Nearly 6 months later...

Well, it's almost December 1st. Had we been successful at our first IVF attempt, I'd be due with a baby any day now.

I've had my ups and downs over the last several months. I've gained weight, felt sorry for myself, asked why several times, but am now ready to just move on.

As of late, my youngest sister volunteered to be a surrogate for us. She was willing to use her eggs to fulfill our dream of having a another child.

Last week, we decided to postpone things. Both my husband and I had this unsettling feeling that something wasn't right.

For now, we are content with our decision to stop the process. Although we'd love to have a baby, something is telling us to stop.

Our IVF journey ends for now...

Sadly, our recent bump in the road has forced us to end our second IVF journey.

I prayed about the situation and am at peace with our decision.

Thank you for all your support.

-Melissa

Holding out for good news tomorrow...

I'm pretty open on this blog, but I got some news tonight that may halt our entire process...and although I'm not going to really get into it here...a lot is riding on what we hear tomorrow from our Dr.

Sometimes I wonder if I've ever wanted anything as bad as this baby...everything seems to be on track...it looks like the perfect month for us to do this and then today...bump in the road...

I'm not one to complain much. I just have to know that if this bump stops our process then it's truly not the right time.

Ultrasound brings good news!

Today was our first ultrasound since deciding to give Invitro another try.

Good News!

We have 10 baby follicles developing!! That's super! We haven't seen more than 5 or 6 through this entire process so to have 10 before any medications or treatments is a great start!

My next appointment is June 4th. We'll see where to go from there!

Received my IVF/Antagon Schedule!

I received my IVF calender today! The next 30 days will be very busy for us!

May 22 - Start BCP (Birth Control Pills). Continue until June 3rd.

May 29 - Ultrasound

May 30 - Payment due.

June 4 - Ultrasound, and teaching (new meds).

June 7 - Egg stimulation starts!! One pill per day...one injection per day.

June 12 - Mock transfer, regular ultrasound appointments begin!! We're getting close!!

June 17/18 - Possible Ovidril Injection Date

June 19/20 - Possible Egg Retrieval Dates

June 21/22/23 - Possible Transfer Dates

The next 30 days are sure to be busy ones! On top of this we are trying to sell our home!!

You can track our countdown at the bottom of the page!

Excited!

I called my Dr. today to let them know that I started my cycle. I also needed to tell them that my husband is being transfered to another state and we are putting our home on the market.

I wanted to know how Dr. R. felt about this and if we should move forward this month or just go with our original plan of waiting and seeing...and maybe doing a transfer mid-summer.

To my surprise, his office called and told me we're starting TODAY!

So, off to the hospital I went for blood work and the pharmacy for my first prescription.

Now, I'm awaiting a phone call from the Dr. instructing me on what to do next.

I'll continue to update...

2 weeks and I'm getting nervous!

I'm now down to just 2 weeks before I start IVF blood work again.

I really can't explain my emotions. I'm nervous and excited.

I'm scared to death to fail again! Emotionally, I'm not sure how I would handle another failure. Last time I cried for nearly a week straight! The difference this time is that I now know that I can fail where as before I didn't even think failure was an option!

This time around I feel the Dr. is better equipped for the ups and downs of my body along with how it responds to the medications. I get excited thinking that this time it might actually work!

My husband and I have already decided that if the blood work and ultrasound look good, we're going to give it another try. If it doesn't, or the Dr. has doubt in our ability to conceive, we will look into adoption.

Wish us luck!

A month away from 2nd attempt!

I'm not sure how I feel about the month of May yet.

Part of me is anxious, part of me is scared. I'm anxious to try again, to hopefully be successful this time around. I'm scared because I don't want to fail again. I don't want to cry those tears again. I don't want to feel that pain again.

I'm due to go back next month for blood work and an ultrasound to see what my body has decided to do since our IVF failure in March.

If the blood work looks good and the ultrasound looks good, we'll make a go at another attempt in June. If things aren't looking so good, we'll most likely wait until late summer.

We have quite a few things on our plate right now. The IVF process is stressful enough, I don't want to add any more stress to it!

Since our failure, I've taken time to heal from the heartache. I've visited Dr. R and decided that this time I will be confident, but remind myself that things can change in a heartbeat.

I've recommended Dr. R to a couple of people. One friend of mine is using his services and raves about him. He truly is a one-of-a-kind Dr!

A couple of weeks ago my husband and I received a card and a check refunding us our transfer fee from Dr. R! I was so surprised because no where in the paperwork does it imply that a refund would be granted if a procedure isn't done.

I'm so lucky to have found him and will continue to praise his work. He's an incredible Dr!

I will update as things progress!

•·.·´¯`·.·• Baby Update! •·.·´¯`·.·•

We went back to the Dr. today and had a long discussion as to what our options are and set a game plan.

Right now, we've decided to use my eggs for one more IVF try. (we still may use my sisters if this doesn't work). The Dr. agreed to give us a bit of a discount (whew), but did warn us that our medications would probably cost $1,000 more than before.

He is going to put me on totally different meds! I'm really happy about this. He's also going to give me a new Rx that is proving to be good for young, healthy women who just don't respond well to just regular stim meds and produce few eggs.

Right now, I'm set to have some bloodwork & an ultrasound done in May. Depending on what those show we'll start in June or July.

He said he'd rather not rush into trying again right away, rather give me some time and give my body some time to get back on a schedule. Which is just fine with me!!!


•·.·´¯`·.·• Fundraiser Update! •·.·´¯`·.·•

We've had 18 donations! Thank you so much! I can't tell you how much we appreciate all of your support and encouragement!!!

About My Blog

Before I started my IVF experience, I searched the net looking for other personal IVF/infertility accounts and had a hard time finding them. I decided to use my blog as a journal, not only to share with others going through IVF but to share with my family and hopefully, one day my new baby.

This blog is about my personal IVF experience. There are a few topics where photos are posted of me giving my IVF injections, if you have a sensative stomach or prefer not to see something like that, please skip it and go on to the next.

I hope you find this interesting, insightful and helpful!

-Melissa

My IVF Failure

A Journal Entry

3/15/07

13 hours ago, I found out that our last egg wouldn't fertilize.

I didn't sleep last night. I kept thinking about that one egg, imaging what it looked like in that petrie dish...I wondered why it was struggling. I tried to think positive...I even tried to invision a positive outcome and what that little baby would look like and be like one day.

I got out of bed around 6:45 am. I was due for my progesterone injection, but thought I'd wait to give it until I knew I had to. I found things to do around the house to keep me busy until 9 am. I was set on calling the clinic at 9 am...9 am, came and past, I couldn't bring myself to call. I didn't want to hear any bad news. Ten minutes later, I called. The receptionist didn't have any news for me. My breath grew short...the phone rang, my heart pumped faster than I thought it could. It was my friend. The phone rings again, and still not my Dr.

I tried to keep myself occupied, but I started to get scared. I prayed and prayed for a good outcome.

I watched minute by minute pass. I decided I would give my shot at 9:30 am. When I didn't hear from the Dr, I decided to wait until 10. At 9:50, my husband came upstairs. I looked at him and said, "Well, I need to give my shot."

His reply; "No you don't"

My heart sank...tears flowed out of my eyes and my stomach hurt.

He told me that the office manager had called and told him that the egg just didn't make it and that the Dr. would be calling around noon.

As we cried together, I apologized for my poor egg production. My husband refused to put blame on anything.

My body began to shake due to my heavy crying. I couldn't catch my breath, I felt as though I couldn't stand. I just couldn't understand why...why???

I made a couple of phone calls to inform my family but stopped short when trying to call my friends. I couldn't gather my thoughts and the thought of making conversation just made me feel worse...I knew that no one could "fix" it.

I ended up cried myself to sleep. I woke up a short time later to the phone ringing. I didn't answer, I knew it was probably my Dr and I was in no shape to talk.

Soon, my husband came back upstairs to relay his conversation with the Dr.

Dr. R said I would soon have a heavier cycle than normal. He also invited us into his office next week to discuss options.

My husband and I briefly discussed what options we knew of and wondered just how much more another try would it cost?

After another hour of tears, my husband and I decided that we wouldn't make any rash decisions, rather allow ourselves to grieve and decide what our next step is next week.

Later this afternoon, my husband and I left the house for fresh air. I was careful not to go any place where people knew we were due for our IVF transfer...I knew I wouldn't be able to hold it together to talk with them.

Telling my kids wasn't an easy task. They seemed to take it well. I suppose because I told them yesterday that chances are the last embryo wouldn't make it.

I started feeling better about the situation after our talk and telling the kids. I was able to take comfort in knowing we weren't going to give up just yet. Will it happen? Who knows, but I take comfort in the fact that it might.

A sad day for us..Journal Entry

Journal Entry

3/14/07

It's been a little over 2 hours now...and I'm still crying. Dr. R called me this morning and told me that 2 of my eggs weren't mature enough to accept the sperm and the 3rd was fighting to hold on.

I started crying immediately. I felt horrible. I couldn't believe what I was hearing. Dr. R told me that he wouldn't know for sure until tomorrow. I can't even explain how much I don't want tomorrow to come. I don't want to hear the bad news. He prepared me for the worse telling me it's been a concern this entire time.

He asked if I was ok and said, we could try something else.

I was so sure about our decision to only pay for one IVF cycle. I just felt that God would bless us the first time if he wanted us to have a baby. Then, to hear that chances are there isn't going to be a baby, I wondered what I did. I started replaying the bad decisions I've made, and relating them to why I'm not going to be pregnant.

I asked God, "Why???"

I truly feel that I'm a good mother and wife.

My daughter emerged from her room to see me crying. When I told her the news, she hugged me and told me how much she, her brother and sister loved me and that she was sorry. Still brings tears to my eyes. Our family wanted this baby so much.

I wish there would have been a sign. Something that would have told us that we weren't going to be successful. I mean, I knew that I wasn't producing many eggs and that my stimulation wasn't what the Dr had hoped it to be, but overall, he had a positive attitude.

I really saw us having this baby! I could feel it, see it...I guess it was just the fact that I wanted it so badly.

When I told my son the news, he held onto me, telling me several times how sorry he was. I asked him to pray for us and he said he would.

I know I shouldn't give up hope yet. I know that God works in mysterious ways and although I don't understand this now, he has an answer.

One of my friends reminded me that it only takes one and I'm begging God to save this one and bless us with this baby.

Megan (my sister) called me. The first thing she said was "I'll give you my eggs". She wanted to know how it can be done. I started feeling better knowing that she would do this for us.

When I called my friend, I burst into tears immediately. There really isn't anything anyone can say to make me "feel better", but I'd be lost without her...she's always positive and loves me like a sister as I do her.

For now...I'm signing off.

-Melissa

My Fertility Expenses

As everyone who's ever looking into fertility treatments or knows someone who has, knows that this is a very expensive process. Some couples spend more, some less...I decided to break down my expenses to give you an actual example of what we spent.

Initial consultation was free.

Dr's fees: $8,400 (This included ICSI, a $1,500 procedure where the Dr. injects the sperm directly into the egg for fertilization).

2 ultrasounds and office visits not included in my package: $600

Anest. (egg retreival) $400

Medications:

2 packs of birth control pills: $14 (copay, covered by my insurance)

Prenatal vitamins: $25.00 (I have some that my insurance convered, but read good things about this one, so I opted to buy them seperately)

Baby Aspirin: $1.99 (This is used to help with circulation during this process)

Antibiotic for Sono: $7 (copay)

900 Unit Follistim: $621

150 Unit Follistim: $103.50

20 vials Repronex: $1,060.00

2 Vivelle Dot: $50

30 Rx Prenatal Vitamin: $7 (copay)

1 Feldene: $7 (copay)

3 Valium: $6.89

30 Progesterone Supp: $50

3 bottles Progesterone 50mg/cc: $84.00

Lupron 14 day kit: $7 (copay) I was so excited when I found out this was covered!!

10 Doxycylcine: $7 (copay)

1 Ovidrel: $68.77

24 Medrol: $7 (copay)

Then my dosage was doubled. That pharmacy bill:

2 vials Repronex: $112.01

2 900 Unit Follistim: $1,254.07

Estradiol: $20

Other fees: $510.11

As of 3/14/07 our total is: $13,432.33

Egg Retrieval!

I could hardly sleep the night before my egg retrieval! I was excited and nervous at the same time.

I was excited that it was finally time to pull the eggs out, but nervous that my follicles would be lacking just that...eggs.

I was instructed no eating or drinking after midnight as I would be put under for the retrieval process.

We hit the road at 10 am. The fertility clinic where I was having the retrieval was approximately 1 1/2 hours away from us.

We hit more traffic than we expected and got lost on the way, but found the place with 15 minutes to spare.

Upon arriving, I paid the $400 fee for the anesthesiologist and had a seat. Mine and my husbands names were called after only a few minutes. I was lead to one room, while he was lead to another room to give his sample.

I entered the room and saw a semi-familiar face there. I believe it was the woman's husband whom I'd seen at the clinic a few times before. She wasn't as friendly as he. We had a nice conversation about infertility and soon that turned to our dogs.

Before long, I was called back and instructed me to undressed from the waist down. Within a minute or two the anesthesiologist arrived and started an IV. We chatted a bit about my Extreme Makeover and how being put under for this is nothing compared to that experience.

Suddenly I felt the room spin a bit and must have fallen asleep because the next thing I know, I was awake, talking to the Dr. and noticed my husband sitting next to me.

The Dr. told me that we only had 3 eggs from the 4 follicles. I was a little disappointed, but chucked it up to, "We only need 3...and God knows what he's doing."

Apparently, I was talking nonsense to my Dr. and thankfully, my husband reminded him that I always do this coming out of surgery. The Dr. got a chuckle and told him that most people do.

After lying there for a couple of minutes, a nurse came in to offer me a hot pack. I declined as I was feeling fine. A few minutes later, another nurse arrived and offered me the same hot pack, I declined, but she insisted I use it, so I did. Shortly after that, yet another nurse arrived and offered me apple juice, I gratefully accepted.

About 30 minutes later I was released. I don't remember much about the car ride home as I slept through most of it. I do remember stopping at the grocery store and waking up to extreme heat. I looked at the thermometer on the car and it said 91!! No wonder I was dying of heat. The window were up and no AC.

Upon arriving home, I called my family and prepared my first progesterone injection. I took the oral medications I was given and sat there, dreading this injection.

After warming the injection in my fist and my behind on an electric blanket, I asked my husband to administer the injection I'd been dreading for weeks.

After forcing him to stop several times, taking the injection away from him, unsuccessfully trying to administer it to myself, I finally bent over and told him to just do it.

YIKES!!! That poke HURT!!! The first few seconds were ok, until he hit the muscle. OUCH! He told me, "DON'T MOVE!!!" as he began to administer the progesterone.

I moved my head twice and was scolded to keep still. The injection sting didn't last too long. Removing the needle hurt just as much as feeling it go in.

Overall, it wasn't as bad as I thought it would be, but I'm glad I prepared myself for the worse!!

As of now, my next step is to call the clinic tomorrow and find out how many of my eggs fertilized and get my transfer date. As of now, it's set for Friday!!

Not Enough Eggs!!

The first ultrasound during my stimulation period was Wed. 3/7. I prayed hard and often for a good outcome, but wasn't expecting much since my E2 level came back at a 58 when they should have been around 100.

I spent Monday and Tuesday (3/5 & 6) crying randomly because of my poor E2 levels. I felt like a failure. I wondered why I couldn't seem to produce enough eggs now, yet I'd already given birth to 3 children without any outside help.

It was the moment of truth. I would find out just how many follicles I had produced. I hoped for 6 or 7.

The Dr. came in a began the ultrasound. I could tell by the look on his face that he wasn't thrilled with what he saw on the monitor. He told me we only had 4 follicles. He also reminded me that just because I have 4 follicles doesn't mean I'll have 4 eggs.

I was discouraged and mad at myself. I walked into his office where he told me that we may want to stop everything and restart all medications. The benefit would be, a much higher dosage of medication in hopes I would stimulate more follicles. He followed that with a grim outlook on doing that, but telling me that I probably wouldn't produce many more even with a higher dose of medication.

My heart sank. I wanted to cry. He assured me that he still felt like everything would be ok, that he can work with 4 follicles. It's just not ideal.

He said, we would make the decision on Friday (3/9) after taking another look at my ultrasound.

There were a few things he noticed that day that were discouraging. I began to spot. This is not good! He told us that he cannot do a transfer with a lining that looked like mine that day. It was measuring a 7 and my understanding is that it needs to measure 10+.

He also found a cyst on my right ovary that wasn't there before. This was a whole new concern.

He put me on Estrodial twice a day to improve my lining and said he hoped the cyst would go away on it's own.

My husband and I left that appointment feeling a bit heartbroken and sad. We continued to talk about the positives the Dr. had told us and that overall, he still thought we'd be successful.

On Friday we arrived at the Dr's office, in hopes we'd get some good news...and we did.

After the ultrasound, the Dr. told us that we were still a go for a retrieval and transfer the following week. I was so happy. However, he reminded me that my E2 levels are continuing to come back low. The one drawn on 3/7 came back at 200. While this is an improvement, at this stage, I should be around 200 per follicle and I was far from that. He told me he wasn't concerned with that right now.

The cyst didn't seem to be a concern either at this point and my lining had improved from a 7 to a 10+. He instructed me to continue the estradiol for now.

He scheduled us for weekend appointments. This way he could monitor my follicle development.

On Saturday my follicles along with my lining were looking good. He instructed me to stop taking the estradiol and to return in the morning.

The next morning, 3 of my follicles measured at 18 and one at 17. This meant they were mature and ready to come out!! I was so excited! This also meant I could stop my injections!!

At 1:15am Monday morning I administered Ovidrel into my stomach. It would be the last injection in my belly for this cycle. It was important that this medicine be administered at the exact time as instucted. According to reports I've read, the ideal time to remove follicles is exactly 36 hours after Ovidrel is administered.

On Tuesday, 3/13 at 12:15 pm, I went in for my egg retrieval. To read about this, please see my blog "Egg Retrieval".

Injections and Bruising

Experiencing bruising at your injection site?

I felt pretty lucky, I was already two weeks without any bruises. I was starting to show injection marks, but they were faint and non painful.

All of that ended on 3/6. I was giving myself my a.m. Lupron injection and for the first time hit a blood vessel. I knew it too...the needle was harder to push in and the immediate pain made me bite my lower lip. I aspirated the needle and sure enough, I brought blood into the syringe.

My hands started to shake and I attempted to inject the needle in the spot next to it. No luck.

After 3 attempts I was successful. By the time I showed my husband the injection site where I hit the blood vessel a bruise was already forming.

Two mornings later, I inject my Lupron and feel a burn and sting. I aspirate the needle and nothing, so I decide to inject quickly. Immediately following my removing of the needle I saw discoloration in my skin.

I asked my Dr. what to do to prevent this from happening again.

"After giving the injection, apply pressure to the injection site for 5 full minutes."

5 minutes seems like a long time, however, to prevent bruising like this, I recommend you do it!

What's a Mock Transfer?

On March 1st, I had what is called a "Mock Transfer". I was so eager to get in and see what it entailed.

I arrived at the clinic on time as usual and ready to go. Literally and emotionally.

I had been told that for the real transfer you need a full bladder, so I naturally assumed I would need a full bladder for the mock transfer. In my case, I was off the hook and told I could use the restroom upon arriving.

As I went into the familiar ultrasound room, I disrobed from the waist down and waited for the Dr.

He arrived and began his exam. A small catheder was placed inside my uterus and just like that, it was over. The Dr. told his assitant the measurement, showed my husband and I where he would be placing the eggs and we were done.

Pretty uneventful, but during this process, each appointment is one step closer to having a baby.

Other information on having a mock transfer:

According to the Cooper Center for Infertility, "A mock transfer should be done on a non-IVF cycle, days 3-11 of your cycle. For the mock transfer, the physician inserts a tiny plastic catheter into the uterus. This allows the physician to measure the depth and direction of your uterus. You may experience some cramping during the procedure. It is recommended that you take Ibuprofen (approximately 600 mgs) 1/2 hour prior to this procedure. This will reduce the cramping. If you cannot take Ibuprofen, take 2 Extra-Strength Tylenol tablets instead. You may schedule to have this performed at the time of your IVF consult or along with having cervical cultures."

Egg Stimulation, The $300+ Nightly Injections

Below are photos of me preparing and administering my evening dose of egg stimulation medication. If you have a weak stomach or don't like graphic photos, I suggest you skip this blog. I post this information and my personal experience to educate those who are considering or going through similar fertility treatments.

As much as I was excited to start my egg stimulation, I was tense, shaking nervously, and worried I would make a mistake or somehow mix the medicines wrong.

Due to my inability to produce eggs, my dose of Follistim and Repronex was probably higher than most.
<----My daily dose of Follistim & Repronex. I gave myself this injection for 9 days.





I begin by placing everything I need on a clean surface.

<----Sharps container, Repronex and Follistim along with my syringe and proper injecting needle.








<----Inside the Follistim Pen. The evening this was taken, I had run out of Follistim and was changing the cartridge.










Here, I've drawn up my Repronex dose and am tapping the air bubbles out. ---->






<----I carefully measure out my Follistim dose, and inject it into the Repronex I drew up in the syringe.







A final tap to release the air bubbles and it's time to inject. Due to a tummy tuck I had 4 years ago, I tend to try to give my injection in the "knumber" areas of my belly. Once I find the perfect spot, I grab onto my stomach, and inject the needle. I asperate the needle to assure I haven't hit a blood vessle (if blood enters your needle, you've hit a blood vessle and need to restart).




After finding the right spot, I wipe it with an alcohol pad and injecting the needle. ->








<----Dispersing the medication.
I feel a sting with the initial poke and start of the medication, but the real burn begins about 1/2 way through the injection and lasts several minutes after I was finished.


If you feel as though you can't give yourself an injection, your mate can do it for you.

My husband gave me my first Lurpon injection and after that I said, "Forget it"...I'll do it myself. There was something about watching him, that freaked me out and I decided from that point on to administer them myself.

The first morning after my stimulation injection, the site was very tender and red. I wore sweats because the top of my jeans irritated the area worse. After calling my Dr. and doing some research online I found out that this is a perfectly normal reaction and that Follistim can burn due to it being kept in the refrigerator.

After that, I decided to warm the injection a bit by holding it in my hands, administering the medication and then apply an ice pack. After Day 3, I no longer had bright red spots and no longer needed to use the ice pack to help with the discomfort.






<---- The morning after my first stimulation injection. The redness and tenderness went away approximately 24 hours later.


On the 4th day of my injection, I had an E2 test. According to pinelandpress.com the ideal result is 100+ pg/ml, mine came in low at 58.

My Dr. called me that evening and doubled my medication dose. This meant I didn't have enough medication to get me through the rest of my IVF cycle. Even though I was a bit nervous to find out how much more Follistim I would need and the expense of it, I knew it would be worth it.


As I stated, I stimulated 4 follicles in 9 days. The number of follicles was very low and caused initial concern. You can read about that in "Not enough eggs".

Egg Stimulation Begins Tomorrow!

The time is finally here!! Tomorrow I start my Repronex and Follistim to stimulate my ovaries!!!

I have to say that up to this point, it hasn't been too bad. I've definitely had some emotional moments. The headaches from the Lupron and birth control were no fun and being on the verge of tears hasn't been exactly a blast. However, knowing that in just 2 weeks, we'll be doing our retrieval and transfer makes the emotional roller coaster, and headaches worth it!

Starting tomorrow, I will give myself a Lupron injection each morning and my Repronex/Follistim injection each evening. I have a blood draw on Monday and another ultrasound on Wednesday to see how I'm progressing.

God willing, I will have produced lots of good eggs for my retrieval the following week!

A Journal Entry

Many couples will hit a "Bump in the road" during their fertility treatment.
Mine was this day. Below is my journal entry.


2/28/07

Yesterdays appointment didn't go as well as I hoped it would.

The Dr. now seems a bit concerned about how many eggs I will produce. I knew my egg count was a bit low for my age, but he didn't seem too worried about it.

However, at yesterday's appointment, he told me he's worried I won't produce the 12-17 follicles and eggs he'd like to see.

It seems that he isn't as much concerned about my body accepting the eggs, rather the ability to produce enough good eggs. Originally, he wanted to do a day 5 transfer, which means he'd grow the embryos 5 days and implant the best then. However, now he's thinking we'll have to do a day 3 transfer, which I'm perfectly ok with...just nervous.

I should have asked for a detailed explanation, but due to the Lupron I had a terrible migraine and random hot flashes and I didn't think to ask.

He said he was going to take a more aggressive approach for us since we are only doing one cycle. This sits fine with both my husband and I. We trust that he's been doing this long enough that he knows what to do to increase our chances of becoming pregnant.

As I sit here today, I'm praying that I produce plenty of good eggs for my retrieval and transfer and that we're expecting in a month!

17 days and counting!

I just got off the phone with the hospital manager from the Dr's office.

She called to remind me of my appointment tomorrow and what I needed to do. Such as remember my medications; I will be having another teaching tomorrow on how to give the next set of injections. She also wanted to let me know that I will be having more blood work done tomorrow and answered a few questions I had for her.

(1) I've read that I should be taking in more protein. Her answer was to follow all recommended dietary guidelines.
(2) Can I get a prescription for EMLA, a numbing creme used to help with the pain of the progesterone injections? The answer...no. This Dr. doesn't recommend that medication.

We're getting down to the wire. Next week we will have to be available around the clock...or between 8am-5pm anyway. :) I will have another blood test done on Monday, March 5th and ultrasounds approximately every other day from that point on, until the retrieval.

She reminded me that we are at a crucial point in this. Everything must stay on schedule and we are not to make any weekend plans for March 10 & 11th, as we may need to be there one or both of those days!

I'm having a hard time containing my excitement! This whole process is a dream come true. I've longed for another baby for years and now, it's going to happen and I truly couldn't be happier!

IVF Questions and Answers

Admittedly, today was a "tough" day for me.

With my emotions all over the map, I decided today was a good day to start looking for answers as to why I felt like this. I found all of the following information at http://www.ivfconnections.com/:

"What side effects can I expect from the suppression medication?"
"The side effects of the suppression medication are similar to that of going into menopause. Some women are very sensitive to the effects of the medication while others experience hardly any changes. You may experience some of the following side effects below. Always contact your doctor if you have any concerns or questions about your side effects or the medications you are taking.

*mood swings
*breast tenderness
*hot flashes
*headaches
*changes in sex drive"

I begin my egg stimulation stage on Thursday, March 1st. I'm very excited to get this stage underway. Although, after today, I decided it was time to learn more about this stage.

"Why do I have to continue to take the suppression drugs, when I start my stimulation drugs?"

"With most IVF drug protocols, you will continue to take suppression drugs while you are taking the stimulation drugs. If you do not take the suppression drugs you may ovulate on your own before the clinic has a chance to retrieve your eggs. The clinic wants to keep you on suppression drugs, so that they can time the retrieval of the eggs when the follicles are at their optimum size for their number."

"What kind of side effects can I expect from this round of medications?"

"You may experience some of the following side effects below. Some women are very sensitive to the effects of the medication while others experience hardly any changes. Always contact your doctor if you have any concerns or questions about your side effects or the medications you are taking.

*Abdominal bloating
*Nausea
*Diarrhea
*Weight gain
*Fatigue"

I've already experienced some bloating, which was somewhat relieved when my cycle began today. I'm not looking forward to the nausea, I'm a real wimp when it comes to being sick.

Weight gain??? Uggg....I'm not ready for that. I'm perfectly ok with gaining weight while I'm pregnant. I guess I'll just avoid the scale over the next two to four weeks. :)

And fun fatigue...I had read somewhere else that fatigue is common during the egg retrieval stage. Good thing I don't mind taking naps!

Helpful tips I found on giving yourself these injections:

"To reduce stinging:
Try putting ice OR a product called EMLA (available at pharmacies) on the injection site to numb the skin before injecting
Before injecting, make sure you let the injection site dry after you clean your skin with the alcohol wipe
Some women find that injections sting less given in the abdomen and others find they sting less in the thigh. You might want to try switching locations to see which one works best for you
Some medications sting less than others. If your clinic gives you a choice, Gonal-F seems to sting less than Puregon or Follistim."

"For better absorption:
Try giving yourself injections in the abdomen instead of the thigh. The abdomen is actually the best site for injections for most people because the blood flow to the tissue remains the same and generally speaking there is more fatty tissue there. However, you must stay away from your bellybutton by at least 1 inch in diameter. The more blood flow to the injection site the quicker the medication is absorbed."


"Progesterone in Oil Injection Tips:
Try warming the progesterone in oil vial next to your skin (slipping the vial in your bra is ideal) for half an hour before the injection.
Change the needle after drawing up the Progesterone to avoid injecting yourself with a dull, oil-covered needle
To lessen the pain of the progesterone IM injections, place warm compresses on the injection site after the injection is given and rub the area really well so the oil gets disbursed more quickly."

"How does the clinic know when my eggs are ready to retrieve?"

"The clinic will monitor you closely, once you begin the stimulation stage of your IVF cycle. The clinic can monitor you in 2 ways: through ultrasounds and through blood work. Some clinics only use the ultrasound method. The number of days that you will be on stimulation drugs varies greatly depending on your drug protocol and how well you stimulate. In the US most clinics are looking for 150-300 units of Estradiol for every mature follicle. In Canada, clinics like to see between 750 and 1,000 units of Estradiol for every mature follicle. A mature follicle is usually between 18 and 23 mm. The clinic tries to do the retrieval when the most number of mature follicles fall within range. This may mean that some eggs may be too mature and some too immature to fertilize."

At this point, I know our Dr. will be doing a procedure called Intracytoplasmic sperm injection or ICSI for short, it's where the sperm is injected into the egg. It can help to improve fertilization rates when the sperm can't penetrate the eggs on their own.

Next is the transfer stage, the most exciting part of the process, the reason the "pain" didn't hurt...the reason the emotional roller coaster was worth every tear.

"What will the transfer process be like?"

"The transfer process is usually uneventful and pain-free compared to the retrieval process. Your embryos are loaded into a thin flexible catheter, which is inserted into your uterus. The embryos are placed as far into the uterus as possible without touching the back wall of your uterus. Some clinics measure how long your uterus is and map out your uterus before the actual transfer date. The doctor doing the transfer tries to place the embryos 0.5-1.0 cm from the back wall of your uterus. Some clinics use an abdominal u/s to help guide embryos in place. Once the embryos are inserted into the uterus, the catheter is slowly removed. The catheter is then sent back to the lab to confirm that there are no embryos sticking to it. The embryos don't often stick to the catheter, but if this happens the stray embryo is reloaded into the catheter and the transfer is tried again. Some clinics will recommend that you rest on the transfer table for about an hour, while other clinics may allow you to leave right away."

After reading about IVF or the past couple of months, I wondered, what is the difference was between an embryo, morula, and a blastocyst transfer?

"Embryo Transfer: An embryo transfer is done 2 or 3 days after retrieval. A day 2 embryo usually contains anywhere from 2-4 cells. A day 3 embryo is usually around 8-10 cells in size. Morula Transfer: A morula transfer is done 4 days after retrieval. Morula transfers are not as common as embryo or blastocyst transfers. A Morula usually contains at least 30 cells, but as the cell numbers increase the morula compacts and the cell borders become less distinguishable.
Blastocyst Transfer: A blastocyst transfer is done 5-6 days after retrieval. A blastocyst has so many cells that individual cells are no longer recognizable."

My Dr has told me that I will be on complete bed rest for 3 days following my transfer. I've already got a few things I will be able to do while lying down. I've decided to take a few extra days off from my part-time baby-sitting job to prevent any unexpected accidents that could happen.

"What else should I avoid following my transfer?"

"I have compiled this list of precautions from the women who have passed along their clinic's guidelines to me. Please always seek the advice of your doctor on what precautions you should take for your situation. If you are in the 2 week wait and have already done something which the list says to avoid, please do not worry. I have known women who have done some of the things on the list and still have gone on to become pregnant.

AVOID caffeine, smoking, alcohol, and drugs
AVOID heavy lifting
AVOID strenuous exercising and housework (this includes vacuuming)
AVOID bouncing activities (horseback riding, aerobics)
AVOID sunbathing, hot saunas, hot tubs and Jacuzzis
AVOID swimming and baths
AVOID sexual intercourse and orgasms"

"Will I experience pregnancy symptoms?"

"From having talked to women who have gone through IVF, I have come to realize that there is not a standard set of symptoms that you will feel if you are pregnant. The range of symptoms differs so widely that it is hard to even begin to answer this question. Symptoms during the 2-week wait can be caused by a number of different sources: the medications you are taking, your body recuperating from the IVF cycle, an impending period or an impending pregnancy. Below are some of the symptoms that women have reported to me before getting a positive result. You may experience some of these symptoms before your pregnancy test, but the only way to verify what you are feeling is a pregnancy test done by your clinic.

*absolutely no symptoms
*pre-menstrual-like symptoms
*breast tenderness
*cramping
*nausea
*food aversions"

"I tend to be pretty impatient, can I take a home pregnancy test?"

"It is very tempting to do a home pregnancy test before the one scheduled by your clinic. However if you had an hCG injection (the one 2 days before your retrieval) it could take up to 2 weeks for the hCG to leave your system. If you have received hCG boosters it could take even longer. If you test while the hCG from the injection is still in your system you could get a false positive. You could also get a false negative if the hCG from the injection has left your system and the hCG produced by the implanted embryo isn't strong enough yet. If you do decide to do an HPT, please realize that it is not a conclusive result and that you should always have your cycle results confirmed by your clinic."

I guess I'll just have to wait out the 2-week wait to find out for sure if we'll be expecting a little one in December.

"What if I experience spotting during my 2-week wait?"

"Spotting during your 2 week wait could mean a number of possible things: an embryo is implanting, one embryo is implanting while another is detaching, your period is arriving. Please always call your clinic if spotting occurs. You should always go ahead with your clinic's pregnancy test even if the spotting is heavy. There is really no way to tell what is happening until the pregnancy test gives the clinic some indication."

The night before each of my appointments I make a list of questions to ask my Dr. He is always more than happy to take the time to answer each one of them.

This blog is simply the information I believe to be true, always ask your Dr any and all questions you have regarding your IVF process!

If you are in the process of IVF or AI, I wish you luck!

Lupron Injections

First of all, I want to say that I thought and thought about whether or not I should post this blog. I wrote it and included the photos, because in my search for IVF information I couldn't find anything like it. For me, seeing something like this would have helped prepare me for the process...so here it is, my experience with IVF injections. If you have a weak stomach or don't like graphic photographs, then you should skip this blog.

I'm 6 days into my injections and am beginning to feel like a real pro at it. I am however, growing concerned about my upcoming Progesterone injections.

I've talked with other women who have had to have them and hear that they are quite painful. I've also read tips on how to make them easier online, so I feel my concern is justified.

I decided today would be a good day to blog about these injections.

As I begin, I get everything together on the table, I have my Rx, one syringe, 2 alcohol pads and hand sanitizer.

I thoroughly wash my hands before I begin, but use hand sanitizer as extra insurance that my hands are clean.









I begin by following the instructions given to us by our nurse as to how to fill the syringe. ---->


<----I prep the site where the injection will be administered with an alcohol pad.













I take a deep breath in and give the injection. It stings for a few minutes, but overall, it's a piece of cake...and I'm done for the day.
---->









The pain of the injection is lessened knowing that these will help us in our goal to become pregnant.

InVitro Fertilization through my eyes

In November 2006, my husband and I decided that we'd like to expand our family.

Now, as easy as that may sound to do, it wasn't going to happen the "good ol fashion" way. In 1996, when I was 21 and in an unsuccessful marriage, I made the decision to have my tubes tied after I delivered my 3rd child. At the time, it was the right choice for me. However, I regret not doing research to find other alternatives to tubal ligation.

Ok, fast forward to November 2006. My husband and I had been discussing babies for about 6 months and a few days after my nephew was born, we knew we had to give IVF a try!

Our first appointment with a specialist was December 7th. We were very excited to hear what the Dr. had to say.

We chose a Dr. in Manhattan Beach, CA. Our first appointment was a success. The Dr. told us that he felt we had a good chance of becoming pregnant due to my age, and the fact that I've already been pregnant and delivered three healthy children.

We were told to come back the third day of my next menstrual cycle. On cue, I arrived with bells and whistles. I couldn't wait to get started. My stomach was in knots. I was so excited at the opportunity to share a pregnancy and child birth with my husband. We went in thinking we would be able to do our transfer in February.

To my disappointment, my ultrasound showed eggs developing early. This set us a month behind. The Dr. told us we would have to wait until my next menstrual cycle to start. He gave me a prescription for birth control pills along with the instruction to start taking them on Day 1 of my cycle.

Although, I left the office sad because I didn't want another delay, I knew that for one reason or another it wasn't the "right" time.

I spent the next 25 days thinking about having a baby and counting down the days to my cycle. Finally, it arrived. I started taking the pill on day 1 of my cycle. The advantage to taking the pill on day 1, was that it was a light cycle with fewer cramps.

Day 3 of my cycle, we headed back to the Dr for another ultrasound. I prayed for my ovaries to be "quiet" so that we could move forward and they were!

We sat in the Dr's office and went over my IVF schedule. He ordered my prescriptions and warned us that the expense would be high. That day we paid $600 for our two office visits and two ultrasounds.

I went home on cloud 9! I couldn't wait to get home and share our good news with our family and friends. We now had a projected transfer date of March 15th!

On Feb. 9th we received the call from the pharmacy that our medications were in. Our cost, $2,065.15, not bad considering we were expecting them to be around $5,000.

On the 14th, I started an antibiotic called Doxycycline. This was given to me to prevent getting an infection from my upcoming SonoHSG.

About SonoHSG (copied from http://www.pinelandpress.com/):

"A hysterosalpingogram is where dye is injected into the uterus to look for anatomic problems, such as tube patency (if they are open), fibroids, polyps, or structural problems with the uterine cavity. This test is usually done in the first half of a woman's cycle, between days 7-10. A small catheter is inserted through the cervix in order to inject the dye, or, in some places, a balloon catheter is used to push dye through the cervix without actually threading anything through it. You'll be expected to turn a little as the doctor / radiologist takes pictures or views the process through something that looks a lot like an ultrasound. It should only last about 5 minutes. Some cramping and discomfort is common during the procedure and for a little while afterward. Also, some spotting is to be expected. Your doctor may prescribe antibiotics and suggest a painkiller be taken. Be sure to tell your doctor if you are allergic to shellfish. Women taking metformin (brand name Glucophage or GlucophageXR) should discuss whether the medication should be discontinued for a couple of days before the procedure."

This procedure was a bit uncomfortable.

My husband and I were also instructed on how to give my upcoming Lupron injections. It was a bit nerve wracking thinking about my husband giving me shots in my belly.

Monday, Feb. 19th, I begin my Lupron injections. I was terribly nervous about my husband giving me this injection, but even more uneasy with the thought of doing it myself. So, armed with my Lupron, a syringe and 2 alcohol pads, I take a deep breathe and reinstruct my husband on how to do it correctly. I then, stop him, restart him, then stop him yet again. I didn't like the look of the first needle, so had him get a new one. Then, I wanted a new alcohol pad. Finally, he begins to give me the injection while I let out a
"Eeeeekkkk" followed with a
"Are you almost done???"

Then, it was over....my belly stung for a few minutes and my husband decided that in order for tomorrow's injection to go better than today's, I would have to be quiet.

The following morning, I decided I should try to give myself the injection and to my surprise it went much easier!

Feb. 20th, payment day! I think this was the most painful part of the entire process. :) Our IVF bill was a bit higher than our initial quote because the Dr. decided to add on a couple of procedures to help our success rate.

Feb. 22nd, we headed back to the Dr for our mock transfer. The procedure felt like a single menstrual cramp and only lasted a few minutes. Everything went according to plan and we continue to stay on schedule.

That brings us to this weekend. Our weekend will be a quiet one. I took my last birth control pill on Thursday, so now I'm only taking the Lupron each morning.

Tuesday we have another ultrasound and injection teaching and I begin egg stimulation on Thursday with Repronex and Follistim!

More blogs to come on this subject!