11 June, 2019

Water Ultrasound

One week ago today, we drove up to the nearest clinic that would do an SIS for me. The drive was over 1.5 hours away. My toddler was in the back of the car, complaining the entire way.
As we arrived at the clinic, we were a little surprised to see it was in a large building with dozens of medical offices. I guess I am used to my small town clinic with its own beautiful building. Being in a large metropolitan area means that space costs much more.
We purposefully arrived half an hour early. After all the difficulty in booking the appointment, we did not want to risk missing the appointment.
As we sat in the waiting room, my toddler played with a few toys we had brought in and the husband and I watched a reality large-scale fish tank builder show. Who knew such shows existed. We were laughing at the drama they created and the blatant ad for Dairy Queen in the middle. The humor they tried to create for the show was terrible.
Previously when I have had to have a catheter inserted for an IUI or another type of ultrasound, my clinic discovered that it was much easier if I had a full bladder. Remembering this, I was prepared and had to pee badly the entire time we sat in the waiting room. After we were called back, they asked that I empty my bladder. I cringed, thinking that it could take a while for the ultrasound to take place if I had to drink more water but complied.
As I sat on the examination table, I stared at the ultrasound display on the television screen and got a little choked up. I was sitting in a room, finally starting on the first steps to get our second child. Next to me was my darling little girl and my husband. I could not stop thinking how blessed I was. I already had a baby. Could I control my emotions better as I went through the process again? Would I be able to emotionally make it through more than one cycle?
My husband asked our daughter to hold my hand as we did the ultrasound. She very solemnly placed her hand in mine as we waited for the catheter to insert the saline. She watched in awe as the wonderful RE took a few pictures of everything that he found. It was, thankfully, uneventful. He said everything looked great and that I should be able to proceed with the FET in a month or two.

We were extremely grateful for him. We chatted a bit prior to the procedure and he agreed with us that it is more than slightly preposterous that very few clinics in the area will help patients that are working primarily with another clinic.

Later that day, I called the clinic and we scheduled the transfer for July 25. We then learned that we may have to push that date back by a week for my husband's school schedule. I will have a definite date by tomorrow. (A very good thing because flights keep getting more expensive!)

28 May, 2019

Birth Control

The first time I took birth control pills was a few weeks before my wedding. It turned me into a hormonal mess. I stopped taking them after a few months. It wasn't worth it. When we started IVF, I was on birth control briefly to regulate everything and make sure the timeline would be accurate.
Last night, I took a pill. After the debacle we had with scheduling the SIS, I thought that my IVF coordinator calling in birth control pills should not be a problem. I waited two days and then asked my coordinator to call in a new order. I am glad I received the order when I did because for whatever reason, yesterday was the last day I could have started to stay on schedule.
I just took my second birth control pill. I figure I have one to three months on it this go-round. I am hoping I can keep hormones in check, especially because I have more hormones to inject starting in July.

21 May, 2019

The Ballad of the Saline Infusion Sonohysterograph

After I had the phone consult with my RE, I was tasked with two assignments: Have eight blood labs completed and receive a saline infusion sonohysterograph (also known as a water ultrasound).
I turned my attention to the ultrasound. I popped into my regular OB's office to inquire if they performed the ultrasound. The receptionist gave me a blank look. After a few seconds of gears turning in her head, she informed me that she believed that type of ultrasound was completed in the hospital.
A few days later, I performed a quick google search and pulled up the name of a doctor in my area that might do the procedure, so I called them next. I had to leave a message after sitting on hold for 20 minutes. When the secretary called me back, she was less than helpful and not very cheerful.
"Do you do saline infusion sonohysterographs?"
"Yeah."
"Would you still be able to do the procedure even if the order is from another state?"
"I guess so."
"Would you be able to set up the appointment just a few days before I need it done?" (My instructions were to either have the ultrasound completed on day 6-10 of my cycle or while on birth control.)
"We usually can."
"What do I need to do to set this up?"
"Fax us the order and your entire medical file."
"I have a copy of the order I can just run in."
"We need it faxed."
"You need my entire medical file? I just need this ultrasound completed."
"Yes. We will have someone call you when we receive your file."
End of conversation.

I emailed my IVF coordinator to tell her the good news and she said she would fax over the information. I waited a full business day before I called the OB clinic back.
After waiting on hold for 15 minutes, a new, happy girl picked up the phone.
"I had an order sent in for a SIS."
"Can I put you on hold for a few minutes?"
After waiting off and on for another 20 minutes, she finally was able to help me. Apparently, someone had already scheduled the SIS, but put it into the system incorrectly. The girl started going over my information before we did the appointment information.
"Is your address 1501 Orchard Lane?"
"...No...It's __." (I've never lived on a street called Orchard Lane.)
"The number we have listed is this."
"My phone number is actually this: __."
"The emergency contact written down for you is Matt Lancer."
At this point, I was very confused. No offence to Mr. Lancer, I am sure he is an upstanding fellow, but he is definitely not my emergency contact, just like every other bit of information had been incorrect.
"He's not my emergency contact. I am a little worried that you have the wrong person."
"We can change the emergency contact, no problem! He will never find out that we took him off. If it's an ex-husband or something, he won't be notified."
"Sorry. I meant, I think you have the incorrect patient file pulled up. Every piece of information you have asked me about has been wrong and I don't want to completely change someone else's file."
"Oh. Well, we can check by your SSN."
Surprise! It was the wrong person. Thankfully the girl had not saved any of the new changes.
We made the appointment and I was giddy that I had finally nailed down the appointment after not too much trouble.
Half an hour later, the girl called me back. She had apparently called my RE clinic. After talking with my IVF coordinator, they discovered a problem. The OB in my city apparently would not be able to perform the ultrasound the way my RE clinic needed. I am really fuzzy on the details, but apparently the conversation the conversation got a little heated and the RE clinic hung up on the OB office. Whoa. Drama!
Around the same time as the phone call, my IVF coordinator emailed and informed me that the OB would not be able to provide the type of scan that was needed and I would need to find someone else.

The next day, I called an RE clinic in my area (1.5 hours away--the closest there is). I had given up on local doctors and know some friends that have been to this RE clinic. 'They're such a great clinic and I have only heard great things about them! It will be more of a drive, but they will be great!' I knew that my window of opportunity was closing. I could tell that cycle day 1 was going to be the following day and so I had around a week to get this figured out.
With the feeling of ease and anxiety, I called the clinic. The quick conversation was over in a matter of a few minutes. The receptionist transferred me to the scheduler who very firmly told me that they do not do outside orders, thank you very much. I hung up. I wiped away a few tears.
Over a week had gone by with many phone calls to several doctors' offices, being put on hold, and dashing my hopes. I was so frustrated that planning one ultrasound before I even "officially started" IVF was not working out. In the back of my brain, I was thinking worst case scenario. I would have to take a day trip back to my clinic to have the ultrasound completed. After pricing tickets and discovering it would cost close to $1000, I decided it would be extreme worst case scenario.

The husband was wonderful. He asked me if I would like him to make the next round of phone calls. I hesitated. I would do anything for another baby, right? After thinking for a second, I told him yes. Bless him.
He called our (tiny) local hospital. After a fifteen minute conversation in which the poor scheduler kept asking to verify what kind of ultrasound was needed, she asked if she could call back. She did not know for sure whether or not they could do it.
That day ended and we were hit with the weekend. When husband finally called back, he ended up on a wild goose chase calling more than a half dozen different hospitals and clinics. People would ask for the name of the ultrasound and put him on hold before they denied that they could perform the ultrasound. Thankfully, he was always given another place to call.
When he finally emerged from the room where he was making calls, he emerged successfully. He had a name. They specifically do out-of-area SIS and they told him they might be able to fit me in on Thursday. I emailed my coordinator and updated her with the (new) good news. She called me a few hours later and said she could prescribe birth control so that even if I am not able to go in on Thursday, I can have the ultrasound at any point.
I want to get the ultrasound over with, but I would rather have it done after Thursday. Husband has his last day of his first summer class this Thursday, so we would have to get a sitter to watch the my toddler so that we can both get to our individual appointments. She has yet to have a sitter since we moved in July. We will figure out the solution to that problem if we come to it.

We will have to wait a few days before the story ends. My family also gets the fun experience of seeing what I am like on birth control. I have only been on birth control for 4 months, spread out over two different occasions. The first time was not great, so hopefully I can have normal emotions for the next couple of months.

26 April, 2019

Phone Consult

Yesterday was our phone consult with the reproductive endocrinologist. We are now two time zones away from our clinic, but are excited to go back and try with our next blast. The conversation was extremely optimistic and helped excite me. I have never been nervous for any of our infertility medical intervention. I became more and more giddy about starting the process again.
We chatted about timing. I told her that we were hoping the baby would arrive after next spring semester. She misunderstood and thought we wanted to do our FET next spring. "You certainly are on the ball, aren't you?" After conversing for a few more minutes (why does she want to know if we are coming out over the holidays? Shouldn't I hopefully be pregnant by then?), we realized the misunderstanding and I told her our real timing plans. August. We want to try in August. "Oh! That makes much more sense! You are calling at a perfect time. We are a week or two out from scheduling in August."
We went over details. One embryo. The husband is terrified of a multiple birth. She told us that it would be best for us to be in the area for around 9-10 days. They would like to do an ultrasound of the lining a week before the transfer to make sure it is nicely thinned and then the day before the transfer to make sure it has thickened. We will then do the transfer and I will get my two "princess days." I know that bed rest is not encouraged like it used to be, but if she told me it would be best for me to do a handstand for an hour after the transfer, I would start practicing my handstand technique.
My homework is to find a clinic in the area that will do a saline ultrasound. I really hope that an OB in our small city has the capability of doing one because the nearest RE office is 90 minutes away. I also was emailed some labs for blood work. Wahoo!
The RE told me that we have a great looking blast to transfer. Baby number one was just about as perfect as it gets. This next blast is graded only slightly lower than my miracle baby. We talked about the remaining 6 blastocysts. They all look great, but the first two were better than the other five. I still feel so blessed that I ended up with seven blasts and hope that I do not have to do an egg retrieval again.
I am still mentally planning on having to go out for two attempts at a FET, just in case. It would be much harder if we have to try twice because the second time would be in September or October and Husband will be in school. I might get to take a solo trip with my adorable toddler while going through this physically and emotionally demanding trip.
I am not looking forward to the progesterone shots this time around. I got used to the multiple shots a day with needles of different gauges prior to the egg retrieval, but having large needles thrust into my rear that deposit progesterone in oil does not sound like fun. I will have to start doing research about the best ways to get ready for this.

Coincidentally, I received a call from my new OB in the area shortly after finishing the call with my RE. They ran some labs on me last week to see what the current state of my anticardiolipin antibodies are. The previous three times I have been tested, I always came back at an indeterminate level. This lead to heparin shots twice a day during my last pregnancy. The results came back as normal! I was extremely excited to hear this news. No twice-a-day shots for the next pregnancy? I do not know how to manage a pregnancy without bruises forming on my abdomen and the occasional eye grimace as I come across a dull needle. (Being the overly cautious person that I am when it comes to pregnancies, I will probably ask my RE if we should maybe test one more time before the next pregnancy, just in case.)

Getting ready for the FET over the next four months, I want to work on being as healthy as possible. I currently exercise 2-3 hours a week and want to make sure that it is at least three hours a week. My husband's last day of school this semester is today, so he will be at home a little more until August (although he does have several summer classes). Husband and I have also decided to cut back on sweets (my weakness) to improve our health. After going through so many fertility treatments before becoming pregnant with my darling girl and working full-time, I was not in the best of health.

30 March, 2019

What Comes Next

My baby is not really a baby anymore. She is a curious, energetic (almost) 2-year-old toddler. She is a momma's girl through and through and a copycat. I cry sometimes when I think about how much I love her. She is everything to me. I read a study once that claimed children conceived via IVF are loved more than the average child conceived naturally. Maybe this means I love by baby more than I would have if she did not take years to come and all our money.
I do know that I am different from other moms. Having a baby does not cure infertility, nor does it cure the feelings and emotions.
In July, we moved halfway across the country. I have met a handful of women that area dealing with infertility issues. It is nice to be able to glance at them for half a second when other mothers talk about how much easier it was with one than two kids or other problems that I wish I had. They know.
Husband and I just had "the talk" a week ago and decided that late this summer will be when we will try our first frozen embryo transfer (FET). I hope it only takes one. In my mind, I am planning on at least two because it will hurt less that way. I know that when I get caught up in the middle of the shots and ultrasounds, everything will become more real to me and I will wish and hope and pray with all my might that it will only take one transfer, but I cannot put all my emotions in one emotional basket (that would make me a basket case). It's not me being pessimistic, it's being realistic. On the bright side, if it does take more than one FET, it means I get to visit my home state more than once. I would really look forward to that.
We are planning our FET so that the baby would come next summertime, during my husband's summer break from his doctorate program. The first time we go out for a FET, we are hoping to make a 1-2 week vacation out of it and really enjoy ourselves. My current medical insurance does not cover any infertility treatments at all, so it doesn't really matter if I do all the blood draws and ultrasounds where I live currently or with my clinic. If I have to come out for a second (or third) FET, it will just be me and the baby.
We are scheduled to have a phone consultation with my RE at the end of April. I wanted to schedule it early for two reasons. 1. Because it will be a long-distance FET, I want to make sure everything is laid out perfectly. 2. My current city is notorious for getting an appointment with a doctor. I need to know if I need to see an RE out here (closest one is 1.5 hours away) or if I can get away with just seeing an OBGYN or if I can just do all the preceding medical work at a lab somewhere.