Looking Forward

I've received all of the medication for the Frozen Embryo Transfer.  This is going to be so much easier on my body than all of the medication leading up to the egg retrieval.  Not a single shot.  A lot of the medication I'm taking now, the doctor is recommending that I continue taking throughout the pregnancy.  Fish Oil (for baby brain development), Folic Acid (to prevent neural tube defects), Prenatal Vitamin (makes sure I have the right mix of vitamins in my system), Synthroid (to keep my hormones regulated throughout), and Singulair (because allergies in Colorado are miserable).

The rest of the medications are meant specifically to get my body ready for the embryo transfer.  Estrogen patches (to help make my uterine lining nice and cushy), Aspirin (to increase blood flow prior to the procedure), Doxycycline (to prevent infection from the procedure) and birth control (to get my hormones on track before everything begins).

I have been taking the birth control for a few days and Friday is supposed to be my last dose.  On Friday, I have an ultrasound to make sure that I am completely healed after Ovarian Hyperstimulation Syndrome.  The last ultrasound found that I no longer had fluid in my abdomen, but I still had three small sacs of fluid in my ovaries.  They want to make sure that those are gone before going ahead with the embryo transfer.  If they are gone, then I will be done with birth control on Friday and gearing up for an embryo transfer on Thursday, September 20th.  If they are still there, they are going to keep me on birth control for a few more days, recheck, and then do the transfer on Wednesday, September 26th.

In the weeks leading up to the transfer, I am going to start acupuncture again.  I am also going to do all that I can to decrease stress and increase positivity.  I've decided that this month, I am going to try to do the fun things you're not supposed to do while you're pregnant.  Not everything, though.  I'm not going to light up a cigarette, snort cocaine, or bungee jump (looked into it--too expensive), but I've made a list of some of the things I'm going to try to fit in.   Here it is.  Feel free to let me know if you think of more.  It's already going to be a busy month, but I will try to do as much as I can.

Fun things to do BEFORE pregnancy:
1)  Jump on a trampoline
2)  Get in a sauna or hot tub
3)  Sky diving (it's indoor, but I will still count it)
4)  Horseback Riding
5)  Eat Sushi
6)  Ride Roller Coasters
7)  Clean the litter box (Ryan will love that)
8)  Drink alcohol (not a lot, but I will be down to zero when I'm pregnant)

This weekend, our friends Jim and Christina are coming into town and we're going to do some horseback riding near Garden of the Gods.  Also, I'm going to head over to the Mason's house to hit up their trampoline.  Finally, I'll head over to the gym and soak in the outdoor hot tub on a night that's cool.  Next weekend, we'll cash in some free amusement park tickets we have and get on some roller coasters.  Finally, our anniversary weekend, we're going to go to Denver for some sushi and indoor skydiving.  All of these fun activities will be punctuated with the occasional adult beverage and litter box scooping.  I'm very much looking forward to September.  Hopefully, all the fun will keep my mind off the waiting game and my spirits high.

Dealing with Sadness

I write each of my blog posts sitting in a glider in the corner of the bedroom that we set up as a baby's room when we moved into this home over a year ago.  We thought for certain we would have news of joy very soon after we arrived in Colorado.  Now, this room is a standing reminder of the missing piece in our lives.  I have been having trouble dragging myself to the computer to write over the past week.  Tonight, I just decided to sit down and write whatever thoughts came into my head.

If everything had gone according to plan with our first IVF cycle, we would have been finding out whether or not we were expecting a child this Friday.  It is strange to think that only two short weeks ago, I was filled with so much hope and happiness about the whole process.  Since the transfer was cancelled, so many things have brought me sadness.  I have had to avoid Facebook, because each time I log on I am bombarded with baby pictures, birth announcements, pregnancy bump updates and stories about children.  I used to be so extremely happy for everyone, but now I can hardly keep tears away.

It makes me feel so guilty that I am so wrapped up in my own sorrow that I can't even feel joy for others.  I have never been this way.  I have always been a supporter and a lover of other people; in the past, I considered this one of my best qualities.  I don't even feel like myself these days because I have lost that.

As we proceed with the Frozen Embryo Transfer, I feel emotionally empty.  I am afraid to be hopeful.  After everything that we have been through so far, all that has happened is that I have had to recover from an illness, I have an empty bank account, no vacation days left at work, and I am 10 pounds heavier.  We haven't even had a chance at creating a family yet.  I don't think I have ever hurt so much in my entire life.

Two days ago, I started birth control to regulate my hormones in preparation for the next phase of IVF.  The good news is, that prior to the Frozen Embryo Transfer, there are no shots.  The only goal this month is to create an environment that is perfect for growing a baby.  This means that I will be taking medication to help create an ideal uterine lining for the embryos to implant into.  This also means that I am going to have to figure out how to get my emotions under control.  I need to find a way to get rid of all of the negative thoughts and surround myself with positivity over the coming weeks.

One thing that made me very happy this past week was shopping for a gift for my nephew's 6th birthday.  I am sad that being away from Kentucky is causing me to miss so many milestones for my nieces and nephews, but when I go back it will make being with them that much more special.

The picture we sent with our nephew's gift.  

Embryo Update

Over the past few days, I've been receiving daily phone calls about the progress of our embryos.  Each day, I waited on pins and needles for the report and, even though I knew they couldn't all have stayed near perfect, I was still extremely disappointed whenever I heard one was struggling.

After investing so much in the egg development, I found myself extremely emotionally attached to the growing embryos.  I would cheer for them, pray for them, and each time we lost one my heart would break a little.  Unfortunately, as is the nature of this sort of thing, time showed clearly which were strong, which were weak, and which were irreparably flawed.

When the growth period ended and the dust finally settled, we were left with only 6 embryos that were of high enough quality to freeze.  Of those, 2 were Grade A blastocysts, 3 were Grade B blastocysts, and one was still in the morula stage.  When the cells become blastocysts, they have two distinct cell types that become baby and placenta.  Grade A blastocysts are the best that you can transfer.

Day 5 Morula

Day 5 Blastocyst

A study conducted by the Advanced Fertility Center of Chicago found that in women under age 35 who had blastocysts transferred, 69.4% resulted in a live birth for each embryo transferred.  These statistics are very encouraging to me.  Now that we have only six embryos, we need this to work.  We don't have a lot of chances.  Because we are going to try transferring two embryos, that will leave us with only three chances total to get a baby of our own.  After all the expense and the heartache that goes into this process, I'm not up for repeating the whole thing again.  As far as we're concerned, if these transfers don't work, we will have to make the decision between adopting a child or having our family be complete as it is.

I have to admit that after beginning with so many eggs that I suffered from OHSS, to end up with only 6 embryos is extremely disheartening.  I feel like I've been through so much and I've been given such positive feedback that I genuinely expected better results.  It also hammers in the notion that if it is this difficult for us to make a baby with assisted reproductive technology, our chances of having a baby without it are likely as grim as they told us.  That is a difficult fact to accept.

During today's phone call, they told me that the transfer would be scheduled for September 26th.  That seems such a far distance away.  It would be nice to know now what the next step for us would be; whether heartfelt discussion or preparing for our new love.  I'm pretty sure with all of this, the waiting is the hardest part.

Excellent Embryos

As I sit here writing this post, our future child (or children) is sitting in a petri dish across town dividing like crazy.  On Tuesday, the doctor was able to remove 19 eggs from my ovaries.  Of these, 18 were mature and one was overly mature (too old to fertilize).  The embryologist fertilized the 18 good eggs using a process called Intracytoplasmic Sperm Injection (ICSI).  Traditional IVF put several sperm in a petri dish with each egg and let them fertilize at will.  For ICSI, they hand pick individual sperm, remove the tails, and directly inject them into the egg.  This is ideal in circumstances when the sperm is not very strong.  At our clinic, they do it for every single patient because it is more predictable.

Beginning with 18 eggs, only 11 fertilized normally.  Unfortunately, this is a testimony to the overall quality of the sperm used.  However, today, all 11 of the 11 that fertilized are not just alive, but thriving.    Dr. Magarelli informed us at our appointment this morning that 6 of the embyos are Grade A and 5 were Grade B.  He said, and I quote, "You really couldn't have hoped for better."  

The grading system works as follows:

Grade A:  Even, equally sized spherical cells with no cellular fragmentation that are viable.

Grade B:  Embryos have uneven or irregularly shaped blastomeres, less than 10% fragmentation and are viable.

Grade C:  Embryos have up to 25% fragmentation, may be viable.

Grade D:  Embryos have 25-50% fragmentation, may be viable.

Grade E:  Embryos are considered non-viable with lysed, contracted, or dark blastomeres.

When it comes to embryo transfer, both Grade A and B are transferred with a high rate of success.  Grade C may be transferred, but has a much lower rate of success.  Grade D and Grade E are not typically used for transfer.  So, basically, we have 11 excellent embryos.  Yay!  My biggest concern with doing a Frozen Embryo Transfer (FET) was that we wouldn't have any embryos that were high enough quality to freeze.  So far, it looks like that is not going to be the case.  They will continue to watch the embryos divide until Sunday, then freeze all of the remaining ones that are viable.  By day five, ideally they will be blastocysts and will be ready to implant into the uterine wall.  Here is a little diagram of what they should look like over their five day development with the first picture being day 0 (egg retrieval day):

They did an ultrasound at today's appointment and found that I still have some fluid in my abdomen from the Ovarian Hyperstimulation Syndrome (OHSS).  When Dr. Magarelli walked in he said, "I really wish you felt terrible so you'd believe me when I tell you that it's not safe to proceed.  You probably think I'm just being overly cautious because you feel so good."  He's right.  It's hard to understand why I can't just move on when I feel good.  But, at least with the ultrasound I could see the fluid that wasn't supposed to be there.  

They told me that I should recover completely by the time my next menstrual cycle begins.  Also, they told me that they would be able to do the FET at the end of September!  That's only a month or so away.  I know that my doctor is trying to protect my well-being, and I appreciate that.  However, it is a little unnerving to tack a month onto the process and to shell out more money for the FET.  I feel good about things after today, though.  I was starting to feel my little flame of hope flickering out, and now it's back.  We may get to have a child of our own after all.  

Cancelled.

Yesterday morning, I went into the doctor for my egg retrieval procedure.  I was so relieved to have the eggs taken out and some of the bloating and discomfort relieved.  When we arrived, they took my vital signs and placed the most painful IV ever into the back of my left hand.  The nurse who ran the IV was on her 2nd day.  Yay!  Love feeling like a guinea pig.  As she placed the IV needle, blood got absolutely everywhere.  I thought Ryan was going to pass out as he watched.  Honestly, I'm not sure how I held still as it was going in.  Today, there is a huge bruise on the back side of my hand and I believe it is the most painful side effect I have remaining from the surgery.

After they placed the IV, I was given Doxycycline which stung like crazy as it was going through the skin.  Finally, the nurse anesthetist came in to talk to me a little about the procedure.  He asked what was wrong and I told him that the medication was stinging, so he adjusted a few valves to dilute it and I could no longer feel it going in.  Where was he five minutes before?  Goodness.  Anyhow, we talked just a little about the anesthesia, then he went back to the treatment room to get ready for the procedure.

The last person to make an appearance was the embryologist.  She came to discuss her part of the procedure.  After the eggs are removed, it is her job to fertilize them and keep the embryos safe while they grow and divide.  She proceeded to tell me that because my estrogen levels were so high (8200), they would likely have to freeze all of the embryos at the five day mark.  What?  ALL of the embryos?  I told her that this was the first time I was informed about this.  She seemed a little confused about that, like she had expected me to know already.  As far as I knew, everything was going along swimmingly and I was going to have the embryos transferred back in on Friday or Sunday.  Not so much.  

After that, I moved down the hallway to the treatment room with a heavy heart, trying to push back tears the whole way.  I was then sedated and the eggs were removed.  As I was waking from the anesthesia, I heard Dr. Magarelli say something about fluid, lining, and freezing.  That's when I knew for sure that any hope of getting pregnant this month was lost.  

Turns out, I have mild Ovarian Hyperstimulation Syndrome (OHSS) which is when the estrogen levels in the body are very high and it causes fluids to leak from the ovaries into the abdominal cavity.  This also effects the quality of the uterine lining, making it a less than ideal place for an embryo to implant.  Not to mention, OHSS is exacerbated by a pregnancy and if you get pregnant, you can end up hospitalized as a result.  

They were able to retrieve 19 eggs, but we don't know yet how many were mature and how many fertilized.  That sounds like a good number, but they have to be extremely high quality in order to be frozen as embryos and survive the thaw at the other side.  If you do a fresh cycle, you have the option of putting in average quality embryos and having them be successful.  Frozen Embryo Transfer (FET) takes away this option.  The good news is, if you have embryos that are tough enough to make it to FET, your chances of success are very high.  But now, there's no room for error.  We have to pray hard that the embryos grow strong and make it to the freezer.  

So where does this leave things for Ryan and I?  At this point, I just have to recover from the soreness of the egg retrieval, continue taking the Lupron shot (so much for being done with injections), and drink tons of fluid to help keep OHSS from rearing it's ugly head.  At this point, I am fortunate that I do not really have any symptoms.  However, now I have to wait until I complete two natural menstrual cycles before we can attempt the Frozen Embryo Transfer.  So, we're looking at October.  That's assuming we have quality embryos to proceed with.  

This afternoon I will get a fertilization report that lets us know how many eggs were mature and how many fertilized.  Tomorrow, I go in for a follow-up appointment to make sure that I am recovering appropriately from the procedure and to discuss our next moves.  Needless to say, I am super nervous about this afternoon's phone call from the embryologist.  Just hoping for good news.  

Egg Retrieval Day

In a couple of hours, I leave for the egg retrieval.  Today they will put me under IV sedation, place a catheter with a small needle on the end into my ovaries and remove all of the eggs from each follicle that I have been taking medication to grow for the past few weeks.  Each follicle that I've developed should have one egg in it.  At last count (on Saturday), I had 23-25 follicles total.  In theory, that means that they would retrieve that many eggs.  However, not all of the eggs will be fully mature and usable for the IVF process.  In fact, some may have matured too much to be usable for fertilization.

After the procedure today, I will be told the number of eggs that they were able to get, but not the quality.  They won't know that until they get them into the embryology lab.  Also, they will fertilize the eggs today with my husband's sperm to create embryos.  Tomorrow, we will find out what the quality of the eggs was and how many fertilized.  Then, we wait and watch them to see which develop the best and, after three or five days, they will put them back in.

There has been a lot of "hurry up and wait" in this process.  I've been pushing through the medication and injections now for weeks in preparation for the egg retrieval.  Now that it's here, I'm extremely nervous about it.  On top of general nervousness for undergoing a surgical procedure, I worry that the results won't be exactly what we wanted.  We could get bad news at any juncture.  We could end up with very few eggs, we could get lots of eggs, but very few of them be mature, we could get good quality eggs and have very few or none fertilize, they may not grow healthy and strong after they are fertilized, they may decide not to implant after they are put back inside me, and, probably most heartbreaking of all, everything could go right and then a miscarriage could happen in the future.  I'm not trying to be a negative Nancy, but I'd be a liar if I didn't admit that these concerns are going through my head.

At this point, I would say that I am cautiously optimistic.  So far, almost everything has gone according to plan.  I've done everything that I am supposed to do and have responded very well to the medications.  Also, in our circumstance, the infertility appears to be male factor rather than female.  This also gives us a good prognosis for the procedure.  All we can do at this point is wait and pray.

I am a firm believer in the "everything happens for a reason" philosophy.  If this doesn't work for us, there is a reason for that.  Maybe it wasn't our time and we will have our own child in the future, or maybe there is another child out there in the world that is meant to be ours.  We will know what the reason is in time.  But I do know some of the reasons why we are going through this process.  Since we've opened up about our situation, we have learned of so many others that are struggling with infertility.  We have been able to be sounding boards and guides for those people and it is a blessing that we have been able to fill those roles.

Another thing that this process has allowed us to do is to be firm on our decision to have a family together.  This is more for me than Ryan; he always wanted children.  In fact, when I first met him he told me he wanted four and I almost broke it off on the spot.  For many years, I was convinced that I wanted my career and my freedom over a family of my own.  I wasn't interested in marriage unless I could find someone who, without a shadow of a doubt, was exactly who I wanted to marry.  I dated many kind, wonderful people and did not want to marry them, so I assumed for a long time I wouldn't even get married.  Then I met Ryan and everything changed.  Not only did I find myself wanting to make a life with him, but, eventually, I wanted nothing more than to raise a family with him.

I assumed that creating a family would be the easy fun part.  Not so much.  But, as we fight for a family of our own, I realize how important it has become to me.  I am solid in my resolve.  This is very good for me. I know that if a child had been thrust upon me, I would have had trouble accepting it as what I really wanted out of life.  Now I know that it is what I want, and when we have a family, it will be so much sweeter.

Pulling the Trigger

A ton has happened since I last posted.  I had blood work and ultrasound appointments on both Friday and Saturday.  You know it's getting close when they make you come in everyday.  As you know, they had just decreased my dosages of medication to make sure things didn't progress too quickly.  Unfortunately, that slowed things down so much that it pushed back the schedule.  On Friday, my estrogen level was 2, 470 which is not quite double what it was on Wednesday.  (Double is the mark they are trying to hit every 48 hours.)  At the Friday appointment, the nurse let me know that they would probably have me taking stimulation medications for a few days longer than they originally thought.

Being the planner that I am, hearing that we were deviating from the initial plan really upset me.  Having unnatural quantities of hormones floating in my body also probably contributed to my overreaction.  I basically pouted the whole way home, but that wasn't the bad part.  My first official IVF meltdown came that night when I was giving myself the "big" shot.  As per usual, it hurt as I was starting to put in the needle, so I proceeded to pull out the needle, kick my flip flops to the ceiling, yell a few choice profanities, and heave the needle across the kitchen.  After that, I melted into a puddle of tears.

I think what upset me the most is that I had originally thought I only had one more day of shots left and then was told that I had to keep doing this for an undetermined amount of days.  There was no light at the end of the tunnel anymore.  They shut it out.  Lame.  I did eventually scrape myself off of the kitchen floor, pull down my big girl panties, and give myself the shot.  But all of the accolades I had given myself thus far about keeping my cool through the process melted into oblivion.

The next morning, I went back in for my blood work and ultrasound and was given the same vague "a few more days" answer when I asked about the schedule.  Not only that, but they added another shot to my daily routine.  Yes, that's right, more shots.  Ugh.  Fortunately, that afternoon when they called to tell me the results of my blood work, they also told me that Sunday night (that's tonight) I was to take the "trigger" shot.

The trigger shot is taken exactly 36 hours prior to the egg retrieval.  That means that the end is in sight.  Finally.  I'm so tired of being bloated and feeling full all of the time.  I'm ready to get these eggs out.  Basically, the shot triggers the oocytes to go through final maturation to prepare them for retrieval.  I am scheduled to take the shot at 11:00 pm Mountain time.  This is the last and largest shot of them all.  I've made it!!!

I go in tomorrow morning for blood work to make sure the shot took properly, then I go in at 9:15 on Tuesday morning for my egg retrieval.  After that, they fertilize the eggs and we watch the embryos grow until it's time to put them back in.  Almost there.  Can't wait to have a munchkin of our own.  Here's praying!

Practicing baby-holding with our niece the day she was born.

Moving Right Along

Prior to my ultrasound yesterday morning, I asked the nurse what she was looking for.  She said she was hoping to see the largest follicle at 14 mm.  Out of the 19 that were measurable (others may catch up later), two were measuring 13.5 mm.  That's very good.  If they develop too quickly, they may mature too much by the time of egg retrieval, or it may be a sign that they are not of particularly good quality.  Mine appear to be moving at a slow but steady rate.

Yesterday afternoon, they called with the results of the blood work.  My estrogen level was 1570, which is slightly higher than they were hoping for.  They would have liked to see it closer to 1400, because that would have been about double in 48 hours.  Since I'm progressing just a tad faster than they want, they decreased the dosage of one of my injectable medications (Follistim).  I don't love that because it still means I have to stick myself with a needle three times a day.  I would like them to have told me to skip the shot in the buttocks.

Tonight I was about three hours late with my medications.  (I was in Denver picking up our new kitty...more to come on that soon).  I'm not sure if that is going to throw things off or not.  I will let them know when I go in tomorrow and see what they say.  From tomorrow morning until the egg retrieval happens, I will have blood work and an ultrasound everyday.  I can't wait until the procedures are over so I can rest a little bit.  I am so worn out lately. Not to mention, my stomach is uncomfortably bloated.  I've really been struggling to eat lately, which is probably contributing to my fatigue.

I have been out processing at work all week.  (For those of you not in the military, it basically means I have to run all over the base tying up loose ends and getting things signed before I leave.)  I am not ready to leave Peterson and go to the Academy.  It would be nice if I had been able to stay put.  With all of the changes going on in my life with IVF, I would have enjoyed having the stability of my job and the support of the friends that I've made there.  Tomorrow is my going away luncheon, and I am certain that my hormones will take over and I will shed some tears at some point.  I just hope it doesn't happen in front of anyone.

Sorry for the lackluster report, but it's all I have in me tonight.  I will do better next time.

Polka Dots

I had a blood test and ultrasound yesterday morning.  The ultrasound went really well.  My follicles are growing at a very reasonable rate.  My lead follicle (that's the one that gets the biggest first) is 10 mm which is exactly what they would have expected.  A fully mature follicle is 18-20 mm, so when the time comes for them to retrieve the eggs, we are hoping that the majority of the follicles are within this range. 

The blood work from Saturday came back with my estrogen levels being at 252.  Ideally, those levels double every 48 hours.  On Monday, the levels should have come back around 500, but instead, they were at 699.  According to the nurse practitioner, this is not a huge concern.  However, they decided to have me skip one night of the Menopur stimulation medication in an attempt to slow things down.  That's the super long needle, so I was totally stoked to skip out on it for one night.  I was in such a good mood, I think it confused Ryan.  

Lately, I've been noticing that I bruise much easier than I ever have before.  I think that it is likely a result of the 81 mg aspirin I take daily.  (Aspirin is a blood thinner, so bruising is a common side effect.)  I am basically covered in bruises.  It seems like everything I touch leaves a purple spot on my skin.  That includes the three needles I use daily.  I wish I could have gotten a clearer picture of it, but my stomach looks like it's covered in purple polka dots.  This picture doesn't do it justice, but to give you an idea of what I'm looking like these days, here is my super bloated non-six-pack.  There are probably five or six more needle sized bruises you can't see.  The buttocks looks worse, but I will spare you the torture of that photograph.  

Tomorrow I am going in for more blood work and an ultrasound.  They will measure the follicles again, let me know how my estrogen levels are progressing and adjust my dosages accordingly.  Also, tomorrow, they are doing something called a trial transfer.  That means they are taking the same catheter that they use on the day they put the fertilized embryos back inside of me and they are placing it through the cervix into the uterus so they know exactly how long that catheter should be.  This keeps them from risking hitting the lining of the uterus with the catheter on the day of the transfer.  That is important because that lining needs to be intact for the embryos to implant into it.  

As we get closer and closer, I am getting more and more nervous about things.  I can handle the needles, the surgeries, the procedures.  What I am most frightened about, is going through all of this and having the result be a negative pregnancy test.  Granted, things will change as we find out what egg quality and embryo development brings, but currently our Reproductive Endocrinologist (RE) is advocating that we place only one embryo because our statistics are looking very good.  In the average woman going through assisted reproductive therapy, there is a 30% chance of one embryo implanting and a 60% chance of ending up with at least one child if you place two embryos.  If you place two, there is also the risk of twins which increases the chance for preterm birth and risk to the mother.  However, we are still going to push for two embryos.  I don't care if my odds "look" good.  I would much rather deal with the risk of a multiple pregnancy than the defeat of no pregnancy at all.  Not to mention, with the expense of this process, we would have to wait 2-3 years before we were able to attempt it again financially.  By that time, our chance of success would decrease simply because of our age.  I am hoping that the doctor sees our point of view when the time comes for transfer next Saturday.  But, I suppose I am worrying unnecessarily now.  These things won't become sincere issues for another 11 days if everything goes according to plan.   

Bloated Belly

Early Saturday morning I had my first of a series of blood tests leading up to my egg retrieval.  The blood tests measure varying hormones, but the one that they are looking at most closely is the estrogen level (also called E2 or estradiol).  This hormone is important because it gives an idea of how the follicles that house the eggs are developing.  Each follicle produces estrogen as it grows, so the E2 levels will vary based on the number of follicles that a lady has present.  As a general rule of thumb, if the level doubles every 48 hours then everything is progressing as expected.

Saturday afternoon, they called to let me know that my E2 level was 252. Dr. Magarelli is very happy with this number and decided to keep all of my medication dosages the same.  If the levels jump dramatically, it can be a sign that you're at risk of developing Ovarian Hyperstimulation Syndrome (OHSS) which is a very serious condition that can lead to hospitalization and causes the cycle to be cancelled.  When this happens, the lady produces a high number of low quality eggs, so the chances of fertilizing and freezing them to use later is very low.  

Tomorrow, I have another blood test and an ultrasound.  They are going to be counting and measuring the follicles in my ovaries.  I think they are looking for several small follicles at this stage, but I will ask more questions about it at the appointment.  In the afternoon, they will call me with the results of the blood test and we will be hoping for a number somewhere in the ballpark of 500.  If they don't see that, they will likely adjust the dosages of my medication.  

Honestly, I am hating all of the meds.  I know no one likes them, but I am so frustrated by all of the side effects.  Right now, bloating tops the list of most hated side effects, followed by feeling tired all of the time and crying about nothing tied for second place.  Throughout the process, your ovaries grow from the size of walnuts to the size of oranges and your stomach bloats.  When I look at my belly sideways in the mirror, it looks like I'm already about three or four months pregnant.  If I keep growing at this rate, people are going to be asking me when I'm due by the end of next week.  And the last thing you want when you're going through all of this mess to get pregnant is to look like you're pregnant already.  

The only good thing about all of this is that I have such a loving and supporting husband.  Ryan is always telling me how beautiful I am even when I look in the mirror and see a potbellied chick with dark circles threatening to swallow her tired eyes.  He goes with me to every appointment and asks questions to clarify things.  And, most admirable of all, he listens attentively when I ramble on and on about the whole ordeal.  I am so lucky to have Ryan as a partner in all of this.  He is amazing.  

I love this picture of Ryan.  Such a beautiful smile.  

The Calm Before the Storm

Tonight I began my first full day of stimulation injections.  Most of the shots were alright, but the Menopur shot was very uncomfortable.  It was the shot that went into the behind.  I administer shots multiple times per day at work, but putting a needle into yourself is an entirely different thing.  And this shot is three times as long and more than twice as thick as any of the others in this process.

The shot itself stung quite a bit, but I've only got to do it 10 more times after tonight.  Unfortunately, it looks like I'm going to have to do them all myself because I'm married to Mr. Shakeyhands McScaredofneedles.  I swear he was more traumatized by the shot than I was.  He was still recovering about an hour later.

I'm in the midst of the calm before the IVF storm.  Starting Monday, I will be in a flurry of ultrasounds, blood tests, and acupuncture appointments for two full weeks.  I think I will welcome the four days of bed rest at the end of this process.  I will have earned it.

Already Losing Steam

Yesterday was my baseline ultrasound and blood work.  The ultrasound went really well, they were looking to make sure that I had several follicles (little sacs that hold eggs) and that the lining of my uterus was nice and thin.  They called today with the results from the blood test and all of my hormone levels are exactly where they should be.  Also, today was acupuncture appointment number 8 of 12.  I'm already weary of appointments and I haven't even gotten into the meat of the IVF process yet.

Tomorrow, I begin what is known as stimulation.  It adds two more injections to my once daily injection regimen.  These injections are hormones that help eggs to form and develop.  Normally, each month, a lady only has enough fuel in her body to allow one egg in one ovary to develop.  With stimulation, all of the eggs in both ovaries will develop.  From what I understand, this is supposed to make my ovaries feel "full and heavy" and I may even have some visible swelling in my abdominal area.  

The medications I begin tomorrow are called Follistim and Menopur.  They both help the follicles in my ovaries to develop, but while Follistim contains only FSH (Follicle Stimulating Hormone) which helps stimulate egg production, Menopur contains both FSH and LH (Luteinizing Hormone) which helps the eggs to mature and release.  I'm not so worried about the Follistim.  It's a subcutaneous injection in the stomach just like the Lupron that I've been taking.  I've kind of gotten used to that.  However, I'm terrified of the Menopur that I will be taking in the evenings.  It is a serum that I mix myself with a powder and a liquid and I inject it intramuscularly into my bottom.  And, for my dental friends who can visualize this easily, I will be using a 25 gauge  1 1/2 inch long needle and I have to bury it to the hub.  Scary.  

The Menopur I have to mix myself before I inject it my bum.  Here is a YouTube Video of how that works.  Menopur Mixing Video .  Tomorrow I'll include some actual pics of the mixing process and the needles that I'll be using.  

So, my schedule has been updated some: 

Thursday, August 2nd:  Stimulation Start

Saturday, August 4th @ 8:00:  Blood Labs

Monday, August 6th @ 8:00:  Blood Labs and Ultrasound

Monday, August 6th @ 4:30:  IVF Protocol #8 (Acupuncture)

Wednesday, August 8th @ 8:00:  Blood Labs and Ultrasound

Wednesday, August 8th @ 4:30:  IVF Protocol #9 (Acupuncture)

Friday, August 10th @ 8:00:  Blood Labs and Ultrasound

Saturday, August 11th @ 8:00:  Blood Labs and Ultrasound

Monday, August 13th @ 7:00:  Egg Retrieval

Saturday, August 18th @7:00:  Embryo Transfer

August 18th-August 22nd:  Bed Rest

August 28th:  Pregnancy Blood Test

August 30th:  Pregnancy Blood Test Recheck (if positive)

The list is looking much more manageable.  However, I get more and more tired every day.  The medications are really starting to take their toll.  I dread the next two full days of work.  I'm like a zombie at the office.  A crying zombie.