo, I started drinking decaf coffee and water on the way to the clinic and continued to do so while waiting on the gurney.  The embryologist came in next and gave me my first picture of my embryo!! It was so cute!  It had grown to 6 cells and was given a grade of B.  The embryologist said anywhere between 6-8 cells is good and normal.  He said he is a very tough grader and very rarely gives A's.  Wish I had known that before!  Anyway he said a B is great!  We signed some forms with him and he went about his way.

The doctor came in next to say hello!  Oh, I forgot to mention that my mom and step dad Bruce came in town to hang out.  I wanted my mom there for the transfer because she has such good energy.  So, anyway when the doctor came in he and my mom immediately began talking and somehow it came up that I was conceived in Maui.  The doctor then said how he got married on Maui.  They were both saying how magical it was there.  After our 10 minute chat and me chugging water, my bladder was FULL and we were ready to start.

I once again did the walk from the bed to the procedure room trying not to moon my mom or Justin who were following behind.  The nurse got me into position and had my mom stand at my head and Justin on my left side.  The ultrasound machine was on my right so we could all view the screen. 

The doctor came in a minute later with his IPhone and said would u like some music during the procedure? We all said yes!!   And you will never freaking guess the song he turned on!!?? 

"Somewhere over the rainbow," the Hawaiian version by Israel kamakawiwo'ole!!!!!!!!!!  (if u haven't heard this song, GO listen to it now! It's amazing!)

The doctor said it reminded him of what we were just talking about, Hawaii!  I immediately got the goose bumps and said, "That's Tommy's song!". The doctor said who is Tommy?  And then I tried to hold back the tears and told him that Tom was one of my best friends that died right after we got back from Maui, 4 years ago.  This was the song they played at his funeral, so every time any of our friends hears it we think/remember him.  I always think its his way of letting all of us know he is around. I know, goose bumps again!  The doctor asked me if I wanted him to turn off the song, and I said absolutely NOT.  The room was filled with this sort of peaceful, amazing, positive energy and I was just trying to soak it in.  All the variables were perfect!

So the doctor inserted a catheter and then told the embryologist, and he walked in the room with this tube and says, "Jennifer Naber, transferring 1 embryo".  And we all watched as the music played as they delicately put the 1 tiny embryo through the tube and you could see it go up the tube and finally was placed in the uterus.   It was honestly the most amazing thing and best moment of my life so far!

The doctor said he wasn't going to give us any sort of odds or statistics, but that it was just up to a higher power at this point.  He said I just needed to relax and be positive.  He printed out a picture from the ultrasound machine and circled the area where the embryo was placed with a heart and handed it to me.  I had to lay there for about 10 minutes and then I was transferred to the gurney for another 10 minutes of rest. Then I got dressed and the doctor came in and gave us each a hug.  

As we were walking out the nurse coordinator came up and leaned down and talked to my belly.  It was cute!  She walked us to the front and gave us all hugs and said relax!  She said now we would begin the last step which is the dreaded 2week wait.  

Justin and I had also read and been told that a mandatory laying down period after transfer has been proven to be helpful with getting the embryo to implant.  Soooo, for the next 48 hours I will be laying horizontal.  Meaning lots of movies, books and relaxation.  It is great to have my mom, Bruce and Justin around to take care of me and just hang out and talk with them!

So once again, I don't want to think any further than now.  I will take step 5 day by day.  I am just so excited and grateful for the magical experiences of today. Thank you everyone for your positive thoughts and messages! Keep them coming! We need positive implantation thoughts now!

Jenny
Injections 53

Step 2 update

Here is how things went on Wednesday. We got to the clinic about 7am and Justin was taken back shortly there after by the embryologist to get his sample. Enough said, I won't elaborate on that anymore. I was taken back about 720am and prepped for the procedure. I changed into my lovely hospital gown with the open back and hopped on the gurney. Justin hung out with me while we were waiting and about 745am the anesthesiologist lady was there to start my IV.

Here come the water works! She started asking me health questions and tears just started running down my face. I don't know why this happens every time I get an IV. All I can think is that when I am afraid or nervous, my natural instinct is to cry?! She asked me like 20 health questions and honestly I can't tell you one thing she asked me. All I know is I kept saying "No", so hopefully that was the right answer. After she was finished my crying ceased and we waited for the doctor to come brief us.

The doctor arrived about 8am and said we were ready to go! I walked into the procedure room on my own trying to hold the back of my gown closed for fear of mooning anyone. And then as soon as I layed down on the table the water works stared again. Must be a fear related response! Ugh, everyone there must think I am such a crybaby! And then, I was out.

I woke to the sound of lots of voices around me about 30 minutes later. I heard the doctor talking to Justin. I heard the embryologist talking to the lady on the gurney next to me hidden by only a curtain. I heard the nurses talking at their station close by.
I heard the doctor tell Justin he retrieved 2 eggs. I heard him say there was a 3rd follicle that had nothing in it. I then heard the embryologist tell the lady next to me she had like 12 eggs retrieved and 5 embryos. (she obviously was there for a transfer). Hearing these 2 conversations simultaneously while coming out of anesthesia apparently got me quite upset and I started crying hysterically. Because for some reason in my drugged up mind I thought they were going to get more than 2 eggs. But in a realistic sober state I was totally content with the fact that I knew we wouldn't get mores than 2 eggs.

Ok so after calming down I realized WE GOT 2 EGGS!! Yay!! That was great news! The nurse coordinator then came over to let me know we had to start the dreaded progesterone shots right now! So she rolled me over and drew a circle with a sharpie on both sides of my butt, to give Justin a reference for injection places. The nurse gave me the first one and showed Justin the procedure. It hurt, but not too bad because I was still pretty out of it from the drugs. But I was not looking forward to doing those daily, especially when I was not on anesthesia.

I went home by about 930am and spent the rest of Wednesday in bed relaxing. I was a little sore from the procedure, but not too bad. Thank you to Justin and his mom for taking care of me all day yesterday! Much appreciated!

I woke up this morning feeling better and a little less sore. I think I am just going to need to take it easy today as well.

I got a call from the embryologist about 830am this morning with news.......

He said that both eggs were fertilized yesterday, but one of the eggs was not mature and did not fertilize correctly. But the other one was mature and DID fertilize properly. So we have.....

1 EMBRYO!!!

Again, it isn't a lot, but it isn't zero. I was really hoping both would fertilize, but hey we really didn't have good percentages with only 2 eggs, so getting 1 is pretty good! All you need is one right!?

I was thinking this morning about the world series and how our local stl caridnals team this year had no chance of winning. And every time people thought the team was out they would come down to 1 strike or 1 out or 1 game and come back and win! And they went all the way and won the big game. It only takes 1 right! And it was the cardinals 11th championship in 2011. And you know my thing with 11's! I am taking it as a sign.

To add the the 11 superstitition our retrieval and embryos were created on 11/16/11. If you add those numbers together 1+1+1+6+1+1= Eleven. Kinda cool, huh!? I think so! Even the fact that it's 11/11 is pretty cool and good karma in my book. Ok, enough of my mumbo jumbo.

So we are a GO for an embryo transfer on Saturday. We won't know the grade or quality of the embryo until we get there on Saturday. They grade the embryos based on a list of characteristics and give it a grade just like in school. So obviously A+ is the best, and what I am hoping for. The grade is a good predictor of how well the embryo might perform and attach in the uterus. It is not a predictor of a healthy vs unhealthy baby.

So step 3 is getting the embryo to grow and be strong over the next 2 days in the lab. Step 4 will be the transfer. And step 5 is the dreaded 2 week wait to see if the embryo attaches and we indeed get pregnant.

In the meantime, we will continue to do the dreaded progesterone shots daily. Ugh! The first one on our own this morning was nerve-wrecking and again I got a little teary-eyed. Justin did a pretty good job, but I know he will get better as we do more. I just have to remember that the pain, fear, and soreness are going to seem so worth it and forgotten about so quickly when we are holding a baby.

Keep the good thoughts coming, but just change to lingo to strong, perfect embryo!!!

Jenny
Blood draws 11 Vials 30
IV pokes 3
Injections 51

It's almost that time....

And I can't sleep.  And I am thirsty!  Why is it whenever they tell you that you can't have food or drink after a certain time, you all of a sudden are the hungriest and thirstiest you have ever been!? So annoying.

 As you can see I survived Monday and my 22 needle pokes.  The trigger shot was about the same as the morning shot I did and was quite tough to get to pierce the skin.  The nurse who draws my blood told me that is because your stomach starts to get tough and gets knots in it from all the injections, so that is the reason the needles get harder to push in, and your stomach gets sorer.  I know, Gross!!  I will stop because I am making myself sick typing it.

Today was a nice relaxing day with no injections (yay!) and I tried not to think about what is going to happen tomorrow, but it's hard not to.  I am more nervous about getting bad news than I am about the procedure or the IV poke.  I told Justin tonight, it seems crazy that we are at step 2 in the IVF process.  This isn't how I imagined I would feel, when I was thinking about it 8 months ago.  I thought it would mentally feel much more chaotic, and that I would be much crazier than I am. He he!  But I also had no idea that I was strong enough to go through this process.  I thought I would NEVER make it through that many needles.  I really thought I would die of fear first.  

Step 2 is kinda out of my hands.  I just have to hope my body made some perfect eggs and that my doctor is the best egg catcher out there.  Then I have to hope that Justin's sperm are looking good, and then I have to hope that the embryologist pairs them up just right and makes perfect embryos.  All this will happen in a 1hr period.  I know, crazy!  Then Thursday (24hrs after) we will have an update.  I don't want to think any further ahead than that for now.  Sorry, don't want to jump the gun.

I will try and update tomorrow about the egg retrieval, but I might be kind of out of it from the anesthesia, so it might be Thursday when I can update again.  We'll see how loopy I am.  Ok I have to get some rest, 530am is going to come quickly.  Love you all!

Jenny 

Blood draws 11 Vials 30
Injections 49
Acupuncture needles 16 (just Monday, too many to count in the last 18 months)
Total needle pokes for Monday 22! Holy cow!

Step 2 is around the corner.

That being said. I can also say it has been a looooooooong step 1.

We went to our dr appt this morning at 10am after doing our last morning injections at 7am.  Yay! Done with that portion!  We met with the doctor and he said my estradiol level came back from Saturday and we are right on track.  I can't remember exactly what he said the number was but I think he said somewhere around 250-275.  He said each mature follicle produces between 150-200, so by Wednesday that number should be at least 400 (because I have 2 follicles), probably closer to 450-500 is ideal.  
So he did the ultrasound and I definitely have 2 follicles on the left that are the right size.  There is a small one on the right that he will go after, but it doesn't look promising.  Anyway, I am thrilled about the 2 good ones that we have!  

I asked the doctor if I was in a small category by only having 2 follicles.  He said absolutely not.  He had actually just done an egg retrieval right before my appointment and the woman had 2 follicles.  That made me feel a little better.  I also asked some questions about percentages and probabilities.  The doctor gave us some good odds because of our age, but again he doesn't want to think past Wednesday.  His first and only goal at this moment is retrieve at least 2 good quality eggs.

I also asked him about some medicine I could take for this horrible cold, sinus, flu thing I have going on! Ugh! It's been 5 days now of feeling crappy.  He said I could take some Zyrtec, but I am going to try and hold off cause I would rather not have those drugs in my system.  (I wouldn't want to be able to blame the drugs if something goes wrong, ya know.). So I'll continue with the fruits, vegetables, fruit juice and airborne.  I have also been instructed to stop taking the baby aspirin and any other supplements besides my prenatal vitamin with DHA, and b-complex.

Oh yea, and I got another blood draw to once again look at my estradiol level.  The blood drawing lady told me this is the last one for awhile! Thank goodness!

Plan?? Glad u asked!

Tonight Justin and I will go at 6pm to the chiropractor to get acupuncture treatments.  My doctor highly recommends it before retrieval.  Then at 7pm we will do our last 2 injections (which is actually 3 because the cartridge on the one will run out).  Yay, last burning injection! Very glad for that!  At 8pm Justin will give me the trigger shot in my stomach as well.  So by the time this day is over I will have had probably about 22 needle pokes.  Talk about confronting your fear head on! Never thought I would have a day like today.

Tuesday will be a relax day.  Then we will head in Wednesday morning at 730am for preparation, and then the fun will begin at 8am.  

So now more than ever, we need positive thoughts and energy, prayers, and support.  I figure the more people we have putting good energy towards this the better outcome we will have.  Thanks for listening and for the great notes, texts, and emails of encouragement! They help keep my spirits up and help us to know that we are loved.  

Think perfect eggs! Be perfect eggs! I have perfect eggs!

Jenny

Moving forward with short term goals

Moving forward is great! We are happy and excited!

We got up very early for a Saturday morning to be at the doctors office by 830pm.  The clinic is about 45 minutes to an hour from our house, so we had to leave by 730am, and we had to do morning injections at 7am, so I am destined NOT to sleep in for awhile.  

Anyway, we got GOOD news!  Dressed once again in my paper towel skirt the doctor did the ultrasound and we discovered that I have 2 good sized follicles on the left side.   The 3rd one we saw on Thursday on the left side has disappeared, and the doctor said there might be 2 small ones on the right side that still could have potential.  He also said there is still time for more to pop up, and no matter what when they go in for the retrieval they will go after anything and everything, just to be certain they get all the eggs.  He also said my uterine lining looks perfect! Perfect? Yes, that's what he said! So I'll take a compliment, even if it's about my uterus! Ha ha!  Just for reference, 2 follicles is a pretty low number to have, I think 6-10 is an ideal number.  More than 10 is not good either.  But 2 is more than zero!!  So I am going with that positive outlook! Some is better than none.

My Estradiol level blood test came back from Thursday and it was at 150!!!! Yay, that is great news too!  The doctor said he expects it to be over 300 with the blood test I did today.  Yep, that's right, another blood draw today, and another vial of my precious blood donated.

So what is the plan you ask? Well, I will do 2.5 more days of stimulating drugs.  The doctor has reduced the amount of Follistim back to 150iu for the remainder of those injections, but the other 2 drugs will stay the same. So Monday evening will be my last 2 injections of the stimulating hormones. Yay!!  But there are more to come.  (Yes, there are more new drugs to inject as we get to the next steps in the process, ugh!)  I will go in Monday at 10:00am for another monitoring appt, and the doctor is 90% sure I will trigger that day and most likely do the retrieval on Wednesday.  What is trigger? Well I will have to go get a shot of a hormone called HSG and inject in at the precise moment they tell me to on Monday.  That trigger will send my body into ovulation mode.  Then exactly 36 hours later (Wednesday morning) they will retrieve the eggs during an outpatient procedure.  I will be put under sedation for that.  At the same time they are retrieving the eggs, Justin will make a "donation".  Then as long as they get at least 1 good egg they will insert the sperm into the egg/eggs right away.

The doctor doesn't seem to want to talk about things that are more than 1 step ahead of where we are now.  I guess it's good because you just focus on the next step, and not what "might or might not" happen 2-3 steps from now.  Meaning, he didn't want to discuss embryo transfer, or fertilization.  His immediate thoughts are when to trigger and retrieval.  So I guess that is what we will focus on as well.  Short term goals.

The doctor has also put me on an antibiotic to fend off infection before retrieval and because I have a horrible head cold right now.  

We are very excited to be moving forward!! I am trying to send positive messages to these 2 large follicles, to be strong and perfect! Twins, twins, twins! Ha ha!

Jenny
Blood draws 10 vials 29
Injections 36

Yesterday I yelled, today I cried

Today is 11/11/11 which in our world is a very cool thing!  I have always had a thing with the time and date being anything with 11's.  I have read many articles about the significance of 11 and how in numerology it is a powerful number.  So Justin and I spent the day together (he was off work) and pampered ourselves with massages, a nice lunch, and pedicures. Justin and I noted the time today when it turned 11:11am and will do it again at 11:11pm.  I know we are weird, but I am hoping the day brings some positive energy to this process.  

Ok on to the crazy:

The effect of the hormone injections have definitely set in!!  My hormones are going crazy! I have hot flashes throughout the day and my mood seems to be on a roller coaster from happy to sad to mad in a matter of minutes.  Wow, look out!   I yelled at a girl i work with last night, because honestly I haven't had the guts to do it, but apparently these hormones raging through me have given me the gumption to tell people how I really feel and call them out if they are rude.  Not sure if that's a good or bad thing, but I'll have to say I felt great after it happened.

We went to the doctor yesterday (Thursday) and had the usual things done.  First was the paper towel skirt portion with the ultrasound.  The doctor seemed to be in a positive mood and I told him about my positive thinking and mantra.  He agreed that thinking positively is actually scientifically proven to help have a better outcome with this process.  

He said the results of my blood work came back from Monday and my baseline estradiol levels were normal and my progesterone level was baseline normal as well. That's a good start.

So the ultrasound showed 3 follicles on the left side and possibly one on the right.  Which is totally weird because the last several months the right side has been the only side producing anything, and now apparently the left side has woken up and decided to be a part of this.  I asked about the possibility of more follicles still popping up and he said it happens all the time, so I need to keep my mantra going.  The 4 follicles that I have are not big enough yet to harvest, so he said I must keep on the same amounts of the first 2 drugs, and then this morning (Friday) he instructed me to start the 3rd injection which is also done in the stomach in the morning.  The 3rd drug prevents your body from ovulating these follicles, so that they can be harvested.

The doctor seemed very positive about the 4 follicles.  He said all we need is one good one, but realistically we want more than 1 follicle to have better odds.

We also had blood work done at this appointment.  Add another vial to the count.  The lady who usually doesn't do her job very well drawing blood actually did an ok job and Justin was there to hold my hand so that helps.  This testing will check my estradiol level again.  The doctor said with the amount of drugs I am on and based on what he sees on the ultrasound the number should be over 100, at least.  Here we are again!  This is the same time that we had to stop everything last time.  But since we see follicles growing, we are moving forward!!  Yay!

We were supposed to have an appt today, but the doctor decided to cancel and have me just come in tomorrow morning (Saturday).  So I haven't gotten my results back from Thursday's blood work.  But I am assuming it had to be over 100 or I would have gotten a phone call. So that is all good news!  

How am I doing with the shots? Ugh! Not good yesterday and today! My stomach seems to be getting really sore and tough from all the needles, so each one has begun to hurt worse.  I have been using an ice pack like always to numb up my stomach before each shot, but yesterday and today the ice pack doesn't seem to be helping at all.   The second drug that burns going in was very painful last night and almost unbearable tonight.  I started crying immediately after Justin did it tonight because it felt like burning poison going into my stomach.  I am not sure how many more of those I can take without losing my mind.  The new 3rd drug we started this AM was not that easy either because Justin couldn't get the needle to go in all the way.  It was really strange.  So after 5 pokes he had to jab it hard to get it to go in all the way in order to be able to release the medicine.  NOT fun!  Makes me nauseous just typing about it.  The worst is when we have to do 2 injections of the first easy drug because the cartridge runs out midway through!!!  So like this morning for example i got poked with needles 7 times before it was all said and done.  Again, NOT fun!  It is a crappy way to start your day.  So you can see how someone might be a little emotional just from that, let alone the drugs that are making you more emotional on the inside.  I started using a heating pad on my stomach this morning after my injections to help with some of the soreness.  As I sit here typing I have the heating pad on there again.  

I can't believe how much different this process is this time around, physically and emotionally! A whole different ball game.

I just have to remember that this is all for an amazing end result! Hard to remember sometimes, but I try.

Jenny
Blood draws 9 Vials 28
Injections 33
Needle pokes-too many to count!

It's funny who you relate to in these situations

Today is cycle day 5, and I have been taking the injections for 3 days now. The first medicine that I have to do twice a day with the pen thingy are getting to be a breeze. Especially the one in the morning at 7am because I am half asleep. I started the second drug injection tonight at 7pm, so I am now doing 2 injections in the evening. The one I started tonight is the one that burns going in, so it makes me a little light-headed and nauseous for about a minute after it goes in.
Justin is taking a class on Wednesday evenings working towards his bachelors degree, so he wasn't able to do my injections tonight. Luckily for me I have a great friend, Jessica that I work with who is on her way to becoming a nurse, so she said she would help me out. She did a great job and I had very little pain with both injections! So thank goodness for good friends! Thanks Jess!
The reason for my posting title is this morning I was talking to my cleaning lady and we started talking about fertility stuff because she saw all the needles and biohazard container on my kitchen counter. Yea, I know kinda creepy but don't worry I will hide them if anyone of you come over. Anyway, she started telling me about how she went through ten years of infertility stuff and surgeries trying to have a baby. She said she never went through the full IVF or adoption because she couldn't afford it. Finally at 45, she had given up and then one of her worker girls came up to her and said "hey I know u want a baby and my sister in law is pregnant again and the state takes them away because she is unfit. I am sure she would let u adopt it.". And so a month later she went to the hospital, the baby was born healthy, the mother never even held it, and my cleaning lady had the papers signed the next day, and the baby was hers for $200. Yea, crazy stuff huh! The point of my story is that you never know who you are going to relate to in the world, and sometimes I feel like I relate better to strangers who have had or are going through similar experiences, rather than someone like a friend I have known for 20 years. Weird!

I am headed to the dr's office tomorrow morning to see what these crazy follicles are doing! (ultrasound and blood work results from Monday) Remember growing big and growing more is what they are supposed to be doing!! I am hoping the are following my mantra.

Jenny
Blood draws 8 Vials 27
Injections 24

Round 2 begins!

Well the day has finally come!! After about a 7 week hiatus we are finally back on the IVF road.  I waited patiently for my cycle to come on its own this time around and was told it MUST start on or before Nov 5th in order to be in the Nov cycle.  Well I guess you could say my body decided to wait till the last second, 4pm on Nov 5th, but hey whatever, it was in time so that's all that matters right!
This morning (Monday)  I went in for my first appointment with the doctor to have an ultrasound and blood drawn to make sure everything looks good to start the drugs.  The ultrasound showed 4-5 follicles, but with it being only day 3 of my cycle more follicles can emerge in the next several days.  So my mantra for the next 2 days is "grow more follicles, grow bigger, grow more follicles, grow bigger."

The doctor again was in his 'think out loud mode' and again started with the rambling about, "ok severe endo, blah blah blah.". After the ultrasound the doctor again told me the AMH level test results from the previous month, which he had already told me.  He tried to start discussing it again and I immediately stopped him because I could see he was starting to go down a negative path again.  I reminded him that I had a follicle count of 9 on my own last month with no drugs and that he had said in our previous appt that he was going to ignore the AMH results and focus on the follicles.  I was not going to start this 2nd cycle with negative shit! I have had enough of people telling me what is wrong with me, so at this point just tell me what is good about what is going on.  The doctor liked my thinking and rational.  So I guess every appt I am going to have to remind him to say positive things to me. 

After the ultrasound the nurse coordinator gave me my first injection of Follistim.  Oh yea I forgot to mention the doctor decided to do the same drugs again this cycle, because the results from the pharmaceutical company who were testing my first meds have NOT come back yet.  I will do 2 injections a day of the max dose (225iu) of Follistim for the next 3.5 days.  I guess I should say Justin will give me 2 injections a day, because we all know I am not looking at it!! Then I will go back Thursday morning for monitoring to see how things are progressing.
The last part of the appt was getting to have more blood drawn to see where my FSH and LH levels are. Yay!! More needles!!  I want my FSH to be under 12 and LH at 30 or over.  I got 2 more vials to add to the total, awesome!  I will get the results of those on Thursday at my appt.

Before I left the nurse coordinator gave me a big bag of drugs and needles.  That was a really funny last sentence to write! Ha!  She gave me a cartridge of Follistim to replace the one that is being tested, along with 4 others and 6 vials of the second drug I will start taking Thursday evening.  All the drugs she gave me were samples (free), so that was really nice, because we won't have to spend any monies for the first 5 days of Follistim and the first 3 days of the second drug.  Basically all the drugs we paid for the first IVF were comp'd this time around.  So if we can get past the place we got to in IVF #1 we will then start paying for the drugs again. Whew, complicated! But grateful for the samples!

How am I feeling? Anxious, nervous, excited, positive!  How is my needle anxiety? Funny, but it actually seems to be getting better.  Since I have been through all of this portion of the IVF process once already the needles seem a little less scary.  And the anxiety build-up that would happen about 10-15 minutes before I would get an injection seems to be less.  BUT oddly enough the anxiety before I get blood drawn is still really high! I get light-headed and nauseous.  I think this might be because the lady that draws the blood in the office SUCKS at her job about 80% of the time.  She usually doesn't hit the vein right the first time, so to know in advance that it is really going to hurt and more than once, might be where the anxiety is stemming from. Ha! Ya think!

So here we go!! Positive thoughts and positive energy, grow more follicles, grow bigger!

Jenny
Blood draws 8 Vials 27
Injections 18

Good News!

My hair has almost completely stopped falling out.  I stopped taking the DHEA supplement Oct 10th, and I also started using this AWESOME natural treatment for my hair and within 8 days of stopping the DHEA and 2 days of using the treatment I have stopped shedding!  You have no idea what that can do for a girls self-esteem!  I felt like daily I was getting sadder and sadder every time I saw the large amounts of hair that I was losing.  But it is amazing how quickly that sadness can turn around.  So I am hoping that this is the end of this part of the journey.  I will continue to use the natural treatment for awhile, and I told the doctor I am not taking the DHEA supplement anymore.  He said that was fine, because it is not vital to the IVF process.  It was just an added thing that had been researched recently and shown positive IVF results, but the doctor said there has only been one study, so he personally doesn't know if it really does anything or not.  I am willing to take my chances and not include it in order to have hair on my head!  In case anyone is wondering the products I am using are:

www.justnaturalskincare.com
Hair Loss Shampoo
Vinegar Rinse Cleanser
Grow New Hair treatment-Spray Oil

A much happier
Jenny

A couple of great posts from a fellow infertility blogger

She really knows how to get the point across!  Love it!

Post: Trying to Conceive: A month-by-month guide.
Link: http://www.jennepper.com/2007/10/trying-to-conceive-month-by-month-guide.html

Post: Did you seriously just say that?
Link: http://www.jennepper.com/2007/10/did-you-seriously-just-say-that.html  

The Waiting Game

As I said in my last blog we had an appointment with the doctor last Friday (Oct 14th) to do a follicle count and to get the results of my AMH test.  Well once again we had good news and bad news, but according to the doctor the good news in this case is out-weighing the bad news. 

Bad news is that my AMH level has significantly dropped from 0.48 in June to 0.16, which is almost undetectable.  The doctor said if this would have been my first AMH, no one would have even touched me for IVF.  But he said it seems that many people who have endometriosis seem to have lower AMH, but many are still able to produce children especially in my case because....  the good news is that the ultrasound showed a follicle count of 9!!!!  And since the follicle count is a more important predictor because we can physically see that there are eggs left, the doctor said he is kinda going to ignore the AMH.  My previous follicle count in June was an 11, but the margin for error is +/- 2 so it looks like my egg reserve has stayed the same which is AWESOME! 

The doctor is puzzled as to how I have 9 follicles on my own this cycle, and 6 last cycle, but during the IVF drug treatment I was only showing 2 follicles.  So we had a long talk and the doctor and I are both convinced that my body doesn't react well to the overload of medication I have been on for the last 10 months.  He thinks the steroid I was on from January to June might have totally screwed up my AMH levels, since AMH is directly connected to your pituitary gland, and the steroid I was on directly affects that as well.  He thinks that all of my hair shedding/loss, the drop in AMH, and the nonreaction to the drugs might all be attributed to the steroid making my pituitary gland shut down.  He also added that the combination of all the hormones in the birth control pills and my pituitary gland being messed up could be the reason for no reaction to the IVF drugs.  Soooo, what is the PLAN?

Well, we are going to try and prepare my body for IVF as naturally as possible and with as few hormones as possible leading up to another IVF cycle.  The doctor is NOT going to give me any kind of hormones like birth control pills or progesterone this cycle to try and force a period to come when they want it to in order to start IVF.  He just said we will leave you alone, but you must start on your own no later than Nov 5th, or else we will be forced to push you back into the December cycle.  Great no pressure! 

The medicine I used last cycle is still being tested, and the doctor said now that he hasn't decided which group of medicines I will do next IVF and he will not decide until those results come back.  Which means he NOW isn't opposed to using the same medicines, if in fact the first ones were counterfeit. 

We also discussed the hair shedding issue and I told him it was a big concern for me.  I told him about my DHEA research and that I had seen several women blogging online talking about their hair loss.  The doctor thinks the hair loss is most likely from 1 of 3 things: birth control pills, the predisone steroid I was on from Jan-June, or the DHEA.  But that is it definitely from a hormone imbalance of some sort, most likely created by all the stuff I have taken.  So I am stopping taking the DHEA for a couple weeks to see if that makes a difference, since that is the only one of the three I have been on most recently.  The doctor seemed to have a strong feeling that the hair loss is the bottom fall-out of the predisone.  Which to me seems strange because I had hair loss with it in June and July, then it seemed to almost stop in August, and then got really bad again in late Sept/Oct.  I wouldn't think that the after effects of something would go up and down like that, but who knows???

My mom found this all natural shampoo, vinegar rinse, and oil spray online that I am going to use to hopefully try and stop the hair shedding/loss.  The vinegar rinse says that it is supposed to help remove the excess build up of DHT which is actually testosterone, which is what DHEA is converted into.  I read a journal article online that said if women have too much testosterone in their body, either naturally, or they are taking too much DHEA, the body converts it into DHT and then tries to expel the excess DHT out of the body, most of the time through the scalp and hair follicles which leads to hair loss.  Ahhh Haaa!  I think I may be on to something!  So hopefully this stuff will help.  Keep your fingers crossed!  I am pretty sure by the time we figure this pregnancy hormone thing out I will either have my MD or PhD or some kind of medical research certification!!  Ha ha!

Basically I am learning more and more everyday that this journey to have a baby this way is a huge guessing game and really the doctor's don't know much more than I do.  They can constantly change up the variables, but when it is all said and done there is no exact science and it is all just a big experiment, that may or may not work.  I am glad that the doctor is willing to listen to what I have researched and then we come up with a plan together based on both of our opinions, research, and his experience.

For now we will just go on about our normal lives because there isn't anything we can control and if my cycle decides to come on or before Nov 5th, then we will jump back into IVF mode.  If my body decides it isn't the right time, then well..... we will wait.  In the meantime, we are sending lots of good energy and love to my friend Dave in New York who suffered a brain aneurysm a couple weeks ago, but is making a miraculous recovery!  My problems seem so small next to what you have been through.  And Go Cardinals!

Jenny

The Hairy Rollercoaster

Today, I am feeling really sad.  I have mentioned in my past blogs how after I stopped taking the steroid predisone suddenly I started experiencing some hair loss in July.  The hair loss went up and down for about 6 weeks, and seemed to be getting better in August.  I then started the birth control pills (2 a day) for 38 days and then did 6 days of injectible IVF drugs.  Well the hair loss has increased noticeably in the last 2 weeks.  Every time I wash my hair my hands are covered in hair in the shower.  If I brush my hair when it is wet out of the shower the brush is full of hair and I can run my hands through my hair and I have a handful.  If I brush my hair while blow drying it my brushes are completely full of hair and when I am done blow drying if I grab the ends of my hair I have another handful.  It is really scary!  So the last 5 days I have tried not washing my hair as much and not brushing it when it is wet or when blow drying, but I still seem to be shedding large amounts of hair.  I have been wearing my hair pulled up because if not, my clothes are covered in hair.  I am scared to death!  The anxiety when I see it all falling out is almost paralyzing.  I feel sick to my stomach.  This is not what I signed up for.  A girl's hair is her identity, and a part of who she is.  I just feel ugly, and well.... like I want to cry.  Actually I am crying as I sit here writing this.  I have asked the nurse coordinator and the doctor about this and they don't seem too concerned.  I have mentioned it in my last two appointments, and they seem to brush it off, and the nurse coordinator even said at my last appt, "Well you just might be a bald pregnant lady."  Ummmmm, not cool with me!

So this morning I called the Dr's office again and spoke to the nurse coordinator and cried to her and told her I was really freaked out about how much hair was falling out.  She said she didn't know what it was from, as it could be from any number of things, but that she would talk to the doctor about it this afternoon and get back to me.  So, I will wait and see what he says.  I am hoping he has a solution!!
Update:  I just heard back from the doctor and he said I should do two things.  One get some Rogaine Women at the store and start using that.  Second, he said make an appt with my dermatologist right away to see if there is anything he can suggest.  So I will start there.

As far as updates go on the IVF front here is what is new.  After being canceled in September, the doctor said I would just go on to have a normal cycle/period.  Well that didn't happen.  My cycle was 34 days instead of the normal 26-28.  Soooo, I thought maybe I got pregnant on my own!?  On Thursday this past week (cycle day 32) I went into the doctor for an ultrasound and blood test to see what was going on .  The doctor did the ultrasound first and for the FIRST time we had some good news!  He looked at my uterus and the lining looked really good, and he thought I might be pregnant, (which we later determined I was not).  He then looked at my right ovary and I had 4 follicles on it!!!  Well if you remember during the beginning of the cycle with the drugs I only had 2 small follicles.  The doctor was very happy to see 4 large follicles on the right and then also saw 2 decent sized ones on the left.  He seems to think an answer to why we weren't seeing any growth with the drugs is that the BC pills screwed up my cycle days and what we thought was day 1 of my cycle really was NOT, and so we weren't stimulating on the right days.  Anyway, he said this just shows that I am capable of producing at least 6 follicles, so he is confident if we can get the cycle days right we should have good stimulation and follicle response.

In regards to the medicine being tested, we are still waiting to hear.  Apparently the process can take up to a month to complete.  The doctor said we are still going to go with a different set of medicines for our IVF in November.  (Well that is if I am cleared to do November's cycle)  What does that mean?  Well the doctor wants to try and NOT use BC pills to regulate my cycle this month, to get me on target for next month.  He wants to try and have as natural a cycle as possible, because the birth control pills jacked everything up so bad last time.  When I spoke with him a few minutes ago he said he wants to introduce progesterone on cycle day 14, for 10 days and then stop taking it and hopefully this will make my cycle start. (I am not sure if it is the big needle injections or just a pill, but I am hoping pills!!??)  He needs my cycle to start by a certain day in order for me to be a part of the November cycle.  If by chance, it doesn't cooperate and start by the time he needs it to, then we might be pushed back to December cycle.  Got all that?  Phew, I am exhausted just trying to understand it all myself. 

Why can't he just let me or everyone else for that matter just have their normal cycles and be more in tune with what the natural body is doing?  Why must everyone be batched into groups?  I don't really understand it myself, but he mentioned something about the lab, and how there is only enough space for a certain amount of eggs and if everyone was on their own cycle then they wouldn't have enough space and it would be super confusing and also the doctor would be on call 24/7/365.  I guess the batching keeps everyone relatively at the same stage so it is less confusing??  I don't know, that is just kinda what I gathered.

So what's next?  Well I have to go to the doctor this Friday to have another ultrasound and blood work done.  The doctor is going to do a follicle count again during the ultrasound to see if he thinks my egg reserve has gone down or stayed the same in 5 months.  They did some blood work last Thursday when I was there, to also check my AMH levels, which also gives them an idea of what my follicle/egg reserve is doing.  So they will compare both of those results and hopefully we will have some more good news, because I am not sure I can deal with any more bad results right now. 

Jenny
IVs-2
Blood Draws-6 Vials-23
Needle Injections-16

Canceled

Well, things have gone from bad to worse.  My IVF cycle has been canceled.  Which means I am off all medications as of 4pm today.  Why?  Well here is how I can best explain it.

I started my stimulation medications last Wednesday.  That morning I did a blood test and my estradiol level came back at 42, which is normal but a little low for the beginning of a cycle.  All my other hormone levels were very normal, but my overall indicator number of my egg reserve was low.

I did 5 injections of the first medication before I saw the doctor again on Friday morning.  The doctor wasn't thrilled with the 42 number, so he up'd my dose of the first medication for the injection Friday night.  He did another blood test to test my estradiol level.  I also started that second stimulation injection on Friday night. 

We repeated the same higher dose (which was the max dose allowed for med 1), and med 2 injections on Saturday and Sunday.

We did the max dose of medicine 1 again this morning as instructed and went in to the doctor for another ultrasound, blood draw appt.   I think I mentioned again in my last blog how the doctor had said that he wanted to see that estradiol level increase significantly.  Well Friday's results came back and my estradiol level from Friday was at a 30.  Lower!!  What??  This is crazy!  So the doctor said to me today, "You are taking the medications right?  You are injecting yourself as we instructed you to with no issues?"  I responded a little defensive, because I kinda felt like for a second he was accusing me of not taking the meds.  I mean why would we hand him all this money and then not follow the rules?  I showed him the bruises on my stomach as proof that we were taking the meds religiously to the minute as instructed.  The doctor said it was very puzzling and strange that after that amount of stimulants in my system that my levels would go down.  He also thought it was strange that I wasn't experiencing any of the normal side effects of the meds, like swollen ovaries, overly emotional, irritable, nothing!  Yes, I did have the 2 small dizzy spells, but that was it. 

So, the doctor did another ultrasound and this time, I was down to 2 follicles on the right side that were still very small and again none on the left.  He said he was even more puzzled, because not only should my levels be rising, but my follicles, even if there is just 2 should be of a certain size and they are not.

Ugh! Ok, so he said lets do one more blood test today and see where your estradiol level is at.  At this point you have been doing 6 days of high dose stimulating meds and your level should be at least at 100.  If it is not at 100 or higher, there is no point in moving forward with this cycle since my body was having no reaction to the medication, and the results through ultrasound and blood work were obvious.  So we did another blood draw and the doctor said he would call me after 4pm today with the results.  And he did......

And that is when he said my test came back and my estradiol was only at a 56.  So it had gone up, but not enough to mean anything.  He said it is very puzzling because all of my preliminary tests showed that I was going to be a good candidate and progress well.  The doctor said his first suspicion is the medicine.  He said he has heard of counterfeit medicines getting into this country, especially since the IVF meds are so expensive and not covered by insurance.  He said the medicine could have also been a bad batch.  So first things first, we have to take all of our empty cartridges into him on Wednesday morning and he is going to investigate and have them tested.  If it is the medicine, I would be so relieved!  If it is NOT the medicine, we go back to the guessing drawing board to try and figure out why I had no reaction at all.

The doctor in the meantime will review all of my past testing to make sure he didn't miss anything, and he said that if the medicine is ruled out as the cause, then we might have to do some more testing on me to make sure I don't have an auto-immune disorder which would make me immune to the stimulant drugs.  In that case, we would definitely need to have a conversation about donor eggs, because obviously I would not be able to use mine.  Or we would need to start looking in a different direction like adoption, if donor eggs weren't something we wanted to pursue.

So after all this investigating is done, we are hoping to try another cycle in November with my eggs, most likely with different stimulating medicines.

Here is the big question you are all probably wondering...How am I feeling about all this?  Well honestly.....probably the most disappointed I have ever been in my life.  I am angry and sad and mad and I want to punch something and I also want to crawl into a hole for a couple days and cry till there are no tears left....but being the kind of person I am I will probably just cry a little and put on a happy face and move on with my life until it is time to try it again.  Why?  Because this process has taught me that I am not in control even one little bit.  I don't know what is going to happen, and I can't MAKE something happen, so I might as well enjoy my life, and not spend it moping around.  If it is going to happen it will, and if it isn't then it won't, and I have to be ok with that either way.  Because if not I am going to waste this short life of ours that we are given in misery and playing the "what if" game.  So I am just going to enjoy each day with what I have.

But I'll be damned if I am not angry about all those needles!!!  16 injections and thousands of dollars down the drain!!  My poor bruised and sore belly!

So I am headed back to work tomorrow, to get my mind off of things and maybe go have some fun and a glass of wine this week!  I could sure use one.  So I will keep up on the blog when I have any updates over the next couple months.  Thanks to everyone for their kind words and support over the last several weeks!  Keep Justin and I in your baby thoughts and prayers!  I will be in touch soon!  Until next cycle.....

Jenny
The Needle Warrior

Day 5 and 6

How things have changed in a few days.  Let me start with yesterday, day 5, Friday.  The morning FSH injection was the same as the 4 before it with no big deal.  

I headed to the fertility clinic in the pouring rain for my 2 o'clock appt.  I waited almost 30 minutes before I was ushered back to the ultrasound room.  The wait was actually good because I was trying to organize my thoughts and remember what I wanted to say to the doctor.  When I got into the room I did the usual routine and put on my floor length paper skirt and sat on the edge of the ultrasound table and tried not to forget what I had just tried to remember.  
The doctor came in by himself first and asked how I was and I smiled and said ok.  He said I had a nice white smile and I immediately started tearing up and led with, "Doctor there are some things I need to say to you.  When Justin and I left here on Tuesday we were very disheartened, and upset.". Did i mention that everytime I am in a confronting situation or nervous situation i cry?  Not sure why, but it just happens.  So here i am in tears trying to sound mean and angry and the doctor looked at me and said, "Was I an asshole on Tuesday? Well if he wanted to put it that way, and I shook my head yes with a giggle.  So I continued through the tears, "We chose you because we liked your personality, and thought you were very personal, and Tuesday you didn't seem to know our case at all.". I went on to mention my blood work that we never heard results on, the severe endo statement, and everything else that I didn't understand that he had said.  His first response was, "I'm sorry.  I think out loud and that is a fault of mine.  I do have lots of patients, but i do know each persons chart backward and forward.  Just because I might not know it that moment because I have seen 6 patients before you doesn't mean I am not putting lots of time and thought into your case. And I'm sorry if I was an asshole."
In the meantime the coordinator walked in and chimed in with some jabs towards to doctor trying to make me laugh.  My tears finally stopped and we got to work on the purpose of my visit.  The doctor said the results of my 15 vials of blood that I had given had come back and I do not have the disorder, disease, whatever it is that causes reoccurent pregnancy loss.  Ok, check one good thing!  He also said my FSH level had come back at 3.2 from the blood test I had Wednesday which is a good sign.  All I know about that number is you want it to stay under 9 to be normal.
Then he did the ultrasound.  He started with my right side again and my right ovary still has between 3-5 visible follicles that are very small. Soooo, not good.  There has been no new follicles or growth of the ones that were seen Tuesday since I started the first med, Follistim.  He then tried to find the left ovary with some difficulty again, and noticed maybe 1-2 small ones on that side, but he wasn't positive about those because it was so hard to see.  Apparently my left ovary is very high and tucked in between some other stuff, ugh! Great!
So here is what he said.  Start your second stimulating medicine as planned tonight.  We are going to up your dose of the first med the Follistim to the max, 225IU per injection.(Twice a day, so 450 per day).  We will do a blood draw today to check your levels and then take both medicines all weekend and Monday morning and come back Monday at 9am for another ultrasound/blood work appt.  He said if we don't see any growth of more follicles by Monday or Wednesday we will need to have a conversation.  Here come the tears again! 

Then I had to go have another blood draw.  Really can this day get better?  Since I am a sissy I asked one of the nurses who is super sweet to hold my hand while I had my blood drawn since Justin wasn't there.  She said absolutely!  The nurse had a hard time finding my vein, ugh, I mean really!!!

So I drove home from the appt crying my eyes out.  I can't imagine going through all of these shots for 7-9 days just to have to cancel everything.  Ok, stop thinking like that and just try to stay positive.  I called my mom on the drive home and pretty much cried the whole time.  Its amazing how moms always know what to say to make you feel better!  Thanks mom!  I also called Justin and told him everything since he couldn't be there and he was also trying to be very positive and supportive.  I have also decided on a phrase that I hate, "If it is meant to be, it is meant to be.". I think maybe I have said this before, but I hate it because it doesn't actually mean anything!  So please don't say that to me. Ha!

Ok, so on to the evening I injections.  Wow, I am not sure if it is coincidence or not but the order they give the injections seems crucial. The Follistim is 95% pain free.  This next injection we started Friday night, yea not so much! I actually mixed the vials, yea I know, I couldn't believe I did it either, but there is no needle involved, only this plastic cap thing that punctures the vials.  So we did the new 225IU dose of FOllistim first, and then we prepared the second one called Menopur.  The needle for the Menopur is about the same gauge but a little longer and in a normal syringe.  Ok, so here goes the second injection, YIKES!  About the same bee sting from the needle, but the medicine burns!! Not horribly bad, but bad enough that I almost jumped.  I did a little wiggle pain dance around the kitchen after the shot which surprisingly made the pain better, he he!

So today is Saturday and boy how things have changed in a few short hours.  We woke up this morning at 650am to do the morning injection of just the Follistim.  The Menopur is only an evening injection, the Follistim is morning and evening.  Anyway, we did the injection like normal and within 10 seconds of doing the injection I got super dizzy, nauseous, and clammy.  I immediately laid down on the ground because I thought I was going to faint, and then quickly had Justin help me to the bathroom just in case.  The feeling went away within about 5 minutes and I thought it was weird because I have been taking the Follistim for 3.5 days now and have never had this happen.  We went back to bed this morning and we woke up about 10am and I felt fine.  We got ready and wanted to go out and get some breakfast before we went to a relaxing couples massage at 12:15.  I called the coordinator on the way to breakfast and told her what happened, and she said sometimes that happens when u start taking higher doses and also adding the Menopur to the equation.  We headed to breakfast and we were sitting waiting for a table and again I started feeling dizzy, light headed, and nauseous.  We left immediately, called the massage place and canceled and headed home.  I went and laid down immediately and felt really tired.  I slept for about 3 hours this afternoon and just woke up.  We will do the evening injections again tonight and hope for no side effects.  The coordinator said to call her again this evening to check in.  So it looks like I might be home bound for a couple days if the side effects continue because I am not allowed to drive.  Let's just hope all these side effects mean something good is happening on the inside!!

IVs-2
Blood draws-4 Vials-20
Needle pokes-8

Day 4

Well today was much like yesterday with little drama with my morning and evening injections.  The morning one seems to hurt less than the evening one, but that hurt is still not much. and I think it is because I am half asleep.  I haven't really noticed any bloating in my abdomen yet, which they said is to be expected during this process, I am just not sure when that will happen, hopefully not at all.  And I think I mentioned already that they said to expect moodiness, irritability, and maybe headaches.  I haven't experienced the headaches yet either, and I double checked with Justin about the other 2 and he said nothing yet....

Today was my last day of work, and it was strange that I won't be back there until the end of September, but I am greatly anticipating the relaxing time off.  Maybe I can work on finding myself a new career in writing with the time off...Ha!

I am off to the doctor tomorrow afternoon, and I will update later after I give him a piece of my mind!

Day 3

Not to disappoint all of you who might be looking for some really exciting dramatic story of my first injection.  Like me passing out or crying.....but honestly it was actually pretty simple, easy, and quick....
I am not sure if it was because I was so tired at 645am, or what but I just shuffled out to the kitchen like a zombie, grabbed the kit out of the fridge, got out the pen, loaded the creamer like plastic thing that holds the needle inside onto the end of the pen, dialed up the
dose, handed the pen to Justin, pinched my right side of my stomach and said ok, go.  And he looked at me and I looked at him and I said, "Wait, maybe I should sit down for this.". Then I realized maybe I should sit down, pinch my stomach and close my eyes. Then I said ok go.  But I opened 1 eye and said, "wait, wait not ready!". Ok, deep breath, third time same position, eyes closed and baby bee sting, the sound of the pen clicking as the medicine went in, and in 6 seconds it was over.  Ok, not so bad.  These first medicine needles are the smallest, and I am thinking the best way to build up to the bigger ones down the road.

Then at 930 this morning I had to run to the Lab Corp down the street from my house to get a blood draw.  I was nervous as usual, but this Russian nurse guy was funny and calming and was super good at doing it quickly, so I survived having 2 vials drawn, no tears, just lots of deep breaths.  Ok, 2 needles down 1 to go.....

The second needle tonight was actually less exciting than the morning.  Justin prepared the needle cap this time and we did everything the same.  He is very gentle and I told him maybe he should think about a second career as a nurse, he he!  Honestly you can barely feel these needles because they are so fine. Great news for me! 

So I survived Day 3 with 3 needles.
Here are my needle numbers to date just for IVF (not including any IUI stuff)
IV's- 2
Blood draws-3 Vials-19
Needle pokes- 2

Frustration and the start

Day 1 of our IVF cycle started last night (Monday Sept 5th).  I was instructed to call the coordinator as soon as the cycle started so that she could let me know what our next steps were.  So I called her around 8pm,  and I informed her that my cycle had started and she said ok, then you will begin doing your injections on Wednesday morning.  And I responded by saying, "Ok, well when and how do I get those medications?"  The coordinator said, "You didn't get your medicine?  No one ever called you to get your payment and send you the meds?"  I told her I hadn't heard from anyone.  She then continued for the next 10 minutes to express how angry she was at some guy named Oscar at the pharmacy who was supposed to call me.  And she kept repeating herself over and over.  Honestly, I am not sure if she had had some cocktails earlier in the evening or what!?  At this point it was obvious to me nothing was going to get accomplished during this conversation, so I just told her we would figure it out tomorrow.  She continued to blame it on Oscar as I hung up the phone thinking to myself, well if she would have called me and verified that I had received the medicines last week, we wouldn't be in this predicament.  I was totally unaware when and how I was supposed to recieve the medicines, so to me it seemed like she dropped the ball by not following up. 

So this morning, Tuesday Sept 6th, Justin and I went into the office for a pre-scheduled ultrasound/blood work appt.  When we arrived one of really sweet nurses named Jennifer took my blood pressure and weight.  We then waited about another 20 minutes and then were were told to head to the ultrasound room where we would see the doctor and have the internal ultrasound performed.  The doctor came in after about 10 minutes and he and Justin immediately began chatting.  I on the other hand, clothed from the waist down with only a large paper towel didn't have much to say, can you say akward!  Anyway, the doctor began talking about Justin's blood test results and said well it came back that he has a serious disease/illness...... um, um, ok, what??!!  And then his next statement was this, "Well when anything like that comes back we immediately re-test it twice and turns out the test was wrong and it was a false positive.  So actually Justin is totally healthy and doesn't have anything wrong with him. Um, um, ok?  Really great way to start the conversation doc!  And honestly why do you tell people these things if the test results were wrong?  Just to scare the crap out of people and see their facial reactions?  Funny joke!

Then the doctor starts chatting with the nurse/coordinator in the room  and mentions that he needs to do this certain "thing" because I didn't have a D&C procedure done.  "Whoa, whoa, whoa," I said.   "What are you saying?  I need a what and why?"  I then said, "I had a hysteroscopy and D&C performed by YOU, 3 weeks ago!!!"  And the doctor responds with, "Oh yea, ok we don't need to do the "other thing". 

Ummm, ok did I just tell the doctor what procedure he had performed on me?  Shouldn't he know these things, my history, my infertility issues, procedures HE performed, etc??  Now I am starting to freak out!  Then he started the internal ultrasound, mentions something about my lining looking good, and then says this, "Oh yea, you have bad endometriosis don't you? (as he is staring at the screen)."  Ummmmm, once again I piped in with,  "Well actually NO, I was told I had mild endometriosis, but not on my reproductive organs."

And his response was, hmmm, ok.  Once again, freaking out!!  Is there something you are seeing, that you want to mention, doctor??  Have you ever looked at my chart or history?  Do you even know my name?  I wanted to say all of these things, but as I mentioned these situations are very intimidating, embarrassing, and your brain seems to float away from you at times.  He finally made it to my right ovary and found 4-5 follicles.  He said this is a low number of follicles.  He then tried to find my left ovary with no success.  After about 5 painful minutes he caught a glimpse of it and very quickly said he didn't see any follicles on it.  It seemed a little too quick of a look to judge or count, but hey what do I know?  Well wait...... apparently more about my medical history than my doctor at the moment.  I asked what this follicle count number meant and he said it is low and I asked if the medicine I was about to begin taking tomorrow would help create new follicles and he said yes.  So that was hopeful!

After the doctor left the room I left my oversized paper towel skirt behind and I was told I was done for the day.  I honestly don't think I could have taken anything else today considering the level of frustration I was at with the doctor's knowledge of my case.  I mean really?  I was relieved that I didn't have to deal with a blood draw and a needle.  I was told I would start the FSH folllistim injections tomorrow morning (Wednesday) and I would do them twice a day 7am and 7pm until otherwise directed.  I was also told I would need to go to a Lab Wednesday morning at 830am for a blood draw to see how my body is initially reacting to the medicine.  The doctor also said I would need to come back to the office on Friday for another internal ultrasound and blood draw.  Well the only time they had was 2pm on Friday, so I had to take off work.  I had planned on taking off work Monday Sept 12- Monday Sept 26th, so it just looks like my medical leave will start a couple days earlier than expected.
 

I picked up my medicine after work this evening from Walgreens and they were really great about only giving me the smallest amounts at a time because it is so expensive and you don't want to get stuck with medicine you don't need!  Let me just say for 3 days of 2 of the medicines it is $1200!!!  Crazy!

So tomorrow morning Justin will become my needle adminstering buddy for the first time.  Do I think he is a little nervous?  Yes.  Am I nervous?  I think everyone knows the answer to that. 

But on Friday you can bet your ass I am headed in to the office and I am going to have a serious conversation with the doctor, just him and I.  I have written down my frustrations from today, and all the other questions I have.  Because we deserve a doctor who knows us and knows our case.  I don't want to feel like a number or something on an assembly line.  I really didn't think after our initial consultation with this doctor that this is where I would be right now.  Frustrated and confused, and angry!  So tonight as I go to bed, I thought my anxiety would be more about this needle waiting for me at 7am (and the one at 830!), but my anxiety now has turned to questioning our choice of doctor and his staff, and putting all of our hopes and dreams into the hands of someone who probably doesn't even know my name.......UGH!!!

Wow, all I can say is WOW!

Well, where do I begin.  My stomach was in knots all night last night thinking about where we were headed this morning.  The dreaded injection class!!  So needless to say I didn't sleep very well and the drive to the Dr's office wasn't any better.  Justin and I walked into the office and there, right in front of us was a long table with over 100 needles and syringes on it, oranges, those red needle disposal containers, vials of liquid, and 8 chairs surrounding the table.  I wasn't sure beforehand if this "training" was going to be a group thing, or individual by couple, but we soon realized we were going to be sitting shoulder to shoulder with 7 other couples in our position whom I am sure have similar stories to ours.  It's kinda strange since infertility is such a taboo thing to talk about, and we have noticed through the many doctor's waiting rooms we have sat in that no one wants to make eye contact, let alone smile or even acknowledge you are there.  So this scenario, where we are faced with strangers in similar situations with lots of scary needles in front of us was something completely different and new.  So here we go! 

The coordinator who was leading the training told us that whomever was doing the "injecting" had to sit at the table.  What?  I don't have to belly up and stare at the needles?  Hurray!!  Ok, so I was 2 feet away which was still too close for comfort, but at least they weren't sitting right in front of me. 
So we began by learning where I was going to receive most of my shots.  The abdomen!  Yuck!  She then began to teach the injectors how to use each kind of medication with each kind of needle or injector pen, or vial.  It was honestly like a medical chemistry class.  Load the syringe with a liquid, dial up the dose, inject the area, mix one vial of liquid with a powder, pull it out, put it into another vial, mix that one up, (swirl not shaken please).  I mean this stuff is super complicated!  Each medicine has like 3-6 steps on how to prepare it, what kind of needle to use, etc etc.
And man are some of those needles HUGE!!  Luckily a majority of them are pretty small, but the one big daddy that I will have to take the longest that goes in my hip is SCARY!  I think it even freaked Justin out a little! 
So we sat through about an hour and a half of this injection training (which I was nauseous through most of) and also filled out and signed our IVF/Cryo embryo freezing forms.  These forms specify what you will allow them to do with your eggs, and then your embryos.  Strange, one section asked what would you like to do with the embryos if you get divorced.  Apparently I am assuming they have had legal troubles with this before, so now you must specify in writing who gets the embryos, or they are disposed of pending death or divorce.

Next we had to do our FDA blood work panel which I think I mentioned screens for all infectious diseases.  This is required before you can do IVF.  Well when it was finally my turn, the nurse drawing blood noticed a note on my chart from the doctor that he wanted to do some additional blood work, because he thought I might have previously had some miscarriages.  Oh, I forgot to mention as soon as I sat down in the chair to do the blood work the nurse look at me and asked if I was alright because I was a little pale.  Ha!  And I was the only one who had to have her husband hold her hand.  I mentioned to her that I was very afraid of needles and she responded with, "well these extra tests require several more vials of blood.  Do you want to do them all today or half today and half another day?"  And then the water works started.  I couldn't help it! I responded with, I guess just do it all today and get it over with, and I looked away from her to try and hide my tears. 
And then her next question was, "do you want me to use the small needle that makes it go really slow, or the big needle that makes it go fast?"  Really.......Really?  And what do you think I said....I guess the big one?  So here I am, the only person at the training who is visibly disturbed by the sight of needles, sitting in the blood drawing recliner, crying like a baby, holding my husbands hand, and having to get 15 vials of blood drawn!  Everyone else only had to get 4!  What a crock!  Then I almost passed out because she took so much blood, so I held up the blood drawing process while I drank juice and ate a muffin.  My IVF group probably left thinking oh great, hope I don't have my future appointments for blood work after hers or I'll be here all day, ha ha! 
So here is where we stand with everything moving forward:
I will stop taking my birth control pills next Friday Sept 2nd.  This will then trigger my cycle to start which should be a day or two after I stop taking the birth control pills, Sept 3rd or 4th.  Then from what ever day my cycle starts the dates on my calendar will be filled in according to day 1 of my cycle.  I will take the following medications:
FSH-Follistim/Gonal-F (causes follicles containing potential eggs to develop)-Starts on cycle day 3, injection twice a day 7am & 7pm in my abdomen; I do not know how many days I will take it, but usually around 9-12 days
Menopur/Repronex (stimulates egg follicles to grow)- Starts on cycle day 5, injection once a day at 7pm in my abdomen; 9-12 days of use
Ganirelix (prevents premature ovulation)-Starts around cycle day 8, Injection once a day at 7am in the abdomen
I will be monitored with 4-5 ultrasound and blood work appts starting Sept 5th-Sept 19th to see when my follicles are mature.  I need to have multiple 17-18sz follicles in order to do the retrieval.  If I do not have that, the cycle is canceled.  And you start the process all over again next cycle, Ugh!  Let's hope and pray that doesn't happen.  She said it happens very rarely.
HCG trigger shot will be given when they determine that my eggs are mature and ready to retrieve.


Once the trigger shot is given, exactly 36 hours after that I will have egg retrieval.  The target date for retrieval is Sept 19th, but is based on each individual person, so the window it Sept 14-20.  I will be knocked out for this procedure, but it only takes 20-30 minutes to complete.  Then once they retrieve the eggs Justin will give his sample that day and the embryos will be made.  Then we will wait 3-5 days for the embryos to be at just the right stage and then they will transfer them back in.
Then once the transfer occurs, 2 things happen.  The dreaded HUGE needle injection starts daily in my hip.  And we have the 2 week wait to see if it worked.  They will do a blood test exactly 2 weeks from transfer day.  If it is positive (which I KNOW it will be), we will continue the HUGE needle injections for 4-6 more weeks to ensure the pregnancy.  I am hoping I just get used to the HUGE needle and eventually it will be second nature and not scary, but it is hard to imagine.
I have counted and at the minimum I will have 37 injections leading up to the transfer, and then at least 14 HUGE needles, and 5 more blood draws.  I never thought I would say this, but I hope I have a lot more than 14 huge needles and 5 blood draws, because that would mean we are pregnant! Wow, yes I just wished for more needles.  I think the crazy has set in....

Jenny

Alex, Twins, and a Beard

I keep wondering why I am the one out of all the people I know who can’t get pregnant.  Why is this my path?  Is it something I did?  Is it something I said?  Is it something I took or drank or ate?  Is it natural selection?   Am I being punished?  Why me?   

Oh yea, I do get down on myself every once in a while.  I cry and have my emotional outbursts and I play the “poor me” game.  Why?  Because I hear about people getting pregnant around me every week.  Does it bother me?  Yea, a little, but I get over it pretty quickly and remember that I should be happy for people and not despise them for having something I don’t.  Because honestly my life is pretty great, and will continue to be great, children or no children.  

I had a dog named Alex that I got when I was 13 years old in 1993, and he was with me until June of this year, which was right after his 18^th birthday.  I never in a million years thought he would live that long!  But he just kept chugging along.  About 5 or 6 years ago I was having a conversation with my mom and I said something about Alex being like my child, and that I would never have human children while he was around.  I don’t know why I said it the first time.  But it was so matter of fact, like the time when we brought Alex home and my mom asked what his name was and I said “Alex.”  Really, Alex?  Not really a dog’s name?  And I said well I just know that is his name.   This was just a very strong thought like I had that day and it stuck with me.    I said this statement many times to people over the years, and someone just brought it up to me the other day.  “Well you said you wouldn’t have children while Alex was still here on this Earth.”  Oh yea!  Crap!  So maybe this is why we don’t have human children yet?  (Yes, we have 2 doggie children, Adel and Annie)  So from now on I am watching what I say, because words can be a very powerful thing once they are said out loud and sent out into the universe.

 I was also thinking about the idea of having twins through this process.  Yes, in case you are wondering the risk of having multiples is much higher with IVF, depending on the number of embryos you transfer.  And we will not know how many we are transferring until we see how strong the embryos are, but NO people I am NOT going to be octomom!!

Anyway, when I was 15 I started working at a holistic alternative bookstore called Third Planet Books on Manchester Road.  The couple who owned the place were super quirky, but the nicest people!  Twice a month they would have psychic fairs in the back room and 6 or so different people each time who claimed to have “the gift” would give readings.  Bobbie the owner would always tell me I could have readings done by them for free either before or after the “psychic fair”.  The teenage guinea pig.  Over the 2 year period that I worked there I probably had my fair share of readings, and there was one thing that always stuck out in every reading I had.  Every one of these people told me I was going to have twins!  TWINS?  Are you crazy I am 16 years old!  But this prediction kept reoccurring when my mom and I would visit other holistic fairs in other cities and states!  They all said it!  So needless to say it is something that has stuck with me since.  Twins don’t run in my family, so I didn’t know how this prediction was going to come to fruition.  But maybe this process is how it is supposed to happen.

Please don’t get me wrong, I will be ecstatic just to have one healthy baby.  But I just think like I said earlier, with things being said out loud being very powerful, maybe we are meant to have twins and this is the only way for that to happen?  Coincidence?  Who knows!?  We would love to have 2 children, and if we can do this IVF process ONE time instead of 2 that would be just perfectly ok with me.  Less needles!

Soooo....today is Saturday, and in 4 days, Wednesday, we are heading into the Fertility Clinic to do injection training.  Do I know what this entails?  Needles!  Do I want to go?  NO!  But I will go, because I know there is a bigger picture.  But I can’t promise I won’t cry, or throw up, or pass out.  Justin and I both will also have our FDA blood work screening done on Wednesday, which means several blood draws for both of us.  This screening just makes sure we don't have any major diseases or issues.  Ahhh!  We will also receive our calendar and protocols, so I will update after our Wednesday appointment, if I survive.

As I said before I am currently taking birth control pills for 38 days prior to treatment starting.  But because my body is apparently ornery, I am now taking 2 birth control pills a day, along with a prenatal vitamin, a baby aspirin, a DHA supplement, and something called DHEA.  I guess there was a study performed recently with IVF patients that they gave 75mg daily of DHEA for 30 days prior to IVF and the embryos were stronger, and there were more pregnancies in the group who was given DHEA.  The DHEA is in pill form and I take 25mg 3x a day.  When I received the instructions from my IVF doctor to start taking it about 10 days ago, I went to GNC and picked up a 90 pill container.  I went home and carefully read the label just because I had already been through the steroid prescription fiasco.  The label clearly stated, DO NOT take more than 25mg daily.  Side effects include hair loss, facial hair growth in women, irritability, and aggressiveness.  WONDERFUL!  I was supposed to take 3 times the recommended dose on the label.  So I am going to be the girl who is pregnant, but is bald, has a beard, and it really angry??  LOOK OUT!  Justin is so wonderful and after I told him this he looked at me with this big grin and said, “Baby I will still love you even if you are bald with a beard.”  Wow, now that is love!  Thanks Babe!

On pins and needles (literally)....

Jenny