Wednesday, January 30, 2008

Prayers

I'm sure it's obvious by my last post that I'm a spiritual person, a religious person, and member of the Church of Jesus Christ of Latter Day Saints. Yes, I'm a Mormon, but like many Mormons, I prefer the term LDS. I'm not very active in my Church, but I still share many of the beliefs and follow many of the practices.

One of them is prayer. I love prayer. I think it's an amazing thing. I love that we have this avenue of communication with our Heavenly Father and I enjoy using it. I pray mostly at night, before bed, as part of my night-time ritual. I find it helps me sleep better to unload to Him. As a long-time sufferer of insomnia and nightmares, prayer has proven to be more effective than any medicine or therapy at helping me to get to sleep and sleep better. My mother once gave me a little wall plaque that read, "at night before I go to sleep, I tell all of my worries to God, since I know he's going to be up all night anyway." I like that concept. It's sort of a "let go and let God" kind of philosophy, one which I'm still trying to adopt in my life (it's not easy to let go).

I also pray at little times through the day. I often don't pray much before meals as my husband is non-religious and I think my praying sometimes makes him feel awkward. We try not to discuss religion much as it seems to make him feel uncomfortable. My friends know I'm spiritual, but I try not to discuss this much with them, either, because I've found that it sometimes leads to false judgments and assumptions. Many of my friends have had bad experiences with overzealous religious people who tell them they are going to hell if they don't get on board. That's always been a pretty amazing assumption. Who is to make that judgment? I think only God has the right to judge this, and further, I don't believe that nonbelievers are going to hell. I would hate to think that my friends might think that I hold them in such low esteem. To think another is going to hell, is to disrespect that person and it is not love at all. It's not Christlike to treat others in this manner. I don't think that I am any better than anyone else because I am religious. Religion is a very personal thing.

Enough of that, though, and back to prayer. Scientific studies have proven that prayer actually works! I don't even think it has to be true prayer (a communication direct with God), but focused positive thoughts or meditation can also lead to extra benefits. There is so much more to this world than the eyes can see or the hands can touch. There is so much more to us, as humans, than we sometimes care to explore.

Over the last month I have definitely felt the power of prayer, through my own prayers and the prayers of others. I feel so warmed by all of the energy my friends and loved ones have given me through this IVF cycle - not just in prayer, but in positive thoughts, kind words, and focused energy.

So, since so many people are praying for me, I thought I would share what, until today, has been so private to just me and God. I thought I would share with everyone what I pray about on a daily basis.

First I always tell the Lord how grateful I am for my many blessings. These include the home in which I live, the food I am fortunate enough to eat, the many good neighbors and friends that share my life and space, and my loving family. I thank Him for granting me goodness and love in my life. I thank Him for my wonderful husband and for Tempest, our kitty that brings daily joy to my life. I am also grateful for warmth, for living in an area where the weather is usually enjoyable, and where Dave and I are able to prosper. I thank Him for the many wonderful people in my life, and for the many good things that I see.

During acupuncture, I thank Him for the ability to use acupuncture and ask him to bless the needles and energy flowing through them, and to also bless and guide my acupuncturist. During fertility treatments, I do the same, thank Him for granting me the ability to get help for my condition, for I know that I am very fortunate to have this opportunity.

Depending on the events of the day, I thank Him for good news, and sometimes bad. Lately, I've been thanking Him for the good news of Nav's positive pregnancy test, and I ask him to bless her and help her and her husband to have a healthy pregnancy and a healthy baby. I know they are going to be excellent parents, but I pray for the Lord to be in their lives and to guide them through Nav's pregnancy and through parenthood. By the way, I believe we all have the same Lord, no matter which name you use.

I feel somewhat selfish at times because I also feel I sometimes ask a lot of the Lord. However, asking always helps me to relieve myself of many worries, because I ask him for things that I cannot do myself or control. Sometimes I ask Him to help me do better with what I can do or control in my life.

I ask the Lord first to bless and watch over those that are ill. By name I ask Him to grant wellness to my brother-in-law Tony, and ask Him to help Tony to live a better life, that through this my sister will have better harmony in her life. I ask Him to bless my cousin, Jimmy, in his long battle with cancer and to bless Jimmy's family during this difficult time. I also ask Him to bless and watch over Kelsi and Cohen, the children of my cousin Ashley, and to help them all to have strength through little Cohen's battle with cancer, and little Kelsi's lifetime battle with heart issues. I pray that Kelsi's heart will continue to strengthen and be less reliant on her pacemaker, and that she'll be able to live as normal a life as possible. I pray for Brian, my father-in-law, that his health problems will continue to improve, that the wounds on his leg will heal, and that he have the strength to endure all of the many hospitalizations and medical treatments he will need to reach wellness again. I pray for my brother and his family, that they may continue to recover from the devastation of the fire two years ago that took the life of little Halie Marie.

I then ask the Lord to bless and watch over everyone else in my life. Sometimes I mention people by name, sometimes it's just a general request. I know that the Lord knows what is in my heart and I don't always have to go into great detail. I also ask Him to bless those that are praying for me, that they will feel His love in their lives like I feel it in mine.

My selfish request is for a family of my own. I ask that He bless Dave and me with the children we've always desired and felt that it was our path in this life and that if parenting is not in our great path, then I ask for guidance and redirection. I've prayed a lot through this IVF cycle and I know many of you have, too. I believe that the success we've had so far is a direct result of all of the prayers and that through this, it reaffirms my belief (for now) that I am meant to be a mother, and for some reason I am meant to achieve this through IVF or at least experience IVF in my life.

I also ask Him to bless certain individuals in my life through the various challenges they are going through. I usually mention some by name, and some of them in groups. I pray for all of the women at a website I find support at called LoungePlace. There are many women there going through a lot of what I'm going through, and I pray that they also be granted the opportunity to have a family, or find their path and meaning through this difficult journey.

At the end, I think of all of those in the world whom I love, but don't know. I ask Him to grant all inhabitants of the world at least one day of peace and love, but I understand that this one day might not be the same day for everyone. I know there is much suffering and strife in this world and I pray for those that suffer the most. I pray for the people of Darfur, that they may see an end to the war and an end to the suffering. I pray for those that are hurting right now, that they may feel His love and let it comfort them in their time of need. I also pray that we all will see better days.

As a Christian, I say all of these things in the name of Jesus Christ.

Amen.

Monday, January 28, 2008

The Passing of a Prophet

Last night a great man passed from this realm to his reward in Heaven. I was saddened to learn of the death of President Hinckley, but I feel very fortunate that he was in this world and was able to spread his influence so far and wide. In my lifetime, I've never known a Church President to be so profound and so (as I believe) close to God. Maybe that's because of all the Presidents, it was Gordon B. that was able to reach me through his words and actions more than anyone else in the Church. He has really helped me to strengthen my testimony and faith, especially through these difficult years. I've never met him, but I always felt his true love for every Church member, including me, as well as his true Christlike love for every individual in the world.

For more information about President Hinckley, here is a lovely article about his works.

Incidentally, within a few hours of President Hinckley's passing, Archbishop Christodoulos of the Greek Orthodox Church also passed.

Today was good. A new friend of mine, Nav, got her BFP today! She is in my IVF group and I feel so fortunate to have met her. We've formed a quick bond and I really hope it lasts. Her husband is also a genuine sweetheart and I feel very fortunate to have met them both. Regardless of the outcome of my test on Friday, I can rejoice in Nav's great news. I hope and pray that this pregnancy is a healthy one. She really deserves it and I know she and her husband will be wonderful parents. I hope Nav's is just the first of the most successful IVF group in my doctor's practice.

Sunday, January 27, 2008

No worries (I hope)

Thanks to a friend's advice, I called the case manager hotline at my clinic and told a nurse about the cramping and other pain I'm experiencing. The best way I can describe it is that it's like a milder version of how I felt after the retrieval and how I feel when I have OHSS. I feel like I have rocks in my groin (or very low belly). I know that feeling to be my ovaries, which hurt when I cough, sneeze, or use the toilet. My belly is getting a little bloated again, too. As mentioned yesterday, just mild walking around increases cramping as well as this pressure around my ovaries. Oh, and the tmi, I was a bit backed up. Sorry.

Anyway, the nurse said that these are all good signs of implantation! I sure hope so!! She said that even the "backing up" can be a sign because all of that slows down for a few days. She said that the ovaries are hopefully starting to get to work supporting the implanting embryo. Further, since I have a tendency toward OHSS, if there is HCG in my system, it can cause the swelling to come back and cause all of those feelings I mentioned.

Let's hope so! I'll take all of it if it means success.

She said to keep resting.

I'm bored, but content.

I'm learning to read outside the bathtub. I'm having difficulty getting to sleep, though, without the whole bath/reading thing. I'm trying to read a bit before bed, but it's not the same since I have done my bedtime routine most nights for years. The body will adjust, though.

Sorry I don't have much to write about today. I just wanted to say that according to my doctor there is nothing to worry about so long as I keep resting. :)

Saturday, January 26, 2008

Dead Bodies

Last night we went to see the Body Worlds exhibition. It was at the Tech Museum in downtown San Jose. On the drive there the radio cut in with one of those emergency broadcast signals. It was telling us about a flash flood warning, then went on to talk about how police were evacuating the downtown business district. We thought they were talking about San Jose, but weren't sure because we missed the location. As it turned out, they were talking about San Anselmo. We made it to the exhibit just fine, but a bit wet just the same.

The exhibit was amazing! I was especially interested in the development of babies. I can see how it would be disturbing to some, though, as it might be disturbing to me at certain times. Fortunately, I'm in a place right now where I can handle it. Dave and I were able to watch a film on a developing embryo and point out how ours looked compared to the one in the film, and then we found an image of where our little ones will hopefully be in 1 week's time, 2 week's time, and so on. If this cycle fails, however, we would have had a very difficult time looking at this area of the exhibition.

That reminds me. I need to go visit a friend of mine, Anne, and her nearly 2-month-old baby. I was unable to visit earlier this month due to my being ill, and I must do it before the end of the week. If Friday's test is negative there is no telling when I might be emotionally ready enough to visit.

My ovaries started getting more painful again yesterday. It feels like the mild/moderate OHSS I had last weekend after ER (and get every time I use stims). I hope that's a good sign.

Dave's stir-crazy. He wants to go out and get some grocery shopping done. I should go with him, though it kind of hurts to walk. I don't know what to do. I don't want to rest too much, but I don't want to aggravate things by walking too much as it just increases my cramping. Is cramping bad? It could be a good sign, but is too much of it a bad thing? I know prostaglandins (which cause cramping) in excess can be bad for embryos, and uterine contractions can be bad, too, so does that mean that cramping is harmful? I wish I knew. I'm trying not to worry, as I'm sure worrying is worse for me than the cramping.

Thursday, January 24, 2008

We now have 2 frozen miracles! (plus our cycle overview)

At our IVF consultation, Dave asked our doctor how many embryos we might be able to hope for to freeze. Dr. E shook her head and said, "you shouldn't expect any to freeze, she really doesn't make that many eggs." I went home and cried.

After my last IUI cycle, I was told that because I had such a poor response, I should pick up my FSH meds as needed, after each ultrasound and blood work because it was very likely I wouldn't make enough eggs to even make it to retrieval. It wasn't Dr. E being cruel, it was just reality and she wanted us to try to save the money if our cycle got canceled and we had to try again.

Part of my problem was this cyst, this endometrioma I named Bertha, that was possibly inhibiting my ovarian response. Dr. E thought aspirating it would help solve the problem. Last year, August of 2006, I had a laparoscopy where Dr. D removed endo, which was significantly on my right ovary and he removed an endometrioma from inside my right ovary. Each time they remove cysts from inside ovaries with a laser (the best method to get an endometrioma to be gone and stay gone) it damages the egg reserve. Part of me wanted to get rid of Bertha once and for all (it causes me pain), but my doctor and I were concerned of the long-term damage that such surgery could cause my ovary, especially since my right ovary may be pretty badly damaged.

While my FSH is okay (8.1 at its highest), and my antral follicle count last summer was 15, Dr. still considers me to have diminished ovarian reserve. She says that this is mainly due to my age and the endometriosis. Stupid endo!!

Dr. E recommended to do the cyst aspiration and it was scheduled for December 12th, just a few weeks before beginning our first IVF cycle. She understood my concern that I wouldn't produce enough eggs to make it to retrieval and sadly, she wasn't able to allay those fears. She said it was very possible.

Bertha was aspirated and it was then that I realized how much pain that cyst was causing. It wasn't a tremendous amount, by any means, but it was a noticeable difference. I felt so much better after having that cyst emptied! Unfortunately, I started feeling the pressure return right around Christmas. I thought it must have been my imagination, but an ultrasound on January 2nd showed that Bertha had come back and was about the normal size it's been at rest (when not stimulating with FSH meds). Bummer. We feared our cycle would be canceled before it even began. It all hinged on blood work that day. Dr. E wanted to make sure that Bertha was not interfering with my hormone levels.

Fortunately, the blood work was good and we were able to proceed, but with Bertha, the fear of not producing enough eggs was greater. My first follicle check on January 9th showed pretty much no response to the medication. I was told that there were maybe 3 small antral-sized follicles on each side and that while I may produce as many as 6 eggs, we should be prepared to decide whether or not to do a retrieval if I only got 1-2 follicles (they like to see 3 for retrieval). They canceled my appointment for January 11th because they didn't think there would be any news.

On January 12th the ultrasound showed 7 follicles, 6 of which were with Bertha on the left (there was also a possible new endometrioma, but we won't worry about that for now)! I was over the moon, but then I got the call that our cycle was likely to be canceled. Fortunately, they had me continue the meds just in case and a follow-up blood test was fine, so they said it was a lab error.

The next ultrasound showed even more follicles. Still, only one on the right and the rest all on the left with Bertha. After the lab error shattered my hopes, I was able to build them back up as I went back to the clinic each day for another ultrasound and daily blood work. We had our egg retrieval on January 18th and they retrieved 9 eggs! Of the 9, 6 fertilized. Of the 6 miracles, 2 of them were text-book perfect 8-cell grade I embryos. We transferred those two along with one 7-cell grade II embryo (also very beautiful and perfect to me). Of the remaining 3, we had one 9I, one 9II, and one 10II. They did assisted hatching on the 3 they transferred and continued to culture the remaining 3 to see if they could make it to blastocysts for freezing. We were told that it's about a 50-60% chance of them making it.

The excellent news is that we now have 2 frozen miracles! They are graded 5BA and 3AA. The best grading at my clinic on a 5-day blast is 5AA. The embryologist said both of our snowbabies are excellent quality and stand a very good chance at making it through FET (frozen embryo transfer).

I actually feel pretty good about this cycle as it is, but I also hope to be able to use the snowbabies. I would love 3-4 children, but I think Dave still is set on only 2. At this point, I would be so delighted with any child, as I realize what a true blessing every child is.

If going through this journey has taught me anything, it has been about hope, faith, and about appreciating people and yourself.

I hope I still feel this hopeful and have this much faith come Friday, February 1st. It's going to be a very tense day waiting for that phone call that could either inform me of a miraculous passage to pregnancy, or bring me heartache and the despair that comes with that BFN (big fat negative - the despair of this seems to be exponentially increased depending on how many times it is experienced and how much one is invested - emotionally mainly).

Thank you to those that read my words here. Thank you even more to those that leave the loving comments. You keep brightening my days.

Needles needles and more needles!

Last night's progesterone shot was nasty. Dave really did nick a vein that time. He said he saw the needle go right through the blue vein near the surface. It bled a lot but didn't really hurt until about 3-5 minutes after. Oh boy that hurt! I think the last one on that side also nicked a vein because it bled a lot, too, but it didn't hurt as bad as last night's shot. Perhaps they'll continue to get worse since he's now injecting into bruises.

Even on my day off from shots (a week ago today) I still had acupuncture. My acupuncturist puts in anywhere from 4 to about 25 needles in any one session. It depends on what is going on with me. I have too much heat in my yang, he says. "Too much heat energy!" It's funny how after 3 years of seeing him I can actually tell when my "heat" is worse and when it's not so bad.

When I was injecting the FSH meds there were as many as 3-4 shots per day. Now I'm down to 1 shot per day but it's a doozy. If this works I won't have a shot-free day for another month or so. Let's hope my bum continues to get jabbed for weeks to come and hope that they become easier.

Still, compared to what I expected they really aren't so bad. They hardly hurt going in, it's after that hurts. A nurse advised me to walk afterward so that's what I do and it helps a lot. She said if you don't walk it off, the progesterone can form a lump.

Ut oh. I just heard a siren get closer and closer until it stopped just outside my house. My first thought was for Mary, my elderly neighbor who has suffered chronic pain for years and now suffers from emphysema. I just looked and don't see an ambulance anywhere, so it's probably down the street or on the street behind us. Still, here I am complaining of needles and someone nearby is in a world of hurt.

I had a terrible nightmare last night. Actually, it was early this morning. I don't recall all of the details, but in the dream it was January 17th and I had planned to go to a motel to reclaim part of my soul from an evil room that took it years ago when I was a teenager. The room was 17B and I had reserved it in advance because the 17th was the only day for me to be able to reclaim that part of my soul and I had waited decades to do it. An aunt of mine, Elizabeth, agreed to go with me. In the dream, Elizabeth had a special talent. She could change form into a red patent-leather cat. So we get to the room but it's still occupied by the people that stayed in it the previous night and they wouldn't leave. The room had taken parts of their souls, too. The motel tried to get me to take another room, but no other room would do. I barged into the room and a woman in there started to tell me about the teenager who left part of her soul behind when she first stayed there and how now the room wants the rest of it - the room wanted the rest of my soul. I looked around for Elizabeth and couldn't find her. I opened the door to the bathroom and there was a young girl in there trying to drown Elizabeth in cat form in the bathtub. I heard crying and opened my eyes, waking up to Tempest, my kitty cat lying on my pillow and Dave giggling at him. The crying I heard was just Dave's giggle and Tempest had been tapping his face trying to get attention since he was getting no attention from me.

Tempest is locked in the house today and doesn't like it. We had our trees sprayed for dormant baddies today and have to wait for it all to dry before little kitty can go out to play. It's driving him nuts. He's looking for toys everywhere and just wants to play.

Wednesday, January 23, 2008

Babies' first photo


Okay, so they aren't babies yet, but we hope they will be! Anyway, one benefit of going through IVF is that we get photos of our embryos. Usually, the first time a couple gets to see their baby (or babies) is through ultrasound after the pregnancy is pretty well established.


I love these photos. I love that we have embryos! I just think they're so cute. You can tell that they have my eyes, but Dave's ears.

Toxins everywhere!

I learned yesterday about parabens, which can lead to hormonal issues and cause reproductive problems. I already knew that phthalates are linked to reproductive issues and is possibly partly to blame for rising infertility rates and declining sperm counts, but I didn't know about parabens.

I've found a great deal of supportive evidence, but I can't say I totally understand it. All I know is that in this fragile state my embryos are in right now, and with how long we've tried to get this far, I don't want to risk anything by using the wrong shampoo or body lotion.

I went through my bathroom and threw out every item with parabens. It filled about 1/2 a kitchen-sized garbage bag and left my bathroom shower and cabinets nearly empty. I still have some new products I didn't toss out, but won't use. I'll give those to someone who isn't ttc, but I feel like attaching a warning "use at your own risk." If nobody wants them, I'll throw them out, too.

This mainly came about because Dave asked me not to use these products. He didn't know much about parabens, but from his university chemistry class he was concerned about the chemical effects on our embryos. We were also told by our doctor to avoid many cosmetic products around the time of the transfer. I was also told not to use the Lidoderm patches on my arm because the lidocaine can be absorbed into my bloodstream. I knew these products could be absorbed, I just didn't realize how toxic they really were, especially to little fragile ones.

I've been banned from having baths or swimming for at least the next two weeks. It's not necessarily a temperature issue, since that can be controlled (my doctor says bathing is fine in pregnancy as long as the temperature is kept under 99 degrees). The big issue with IVF is that they extract those eggs - leaving the woman's feminine bits exposed and at an increased risk of infection. So, for the duration I am forbidden from prolonged water exposure in my nether bits - and it's kind of difficult to swim or take a bath without exposing those bits to the water.

Without my nightly bath I have been feeling deprived. With RSD I've changed my diet and there aren't many indulgences left to me. A nice warm bath, perhaps with a candle, some soft music, a good book, well, that was my big and almost my only indulgence left. Now I don't have that.

In looking for a replacement indulgence, I was thinking of lotions and potions that might help feed my "girly side." When Dave asked me not to use them, I agreed but after a few days I was really feeling deprived. I mean, in this stage of the IVF I'm taking 7 pills a day and getting a big shot of oil in my bum each night. The shots really aren't so bad, but after a few of them now my upper bum cheeks are a bit sore.

The sacrifices are definitely worth it, but I still needed some sort of indulgence. I know, that could be selfish of me, but we all need "me time" and some pampering or we suffer and it's more difficult to take care of others.

A friend of mine suggested a foot bath at night. Good friend and great suggestion! I have a really nice foot bath but only use it a few times a year - didn't see the point if I was going to take a full bath most evenings. I went to Whole Foods and replaced my shampoo, shower gel, bar soaps, and body lotion with organic and simple solutions. In the foot bath last night, I used some of the citrus bath salts (naturally scented with essential oils - I hope citrus is okay). My foot bath has 3 settings: massage, bubbles, and massage with bubbles. It also has an infrared area for a little extra heat on parts of my feet and a massager/pedicure device that allows different attachments and spins on pressure.

After using it I felt so relaxed! It was great. :)

Tuesday, January 22, 2008

Tick tock tick tock tick tock

Okay, so this is the 4th day of the longest two-week-wait of my life. Aagh! Actually, it's not so bad.

Yesterday's PIO (progesterone in oil) shot hurt a tiny bit. The needle felt like a sting, unlike the 2 previous shots. Still, it wasn't as painful as my acupuncture needles (which I'll be getting in about 2 hours). The area feels quite bruised now, even though it doesn't show it. The bandaid was also a bit more bloody than normal. Maybe that's the low-dose aspirin's fault, or maybe Dave nicked through a vein when putting in the needle (he didn't inject into a vein, though, he's pretty careful about checking). He's pretty good at these shots for being a beginner and bless his heart, he tries his best to make this ordeal easier on me.

In addition to preparing the whole shot himself, he hides it so that I don't have to see the needle. Even though I gave myself all of my subcutaneous shots, I still have a deep and long-term fear of needles. I don't really know why, but it's just a part of my being. I'm better at hiding it, or at psyching myself up for getting jabbed now, but I still have difficulty looking at the needles, especially the big ones. I can work myself up into quite a panic in anticipation of the jab. I find yogic breathing really helps, as well as other techniques (sort of a self-hypnosis method).

I've been getting treatment from my infertility clinic for nearly 2 years now and that has brought a lot of jabs with frequent blood tests and injectable hormones. To truly understand what an infertile couple goes through is to walk in their shoes. I have found, however, many people who don't have to experience infertility to be sympathetic to our situation. Thank you to my family and friends who have been so sweet and supportive. I know sometimes it's hard to know the right thing to say, but when you're sincere, that shows through more than anything.

When getting infertility treatments it's amazing that the couples, women especially, don't fall into a mind-set of the chronically ill. Infertility treatments can vary but it is common to have to get blood drawn frequently, sometimes daily. There are sometimes daily injections, frequent ultrasounds, other tests like the HSG, SHG, and hysteroscopy that cause anxiety and pain. Many couples, again - especially women, have to submit to surgery to diagnose and treat some conditions. the desire to have a baby pushes the couples through all of this and gives them the strength to bear it, month after month.

A typical natural IUI (intra-uterine insemination) cycle (no medications) may involve 2-3 blood tests in one month, 2-3 ultrasounds, and perhaps an injection of HCG (the hormone to trigger ovulation if the woman has difficulty ovulating on her own). A medicated cycle can include pills like Clomid or Femara or injections like Follistim, Gonal-F, Menopur, Repronex, or some others that are similar. The medicated cycles usually require daily administration of the pills or injections. These hormones make a woman feel physically sore and give emotional boosts (that's the best way I can describe it - everything is magnified).

The ultrasounds, or "dildoscans" as we patients like to call them, can leave you feeling sore and violated. They use a blue-green gel as a lubricant and sometimes that can bring about a little panic for days after as the female patient discovers an oddly colored discharge. Any internet search for a blue-green vaginal discharge can lead one to believe she has a terrible infection. Her first worry is not necessarily for herself, but for how this will affect her cycle and her chances of getting pregnant.

While women do usually have to deal with more of the brunt of the doctor visits, the injections, and surgery, men also have to face ordeals of their own. Society places a lot of value on a man's masculinity and virility. When dealing with infertility, this can wreak havoc on a man's self-image and psyche. They have to "perform" for a cup, sometimes quite often. They need to submit to semen analyses - sometimes repeatedly. When doing IUI or IVF, they need to perform on the spot on the ovulation or egg retrieval day at a specific time. Clinics usually want the specimen at a specific time and you only have about 1 hour to get it to them from the time of collection. Show up too early and you have to hold it somewhere difficult (between your legs, under your arm, or between your boobs if you have bigguns) until someone at the clinic can take it from you. Show up a few minutes late and you may have missed the pick-up from the andrology lab.

At my clinic, the patient may be seen by any of the staff members. There are 4 Nurse Practitioners that usually perform the ultrasound and coach you through what needs to be done. There are 3 Reproductive Endocrinologists (the REs - doctors that specialize in infertility treatment - Obstetricians with extra school and training), and several Registered Nurses who check the patient's blood pressure, weight, administer injections, give lessons on injections, offer extra support, make appointments, and give advice. I think pretty much every staff member at my clinic except for the receptionist has seen parts of my body that I would get arrested displaying anywhere other than Santa Cruz or Berkeley. With IVF I was introduced to another clinic and now more people are way too familiar with my personal bits.

With all of this it totally amazes me at how couples are able to hold their heads high and continue month after month and pursue this goal that comes so easily to most of the population. They experience extreme despair, sometimes complete loss of hope, and somehow are still able to pick themselves back up and build up hope again for another cycle. They do this cycle after cycle until they actually succeed, or until they have exhausted all avenues and cannot proceed any further.

These people are amazing and they deserve nothing but love and respect. I've learned so much from these years on this journey and feel very fortunate and blessed to have met the people that I otherwise would never have met, had I not shared this journey with them.

Monday, January 21, 2008

I'm a little bit pregnant, I'm a little bit rock and roll

It's a strange feeling knowing that I actually have real embryos in me trying to make their way into my endometrial lining. How exciting!

We had 3 embryos transferred today. Of the 6, all of them were still going strong by this morning. We have 2 grade I, 1 grade II, and the other 3 were a little overdeveloped (7, 8, 9 cells at good grades). We decided (with the doctor's advice) to transfer 3. We transferred the 2 grade I and the 1 grade II. The rest will try to make it to freeze. They only freeze blastocysts. We'll find out Thursday if any made it. They said it was about a 50% chance.

So, I have to make another correction. Boy, all of this is so complex, I get confused about so much information. At day 3, they are graded from I to V with V being the worst and I being the best. At day 5 the grading changes so that grade I is the worst. I know some IVF veterans know much more about this than I do.

I'm just taking it easy and resting the best that I can. I'm really tempted to change the sheets, do the laundry, clean the kitchen, clean the office... but Dave won't let me. He's sweet. He says if I really want it done, he'll do it tonight after work. :)

I'm watching "The Jerk" on Tivo. I love the line, "I was born a poor black child..." coming from Steve Martin. The movie is a classic and I can watch it several times.

Speaking of classics, I have my "Gone with the Wind" dvd all ready to play. Dave gave it to me for my birthday in anticipation of this rest period.

I love the feeling of having 3 little ones in me.

Originally I was referring to the 6 as Greg, Peter, Bobby, Marcia, Jan, and Cindy. I asked Dave what we'll call the 3 we put back and he doesn't want to tempt fate. So, I guess blobby 1, blobby 2, and blobby 3.

Saturday, January 19, 2008

Six embryos!

We got our fertilization report early today, at about 11:30am. Of the 9 eggs, 6 fertilized. That's all she could tell us, but she was as excited to give us the good news as we were to receive it. As happy as I am with the news, I wish I knew about the eggs, the maturity of them, and whatever else they might know from analysis of the eggs and/or embryos. I guess we'll find all that out on Monday.

The transfer is scheduled for Monday at 9:30am. They don't plan to go for blasts unless there are more than 5 really super quality grade-5 embryos at day 3, so there is a slight chance we'd get pushed to a 5-day, but not likely (especially since it's on a Monday, rather than later in the week - I gathered that they work with minimal staffing on Sundays).

I'm just dying to know all the information that I can! However, sometimes that desire of mine just pushes them to give me bad news that doesn't do me any good.

It seems that we now have a choice as to how many embryos to put back. The recommended amount for my age is 2-3 depending on the grade. I feel very blessed to be able to have a choice, as we were told all along that if we made it to retrieval, we'd probably barely have the recommended 2-3 to transfer (or maybe even 1).

Thank you for your prayers and continued support. I've been very warmed by your comments, too.

Friday, January 18, 2008

Wow! We got 9!

The retrieval went very well. They all took such good care of me and Dave. The wonderful news is that we got 9 eggs! That's a lot more than the 1-3 I was told to expect. They're doing the ICSI now and I can't wait for the results.

In my post yesterday I made at least one error (probably more, but I explained it as I knew it). The grading for the embryos goes from 1-5 with 5 being the best. That's the grading before they push them toward blast stage, when the grading changes and 1 is the best. I was told again not to expect blasts because of the lower number of eggs. They push more for blasts when there are many more than 10 eggs.

So basically, now we just wait for the fertilization report sometime tomorrow. The plan for now is to go in Monday for the transfer. I don't know what time.

Thursday, January 17, 2008

We made it to retrieval! It's tomorrow.

We have to leave around 6:30 to check in at 7:30 for a 9am retrieval. The person doing the anesthesia is named Pat and she's wonderful. She's been drawing my blood all week. She's very kind and good with the needles. She also is aware of the RSD and promises to do what is necessary to reduce any RSD flares.

I'm amazed to have made it this far. If you've read the rest of this blog, you'll know that my doctor didn't know if I could make enough eggs. Well, I did! The last follicle count was 12, but that could have included cysts and it definitely included some that aren't so big. Still, about 8 may be mature by retrieval time. I can't wait for the fertilization report.

A friend of mine, Renae, had her retrieval this morning. She and I knew each other before this cycle, but were acquainted by chance. Now I firmly believe we were meant to meet and we were meant to go through this together. There is just too much chance going on with this friendship. Anyway, I'm so delighted that she got 7 eggs today. I am just as eager to hear her fertilization report as I am about mine. If you pray, please add a special one for Renae.

A virtual friend of mine on a bb asked me to explain our process. Rather than write it twice, I'm copying it and pasting it here, too.

Basically, what I'm doing is called an antagonist protocol. As far as I know, it's a protocol the experts use on women who don't typically produce much eggs. The hope is to get enough good eggs for retrieval and transfer. I started the injections on January 5th. I did two to four shots in my belly each day. In the mornings I did a medication called Follistim, which is injected with a pen, much like many diabetics use. When the medication would run out in the pen, I would have to do a second shot to finish the dosage. In the evenings I injected Menopur with a syringe and needle. It is also done with a diabetic needle, which is really thin and only 1/2" long. They don't hurt that badly, just sting for about 10 minutes or so. I got bruises from the follistim, though, so my belly is a bit colorful.

After a week of stimulation with the FSH medicines (Follicle Stimulating Hormone - the Follistim and Menopur are FSH, which helps a woman to recruit and produce more and better eggs) I started the antagonist (the drug that makes it an antagonist protocol). The antagonist I used was Ganiralex. It's also an injection in the belly. It comes in a pre-filled syringe ready to go. I did that shot at the same time each day to prevent me from ovulating so that my smaller follicles had more time to develop and produce mature eggs.

Last night I gave an additional injection, the hcg trigger shot. Since I was using the ganiralex to inhibit ovulation, I needed the hcg to induce ovulation. Ovulation usually occurs about 36-48 hours after this trigger shot. The egg retrieval procedure is scheduled for 35 hours after the trigger shot - so tomorrow morning at 9am (though I have to be there at 7:30).

Tomorrow they will give me an IV and make me go floppy sleepy. Basically, I will be deeper than sedation but not as deep as general anesthesia. They'll use an ultrasound to guide a needle to the follicles. They'll stick the needle in each follicle and suck out all the fluid and the egg. After they are done with that, they flush out my ovaries to try to get anything they miss. Since they suck all this out with the eggs, I will need to supplement myself with essential hormones in this 2ww.

They'll tell me at some point how many eggs I have and I will be told to rest for the weekend. They'll be doing a procedure called ICSI on my eggs. ICSI is where they cut a tiny slot in each egg and implant a sperm. They will basically be creating the embryos. We need to do this because on top of my own infertility issues (advancing age and severe endometriosis), my husband has low counts, low motility, and low morphology (morphology relates to the shape/quality of the sperm).

They will also do "assisted hatching," which I think it means that they will do what needs to be done to make sure that the eggs are ready for being embryos. I'll get a phone call on Saturday with the fertilization report. Basically, that will also be indicative of the quality of my eggs.

Through this whole process they monitor the embryos and watch the cells multiply as they study the embryo quality. They will grade the embryos each day from 1-4 (I think), with the higher number being the better grade. On day 2 they will decide if they are good enough quality to go for day 5 blastocysts (after day 3 the grading changes so that the best quality is grade 1) or whether they should be put back on day 3. Sometimes if they aren't doing so well they will put them back on day 2 since they sometimes tend to do better in the womb.

The best transfer is a day 5-6 blastocyst - there is more of a chance of pregnancy from those. Anyway, with any luck I'll go back on Wednesday for the transfer. With a little less luck I'll go back on Monday, which is still good.

Starting tomorrow I'll take Medrol, an immune suppressant and anti-inflammatory medication. This will help suppress an auto-immune response and inflammation from all of the medications and procedures. Starting Saturday I'll add baby aspirin to help support a better endometrial lining for implantation, and estradiol tablets along with progesterone (it's in oil and given by intramuscular injection - in my bum by my husband and ouch) to help support the embryo. The estradiol and progesterone are the hormones needed since they suck all of that out of me at the retrieval.

My pregnancy test will be on February 1st.

Sunday, January 13, 2008

What a roller coaster ride!

My lab test results are back to normal. My estradiol is above 500 now and my progesterone is .2. I'm quite confused.

The coordinator called and said it had to have been a lab error. She said that she and the doctor both had difficulty sleeping last night because they felt bad about my situation. That's very sweet of them. However, if the results had been right it would have meant that the doctor may have messed up, or the coordinator for cancelling my appointment. Still, even if there was something my doctor hadn't seen, or if I had that appointment, and I had ovulated, it would have just been caught earlier, that's all. It wouldn't have changed the outcome.

So, it's on the lab now. The lab must have messed up. Dave thinks that today's may be the error. Maybe, but not likely. My estradiol continues to go up, which doesn't correlate with the progesterone fluctuations. My coordinator thinks that yesterday's result was posted incorrectly, that it should have been .25 and not .2. The coordinator said she talked the doctor into having me continue as planned and get another blood test, otherwise this all would have been canceled yesterday without a second thought. Still, I'm not sure what the whole story is there. I'm all confused and I could even been reading deeper into some of these phone conversations with the coordinator and the doctor. All I really know now is that we are back in the game, at least until tomorrow morning.

I'm supposed to go back tomorrow for another ultrasound and blood work. I knew IVF had its ups and downs, I just didn't expect them to be this extreme. I'm getting a bit numb with it all.

Saturday, January 12, 2008

I JUST CAN'T WIN!!!! GRRRR!!!

I got a call from my IVF coordinator. She wasn't supposed to call unless the blood work was not good news.

It's bad.

It's the worst.

I ovulated.

No more IVF this month, at least we think so.

She said there isn't a mistake.

I have to continue doing the injections until tomorrow afternoon when we get the results of another blood draw.

She said they just opened some more slots in the March group and we are first to get one. There is a waiting list until July otherwise.

There is still a chance that the progesterone could go down and the estradiol go up. Not much of a chance, though.

This sucks, but for some reason I don't feel that awful. My body is working. I developed 8 follicles. So one of them was a monster that popped early and turned into an endometrioma. Okay, but still, I made enough follicles and I can do it again. My body works!

A better day

The news today is actually good! Well, mostly good, but I don't want to think much about the slight bad news.

To start with, I have 7 possible follicles for retrieval. This is much more than anticipated. I was told I'd be lucky to have 3. 6 of the 7 are all on the left side with Bertha. Only 1 is on the right side. How odd. Anyway, they range from 6.9mm to 11.4mm. They will trigger when they get to about 18-20mm. I start the antagonist suppressant tomorrow and go back Monday for another ultrasound. After that, then we can estimate the day of retrieval.

The bad news is that it looks like Bertha has a cyster. Dr. Farah thinks I've got another endometrioma brewing next to Bertha. Should we name this one? I don't know, but I'm not going to give this much thought until I have to, if that time comes. Right now I'll just focus on the task at hand, getting through this IVF and hopefully with a positive pregnancy test. If it fails, then I'll get a laparoscopy to remove both cysts and the endometriosis before trying again, but for now the focus is on this cycle and on putting some hope out there that the cycle will work and that I won't have to worry about the cysts until a year or two from now, when we want to ttc#2 (or 3).

On another note, a good friend of mine, Corinne, is in pretty bad shape right now and she's been on my mind a lot. She was hit by a car as she crossed the street Thursday afternoon. It was pretty scary on Thursday as she underwent several hours of surgery and suffered cranial damage as well as broken bones and a lot of cuts. She's doing much better today and I'm eager for her to be ready for visitors. I'd love to see her. She's been a pillar of support through this whole process and her friendship is invaluable. Even in her current condition she wants to know everything going on with our IVF cycle. She's amazing and I know with her spirit she will have a better recovery.

Friday, January 11, 2008

Just another day

Nothing much going on today. I'm only just starting to feel a little achy in my lower belly. I guess that means some action, but I'm not holding out much hope for tomorrow's ultrasound. Dave and I have decided that if the news tomorrow is not good, meaning that I have fewer than 3 maturing follicles, then we're going to scratch this cycle to save what money we can for another try. We will be credited a substantial amount for any unused medications and services.

If we scratch this cycle, then I'll book myself for a laparoscopy to remove Bertha (remember my stubborn endometrioma?) once and for all... I hope. It's risky. I could lose my ovaries. I could lose more ovarian reserve. I could lose what remains of my fertility. However, if I don't get rid of this cyst and clear up the endo before trying again, it could give us very little chance of even making it to the IVF part of IVF. We're stuck between a rock and a hard place.

I'm not ready to consider donor eggs. While I've had many very sweet and generous offers, all offers have been from others that also suffer from similar issues, as well as advancing age, and I'm not sure that would work. It's also a whole other avenue to travel.

So, we go tomorrow to the clinic where someone else who started the process the same day as me actually gets to have her eggs retrieved. I know it's petty, but I'm jealous. I know there are other women worse off than I am, but at this clinic tomorrow I will be that woman worse off than the others there. I should be taking some solace in that we will all be there for the same purpose and that we all struggle, but all I can see right now is that my struggle seems to be more difficult than the others there.

I feel very self-absorbed about all this and it makes me feel even worse. This is a very personal struggle and as much as I have a tough time seeing pregnant women or babies right now, I'm also starting to have difficulty seeing infertile women with more hope than I have.

I'm terrible.

Thursday, January 10, 2008

It's all relative

Yesterday, I wrote about how I feel when subfertiles complain about their issues when they seem pretty good to me. I've seen some complain about a sperm count of 50 million. Yes, I have seen it. Some people would be happy to get to that IUI and have 4 million. Heck, some people are happy just to have the 1-2 million required to proceed with an IUI. For those not in the know, an IUI is Intra-uterine-insemination. It means first of all that conception happens without sex occurring. Yes, people get pregnant all the time these days without sex. Actually, I have a difficult time believing in this myth of conception through sexual means! Anyway, the sperm gets washed and then inserted directly into the uterus through a catheter. It's relatively easy, not necessarily painless, mostly uncomfortable and somewhat humiliating. Sometimes the IUI is done with the help of hormones to stimulate egg production, and sometimes it's done with the natural cycle. We did 10 IUIs all told, at least so far. We did 5 natural (no hope) and 5 medicated (Bob Hope).

Another issue I see a lot is when people get to the IVF stage, they complain about so many things. They complain about the medications. Well, the shots help. Yes, they do burn and bruise and are pretty scary, not to mention tedious. I hate doing them and reserve the right to complain about it from time to time, too. Another complaint is that they don't get the response they desire. Everyone wants tons of eggs to work with when they spend over $10,000 (average of $10-$15 thousand dollars per cycle), but not everyone can make the 18+ eggs we've heard others make. So, I see people complain about 9, 12, or even "only" 15 eggs! Right now I'm struggling to bring up 6 follicles to maturation. I'll be lucky to get the requisite 3 that is needed to even proceed with IVF. I know a few other women with the same problem. I'm sure it's as difficult for them to hear someone else complain about 9 follicles as it is for me. I have a friend who did quite well with 7. I have another friend who didn't do so well with 18. Really, it's all relative.

No matter what the issue, there is always someone worse off than you. Here I am terribly upset about my 6 baby follicles that might not make it. I'm sure that sounds pretty trivial to a woman who has no eggs, who may have suffered premature menopause, or some other issue. The grass always seems greener on the other side of the fence. Actually, in reality, the grass is definitely greener on my side of the fence. My next-door-neighbor has a dead lawn.

My friend, Santino, is one of the Lost Boys of the Sudan. He walked through the desert in search of a safe place. He lived sometimes on mud and morning dew. When I think of his situation, I truly realize that it's all relative. If I go a whole day without eating, I think I'm hungry. But my hunger is nothing, I'm sure, compared with what Santino felt.

Wednesday, January 9, 2008

Not bad, but not good

We've started the cycle and so far we still don't know if we are really going to be able to do IVF. I thought we'd find out today, but now it is going to be Saturday when we may find out. It really is a day to day thing. Most women get to pick up all their meds at once and have some assurance that at least they'll make enough eggs to get to the retrieval. I, on the other hand, don't make that many eggs.

My doctors say it's the endometriosis. They say that most women with endometriosis don't have this problem, but some do. It appears that the endometriosis, which causes me to develop endometriomas (blood-filled cysts in my ovaries), inhibits my ovarian response to the medications. I just get bruised, get all the risks and side-effects, without much benefit. I'm on the maximum dosage now, or at least I think it's the maximum (450/iu of FSH). I do 300/iu in the morning of Follistim and 150/iu of Menopur in the evening. Until today I was taking 225/follistim and 150/Menopur. Maybe the increase will help. There isn't much else we can do.

The ultrasound showed only maybe 6 possible follicles. They are too small to measure. What happens from here is that they could all grow, or some of them could grow, or none of them could grow. Bertha, my endometrioma I developed this same time last year, is doing well. She's growing just fine. Grr. We tried to get her aspirated on December 12th, but she came back. Maybe I shouldn't have named her and started calling "it" a "her." Maybe that's why she doesn't want to let go. If this cycle fails or gets canceled, then I'll probably get surgery to get Bertha excised with a laser.

My estradiol level was also very low at 81. Basically, we just have to wait and see.

I have found a wonderful support network of other women going through the same thing. Well, they are going through infertility treatments, it doesn't mean it's the same thing. Even among the infertility communities, I feel really low and desperate. I'm tired of hearing women complain that they only got 12 follicles, or 25 million sperm, or that they have "mild" endometriosis, or that it took them a whopping 16 cycles to get pregnant.

I'm tired of the pep-talkers telling me that things will be better than they turn out to be. The problem with the pep-talkers is that I start to believe them and then crash even harder when I get the bad news. I really need to not listen to the Pollyannas and listen to my doctors. My IVF doctor told me to expect this kind of result, but I listened to well-meaning Pollyanna friends that told me that my doctor was full of it. Well, those friends are very sweet, loving, and supportive, but they are probably really the ones that are full of it. While my IVF doctor might not give me much hope to live on, she doesn't give me false hopes. I prefer the truth, even if it hurts.

Anyway, I have to go shoot up again, and then wait until Saturday.