Friday, April 27, 2012

Infertility Awareness Week

Ironically enough, this week is National Infertility Awareness Week.  RESOLVE is an organization dedicated to bringing awareness to infertility that I have recently come across.  Although I hated to think of us as infertile, the definition of infertility is anyone of child bearing age who has tried unsuccessfully to conceive for at least one year.  After a year and a half plus, three failed IUIs and now a failed IVF under our belt, I think it's official that we are infertile.  My stomach just turned when I wrote that.

I'm grateful that there is an organization out there that is working to help people understand this common, yet often undiscussed, issue and providing much needed advocacy.  Matt and I are so fortunate that his insurance covers much of our treatments, but I know we are in a very small minority.  I can't imagine it costs an employer that much more (especially in a large plan) to cover infertility when a relatively small percentage of the general population deals with it.  They also have some great resources for those going through infertility, as well as those supporting friends and family.

Through this process, I've connected with so many people that are also facing their own battles with infertility, one of them being a sorority sister whose husband started a blog.  Besides being a fantastic writer, it's really great to hear from the male's perspective.  He wrote an awesome "primer" on infertility that you must read if you are interested in that sort of thing.  It's truly amazing some of the things people say to you when you're facing infertility.  I swear, if one more person tells me to relax and maybe it will happen (especially after our very low fertilization yield), I will drop kick them.  Do you not understand that if you were to put odds on our chances of getting pregnant without IVF, they would probably be 1% or less?  Yes, that's still a chance but under the assumption that I have 12 cycles per year as a normally ovulating woman, that means that statistically, I would get pregnant once every 8 years and 4 months.  Of course, that's only statistics and means jack squat, but I just want to point out that relaxation is not usually the issue for why people don't get pregnant.  With IVF, the success rate for my age group is roughly 40-45%.  Lucky for us {dripping with sarcasm}, we fell into the 55-60% group this time.  Odds are that we will eventually get pregnant with IVF, but there are no guarantees on anything in life.  We also don't get an unlimited number of insurance covered tries and God willing, we don't max them out, but if we did, that's it.  If it hasn't worked by then, chances are it wouldn't.  So, we'll be saving up for adoption.  But, I digress.

As Carson pointed out in his post, the best thing you can say to someone facing this rollercoaster is just that you are thinking of them, praying for them, etc.  Provide support.  Don't ask questions (unless you are very close with said person).  Don't offer advice, especially if you haven't been there.  Don't diagnose.  Everyone deals with it so differently, but I think these tips would apply to anyone going through this.  For me, I am personally more open about it.  I am not bitter (much... yet).  Yes, I sometimes roll my eyes when I see yet another pregnancy announcement on Facebook, but generally speaking, I am truly happy (and slightly jealous, yes, but happy) for my friends who are expecting.  Close friends, please let your friend who is aching for a child know personally and privately that you are pregnant.  I think this is a common courtesy and though it may be a hard thing to do, she (or he) will appreciate it.  If you are pregnant, please don't complain about it.  I get that pregnancy is tough.  I am not saying that I won't ever complain about nausea, aches, pains, etc. when I am (God willing, please and thank you) pregnant.  But, for Pete's sake, DO NOT COMPLAIN in front of people who would kill for morning sickness, exhaustion, and sciatica over infertility treatments and more heartbreak.

Bottom line is there is nothing anyone can say to make it better but just knowing you have people who love, support, and pray for you means more than you probably realize.  Sending wine and Twizzlers as reinforcements probably isn't a bad idea either.

Thursday, April 26, 2012


Well, the good news is that IVF was not physically hard on me, not even the IM progesterone shots (seriously not so sure what the big deal is about those... maybe I'm just extra tough or I just have an extra big butt or I had a good "nurse", but they didn't bother me). This is good news because we'll be doing it again.

Obviously, the bad news is that I am not pregnant. But, I already knew this. Unless I am some sort of freak of nature that does not metabolize hCG in my urine, I knew I was not pregnant. I did hope that I was that freak of nature, but it was certainly no shock to hear from the doctor with the bad news.

What was a shock was that it didn't work. I knew there was a chance it wouldn't, but I REALLY thought this was it. So did the doctors. Clearly, fertilization appeared to be our issue, especially once we only got three of thirteen to fertilize through ICSI. So, it seemed almost like a forgone conclusion that a good embryo would make a happy home in my womb. I am healthy in every way they can test for. Did they miss something? Was it just bad luck? After all of the initial drama, why would God even give us a chance, give us hope, if it was going to turn out this way? I am sure there is a reason, but I just don't see it. I guess it would have been no better if we had ended up with no good embryos at all... that would have sucked just as badly. All of the doctors in the practice will meet to discuss our case, what was good/bad, talk about the whole fertilization issue and talk with the embryologists in more detail about anything they may have seen with my eggs or Matt's sperm. Then we'll meet and discuss next steps.

I talked to Matt briefly and he wasn't able to talk too openly, but I know he is as crushed as I am (and we both just want to go home and cry... I, however, clearly have no problem crying in my wide open cube for all the world to see because I've been doing it for a good part of the day). We put two beautiful embryos inside of me (okay, maybe one wasn't that scientifically beautiful but it was to us), and I just don't understand what went wrong. How could neither one of them have made it? Did they both stop dividing, were they not able to implant, what? I will never know, but I can't help feeling an emotional connection to them. Obviously, I've never miscarried, but I am sure these emotions aren't like those. However, it is still such a feeling of loss even though I was never actually pregnant. Lost hope, lost opportunity, lost life. Much different than the three failed IUIs or many months of negative pregnancy tests.

I can tell you that I went from adamantly not wanting twins and thinking that I might rather have this first try result in no pregnancy than putting in two and getting twins to not really having a choice in the matter and putting in two and rooting for both. Obviously, we would have been thrilled with one healthy baby, but I know I'd rather deal with all that comes with twins than to feel this disappointment again. (To be clear, I'd still prefer they come one at a time. I am still sane.) :) We just want to be parents. Why does this have to be so difficult for us?

Last week, I was researching whether or not the first hCG tests could tell whether or not there were twins and when I'd have my first ultrasound. But, life goes on and we'll be fine. I've said it before and I'll say it again, our problems are nothing compared to so many but it doesn't take away from the suckiness or hurt. But, we still have SO MUCH to be thankful for and so we will try to focus on that as we build back up our hope for next time.

Monday, April 16, 2012

And then there were two...

So, we didn't get the call on Saturday morning, which meant it was time to gear up physically (by drinking a lot of water because you need a full bladder for the transfer), spiritually, and mentally.  We had no idea what kind of decision, if any, we'd have when we got there.  Did all three continue to develop and divide normally?  Two?  Just one?

Once we got to the office, they put us in a room to change into our scrubs and hospital gown.  I didn't realize the transfer was so sterile, because the IUIs weren't and it's a very similar process.  We joked around a little bit but I feel like there was a lot of silence as we just waited and wondered.  The woman doing a transfer before us didn't have a full enough bladder, so we went ahead of her.  We had to wait a bit in the OR (same room the retrieval took place) before the doctor came in, and I was ready to know what we had.

This cracks me up.

Two thumbs up... a sign?
After what seemed like a pretty long time, the doctor and embryologist came in and showed us a picture of our two remaining embryos.  The third arrested.  We once again asked why we would have only gotten three embryos out of fourteen eggs, but they really don't know.  Our sincere hope is that we don't have to worry about it too much in the future.  As I think I mentioned, we really don't want twins, and we had always planned to put only one embryo back in.  However, we were also planning to do a Day 5 blastocyst transfer and have embryos left to freeze, so you see what happens when you try to make plans.  :)  So, we were presented with our options - put in one or both.  One was a "perfect" 8-cell grade 1 embryo and the other was a 5-cell grade 3 embryo.  The second really would not have had a chance to mature outside of me, and it may or may not inside of me.  But, both the doctor and embryologist were pretty adamant in their recommendation that we transfer both, even knowing that twins isn't really something we wanted to consider.  And, so in the thirty seconds we had to make that decision, we decided to take the plunge and leave it up to God from here.

So, I've got two embryos inside of me (or maybe one or none).  It's weird not to know if they're still growing, dividing, and getting ready to implant.  So, we wait.  I'm working from home for a few days (milking it for what I can), and then I'm heading to NYC on Sunday for a little girls trip, where they've told me they will force me to rest.  I mean, it's not like they are going to fall out!   My beta test is the morning after I return from NYC, so that should help the last few days of the dreaded two week wait go by more quickly.  I'm at peace about it all.  Obviously, I dread another negative pregnancy test, but I know that we've done all we can and now we just need to trust.

*Fingers crossed, prayers continuing, keeping the faith*

Friday, April 13, 2012

Not for the faint of heart

Wow, what a rollercoaster the past few days have been.  We woke up Wednesday morning excited for what laid before us.  The egg retrieval was an easy process.  I had no problems with the anesthesia, it wore off very quickly once they woke me up, and I felt completely fine all day Wednesday, although I did take advantage of laying around and taking a nap or two (and watching Game of Thrones in bed with my love).  We got 14 eggs, which is a pretty good number.  I was hoping for more initially, since my AMH (measures egg supply) is so high, but 14 is good.

I woke up yesterday and felt pretty good albeit tired (still not sleeping well).  My ovaries are a bit sore (and I'm constipated... maybe TMI but something has got my system jacked up and swollen ovaries + a stopped up system = a not happy abdomen).  Then, as I was on my way to work, the number for the fertility doctor came up on my phone, so I knew it was probably the embryologist and I was excited to hear how our embryos were doing.  BAM!  They were able to perform ICSI on 13 of the 14 (I actually have no idea what happened to the 14th... maybe it was the runt of the litter), and only 3... THREE!!!!... fertilized.  Huh?  Come again.  I was not expecting that, and it definitely threw me for a loop.  They have no idea why; it could be that my eggs did not activate once the sperm were in there or that the sperm were somehow deficient.  There's really no way of telling.

I was in a funk most of the day.  I e-mailed our support group and prayer warriors when I was probably at my worst, and I know their prayers sustained me and they stood strong for me and held onto hope when I felt like mine had been ripped away and then someone sucker punched me in the gut.  I mean, we still have three embryos.  And, all we need is one to make a baby.  But, that's just not how things are supposed to happen, so it was just shocking and not welcome news.

Once I got home, Matt and I were able to hug, talk about it, shed a few tears, share our concerns, and get over it and focus on the three potential babies we have still growing.  No news is good news today, and I haven't heard from the embryologist and pray that I do not.  We are tentatively scheduled for a 10:30 am transfer tomorrow, but the embryologist will call by 8:20 if we are good to go for a Monday blastocyst transfer, as planned.  I have no idea how our embryos are graded, if they look healthy, etc. but I am surprisingly at peace about it.  Matt shared his worries last night that we would end up with none, and not to say that the thought hasn't crept into my head, but I'm just not worrying about it.  My God can do immeasurably more than I can hope or imagine, and He is in control of this.  Maybe the other ten embryos would have had chromosomal issues or something... who knows?  It's not the first time my faith and hope have been put to the test, but I'm still hanging on and I refuse to give those up.

And, because I have absolutely no shame anymore (I never had much to begin with... just ask anyone who attended or saw me at my bachelorette party... let's just say it involved a Burger King like cardboard crown, only it wasn't a crown), I have to show you the super sexy side of infertility. I mean, I just shared with the entire interwebs that I am constipated, so whatever.

I'm sexy and I know it.

In recovery.

Heat in the front, ice in the back.
I started the progesterone shots yesterday, and while I am going to try to do some shots myself, I felt like I needed to know what was coming before I attempted to stab myself at a somewhat awkward angle with a one and a half inch 22-guage needle.  So, Matt reluctantly kindly volunteered.  It only took him almost passing out when I flashed the needle in front of him, having to sit on a chair, and count to three at least three times before he finally got the guts to proceed.  I am happy to report that it truly didn't hurt at all.  Until today.  Yikes!  I am going to have one soar rear end, hopefully for the next 4-8 weeks.  It will be more than worth it for a healthy baby in 38 weeks.

Tuesday, April 10, 2012

It's time

Work has been super busy, as has life, so I have not had a chance to sit down and blog about IVF thus far.  I have sent a few e-mails to friends, so for simplicity sake, I am just copying and pasting them below along with the date so I can record this time.

April 2, 2012
Ladies, it's officially go time for Operation Baby O.  For real this time... the rest of the last year and a half was just practice, apparently. 

Tonight I will begin ovarian stimulation in hopes of producing many lovely eggs.  I will inject 100 IUs of follistim and 1 unit of menopur (don't worry, I don't really know what that means either) every night for the next 8-12 nights.  I go in Saturday for my first bloodwork and ultrasound to see how things are progressing.  Assuming everything seems good, I'll go back Monday morning but it's possible I could go back Sunday depending on how things look.  Once my eggs are about 16mm (>20mm to "harvest"), I will add ganirelix, which is the antagonist.  This will allow my eggs to keep growing but will keep me from ovulating prematurely.  Once they add this, I will be on it for three days and then it will be time for my hCg shot, which is followed by pre-op the next day and then retrieval the following day. 

More than likely, I will have retrieval on the 12th or 13th but it could be a few days earlier or later.  When they do retrieval, I will be put under general anesthesia, and then will insert a very long needle (guided by ultrasoud) through my vaginal wall and into my ovaries to retrieve the eggs (sounds pleasant, huh... that's why you get drugs).  Matt will also make his deposit at this time, then we pray that we get lots of Grade A embryos!  (Not kidding, they grade them and being the overachiever that I am, I expect nothing less than straight A's.) 

After the retrieval, I have to start progesterone injections right in my butt with a needle that sort of scares the bejeezus out of me (in addition to estradiol orally... I don't even know what that does but I just do what I'm told).  Apparently, this is going to be a lot of fun.  I have determined that I can handle the right side, but the left side is tricky, which means Matt will have to do that side.  This scares me even more.  Pray for us.

We are doing a blastocyst transfer, which means we let those babies mature for five days in the lab (and get pictures of the cell division along the way... Baby Olson's first glamour shots?) before he or she goes back in me for a 38-week stint in lockdown.  So, retrieval day is day 0 and day 5 will be the transfer of our future child.  It's all very scientific and mind blowing, really.  If all goes as planned, I will know that I'm pregnant by the end of the month.  If it doesn't go as planned, send lots of reinforcements, and by reinforcements, I mean wine and twizzlers.

If you could keep us in your prayers over the next few weeks, we'd sure appreciate it.  I like to make light of it, but as we all know, this is a pretty big deal and will hopefully be the beginning of a majorly wonderful and wonderfully major life change for us.  But, whatever happens, I am just trying to put my hope, trust, and faith in the good Lord who I know hears my prayers and will grant them in His perfect time.  I've been leaning on this verse lately...

"But these things I plan won't happen right away. Slowly, steadily, surely, the  time approaches when the vision will be fulfilled. If it seems slow, be patient!  For it will surely take place. It will not be late by a single day." Habakkuk  2:3

I know the vision will be fulfilled, and when it is, it will not be late.

Thank you for supporting us and I will keep you updated as things progress.  Now off to play human pin cushion!


April 7
Well, speaking of overachieving, my ovaries are winning that award. In the words of the doctor today, "it's not often that I can't remember if I've already counted that follicle." I don't even know what the final number was but I had a lot of follicles ranging from 11-16mm, most were 12-14mm. This is good, but it's also fast. All my bloodwork looked good though. So I've dropped my follistim dose to 50 IUs (half of what I had been doing) and added the ganirelix (to keep everything growing but keep me from ovulating).

I go back Monday, and more than likely, Wed will be retrieval day. I will know for sure on Monday. This would put the transfer next Monday.

As for how I've done with the meds, the shots have been easy so far (big needle in the butt doesn't come until next week). I have had no side effects except some tenderness in my ovaries, which isn't surprising given what we saw today! So, other than the fact that I wish we had gotten pregnant on our own a year ago, I don't have any major complaints.

I will update Monday after my appointment. Happy Easter!

April 9
Well, it's good news and possibly not great news.  The good news is that my sleepless nights are almost over (for the time being).  Since going off the pill, I've realized that right before I ovulate and start my period, I sleep very restlessly.  So, I guess it's no surprise that excess levels of FSH and LH have the same effect.  Also, I was a little worried about timing w/ my NY girls trip on the 22nd, but there's a chance I will know I'm pregnant before said trip (as opposed to doing a transfer too close for comfort to the trip).  The not so good news is while I have a ton of follicles, we might not get as many mature eggs as I thought.

At my appointment this morning, the first thing the ARNP said was, "Wow, your ovaries are big!"  I believe she also remarked that my uterine lining was beautiful with a nice triple stripe.  She concluded by saying I had nice ovaries.  It sure is nice to be paid such compliments on your female anatomy.  ;)  I had several follicles that were 20mm (i.e., ready to go) and several more than were close.  I also had many more that were still less than 16mm and thus not so mature (and likely won't mature before retrieval).  They wanted to try to eek another day out of me to get those ones bigger, but no such luck according to my lab results.  So, tonight at 9:30 I do my hCg shot (no more of the other meds) and tomorrow I go for my pre-op.  Then Wednesday at 8:30 am is the retrieval, which puts a transfer (God willing) on Monday.

I am definitely anxious, especially since there aren't as many big eggs as we'd like, but hey... we only need one embryo to make a baby!  I know it's in God's hands and if it's meant to be, it will happen no matter how many embryos we get.

Please say a prayer for the procedure, as I will be going under anesthesia.  And, obviously, a prayer that this is our time.  One thing I've wrestled with a teeny bit is whether I/we are trying to play God by doing this, but I truly feel like God has only opened doors and not shut them in this process.  I mean, going into it, we had NO IDEA that our insurance had fertility coverage.  I can't imagine dealing with the heartache of longing for a child and not being able to afford options to get there, so I feel very fortunate.  And, I think where something like this might push people away from their faith or away from their spouse, Matt and I have only opened our hearts more to Jesus and grown closer to each other.  Sure, I would have loved to skip all of this and gotten pregnant right away, but I know that He shapes us through hardships  (James Chapter 1 - straight up wisdom, y'all) and I know He is working in us.  God knows we both talk to Him a heck of a lot more than we used to, and I, for one, am better for it.  And, I've found more opportunities to share my faith and be comfortable in sharing my faith over the past 6 months than the previous 29.5 years.

And shoot, our child will NEVER doubt how much we loved, prayed, and wished for him/her.

With love and anticipation,

Side note: I just found out at pre-op this morning that a Day 3 transfer is still possible.  It depends how many embryos are progressing well as to whether or not they will let us go to Day 5.  So, a Saturday transfer is also a possibility at this point and we won't know which we're doing until early Saturday morning when the embryologist calls us.  I have my fingers crossed for Day 5!

Wednesday, April 4, 2012

Lucky Rabbit?

You probably had a lucky rabbit's foot at some time in your life.  I know I had several (and thinking about it now, it's really pretty gross... I sure hope they weren't real).  Well, I can now one up that... I have a lucky rabbit.  Meet Jack.

This was after I found Jack (for the second time) hopping around my back yard (like the sweet bathrobe I've had since freshman year of college?).  We actually found him the night before, and he let me pick him right up.  Due to unfortunate circumstances (my 3-1/2 and 10 year old neighbors), he jumped out of my arms and hid.  But, lo and behold, he was right back eating our grass the next morning and once again, let me pick him up.

Now, I don't have a lot of experience with pet bunnies, but in the experience I do have, they typically are not super friendly.  They might let you play with them for a little bit, but then they might nibble on you and try to get away.  Not this guy.  He is so soft and sweet and squishy and lovable and huggable and downright adorable.  And, right in time for Easter!  What are the odds?

I sent out an APB on our neighborhood listserve, and no one has claimed him.  It's Spring Break here in Atlanta, so I'm thinking someone doesn't even know he's missing because they are out of town (and don't get our neighborhood e-mail) or he was set free.  Either way, we're holding onto him until Monday (when people should be back), and if no one has claimed him, we've got some neighbors with a female bunny who, why unbeknownst to me, want a male bunny.  And, he'll have a good home there with a huge area to roam free, three little girls to love on him, and a playmate.  No pun intended.

It's also funny to me that he showed up (or more accurately, we saw him) mere minutes after I officially started my IVF regimen.  I didn't think about it at the time, but someone who has no idea what we're even going through at the moment said he was good luck, so I am just fine considering him our lucky sign.  (And, on that note... two days of shots down and all is good... I'm sure I'll post more soon.)

So, until his owners step up or Monday rolls around, we've got a little friend to play with... and make the dogs insanely jealous.

Jack's no dumb bunny.  Maddie wants to play.

And he jumps.  Pretty sure he wanted to escape.  Sorry guy.  You're too cute to be eaten by an owl or a hawk.