Thursday, April 29, 2010

Planning for 2nd IVF Cycle

I spoke to my doctor yesterday. She said my embryos were a B+ and a B-. Whatever that means. I always get the feeling my clinic is trying to skate by this type of data without really giving it proper attention. I mean I realize not everybody wants to know this level of detail, but I'm an information hog. I want to know everything, about everything!

She wants to keep me on the same medication for the next cycle and just increase the dosages.

follistim 300 twice a day
menopur 75 twice a day

I'm a little surprised that they are not changing the meds at all. And I got the impression that they only have one other protocol for "young patients." That is is a down-regulation protocol. She said that she felt my response to the meds was appropriate for my age. And when I asked why no BC pills and a change of meds she said "well, large randomized studies have shown that none of that really makes a difference, anyway." Uhhh, thanks! "But of course we don't know how it will effect you on an individual basis." Yeah, thanks. I'm not ready to start clinic hopping, but I'm annoyed.

I did get one piece of good news. Apparently my 25% copay on the infertility medication is only up to $2,500. After that it's 100%. I'm nearly at $2,500 already! But that means I need to do as much of this stuff as I can this year. Still, I'm trying to tell myself that, even if I have to wait a month to start (due to scheduling), I will not get all worked up over it. I'll just use that month to lose some of the weight I've gained. I was already overweight before all this mess started. Now I'm just miserable.

Tuesday, April 27, 2010



First IVF cycle, the end.

Friday, April 16, 2010

What Embryo Transfer Was Like

We transferred both embryos this morning. One was 6 cells and the other was 7. They gave me a cute little "best wishes" card with a photo of each one inside. There was no fragmentation but he said they were a little "asymmetrical" which reduces the chance of implantation. My pregnancy test is Monday April 26th.

At my clinic, the transfer was done in the same area as the retrieval. I had to shout my name to the embryologist again and I also had to sign for them. The doctor goes "this is just like Fed Ex. You've gotta sign for your embryos."

I was tilted slightly backward, the speculum placed, cervix cleaned with water and a cotton swab, then he did the trial run. I guess the trial run consists of opening the cervix and placing the same type of catheter inside that will be used for the transfer. After that, he just kept saying, "you are going to have a very easy transfer." Once he was done with the trial run, which only took about a minute, he asked the embryologist for the embryos. It took less than 5 minutes. Then he gave the catheter back to the embryologist to verify that the embryos were no longer there. After the transfer, I stayed there in the slightly upside down position for about 20 minutes.

I had acupuncture before my transfer today. Afterwards, I came home, at a salad and some chocolate pudding and took a 3 hour nap.

If you've got a success story about getting pregnant from crappy embryos, I sure need to hear it.

Wednesday, April 14, 2010

Fertilization Report

Of the 4 eggs retrieved yesterday, 3 were mature and fertilized. This morning, 2 were growing normally. According to the embryologist, 95% of embryos continue to grow once they get to this point, so I'm hoping we can transfer both this Friday.

One more hurdle down! When I returned the call to the embryology lab this morning I thought I was going to vomit while I was on hold waiting for her to get on the phone. All this stuff is so anxiety provoking.

The embryologist said that they won't look at them again until Friday morning when they'll grade them then do the assisted hatching right before the transfer.

It's weird and very lovely to think about two potential babies that my husband and I created growing in a lab. I wonder if they are boys or girls.

Tuesday, April 13, 2010

What IVF Egg Retrieval Is Like

They retrieved 4 eggs today. A very low number, but one more than they saw on all my monitoring ultrasounds, so I'm happy.

I reported to the clinic today at 8:30, about an hour before my retrieval was scheduled to start. I only waited about 10 minutes in the waiting room before they called me back. My clinic does the retrievals right there in the office but they do have a separate space for the procedure rooms. There was one large room where the nurses congregate with the patient lockers and recovery beds on the left and two procedure rooms on the right.

I was instructed to change into a hospital gown (I was only allowed to keep my socks on) then to lay down on one of the recover beds. The recovery nurse went through a series of questions like "when is the last time you ate. When did you take your ovidrel shot." Then they started an IV with a bag of fluid and gave me a Zofran to try to prevent the nausea that patients often get from the sedation.

They wheeled me across the hall to the procedure room which had a bathroom and asked me to empty my bladder as much as possible. The embryology lab is connected to the procedure room by a small window and before I was moved to the procedure bed, I had to stand in front of the embryology lab and state my name and date of birth to the embryologist who was standing right there in front of tubes labeled with my name. I was relieved that they'll have my eggs clearly identified. The procedure bed is more like a reclining chair with a collapsible bottom. Once on the bed with my legs in the stirrups, They put oxygen in my nose and a blood pressure cuff on my non-IV arm. Then they turned down the light and gave me a dose of something that made me feel very good and very chatty. Within a couple of minutes, my RE came in the room and they started working. They couldn't find anything on my right ovary, even after pressing on my stomach to move things around. My right ovary is only a partial and they always have a hard time finding it. And then they moved to the left. They had given me as much of the Versed and the Fentanyl as they were able to and I was still awake but groggy. I could feel what they were doing and I'm pretty sure I was screaming. At some point I heard the sedation nurse tell my doctor "I can't give her anymore. She's at the max." Still, it wasn't as bad as the HSG I had last year. I heard them say "Gina, we found one they didn't see on ultrasound" which was great.

After they finished, they immediately had me turn over and gave me a progesterone shot on my left side. They transferred me back to the recovery bed, wheeled me back over to the other side of the room and let me lay there for a few minutes. They asked me to drink some ginger ale and eat a few crackers to see if I was going to be nauseous. I wasn't. Thank goodness! I believe I was in recovery for about an hour and they brought my husband back a few minutes before they let me leave. They also gave me Tylenol right before I left because I was already starting to feel pretty crampy.

Walking to the car was kind of scary. I felt pretty wobbly. I came home and slept for 3 hours. Right now I do have some cramping and I do feel a little groggy but I feel much better than I thought I would. All in all the procedure wasn't that bad.

I'll hear from the embryologist tomorrow with a fertilization report. I sure hope they all fertilize and are beautiful embryos.

Monday, April 12, 2010

IVF Stim Day 11

Is it still called "Stim day 11" if I didn't take any stimulation drugs today?

I triggered promptly at 9:45 last night. I didn't sleep well because I'm very nervous about tomorrow. And I've spent most of today thinking of all the horrible things that could happen.

When I spoke to the nurse today about my progesterone level that was added on to the bloodwork from Sunday due to the decrease in my estrogen level, she said she didn't even know why they ordered that. That the estrogen level always goes down a little when you start the Ganirelix. My progesterone was only 1, which means I have not ovulated.

We're due in the office tomorrow at 8:30. That's about an hour before the retrieval which is my clinic's protocol. I wish I had some prophylactic sedation like Valium or something. I think I'm more nervous about the sedation than the procedure itself.

I had another acupuncture session this evening. She did electroacupuncture on some points along my back which is meant to improve the blood and the blood flow to the reproductive organs. My lining was only 9mm yesterday so I'm hoping that'll improve a little. She did not do the points on the back of my legs this time which she said are more for the egg inside the follicle. It's too late for all that with my retrieval scheduled for in the morning. I was also really bummed to learn that my acupuncturist is headed out of town this Friday which I hope will be the day of my transfer. She was trying to find somebody who could treat me before and after my Friday transfer but then she found out her husband messed up their plane tickets and since she's now leaving later in the day on Friday, she's planning to come in just to treat myself and one other girl who is transferring on Friday. That's why I love her!

If you think about it, send me some good thoughts around 9:30 tomorrow morning.

Sunday, April 11, 2010

IVF Stim Day 10

At my ultrasound today they saw the same three follicles on my left ovary. They are measuring 16, 17, 24 today. I was very surprised that the one grew 10mm in two days. Is that normal or does that mean there is probably something wrong with that egg?

I have not heard from my nurse yet but I'm assuming they'll have me trigger tonight for a Tuesday retrieval. I'm really nervous and all I can seem to think about are negative outcomes. I sure will be glad when this is over!

Update: nurse called to say trigger is at 9:45. My estrogen level was only 1500 which is down from 1685 on Friday. That worries me. The nurse said they added a progesterone level to my bloodwork to make sure I haven't already ovulated. I have no idea what they'll do if it's elevated.

Saturday, April 10, 2010

IVF Stim Day 9

I don't feel much of anything in the ovary area today. So I'm overcome with fear that I'll show up tomorrow's ultrasound only to learn my 3 little follicles are gone. Or maybe I've just been laying around so much today that I haven't been in a position to be in pain. Hope.

Eight am acupuncture session. She treated me laying on my stomach again with the needles in my back and legs. With electricity. And I've got another session scheduled for Monday afternoon. Next week is bound to be pretty exciting. In a good way, or a bad way.

Friday, April 9, 2010

IVF Stim Day 8

The same 3. Now they are 14, 13, 12. Wow.

Thursday, April 8, 2010

IVF Stim Day 6

I'm in a bad place.

Had my ultrasound this morning and when she only had the wand on the left side for a sec, I knew something was wrong. Nothing on the left over 10 mm and only three on the right measuring 11, 11, 10. There were a few less than ten, I think on both sides. When I asked the ultrasound tech to tell me how many, she replied "we can't discuss that." They only say that when it's bad news. If it's good, they're happy to tell you. At least that's my personal experience. Stupid bitches. Sorry, but that just pisses me off. Who do they think they're fooling?

When the nurse called with my results, I was disappointed that it wasn't my regular nurse. This other lady just ran through things in about 15 seconds. I could tell she was in a hurry.

her "You've got three follicles, two at 11 and one at 10. Your estrogen is 900. Stay the course with your Follistim and Menopur. Start your Ganarelix Friday morning and come back in Friday morning for another ultrasound."

me "Only three? Won't they just have me convert to IUI with that few?"

her "Well lets just cross our fingers that you get some more growth. Ok thank you bye"

What? What kind of explanation is that? I'm fragile! I need reassurance that I should keep going and not just go hide under a rock!

So I sat at work depressed for several hours before deciding to call my regular nurse in hopes that she was in the office today. When she called back I just flat out told her that I'm looking for some reassurance because I had this level of response to Clomid one month. She says she's not worried at all. That my estrogen level being 900 should mean there are some good follicles there and that she expects I'll have more when I come back on Friday. Ahhh. Relief. One thing we realized during our conversation is that I'm taking the Menopur in the morning and I'm supposed to be taking it at night. I don't know how I misunderstood that but of course I'm wondering if that has somehow caused my bad response. The nurse did not want me to move to a night Menopur dose but I could tell she was not happy with me. And she said I'll just have to do three injections in the morning, the Follistim, the Menopur and the Ganarelix, then the Follistim again at night. I don't care about the injections, I just hope my body can handle all the drugs at once. And I've been reading up on Menopur. It seems that headaches are a common side effect, and boy have I had them. I imagine taking it at night would have really helped with that.

I've noticed I'm back in that hole where I am fixated on reading infertility stories on the Internet. And they all seem bad. I mean compared to 3 small follicles on day 6. It's started consuming my thoughts again. Why should I go through that retrieval with only 3? Why not just do IUI? All the money I've already wasted on these injections. Why did I wait so long to do this. Why did he take so long to make the decision that he wanted to have a baby?

It is not good.

Tuesday, April 6, 2010

IVF Stim Day 4

Yesterday was pretty uneventful, thankfully. Being at work sure does keep my mind off my ovaries. I'm still super aware that they're there. I keep hoping it's a good sign that the injections are working and that I've got like 20 follicles developing in there. But I've dreamed up many good signs on this journey. I know my mind can trick me. I'll be relieved to get my ultrasound tomorrow morning. 20! I want 20!

After work last night I had another acupuncture session. This time she had me lay on my stomach and she placed the needles in my upper and lower back, and in the back of my legs in the calf area. She also hooked up the electrodes (electroacupuncture) to two of the ones in my lower back and one on each leg then turned the transmitter on so that it sent continuous electrical pules through the electrodes. The only other time I've had this done was the month I had a particularly good response to Clomid. That month, I had 3 mature follicles, which is good for my age. Unfortunately, they were on my blocked side. The electrical pulse does not hurt at all. In fact, after a couple of minutes I can't even feel it anymore, so when she comes in to check mid-way through the treatment, she cranks it back up a little more, just until I can feel it. I go back for another treatment on Saturday morning, unless something important (early trigger, God forbid cancelled cycle) happens at my ultrasound tomorrow. It'll be interesting to see if she hooks up the electricity again on Saturday. It seems like she only does this pretty early in the cycle, so I don't expect she'll treat me like this again.

If you are cycling this month, good luck! I'm sending good thoughts to all of you.

Monday, April 5, 2010

IVF Stim Day 3

Last night sometime, my ovaries started to become kind of painful. It's not unbearable, but I can definitely feel them, and they're sore. Since this started after only 3 full days of injections, I'm really worried about how bad this will get before retrieval. I'm scheduled for day 6 ultrasound this coming Wed. I'm just trying to stay busy hoping I can keep my mind off it.

I've been trying to exercise a little every day. I'm so scared about the severe bloating I keep hearing about with IVF and since I need to lose weight, anyway, I'm trying to counteract that side effect as much as I can. So far, it's working. I don't really feel bloated at all. Just sore.

I didn't sleep well last night. Probably because I had a long nap earlier in the day and we were up late watching movies. I hate starting weeks like this. To summarize, I'm grumpy. And sore.

Sunday, April 4, 2010

IVF Stim Day 2

I can feel my ovaries, already.

Saturday, April 3, 2010

I Survived IVF Stim Day 1

When I went to my medication education session, the nurse suggested that, when we get our big-bag-o-meds, we lay them all out, make sure they're all there and that we know how to use them. Well, I didn't do that. I don't know if it was laziness, or that I'm really trying to minimize the IVF process obsessing for my own sanity. I tend to get very fixated on things and it takes over all my thoughts. That's what happened during the last year I was trying to get pregnant. So, I threw the bag on the kitchen table and tried to forget about it. Sometimes I'd walk by and have moments of proudness. Like "look, I'm so chill I'm totally ignoring the thousands of dollars of medicine and medical equipment I have right there on the kitchen table. I am so awesome and cool!"

Then yesterday it was time for the shots. That's when I decided to dive into the goody bag. Stressful! I forgot everything they taught in the education session. (I knew I should have recorded that on my iPhone!) I spent an hour or so on youtube looking for videos on how to give Menopur and Follistim injections. Thankfully, I found quite a few. Other than agonizing over how much saline I was supposed to mix the Menopur with, it was OK.

I thought the Follistim injection was a walk in the park. I had surgery to remove an ovarian cyst back in the 90's before laproscopic was all the rage. And I've never fully regained the feeling around the bikini incision. This was helpful for the injections. The Menopur still burned a little, but I was expecting it because my new IVF friend had told me about it.

I survived day 1! I know it'll get worse, but for now, I'm OK.

Thursday, April 1, 2010


Tomorrow's the big day. I'll start my morning bright and early with 75 of Menopur and 225 of Follistim. I'm nervous, and excited.

Today was a beautiful day in Chicago. It was one of those days where everybody has burst outdoors after a long snowy winter. Lots of runners. Lots of outdoor eating. Walking and talking. I had lunch with friends out on the lawn of one of the buildings on campus. It was lovely. And tonight I played basketball outside with my husband until it was too dark to see the ball. It was nice to get my heart rate up out in the fresh air. I'm really glad spring is here.

This week I found out that a business acquaintance who I've become friends with got pregnant on her first IVF cycle. I knew she was pregnant, but had no idea she'd been struggling with fertility problems. When she asked me if I planned to have kids, I ended up telling her in an email that I was starting IVF and that I was nervous. She called me immediately. It was good to connect with somebody who has actually been through it.

She had some interesting advice about not sharing all the gory details of shots and emotions with my husband. She said that her husband had a hard time with that stuff and made the statement "well lets just stop, then" somewhere mid-cycle after she'd already taken a bunch of the injections. She wanted to kill him. I don't blame her. I suspect this type of response from husbands is probably not that uncommon. In fact, I could see my own husband saying the same thing if he thought I was in pain or really struggling. He has already said that he would not be able to go through what I'm going through (needles, retrievals etc...) if he were me. So while I don't plant to hide things from him, I will probably try to spare him some of the details. There's no need in both of us being miserable, right?

Before I hung up with my friend, she suggested that I identify a couple of close friends that I could talk to when I needed it. And she told me not to hesitate to call her any time. That really meant a lot to me. I mean like I want to send her a thank you card or something, except I'm afraid she'll think I'm crazy. I just hope I can hold it together for this.