28 July, 2016

Waiting

The blood has been drawn. The usual cheerful phlebotomist remembered that I teach. I am getting well-known at the clinic.

The earliest they have ever called was 10:18. That time has come and passed.

One phrase keeps drifting through my mind. Chemical pregnancy. If the number is over 5, please let it be significantly over 5. Over 100 would be grand. I will not complain with a number over 100.

I have literally done nothing for the last thirty minutes. I have sat on the couch, glancing occasionally at my phone.

Hopefully the call comes soon.

26 July, 2016

After the Blood Work

My 2WW is almost over. Thursday at 8:00 am, I will go in for some blood work. There is always a range in when they call with the news. I have been called at 10:30, but I have also been called at 4:45. I am just crossing my fingers that the call comes before my class.
I think I have decided.
After the blood work, I do not think I will do any updates on the result for a week or two. Here is why.
I am (personally) a firm believer in not announcing pregnancy until you are decently along (at least 12 or so weeks). If you do not believe in this idea, that's great. This is simply what I believe. My reasonings:
1. Miscarriages. If 20% of pregnancies end in miscarriage, if you have five pregnancies, chances are at least one of them will end in a miscarriage.
2. The people that announce their pregnancies earlier than other people seem to be pregnant way longer.
3. I think it is exciting, fun, and sacred to have that secret with your significant other. I loved how close I felt to hubby when I was pregnant the first time (for a whopping eight weeks) when we were the only two that knew. (Okay, we told my dad and baby sister. But they found out shortly before the miscarriage.)
Like I said, no judgement if you pee on a stick and immediately post that to social media. That is completely up to you.
Ironic that I am leading you through my extremely sexy story of getting pregnant, right? Here is what will happen (unless I am too overcome by grief or excitement). The beta blood test will be done on Thursday. If I have enough HCG in my blood that I am classified as pregnant, I will go in two days later for a second blood test. They want the number of HCG to grow (double). They may do blood test every two days for a while, depending on the numbers. Then they will do an ultrasound (pretty sure at this point I have had more ultrasounds than most women that have had two-three kids) and graduate me at nine weeks to an OB.
If the HCG test comes back negative, I go off the fun progesterone suppositories I have been taking and go back to birth control. We can do a frozen embryo transfer within a month.
I will update here 1-2 weeks after the beta test.

21 July, 2016

2WW

The second world war.
Nope.
Two wiley widows?
Nope.
Twice without water?
Nope.
There is an entire world of infertility jargon out there. I'm talking all sorts of things such as AF, BFP, BFN, AH, DE, OTD, EC, ET, FET, the list goes on. I am not the biggest fan of weird jargon acronyms. I would much rather say that I received a positive pregnancy test instead of "OMG! BFP!!!!" (We shall also ignore that I am slightly anti-exclamation point. Ask my students. They know this well.)
The only one I connect with, perhaps because it and I are close friends, is the 2WW. The two week wait. This is the term used to describe the two weeks after ovulation (and hopefully fertilization, implantation, etc.) before you know you are pregnant. These two weeks contain a rollercoaster of emotions for me. Usually I do my best to get my mind off of all things pregnancy related. This works well in the middle of a school year. This epically fails during the summertime. I had an especially rough go of things the last three days when I was on house arrest (bed rest). I sat on the couch, worked on my matter unit for science, read, did homework (aced a midterm), played a little Zoo Tycoon 2 (so glad I just admitted this to you), crafted, and painted.
(Upon sending a text to hubby excitedly declaring, "I'm painting," he promptly called me within twenty-three seconds. "Uh, what are you doing right now?" "Painting." Yeah. In his mind, I was painting our upstairs hallway. We still need to lather on a final coat. Upon realizing I was not breathing in paint fumes, balancing precariously on a chair, and being OCD about painting in a straight line, he was okay. I painted a pencil box for my classroom. It is now blue and beautiful and I have no idea why I painted it in green, pink, and gray last year. Ugly.)
Today I resumed my normal life. I have spent much more of my waking time outside of my house than inside because that is what I do. We purchased an adorable animal alphabet print for a future nursery, for goodness sakes.
Every year we buy one thing for future baby. This is not something we plan to do. ("Let's see. Next week I have scheduled that we need to purchase something for our future offspring. As good parent organisms, we better make sure we fit that in.") I have amazingly soft blankets that I bought from a company I used to work for. I have a car seat cover purchased from the same company. We have an adorable duck we bought in Berlin a couple years ago. Last year we purchased future offspring the most adorable elephant (part of the elephant is made out of a thick corduroy). Now we have the animal print. I love it, but I am starting to get worried for myself.
I am worried that I am getting my hopes up this time. After the first IUI, I received the call, responded with a, "Thank you for calling, have a great evening," told the hubby, and resumed my life. After IUI number two, I was a grump. I decided to answer my phone at school and was not a very nice teacher after that. IUI number three was the worst. It happened the day before baby sister's graduation. I will admit I cried hard enough and long enough that my eyes were still red and puffy at her ceremony the next day.
I have stopped looking up potential due dates.
I have stopped debating over buying slightly larger clothes because, "If I get pregnant, I won't be able to wear this for a long time."
I have stopped planning my future as if life will get more uncomfortable followed by six weeks of maternity leave.
It helps me deal with things when I get that phone call or I wake up to blood or I receive a "not pregnant" on my test.
Am I getting my hopes up?

18 July, 2016

Baby's First Picture (Embryo Transfer Day)

Everything I have done in the past month, six months, years(?) has lead up to today. My first embryo transfer!
In the morning, I decided it would be good to get in a short workout because I knew that would be the last time in quite a while. During my workout, I received a call from the clinic. For a second, I panicked. Was I late? Had I forgotten what time they asked me to come in? Instead they asked me to come in slightly earlier.
I arrived at my clinic at 1:00 knowing that I would stay in the waiting room for half an hour. The reason for the early arrival was so that I would take the valium that was stashed away in my bag. I had several glasses of water prior to leaving my house for the appointment and throughout the experience, I definitely felt the consequence. They ask for a full bladder during embryo transfer to make everything easier to see.
Promptly at 1:30, we were ushered back into a room for the transfer. Just like clockwork, one of the adorable technicians greeted me by name which made my day. They asked that I wore loose, comfortable clothes (glad they did not ask for loose, uncomfortable clothes) and socks. I came prepared with some adorable socks adorned with buttons on the side, but when we entered the room, a present was waiting for me. I was honestly very touched at this gesture. (And everyone that entered the room remarked that these socks were amazing.)




As we waited another ten minutes for things to get going, all I could think about was the full feeling of my bladder and the discomfort I felt. Husband was able to get excited and focus on the sacredness of the situation.
Our doctor showed up and gave us all the stats. As of Saturday, we had 16 embryos growing. Today, only five have made it to a nice blastocyst level. Nine of them are okay and we will let them grow another day to see what they do. (The doctor said that probably only 2-4 extra would make it to freeze, making it a total of 6-8 frozen embryos.) She seemed very positive about what everything looked like and how the cycle had gone so far. She handed us a paper with pictures of our five beautiful embryos with the best one (the A+ embryo as the doc put it) big and bold on the paper. Baby's first picture? After verifying that we were going to transfer one embryo, our doctor went out to tell the lab and switched places with a nurse.



It seems as though this nurse's primary job was to see how hard she could press down on my bladder with an ultrasound wand. Holy moley. (Her real job was to show us where the catheter was being placed and to show us the transfer itself.) The doctor did take longer to come back into the room so we played "bursting bladder" longer than I wished.
The doctor came in and we got started! When she started putting all the fun metal pieces in place, I thought I was not going to make it. (Let's see if we can put pressure on her bladder from the inside and the outside! What fun!) I honestly asked her how long she thought it was going to take. The pain was minimal. It was definitely less painful than an IUI (and an IUI is just momentary poking and prodding). I warned the doctor that in the past, the nurses doing the IUIs had problems getting positioned in the correct spot and had to use an alternative catheter. (Apparently there is a slight bend in my cervix. You wanted to know that, didn't you?) It only took a minute to get the catheter in and then at the last minute, the embryo was sent for.
The embryologist once again ensured that we wanted to transfer one and he passed our (hopefully) future child off to the doctor. Obviously the embryo is too small to see, but they put a couple tiny bubbles around the embryo so that we could see where it was transferred and when the transfer took place.



(That my friends is what part of my reproductive system looks like. The black part on the right I believe is my extremely full bladder. Immediately to the left--the part that looks almost folded over--is my uterus. The bright spot would be where the embryo was placed.)

They paused the ultrasound screen when the transfer took place and pointed out where the embryo had been placed. (The embryologist took the catheter back to the lab to make sure the embryo had not decided to retreat back into the tube.) After taking everything back out of me, they cleaned up, helped me get comfortable on the exam bed, and left us alone.
Husband and I chatted. As I was squirming and pinching myself to get over the bladder situation, he was having a wonderful experience. We looked at the pictures of the embryos and the frozen image on the television screen. As we were enjoying our moment, a technician came in to debrief us.
Strict instructions: Not technically bedrest, but "home-rest." I am not to leave the house, particularly tomorrow. Wednesday I can do a bit more, but the first day of freedom is Thursday. I was instructed not to do laundry, dishes, any other household duties. (Ah man...all my favorite things!) On Thursday I can resume regular activities, but no heavy exercise, no lifting anything more than 20 pounds, etc. They even wrote a doctor's note for my strict professor to excuse me from my class tomorrow. (He has a weird absence policy.)
They turned on a recording of chirping birds after the transfer and instructed us that as soon as the recording was over, I was free to get up and use the bathroom!
Blood test is scheduled for July 28.
I'd never been uneasy about receiving a positive blood test before, until talking with a dear relative that has gone through IVF. She received a false positive beta blood test once. Yikes.
Now it is time to wait. And relax.
This weekend I'm heading off on a short road trip with one (or two) of my favorite people in the world to relax with my grandmother and two aunts.
Here's to a calm ten days.

16 July, 2016

Day Three Stats

This was the longest Saturday morning I have had in a long time. It was reminiscent of the day I took a pregnancy test for the first time. I could not concentrate on my homework and when I finally blurted out to husband what was up with me, he immediately drove us to Target to grab a pregnancy test and remedy the situation. Sadly, nothing could be done to speed up this morning's proceedings. (We tried. Husband tried calling the clinic and they said the calls on Saturday are made between 3 and 6. Ugh.)
Just after 4:00, I jumped at the the sound of my phone going off. Private number. I knew what that meant. With shaking hands, I answered and ran up the stairs so husband could hear. I frantically searched the bedroom in two seconds, looking for a writing utensil. Yellow highlighter. Perfect.
I was extremely nervous. Throughout the day, I would turn to husband with a look of despair and wail, "What if there are only (fill in the blank with a number less than five) left?"
He was supportive. He always is.
When the caller told me how many embryos I had, I could not hear her straight the first time. Maybe it was selective hearing. I asked her to repeat herself.
"You have sixteen that have made it to day 3."
Excuse me?
Sixteen? One-six?
Sixteen!
Every single fertilized egg has made it. They are all growing. I was so happy I could have hung up and collapsed in an exhausted heap on the floor. However, I knew that even more important information was coming. How big each one of them were.
"By day three, our clinic is looking to have them at least six cells. So here are their sizes:
One is six cells."
At this point, my heart flip-flopped as I realized that she could either be increasing in size or decreasing. Please don't decrease in size...
"One is seven cells."
Okay, so she increased in size. It could still be bad. What if she says the rest of them are small and worthless?
"Five are eight cells.
Four are nine cells.
Three are ten cells.
Two are twelve cells."
Holy goodness gracious. They all made it and they're all overachievers? As the nurse continued to talk, I made sure to find the sum of all the numbers, just to make sure it added up to sixteen.

The last things we talked about were Monday. Monday is implantation day! I'll head over to the clinic at 2:00 and the procedure will be at 2:30. I have to bring a couple drugs with me to take. We'll go over the final sizes with my doctor and cross our fingers that we chose the best one. I did ask if there was an approximate percentage of how many she thought might make it to day five. She said the numbers for that are all over the place (as I was expecting), but we could expect probably at least half.

Wahoo!
And, one more time just because I am so happy (and to make it easier to read):
1 six-celled
1 seven-celled
5 eight-celled
4 nine-celled
3 ten-celled
2 twelve-celled.

Now I can concentrate on my homework.

14 July, 2016

Fertilization Stats

Yesterday 22 eggs were harvested.
21 eggs were mature.
Today 16 eggs were successfully fertilized. I'll receive a call on Saturday to see how many made it to day three. They will also schedule a time for me to go in on Monday for the embryo transfer. I don't know if I'll have the ten day five blasts like I wanted, but hopefully half of my sixteen remain.

13 July, 2016

Harvest Day (Egg Retrieval)

Today was the big day. I have taken pill after pill and endured the injections. I have had emotional spins and physical pains. Today was harvest day (as I like to call it). Here is how the day went for me.
I woke up at my normal 7:00 alarm. No need to hastily prepare the injections for the usual 7:30 drug time. I was able to relax. It is hard to relax when you have nothing to do, but over an hour to kill. I could not eat so I dilly-dallied my morning away.
I did choose the best outfit possible. On the bottom, comfy jogger pants with the most adorable (and comfortable) socks given to me by a dear friend.

On the top, the best tee possible. This was given to me by the same friend for volunteering at her adorable market. (She knows me pretty well.) Love the message?

Makers gonna make


Upon arriving at the clinic, my anesthesiologist came out to greet us and show us back to the room. The room was definitely more high tech with a large toolbox holding odds and ends. In the corner was a tray with pipettes. I changed into a hospital gown (I was allowed to keep my socks and bra on). The anesthesiologist gave me a numbing shot and then the IV. Husband claims that a tube for the IV filled quickly with blood and then quite a bit spilled out onto my arm. I love what blood thinners do.


After a while, my endocrinologist arrived along with an array of nurses. We chatted for a second. I remember her asking how I was feeling. I told her that yesterday was crappy and I had gained quite a bit of weight. She remarked that what I experiences was not unusual and that I should feel better in the future. I also remember husband getting kicked out. Then the mask went on and I was out.
When I woke up I heard voices. I could not keep my eyes open for a while. Once they did open permanently, my anesthesiologist was the only one left in the room. I recall asking her if I put my legs in the stirrups on my own accord or if the nurses had to do it. (Why that was important to me, I know not. For all those curious readers, I put them in the stirrups.) I also asked her if she knew the stats. She did not. I did not think she would tell me, but I thought it was worth a shot.
I believe she asked once if I was ready to head to the recovery room. I believe I declined once. After a few more minutes, she lowered the chair and helped me up. Together we hobbled through a back door and into a back hallway. I looked to the right and recall seeing a door with a window in it. Inside there were a few people with masks on. I think that is their lab. On the left were doors. I know that the doors lead into the different exam rooms.
We made it into the recovery room, a sheet was wrapped around my shoulders (to help hide my behind in the hospital gown) and I was helped into a reclining sofa. A hot pad was placed over my reproductive area and I was handed a cup of water.
Husband was taken into the recovery room after just a minute or two. I love that man. We chatted on and off and enjoyed each other's company. When my water ran out, he made a point to throw away the cup and grab a new one to fill. Gotta milk them after giving so much money.
A nurse came in to remove my IV (and clean up the mess on my arm from said IV). I like that nurse. She has helped with my dye ultrasound, water ultrasound, and at least two IUIs. The nurse gave us a sheet of instructions that included the next round of drugs to take. I asked several questions and she remarked that I was much more lucid than many other patients at that point. She did warn us that it might be a while before our doctor returned; she was visiting another patient. I changed and decided that the wait for the doctor might be longer than my bladder could wait. Of course as soon as I entered the bathroom, she turned the corner. (One thing I love about this clinic is that I am known by the staff now. Upon checking in, the receptionist called me by name to ask a question before I had signed in. As I headed down the hallway, an ultrasound technician called me by name and asked how I was feeling.)
Now for the big news. After poking and prodding, the doctor does not think I will be as high of a risk for OHSS as she originally thought. Phew. The real news? The numbers that I had been trying to estimate for over a month now? She retrieved 22 eggs. (Much lower than I expected.) No word on how many she thought were mature. I asked. We will receive our initial report tomorrow on how the eggs are doing. She did tell us that in her estimation, we can expect around 15 to fertilize. (That number will drop by day 5 when they make it to blastocysts.)
The first few hours after the procedure, I felt amazing. I physically felt better than I have in weeks. Now that the drugs from the IV have worn off, I have a nice cramping pain in my ovary area any time I move. I cannot stand up straight and I cannot stand up for long at all.
Throughout the process, I kept two of my biggest fans (a couple sisters) updated with picture texts. One of my darling sisters is finishing a tour in Europe right now with the caption, "I took this pic this morning for you. Because you are a winner." I love those two.


I now anxiously await the initial report tomorrow on how things are going.

12 July, 2016

Cycle Day Twenty-Six

Let me riddle you this: If you have a positive pregnancy test and your mid section is larger than normal, are you pregnant?
Answer: Not always.
This isn't the first time I have had a pregnancy test come back positive without actually being pregnant, but this morning I looked like I could have been several months into what I have been yearning for my entire life. Today I gained almost three pounds. Three pounds is quite a bit to gain in twelve hours. I have been chugging Gatorade and water and all that water weight has decided to stick around.
In 12 hours, I will be done with "harvest hour." The entire procedure will take around twenty minutes. I am excited to see how many eggs they will be able to retrieve and try not to think of what could happen to me after the procedure is complete.

I've actually made it to the egg retrieval. I cannot wait for tomorrow.

11 July, 2016

Cycle Day Twenty-Five: Trigger Shot

I went in for another round of ultrasound + blood work this morning. Instead of my favorite nurse, an ultrasound technician performed the ultrasound. She did not seem to do as thorough of a job with the ultrasound. She found 25 follicles in just a few minutes. Normally ten to fifteen minutes are spent on the ultrasound.
I received the call late in the afternoon. Time to trigger ovulation (and undo the actions of the "follicle glue"). The timing on this is a tricky thing. If you trigger too early, all the eggs will be released and all the money washed down the drain. I was told to specifically trigger at 9:00 pm. It brought back the first two times I have used this injection. I was slightly terrified the first time I saw the supplies because of the size of the needle.

It is so thick and long. Thankfully, it is only the needle to withdraw the fluid. The injection needle is as tiny as all the other needles I have been using.

The other important information that was revealed? Drumroll, please...
I am at a high risk to develop ovarian hyperstimulation syndrome (OHSS). When I have my blood drawn, they measure my estrodiol level. Whenever that number gets over 3000, there is a risk of OHSS. I was measuring just under 5000 today. Other causes for OHSS? Having a large number of follicles (check), having a low BMI (check), under 35 (check), PCOS (nope). I fit most of the qualifiers.
What are the funs symptoms that I might enjoy? Rapid weight gain (such as 5 pounds in a day or 10 pounds in three days), severe abdominal pain, severe and persisting nausea and vomiting, decreased urination, dark urine, shortness of breath, tight or enlarged abdomen, etc. (Many women that have OHSS look as though they are several months pregnant-not really fair.)
I will know less than a week after the egg retrieval if this will plague me. Some women receive it within hours of the procedure.
I am not terribly worried about this, but if I do receive OHSS, we will have to cancel the embryo transfer and instead do a frozen transfer in a month.

10 July, 2016

Cycle Day Twenty-Four

We had a doctor's appointment today. (Today? On a Sunday?) Yeah, it was today. It makes sense if you think about it. I am dealing with time sensitive things here. If they took the day off, we could miss something.
I felt slightly bad because I had it in my mind that the appointment was at 8:45. 8:28 rolled around and I picked up my phone in time to see a calendar notification. "We need to leave. Now!" And of course the road was closed in front of our clinic so we had a four minute detour.
Today they were able to find 27 follicles. Most of them look like they are growing nicely. The largest follicle is at 19 mm and we have several that range from 16 mm to 18 mm. Because I have only been stimming for eight days, the nurses were unsure if I would trigger today. (They want at least three at or above 18 mm, so if you only look at that qualifier, I would have done my ovulation trigger shot today.) I was pleased with my 27 follicles. From my perusal of the Internet the past couple months, it sounds like doctors can often retrieve more follicles than they can see on the 2D ultrasound scans. Not all the follicles that are retrieved are mature enough to be fertilized, and not all of the eggs that are fertilized make it to the five day mark (a blastocyst). I am hoping that I end up with at least ten embryos that become a blastocyst.
When I was done with the ultrasound, I had my blood drawn with the sweetest phlebotomist. He kept asking me if I was comfortable. It was the most pain free blood draw ever (except for the time they forgot to swab me with rubbing alcohol).
I got the call at around 3:30. Even though I have some good looking follicles (I mean, if the follicles are mine, they definitely would be good looking), my doctor wants to wait at least one more day. We are reducing my gonal-f injection from 175 IU to 75 IU. That's a huge decrease.
Tomorrow I will go in for (probably) my final ultrasound to check on the growth of the follicles. I will most likely do my hcg shot to trigger ovulation tomorrow evening and do the egg retrieval on Wednesday morning. It's weird to think I probably only have four more shots to do for this madness.
In terms of how I feel physically: I feel slightly bloated. (I have 27 growing objects inside me that range from 10-20 mm.) I feel slight twinges in my ovary area, but the feeling is more uncomfortable than painful. I am not supposed to engage in any high impact exercise for a couple weeks. As of a couple days ago, I have not gained any weight. (I keep forgetting to weigh myself in the morning. The last time I weighed myself was at 3:00 in the afternoon and it was less than a pound more than before I started the injections.) My stomach is slightly tender from the injections with slight bruising.

I reported to my father that I had not had good days on Friday and Saturday, so he dropped by with these beautiful roses on Saturday afternoon. He is amazing and extremely supportive.


09 July, 2016

Cycle Day Twenty-Three: Emotions Lately

I have been taking my injections for seven days now. If you're counting along at home, that makes 16 injections. I believe it is safe to say that I have graduated from a beginner to an intermediate drug user. I should make myself a ribbon that proudly claims "Intermediate Drug User," but I think if I wore it in public, mothers would quickly usher their children away from me.
Drug stats lately:
My stomach strangely looks like there have been needles thrust into it. Thankfully, I only have little red dots where the needles have gone in. We switch sides everyday so depending on the day, either the right or left side has dots that are slightly more red than the alternate side. The injections are administered on my stomach, approximately 1-2 inches below or slightly to the side of my belly button.
My emotions were fun yesterday. Husband and I watched the USA women's olympic trials and I randomly started crying. No devastating back story about an athlete was being shown. The tears just decided to start pouring during a floor routine. (It wasn't even a breathtaking showstopper.) It was weird. I am normally an emotional person, but I can always peg what makes me cry.
Today I am going to get an entire week's worth of homework out of the way so that during egg retrieval (or harvest) week, I can be a little more lazy. To offset the unexciting nature of completing assignments about curriculum, I will also be dabbling in the arts by attempting to make an awesome painting. We'll see how it goes.

08 July, 2016

Life

Life. I loved it as a kid. This is not me being a depressed woman on hormones. I'm talking about the game of Life. It was one of my favorite games. We did not own it until I was a bit older (at least I am pretty sure we owned it for a brief stint). When I was young, I can recall going over to a friend's house to play it. It was the best kind of friend's house because I was between two of their girls in age. That automatically gave me two friends.
One of my favorite games they owned was Life. I always had the same habits while I played the game: 1. Get a college degree. 2. Get married. 3. Buy the coolest house I could afford. 4. Rake in as many kids as possible. Try to exceed car slots to require second car.


Number four was crucial. If I could have skipped the first three steps and gone straight to four, I probably would have. Big secret: Sometimes I cheated. I hardly ever cheated in games as a child, but I would cheat as often as possible in the game of Life. Not to get more money. Not to get a better career. I cheated by trying to change the number I received on the spinner to land on more baby squares. At the end of the game when the total was calculated, I was perfectly happy losing as long as I had a decent number of peg children. I considered myself the winner if I had the most kids.
I haven't played the board game of Life in years. Now I'm in the middle of the real deal. Numbers one and two on my list for success are checked off. Number three will come someday. I just need to land on the baby squares and start filling up my plastic car with peg babies.

I have been pretty lucky in terms of insensitive people asking unintelligent questions. My students and nieces/nephews occasionally ask when I will start having kids. I usually give them a little hug and tell them I don't know. Then they run off and forget they ever asked.
I do not get offended if someone asks if I have children unless there is a follow-up question. I'm sure that I have had a few questions of those types, but I usually put them out of my mind. Two of the worst stories remain. One is kept private because it happened at school with one of my student's moms. The other one is your regular run of the mill insensitivity story.
I was visiting a lady in my neighborhood with another woman. Small talk ensued. The kid question came up. Nope. No kids.
"Oh, you just don't want them yet?" Punch to the gut. I'd just had my first miscarriage. I was still bleeding from my first miscarriage. I always think of many answers to the dimwitted questions. I consistently answer with the one that gets me in the least amount of trouble.

No matter how long or short someone has been married (or in a relationship), never follow the kid question with anything else.
You don't know their story.

Cycle Day Twenty Two: Ultrasound

I have mucho to write about today. Yesterday was a bad day because I had my class and I worked on school stuff, but I am ready to dish right now.
Yesterday we talked to our Endocrinologist. We asked her several questions such as:
Q: Because we are using frozen sperm (that we banked back before radiation for cancer treatment), do we need a backup?
A: Nope. The frozen sample is just fine.
Q: If we move across the country eventually, would we be able to have our embryos shipped to another clinic?
A: Definitely. Some people keep coming back to Utah to have the transfer, but we can definitely move embryos across country. (Overseas is a little more complicated though.) Some people get nervous because of the minuscule possibility that there will be a fault in the transfer and the embryos will be ruined, but she has never heard of that happening.
Q: What is the shelf life of frozen embryos?
A: Just about as long as we would want to have them frozen.
Q: If this IVF cycle fails, how soon could we begin again?
A: As soon as my period starts, we can begin another round.
Q: Should we try one or two embryos?
A: This one is a little more complicated. I do not want to be the next octamom and transplant twelve embryos. (Shortly before my mother passed away, I asked her if she would have rather had all eight of her kids at the same time instead of over a span of 15 years. I believe she rolled her eyes at me. Granted, this was when verbal communication was getting hard for her to do.) Our endocrinologist prefers to only transfer one. She said she will let couples do two if they are set on that number, but she would much rather transfer one. Here are our odds: 60% chance of becoming pregnant with one embryo transferred. 2% chance of having twins. 70% chance of becoming pregnant with two embryos transferred. 50% chance of having twins.
That was the end of our conversation. She did chat with me for a few minutes about our trip to Europe and how awesome it was. She really is a great doctor.
After the phone call, I had a slight meltdown (husband would claim it was more than slight) about the 60% she gave us. If one of my students had a 60%, they would fail. 60% sounds like basically 50/50 to me. I do not like those odds. I do not think we will make a final decision about that until we get closer to transfer day.
Today I had an ultrasound. Every follicle was measured on both sides (at least all that they could see). Our largest follicle is 19 mm. That is pretty big. The average woman ovulates when her follicle reaches 18 mm. I also have four follicles at 14 mm. I will do an hcg shot to trigger ovulation when at least 3 follicles are over 18 mm. The original estimated date for the "harvest" was this upcoming Thursday, but our nurse today thought it may happen as soon as Tuesday.
She measured 22 follicles today, most of them growing at a pretty steady rate. She said we looked great. I go back in on Sunday for more blood work and another ultrasound to see how close we are. If it is decided that they are not quite ready by Sunday, I will go in daily until it is time.
Because I do have a follicle over 18 mm, I added another shot to my daily routine. I now get to take Ganirelix (pictured below). Ganirelix is a "follicle glue." It prevents me from ovulating until I take a trigger shot. I am used to the daily fun of Gonal-f and Menopur, but Ganirelix is different. As soon as the needle hit my stomach, I felt an uncomfortable stinging sensation. (As opposed to a comfortable one?) It stung for a few hours and it has made my stomach slightly more tender, but not too bad.
I do feel slight discomfort in my uterine area. Something about growing 22 follicles that are around 14 mm. That's huge.


In other news, husband and I discovered something delicious. We froze half a watermelon and then stuck it in the blender along with some water, lemon juice, and a touch of sugar. It is extraordinary.


06 July, 2016

Cycle Day Twenty

Meandering thoughts:
My collection of used drug paraphernalia is starting to become impressive. This does not include all the needles that have been used.


Tomorrow we get to have a phone consultation with our reproductive endocrinologist to discuss some questions with her. She really is an awesome doctor. I wish that she could be my obstetrician throughout pregnancy. We are slightly unsure where to go once everything works and I become pregnant. The original midwife group I went to impressed us at the beginning, through the first couple of miscarriages, but once we started infertility testing with them, they fell flat. The particular midwife we worked with called us over a week after receiving my test results and did not give the best information about the drugs she prescribed.

I had my exit interview for my Master's degree this morning. I think it went well. I wanted to continue to discuss the questions presented, but my interviewer seemed to have a time limit and the questions ended sooner than I thought they would.

Husband has been great with the distractions lately. I feel as though I have not been too crazy/emotional since starting the drugs, but occasionally something sets me off. A few days ago, we were driving home from visiting my father, and I decided I wanted to take a long way home. So we drove to the local lake. We live less than a mile away from the lake, but this is the closest husband has ever been. I used to go boating with friends when I was younger. We left after approximately four minutes because we became immediate bait for the local mosquitoes.



Today's big distraction was milkshakes! (His idea and want, not mine.) We were introduced to a cute little diner, thirty minutes north, by my little sister. She helped develop a brownie mix for their restaurant so last summer the three of us went by for shakes and fries. We were impressed enough to drop by again today.

05 July, 2016

Cycle Day Nineteen: Blood Work

We successfully did day three of injections this morning. We had a rough time with the syringes today. It was the first morning that blood came from the injection area. We felt slightly rushed to get it done on our way to have my blood drawn. They called immediately before my class to tell me the results.
My levels are higher than they want right now. I get to reduce my Gonal-f level from 225 to 175. It was a little funky at first. The nurse thought I was taking a different level of drugs than I am so they had to adjust the amount they now want me to take.
I go in again on Friday for blood work and an ultrasound so that I can look at the growing follicles and get excited!

03 July, 2016

Cycle Day Sixteen: First Injections

Today was the big day. Today I started something I have been dreading ever since I realized we would have to go the IVF route. I received two injections of hormones. They are slightly different in how I get to prepare them and then inject them. Shall we take a look?
First off, I had Gonal-f. Gonal-f is a drug that contains FSH. It basically helps my eggs grow and mature. I receive a dosage of 225 IU (International Units). Upon random observance on the web, it sounds like this is a slightly high dose for a beginner (most start at around 150), but I have full confidence in my endocrinologist.
Here's what my drug package looked like once I tore it open:

Yeah, since each box only contains a dose of 550, I only need two of those syringes, but I am hoping I can just use the rest for the heparin I get to start administering soon. Gonal-f was by far the most expensive drug, costing a third of the entire drug bill.


I needed three main objects today: the fluid, the powder, and a syringe. The fluid is already in a syringe that I easily stuck through the rubber stopper at the top of the powder container. Upon injecting the fluid, the powder dissolved almost immediately. (Dissolved is a science word I get to teach my kids in my matter unit. I probably should not use my specific example with needles when I teach them next year.)


After the fluid was ready to go, I stuck in one of the smaller syringes and withdrew 225 IU. Because it contains 550 IU, I use the same bottle for two days in a row. I have to be careful with the Gonal-f because the same needle that goes through the rubber also goes through my skin. Because it goes through the rubber, the needle is slightly dulled and husband remarked later that the Gonal-f took a little more pressure to insert into my belly. (I also heard from a nurse that sometimes the needle gets bent so you have to work with that as you inject yourself.)
Because I had heard from one of my nurses that the Gonal-f stings a little, she instructed me to pinch my stomach as hard as I could to get my mind off the pain of the needle. When  injection time arrived, I could not get a good grip on my belly. Instead of grabbing a good chunk of fat, I pinched the surrounding area with my fingernails instead. It worked. I hardly felt the needle go in.

The other injection I will do in conjunction with the Gonal-f is Menopur. Menopur stimulates the ovaries to produce eggs. For Menopur injections, I need my syringe (no needle attached), needle, plastic screw cap, powder bottle, and liquid bottle. The Menopur is nice because I do not have to stick the injection needle into anything other than my flesh.


The order of events for Menopur is extremely similar to Gonal-f. I first screwed the screw top onto the syringe and then stabbed it into the fluid bottle. After I pulled up 1 ml of liquid, I withdrew and inserted it into the powder bottle. Once everything was dissolved, I pull everything up with the syringe again. Then I twist off the screw top lid and replace it with the needle. I get to flick the syringe with the needle pointed up until all the air bubbles have risen to the top just like they do in medical shows, so you know I am legit.
Upon doing both injections, husband said that the first one was harder to get in, but the second concoction almost felt thicker because it took longer to inject.
We did the injections immediately before going to church and half an hour into the first meeting, I realized with a jolt that I had forgotten to refrigerate the Gonal-f. Yikes. We rushed home to save the rest of the medicine.

One day of injections down, nine to go. I go in on Tuesday for blood work to make sure everything is working.

02 July, 2016

Cycle Day Fifteen

This morning, I finally skimmed through the plethora of pages the pharmacy sent me along with the medications. It still has not dawned on me that the injections begin tomorrow. I know that eventually I will have to stab myself with one of the needles. It is nearly impossible to get husband to do it when I need my twice daily Heparin shots every day of my pregnancy. The problem is a psychological one. I cannot inflict self-pain upon myself. As each new phase of IVF commences, I think to myself, "It's really starting now!" I had that thought as I began birth control and during the water ultrasound. I also thought that yesterday as we did the baseline ultrasound and paid the clinic enough money to buy a decent car or an extremely luxurious vacation.
Tomorrow, I think I will start to believe myself when I think, "It's really starting now!" as I pinch the injection sight hard enough to diminish the stinging of the needle my husband stabs me with.

And now, for your viewing delight, here is what IVF looks like. Husband sent me this link a few days ago. It is a pretty cool depiction of what most "normal" couples go through and then what we get to go through.




01 July, 2016

Cycle Day Fourteen: Baseline Ultrasound

This morning I had my baseline ultrasound and initial blood work. My favorite technician did the ultrasound. She checked the lining and the number of follicles on each side. This shows how many eggs we can probably get to grow. There were 14 on one side and 11 on the other. It's pretty awesome. They want a minimum of 10 total so I have 2.5 times more than that. Sweet.
They drew blood and just called with the results. They said that everything looks great so I get to start the drugs in two days. I go in for more blood work on Monday to make sure the injections are doing what they should be doing. Also today, they had weird fuzzy covers on the stirrups. We were very entertained when we saw them pulled out.

Today I also had a very serendipitous call from my dentist's office. I had not been in to see the dentist in ten months. It is slightly embarrassing. They thankfully had an opening for a cleaning today and I crossed my fingers the entire time that they would not find a cavity. It's not that having a cavity would be the end of the world, but they would get the option of having me come in either while on heavy IVF drugs or on heparin. No cavities.
Three medical visits in one week. Woot.