Friday, April 30, 2010

Monitoring Appointment #1

Sorry I'm late sharing the results from my first monitoring appointment - it was a very full day! But the first appointment isn't too exciting, anyway, so I didn't think anybody was waiting anxiously. :)

  • After two nights of stims, I had no follicles at or above 10mm (one at 7mm). Since it's still really early, this is perfectly fine according to my RE. From what I have read on the message boards, many people don't have much growth after 4 nights of stims, so I feel "normal."
  • This "normal" feeling contrasts with IVF #1, where after 2 nights of stims I already had two follicles at 10mm and 11mm. I'm no RE, but this seemed really fast to me and these two follicles became the lead follicles that were way ahead of the rest.... and really stressed me out. So maybe I'll feel stressed later over lack of growth, but for today I am actually really happy that no follicles are taking over and jumping ahead of the rest.
  • I started at 225ius of Follistim, which is the same as IVF #1. But unlike last time, he is lowering my dose earlier and I've already dropped to 175ius. Again, I'm no RE, but this sounded good to me...like I'll be slow cooking some similar sized follicles rather than growing a couple super fast.
  • The RE and the nurse both apologized for the misunderstanding about my initial dose of Follistim at my last appointment. I also found out they were very understaffed for a couple days this week, and my usual nurse is visiting family in the UK for 3 weeks. This helped me to see it was probably just a bad and busy day for them, and extend some grace about that difficult appointment.
  • It was a beautiful day, and as I drove alongside the ocean the sun glimmered across the top of the water. They played a whole bunch of my favorite songs on the radio, and while I was driving home DH called me to say what a great day he was having at work. I felt like God gifted me with a good appointment and happy day, even down to the songs on the radio. :)
Until this monitoring appointment, I felt like I was really struggling to hope this cycle. That I wanted this IVF to work so much, but I didn't feel like it would. And the bad baseline appointment only furthered that - I just felt discouraged. But this one "good" appointment turned that around for me. On some level I hate that my emotions are so dependent on how each monitoring appointment goes, and as I write this I know logically I could be very down in a few days if the appointment doesn't seem to go well. But, I hope and pray that God gave me the day to jump start the hope in my heart and use it to carry me through this cycle.

Wednesday, April 28, 2010

Starting stims tonight

My baseline appointment went fine in the sense that everything looks good to go...but I had an incredibly frustrating appointment today.

I have been with my current RE for 3 IUI's and 1 IVF and have nearly ALWAYS been happy with him and his staff, but today he said some things that made me feel like he didn't even look at my chart. As he was doing the ultrasound he said I needed a saline ultrasound, but I reminded him that I had one 3 weeks ago. He then asked if we had discussed having the fibroid removed? Because IVF is such an expensive and big procedure we want everything to be optimal. Nooo....you never said that before. I reminded him that he had said the fibroid was not protruding into the uterine cavity, and that at the saline ultrasound he had said he had no concerns whatsoever with the fibroid. He said he would review that ultrasound but he agrees that it doesn't look like it would interfere with implantation. This doesn't really ease my mind as we start IVF #2. However, he has said TWICE that the fibroid I have is not in the uterine cavity, AND my ob/gyn (who removed the other fibroid) AND my old RE said this one is not a concern. So I'm just trusting all of that and moving forward...

Then the nurse told me I was going to be on 425ius of Follistim (!), and she couldn't tell me why when I asked. She tried to *guess* the RE's reasoning right in front of me - it was so clear she didn't know my case or the answer. I also found out she ordered me a whole bunch of Menopur but I may not use any this cycle. I left the office so frustrated. Anyone else have days like this with their RE?

Anyway, I called the RE directly on the drive home to understand my dosage (I was only on 225 last time and we're only attempting to fertilize *3* eggs here...). The nurse called me back and said she had misunderstood the RE's instructions and I was right to question the high dose. So I'm starting 225ius of Follistim tonight.

Whew. My "one day at a time" motto for this cycle is already being tested! At least I had a lot of opportunities to pray and give these fears and frustrations to God. :)

Tuesday, April 27, 2010

Cycle day 1 of IVF #2

Eeek! It's here. IVF #2 is starting. I *could* be pregnant in less than a month. Dare I hope? Eeek!

Baseline ultrasound and bloodwork tomorrow. If I have no cysts and my estrogen looks good, I should be starting stims tomorrow or the day after.

I'm hoping I will be more relaxed about the cycle since I know what to expect. However, I'm also nervous that the heartache of IVF #1's BFN will tempt me to fear and worry more. I'll just have to trust God one day at a time...

Monday, April 26, 2010

Contagious hope

I have shared many times before just how blessed we are through the support of some friends and family in this challenging season of life. We are so utterly amazed at the tremendous care we have received and humbled by the love we had been shown.

On Thursday of last week we were more amazed, more humbled, and even more thankful than we ever thought possible through the love of some friends.

I received a birthday card from friends with a check for a large amount of money. Although all of this was under the guise of a "birthday card and gift," it was really just an excuse to shower us with love as we walk this infertile road the Lord has set us on.

I read the card before I unfolded the check, and the words of the card alone made me weep beautiful, deep tears. To see how they feel this pain with us, how much they hope for us, and how great their own desire is for us to have a child was profound.

The card ended with this: "We wish this road was easier for you, but we look forward to thanking God with you." As I sat back and cried, I imagined that day of rejoicing with these dear sweet friends and celebrating that God had answered our prayers (collectively) and given us our long awaited child. Oh, what a day that will be! And it will come. One way or another I knew as I read that line that we will celebrate with them, and that the Lord will turn our mourning into dancing.

Our friends' hope for us was contagious to my own heart. What a gift as we start IVF #2.

And the money...wow. DH & I wrote them thank you cards over the weekend, and do you know how difficult it is to communicate just how deeply grateful you are for a gift that exceeds any reasonable expectation of a gift, and that you are in no way deserving of or entitled to? That is exactly how we felt, and we spent some time prayerfully considering if we could even accept the money. Ultimately we have chosen to do so, and are amazed that they are even sharing the financial risk of infertility treatments with us. They are truly living life with us on so many levels.

I hope and pray God is teaching me through the love of others in my life how to really and truly love others who are hurting. Experiencing moments like receiving this card have been a gift that I would never have received had it not been for infertility. I had never experienced the profound ways the family of God can live life together in all its up and downs...until I hurt deeply myself. Thank you, Lord.

Friday, April 23, 2010

Getting ready

Prior to our wedding, I was in my first year of teaching and working full time. I got this job after the school year had started, so we had already planned our wedding for a week before this particular school got out for the summer. I cleared it with my principal when I accepted to job that I would take the last week of school off, but return for the last day of school. That year of teaching was really, really difficult (and is mostly why I am no longer teaching). I cried everyday.

Meanwhile, I was wedding planning. I loved planning our wedding, and while it definitely required a lot of work, I never felt overtly stressed about it. And as the wedding approached I just felt busy and excited. I had to teach until the Thursday before the wedding (while still crying), prepare sub plans, and do all the last minute wedding details. It was a crazy week but I was just so excited I made it through.

Our wedding day was the happiest day of my life so far. :) As we drove away from our reception at 4:00pm, I anticipated a 2 hour drive of talking, laughing, and reflecting on the day. However, much to my surprise I immediately fell asleep. Poor DH. I slept the whole drive.

Every time we got in our car to drive anywhere more than 10 minutes during those 5 days, I fell asleep. To this day DH still laughs about it because I am NOT typically one who falls asleep easily or just anywhere. But we joke that I slept half of our honeymoon.

I think that was how the stress of that year manifested itself - I was finally able to relax and out of my emotional an physical exhaustion all I could do was sleep.

****

I am trying to prepare myself emotionally & mentally for IVF #2, but how does one actually do that? Honestly I think I still feel rather numb. I told this to a friend earlier in the week and she suggested it may be a blessing from the Lord that I can just continue to move forward and the numbness may be blocking some fear and worry. I like that idea. :) Another part of me wonders if I should be "processing" more, but I don't know how to just "do" that. I just keep praying!

I wonder if there will be some point of release for all of this, much like our honeymoon was after that difficult year. Sometimes I can only see these kinds of things in hindsight.

****

I just spoke with a nurse at the RE's. I haven't gotten "the calendar" for the new cycle and I needed some info. I also decided to go ahead and order the meds. I expect AF to arrive in less than a week, and she said that I will NOT be on birth control pills. So I expect to start stimming next week if all goes well at the baseline appointment!

One thing that was odd to me when I told her I wanted to order the meds was that she asked me how much Follistim I wanted to order. I didn't even know what my dose would be, and even when she told me it was hard to figure that out in my head on the spot. Eventually I just ordered a 900iu cartridge and figured I would re-order more as needed....but there's no point in having too much of that expensive liquid gold (and I still have 300ius left from last cycle).

Oh, and DH & I decided last night not to freeze eggs. Thank you all so much for weighing in on that! Ultimately we felt like if we had insurance money for {any} part of our IVF cycle, we would jump at the chance. But since it would be our money taking the risk, we decided not to. My heart was a little sad once we made this decision because the thought of having frozen eggs gave me some extra peace of mind, but the practical side of me thinks this is a wise decision for us. And now I have to rely on the Lord and trust him without having any frozen eggs to "lean on." Not that anyone who does have frozen eggs would be trusting those and not God, but I'm just saying this would have been a temptation for me....and it has been removed. So, God, I am trusting you with this cycle and whatever lies ahead in the future (and can you please let my eggs stay good for awhile??). :)

Tuesday, April 20, 2010

Today was my birthday!

I'm now in the last year of my twenties. It was a great day and I feel very loved. A few weeks ago my in-laws got us a new dining table for my & DH's birthdays. So to celebrate today, DH & I invited some friends over for a "formal dinner." I got to release my inner Martha Stewart. :)

Some photos of my birhday dinner:








Sunday, April 18, 2010

Egg freezing?

As I mentioned in my post about our IVF BFN follow up appointment, one thing we discussed with the RE was the possibility of freezing eggs. We are really undecided about what to do, so I would love any feedback you have.

First of all, a little background you need to know about us: we want to use all embryos that are created through IVF without freezing or discarding any. This means we did a limited fertilization of only 3 eggs in IVF #1, and plan to do the same in IVF #2. You can read more about why we are doing that here if you would like. Just know that this is important to us, so it will be useless to say, "Really, the best bet is to just freeze embryos...." :)

Since we only needed 3 mature eggs, our RE did a "minimal stimulation" cycle for IVF #1. The idea was why spend the extra money for medicine and run the risk of OHSS to retrieve a lot of eggs that would essentially go to"waste." (Although, could somebody with a high FSH (10.9) and moderate AFC (~10) get OHSS?) Anyway, at that time we had asked about egg freezing, but our RE said it is still very experimental and he can't recommend it. I also think we were just really hopeful that IVF #1 would work, so we didn't consider it further.

But as we talked about IVF #2, the idea came up again. Now that I know first hand how much time, money, and emotions go into an IVF cycle, the idea of egg freezing feels like we could "get more bang for our buck" while still operating within our ethical parameters.

Pros for egg freezing:
  • We could freeze eggs for future IVF attempts, whether after 3 failed fresh cycles now or for baby #2 down the road.
  • If they might be used for baby #2, this would be a way of potentially preserving my fertility. My FSH is high, darnit, and I'm only 28 (er...29 on Tuesday). Who knows how high it will be in 2 years?!
  • If we used frozen eggs in the future, the FE(gg)T cycle would be considerably less medicine, stress, and time than a fresh IVF cycle.
  • If we used frozen eggs in the future, the cost of a FE(gg)T cycle would be considerably less than a fresh IVF cycle.
  • My RE has offered to freeze the eggs and store them for 1 year for free.
  • There might even be enough eggs to freeze for more than 1 future cycle (for example, if we got 12 eggs, fertilized 3, and froze 9...that might be enough for 2-3 future attempts).
  • I guess all of this gives me a little extra "peace of mind." It's similar to the feeling of having some cash saved for a rainy day. We would have some eggs ready to go...
Cons for egg freezing:
  • My RE is not recommending it. In his opinion this is still very experimental, and he feels like he can't suggest it to a patient unless he knows through well documented medical studies that there is a reasonable amount of success, and he has not had enough success with it. The technology is not quite there yet.
  • I asked if his clinic has frozen eggs, and he said yes. But of all of the people whose eggs have been frozen, only two have come back to use their eggs....and they were unsuccessful. So a 0/2 track record at this point is not very encouraging.
  • I have read that some clinics are more advanced in this area than others, and it doesn't sound like my clinic is one of the "advanced" ones. My clinic does a high volume of IVF cycles per year and has high success rates, but it just doesn't seem like they moved aggressively into the egg freezing territory. Would it be worth it to try this at a clinic that hasn't done much of it? (But we are very happy at our clinic, and we do not feel like it would be worth it to switch clinics just to do egg freezing).
  • Even though it would be cheaper to do a FE(gg)T cycle and my RE has offered to freeze the eggs for free, there would still be additional costs (obviously). Is it worth it to pay the extra money when the odds of success seem rather low? ~$1,500 for extra medicine to retrieve as many eggs as possible + $2,200 for the FE(egg)T cycle + $650 for the 2nd year of egg storage = $4,350....for a gamble? On something our RE can't even give us our odds of success on? It is over half the price of a fresh cycle, but at least with a fresh cycle we have a 50% chance of success. (But, like I said in the "pro" section, we could *maybe* get more than one cycle's worth of eggs out of one round of egg freezing...which would lower the $4,350 number to maybe $3,000 per attempt).
As you can see, there are a lot of "maybes," but we have no idea how the attempt to freeze eggs would go. We might try to harvest a lot of eggs and still only get a small handful. We may have enough eggs to freeze, but they may not thaw well and we end up with none to use anyway (and I'm sure I would put a lot of hope into those frozen eggs, even if I tried not to). Or we may have some ready for a future FE(gg)T, but none fertilize and we are back to where we started. So many "ifs," just like the rest of dealing with infertility!

Thoughts? I know ultimately my DH & I are the only ones who can make this decision, but do you know anything else about egg freezing? Advice? What would you do if you were in my position?

Wednesday, April 14, 2010

So thankful for good news!

My regular doctor called today with good news: I do not have Hepatitis C!! She said I was exposed to it but am one of the "rare people" who cleared the disease, but that there is nothing to follow up on or worry about. She even sounded surprised (but happy) on the phone.

I am thankful for:
  • A strong immune system
  • Medical technology to test things like this
  • The doctor called with the results much earlier than expected (I thought it would be late next week before she called)
  • I won't potentially infect my baby with this if I am blessed with a pregnancy (a very small chance even if I had the disease, but it is wonderful to not even have to take that small chance)
  • A little good news goes a long way
The only way my life is effected is that I think I am excluded from donating blood. :)

Monday, April 12, 2010

Keeping afloat

I'm doing ok. I really am. I haven't cried since the weekend of the BFN. In fact, the weekend of the BFN was really great...other than the BFN itself. And life has been good, full, and I have felt pretty happy. I have full faith in the promises of the Lord and I know he is with me.

So why is it that despite all of this I barely feel like I am keeping afloat? That although the water is warm and not to deep, I still feel like I am struggling and splashing within it?

I always knew the BFN was a possibility with an IVF cycle - a big possibility, really. And when I had let my mind wander to "what if this ends in a BFN," I had an imagine of my very sad self crying. A lot. And I feared I would perhaps fall into a depression and struggle to get out of it.

But it hasn't really been like that, and emotionally I have been doing ok. But the problem has been in simply living life. I am still doing all of the things I did before, but I find myself lacking any motivation to do them. I don't want to go to work, I don't want to go to the grocery store, I don't want to make dinner, I don't want to do youth ministry events, etc.I can barely even muster the energy to comment on your blogs.

I feel like I need to re-group before starting IVF again, but I don't really know how. I want to start the new cycle with a spring in my step and a prayer of hope in my heart....not just going through the motions.

Thursday, April 8, 2010

RE follow up appointment today

Or, in infertility treatment acronyms, the appropriately titled "WTF appointment." Haha. I actually told DH and a couple friends last night that this is what my internet friends call the appointment, and they thought it was hilarious. So DH said to me this morning as we were driving down, "How do you feel about our WTF (the letters) appointment today?" And then my friend called this afternoon to see how the "WTF" went...both made me laugh out loud!

Anyway, the appointment went really well. The RE pretty much reiterated what he had said to me in the phone call the day after my BFN: he thinks it will happen for us. He said there was nothing in my cycle that he was unhappy about that may have contributed to the BFN....he said it just happens sometimes even when everything looks good on paper. That was definitely reassuring to hear.

The only "new test" he wanted to do was a saline ultrasound to make sure I don't have any fibroids protruding into my uterus and that everything looks good in there. Conveniently it was cycle day 10 so he managed to squeeze me in and get it done today. This was a blessing so I didn't have time to anticipate it, since the last time I had this done it was torture. But today's saline ultrasound was not nearly as bad (although it was still very crampy and I did want to cry briefly), and all was clear in there!! I'm thankful I don't need another surgery or anything like that.

So...we're all set to go once my next cycle starts, which I expect to be in the last week in April. He will probably adjust my medications dosages some, but otherwise we're doing the same protocol. Also, he gave us a $1,200 discount on the cycle! DH & I were both shocked - we didn't ask for anything like that. This is the cost of ICSI at my clinic, and he said that since they often ICSI 10-15 eggs for other patients, he thought they could discount us since we are using ICSI on only 3 eggs. Isn't that amazing?!?

We also talked a lot about the possibility of freezing eggs...but I will have to post more about that later.

I got a little excited again today. :)

Wednesday, April 7, 2010

Non-IF doctor's appointment

I had my pre-screening bloodwork done while stimming for IVF- they actually almost completely forgot to have me do it at all because my cycle started so quickly. (Which, by the way, is pretty ironic considering we did our first IUI without DH's bloodowork....and now we almost did IVF without mine!). Anyway, I didn't think anything of it because I thought it was just an HIV/STD screening thing and I was pretty certain I wouldn't have any of that. I've only had one sexual partner, never did any drugs, and have overall been an old-fashioned "good-girl"....so how could I get anything?

Well, somehow this good-girl has antibodies for Hepatitis C. My RE told me this while I was laying on table before our embryo transfer. He said it would not effect anything with our IVF cycle, trying to conceive, a pregnancy, or baby...but that I need to get it checked out. Since he told me it didn't effect anything that I cared about at the time (ie my embryos and hopefully an upcoming pregnancy), I didn't really think much about it. Plus, I have never been unwell or had any symptoms.

Near the end of my two week wait I did my first Dr. Google search and got a little freaked out. Apparently the vast majority of cases of Hepatitis C are asymptomatic....so I could have it the disease and not know it. It can lead to liver damage and cirrhosis of the liver. Seriously, I might have this?!?

I called my parents to find out if I had ever had a blood transfusion that I didn't know about (they didn't screen for Hep C in blood until 1992, I think). They are 100% certain I never had a blood transfusion that they knew about. BUT, there is the fact that I was born severely premature (at 28 weeks and weighed 2 lbs. 5 ozs....which was very small in 1981) and spent 3 months in the NICU. Obviously, a lot happened in that time that *maybe* my parents forgot about or didn't know about? Or maybe they signed a waiver saying the doctors could perform a blood transfusion if necessary...and they were never explicitly told that I had one? I did read that blood transfusions are fairly common in preemies. So maybe it's that?

Now to make a long story longer....I had an appointment with an internal medicine doctor today. I didn't get much info since I still need additional testing, but got lab slips for bloodwork that will determine whether or not I have the disease. She said about 20% of people will cure themselves of the disease....so, obviously, I am hoping to fall into this group. Although the Wikepedia article said this is actually very rare, but maybe her 20% included people who don't have it severe enough to need treatments?

I clearly don't know much about this, and am trying not to worry until I actually know whether or not this is an issue. It just feels so far out of left field. I'll keep you posted.

PS- In more exciting news, I have my follow-up appointment with the RE tomorrow and am hoping to walk away with a plan for IVF #2!!

Monday, April 5, 2010

Statistics

I saw a survey on a message board I frequent about which IVF cycle resulted in a BFP, and about 50% said it was IVF #1, 30% said IVF #2, and then a decreasing percentage for each subsequent IVF. This makes sense and I knew this fact on some level, but I felt like I got punched in the gut reading it. Like I already missed my "big chance" on IVF #1 and have now moved into the "lower odds" neighborhood.

The feeling is very similar to when we first started TTC. I read that, roughly, 25% of couples conceive the first month of TTC, 40% within the first 3 months, 70% within the first 6 months, and 85% within the first year. With each passing month I felt the likelihood that I would conceive decreased, while the likelihood that I would face infertility increased. I could have still ended up "normal" and pregnant at any point in that year...but the further away I got from the first month the closer I got to being in that feared 15% who are infertile.

And, now, I feel like I am starting a similar game of statistics with IVF, only the stakes are higher. Now it is not just a fear of "what will it take to conceive" with a little "will I ever conceive mixed in," but a full blown realization that I could be facing never having a biological child.

Statistics are such funny things - they are comforting on the front end, but become rather oppressive as you move inside of them. I have to remind myself that God does not always work within statistics (hello, that's a miracle!), but as my mathematical DH said proudly, "God is the creator of statistics!" (He believes that is yet another amazing quality of God). But I don't know which way God will operate with ME and MY LIFE.

And I am so thankful I am not just a statistic to him.

Friday, April 2, 2010

Not quite myself

All week I have felt "off": cranky, easily upset by silly things, and unmotivated. I'm sure it's a combination of the BFN, AF, and a chest cold I came down with. Prior to this March I had not been sick in over a year, but I came down with TWO colds last month (one the first week of stimming and one just after the BFN). I also don't feel very reflective or thoughtful...hence only a few, boring posts this week.

I am so thankful it's Friday...and Good Friday at that. I'm ready to put this week behind me and focus on the blessings I have in front of me. I am praying the Lord would give me a thankful heart as I celebrate the sacrifice he made for me. My IL's are coming up for the weekend and I am very much looking forward to the festivities ahead.

Welcome, happy weekend! He is risen, indeed!