A post three years in the making

I am very proud to say that I am PREGNANT! I can't believe that this whole IVF thing finally worked. I have known since last Wednesday when I tested at home (yes I lost the bet to Garry). I have had three blood HCG tests done and everything is looking good as far as numbers go.
Beta #1 = 102
Beta #2 = 285
Beta #3 = 1801

Technically today I am 5 weeks pregnant. I go for the first ultrasound in about two weeks.

The last week I have been a great big mix of emotions. One minute I am happy beyond belief, the next I am terrified that I will lose the pregnancy. I don't think I will really be at ease with this until I can feel little baby kicks or I am holding our baby in my arms.

So far I haven't had much in the way of symptoms. I am tired a lot, have to get up once in the middle of the night to pee, and I am really hungry all the time, but that is it. My boobs feel fine and no nausea yet (knock on wood).

Garry is totally calm about all this. He doesn't seem to be at all worried about possible complications. I think he is excited, but he isn't showing it a whole lot yet. Maybe it will be more real for him when we find out how many are hiding in my ute.

So far the only people that know are close family and friends, so if you are friends with me on Facebook keep your lips zipped. I don't plan on announcing the pregnancy until the second trimester. Ok, I am going to go look at more baby stuff on Pinterest now.

Better than I could have imagined

That is how this whole cycle has been. I never would have imagined I would be as confident as I am right now.

Tuesday afternoon we transferred two beautiful blasts. And those were the words used by Dr. P, beautiful! The best part is we had two blasts that also made it to freeze. We have never had frozen embryos before, and I am excited to think there may be a chance after this cycle for more hope.



I barely slept Monday night, I kept waking up every hour thinking I was going to miss the call with what time we were supposed to be at the office. Finally around 6am I decided to screw it and get up for the day.

After 4 hours of staring at my phone the nurse called at 10am (literally as I was picking up to call them) and told us to be there by 2:30 for transfer. She didn't have the info on our embryos at the point so I had to wait 4.5 more hours to see how they were doing.

The nurse told me to drink 16 ounces of water when we got close to the office. Once we got to the office they checked us in and I got dressed in the ever glamorous hospital gown. We were taken back to the procedure room around 2:45 and they checked my bladder on ultrasound to make sure it was full enough. Unfortunately it wasn't so I had to sit in the transfer room pounding cups of water for about 45 minutes.

While waiting for my stupid bladder to fill up we got to have a great conversation with the embryologists. They were two of the nicest ladies ever. Christina and Erica came out and asked if we had thought about how many we were going to transfer, I responded "depends on how many we have left." Christina informed us we had four, three were grade 1 and one was grade 2! Then she left for a couple minutes and came back with her cell phone where she had taken pictures of the embryos. They were very excited about something one of our embryos was doing.
Here they are:



It isn't a great picture because it was taken off the screen of the microscope, but I will try and explain what they are so excited about. On the embryo on the left you can see a clump of cells kinda in the middle and to the right, that is the group of cells that will (hopefully) eventually turn into a baby, the cells kinda of lining the outside of the embryo will turn into the placenta. On the embryo to the right if you look in the bottom left and top right sections you can see there are two of those clumps of cells that could possibly turn into babies. This isn't a guarantee that the embryo will split into identical twins, but apparently the theory is that seeing that increases the chances of identical twins by 19%. The embryologists said the last lady they saw this with did end up getting pregnant with identical twins. The crazy part is that if they had looked a half hour earlier or later they might not have seen the two groups of cells. That is just how fast development of the embryos happens.

In the end we transferred the two embryos in the picture. The transfer was awesome. We could see the ultrasound screen the whole time. Dr. Peters pointed out where my uterus was, the catheter as they put it in, and the the little white spot the popped up why the transferred the embryos. We even got print outs with pictures of the embryos being transferred in. I really need scan them in and post them. IF these puppies stick they are going to have one heck of a baby book.

So now we wait. The first blood test will be the 3rd, and if that comes back positive the second will be on the 6th. As a side note, my birthday is the 8th, so this will either be the best birthday ever, or it will kinda suck.

Cycle Update

This cycle has gone better than I ever could have imagined. I am so, so happy I decided to go with SIRM and Dr. Peters. I haven't posted anything since the baseline so let me catch you up:

- I did 8 days of stims. Last week was a little rough because I had to drive to Jersey and back three times. But it was totally worth it. I am impressed that the Doctor does all the ultrasounds to check on follicles himself. He was great about explaining everything to Garry and tell us how big each one was. The two follie checks I had at SIRM were the best I have ever had.

- At the egg retrieval on Thursday they got 11 eggs! (as a reminder I got 4 eggs on IVF #1 and 10 on IVF #2.

- Of the 11 eggs 8 were mature, that is amazing for me! IVF #1 only 1 of the four were mature, and IVF #2 only have four mature eggs. I guess we found the right mix of drugs to get the best results out of my crappy ovaries.

Today is day 3 and I just got the call from Dr. Peters with our update. We have four 7 cell embryos growing today! SIRM has a grading scale from 1 to 3 with 1 being the best and 3 being the worst. Three of our embryos are grade 1 (yay!) and one is a grade 2!

We talked about doing the CGH genetic testing, and since we only have four embryos we decided to skip it. Dr. Peters explained that with three or four embryos it is not worth the cost because more than likely at least one or two of those will arrest by day 5.

So the plan from here is the embryos will continue growing until day 5 If all four embryos make it to Day 5 than we will transfer the best two and wait to see if the other two make it to freeze. If we have three left on day 5 then Dr. Peters, Garry and I will have a serious discussion about whether or not to transfer all three. The idea of triplets scares the ever living crap out of me. I think we could handle twins, and I am sure we would figure out how to handle triplets, but the idea of being out numbered by babies is really scary. I know the odds of all three implanting in me are slim, but there is still a chance.

I feel great about this cycle. Even if it doesn't work and we don't get pregnant I know that we tried everything, got great care from SIRM, and there was nothing else we could do. But I gotta admit, I am feeling very hopeful today.

Hello Old Friends

I haven't posted in a very long time, mostly because I have been incredibly busy. I got a promotion at work, I was helping my sister plan and execute her wedding, we got a new puppy, and that is just to name a few things. I will catch you up on all that in a little bit.

In just a couple minutes I will be heading out the door for my baseline ultrasound and bloodwork, so here I am again. There is a pile of meds on our Booze Bar, I have my bases covered at work for the hand full of days I will need off for the cycle, and I have a healthy level of optimism, hope, and nerves brewing inside of me.

There are so many things we are doing differently with this cycle... going on blood thinners (which really sting by the way) for the immune problems that we discovered in all my bloodwork, I am going to be on a lot more hormones this time around, and we will be doing genetic testing on the embryos as well. I really hope that all of these things will bring us our success, but I am not counting on it. I have come to terms with the fact that I may not ever be pregnant. I am ok with it, because I know that Garry and I will be parents, it may take a few years for adoption to come through for us, but I am confident that at some point we will be parents. That knowledge has taken the pressure off of me, which is a nice feeling.

That brings me to a decision I recently made. At the end of this cycle our journey to have a baby will be over. Either it will end with me finally getting pregnant, or it will end with the road to adoption beginning. Either way I have decided that this blog will be ending with my infertility journey. I went back and read through the whole blog the other day. I cried a lot. There are so many things in here that I want to put behind me at the end of all of this. I might start fresh with a new blog about whatever the next journey is, we'll see. For now I am concentrating on making it through this last IVF with my sanity intact. Ok, off to meet with my old friend the dildo cam!

The plan is set...

We had our consultation with Dr. Peters at SIRM today and it went really well. I loved him, and Garry said what he says about all Doctors "He's a quack, they just tell you what you want to hear." Thanks hun, that helps a ton. But he agreed that Dr. P had the plan that we felt most comfortable and excited about, so we are going to make the three hour journey (one way) to their office to do our last IVF. I thought it was kinda funny how Dr. P explained things to Garry. He used lots of car analogies and even drew pictures on a dry erase board. Hilarious. Garry was half asleep most the time any way since our appointment time was when he is normally waking up.

But none of that is probably what you are all interested in. You want the details, the new plan. Here are the highlights:

- Dr. P does suspect that I have a Diminished Ovarian Reserve, but he doesn't want to officially label me DOR until we run some more tests.

- I got a script for Day 3 testing, I haven't gotten FSH tested in about two years. At least not that I know of, it is possible Dr. F tested it when ever I came in for my baseline appointments and just never told me the results, or put them in the severely anemic copy of my file. AF should be showing anytime this week so I will get that taken care of ASAP.

- We have an appointment in a month to go to the main office for all of the immune testing, something like 29 tests in total. We will also do the mock transfer, SA, and all the businessy stuff that day in the office. I am very curious to see what all this testing brings back. Dr. F ran 4 tests that were kinda immune related, but nothing coming even close to what Dr. P is planning to do.

- Depending on how the blood work all comes back we will likely do either Lovenox, Intralipids or both with the next cycle. This is going to sound weird, but I hope something comes back wacky so we can do at least the Intralipids. I want to be doing something radically different for the first two failed IVFs.

- He wants to up my stim doses to their max level which was 725 (or 750, I forget which one) at SIRM. Last time I was on a total of 525 Gonal F and 75 Menopur. He might mess with the ratio of Gonal F and Menopur a little also.

- He wants to stim me for 9-10 days as opposed to the 7-8 days I have done on the first two cycles. He hopes this will help me get more mature eggs, even if it means sacrificing a couple because they get over baked.

- We will do ICSI.

- We will do CGH (a genetic test that will tell us if the embryos are able to turn into a successful pregnancy) on all the embryos we produce, and do a 5dt of the normal blasts we get (he said he was ok with transferring two, but hesitant about 3 (if I even get that many)).

I also forgot to ask him a bunch of questions, so I am going to see if I can find an email address that I can send the rest of the questions to. Most importantly for me was about DHEA, I want to know whether or not he recommends it, I have been taking it twice a day for the past three months.

Right now we are hoping we will be able to cycle in December or January. I decided I want to start the New Year knowing what 2012 will bring us. Either we will spend the year planning for a baby being born, or spending it getting ready to start the adoption process. I can honestly say I am excited about both journeys. I would be overjoyed to be pregnant, but I will also be super excited about starting the official adoption process. Either path will lead us to the family we are meant to have.

I was also excited to hear that Dr. P is not as strict with the weight restrictions. Their weight limit for IVF is 350, which I am now well below. But that doesn't mean I am going to slack off on trying to lose more weight. I still want to lose as much is safe before the final attempt. I know being a more healthy weight can only help, so why not do everything I can to give this cycle the best chance possible.

So here we go again. This week we are officially trying again. Oy Vey.

It's been a while...

I honestly just haven't had much to talk about recently. We are still on hold as far as our last IVF goes. I had my WTF a few weeks ago with Dr. F, and we will definitely not be going back to cycle with him. He absolutely does not want to do a laparoscopy on me to check for endo. I don't want to attempt the last IVF without doing one (there are conflicting theories on whether or not endometriosis affects the outcome of IVF). Also he would basically not change anything for a 3rd IVf from the 2nd, and I am just not willing to redo a cycle that failed.

So we are going ahead with a consult with Shady Grove. They are quite a hike from us, but we are willing to put the mileage on our cars if it means we get the care we want. I am also going to make an appointment with SIRM in Philly at some point to see if they have anything different to say about our situation.

At this point I am honestly not sure my body will ever be able to get pregnant. I think there is more wrong with my immune system than we know, and I think it is making my body reject the embryos. We had talked about possibly using my sister's eggs before IVF #2, but now I think that is pointless. I believe my body would reject embryos made from her eggs as much as it did mine. We are talking about using my sister as a gestational carrier now. It obviously isn't my first choice on how I wanted to bring our children into the world, but it is better than nothing. And I think Garry will eventually come around to the surrogate option sooner than he would come around to adoption. If we decide to go this route we would do it with the 3rd IVF. That way our egg retrieval would still be covered under insurance and we would just have to pay for her testing and the embryo transfer out of pocket.

But right now Garry is still weirded out by the idea of our children being born to any other woman than myself. In his head who ever gives birth to the baby is the Mom. I tried to tell him that is like saying whoever releases the sperm is the Dad, but we all know that isn't always how it works. Sometimes I get very frustrated with how narrow minded he is about all things adoption and surrogate related. In the end, I don't care how our family gets made, but he does so we have to go by his time table. Hopefully we will be starting therapy soon to try and work all of this out.

Now if you made it through all of that I have a little reward for you. I started work on my newest (and biggest) tattoo yesterday. It is going to be beautiful, only about a 1/3 of it is done so far, but here is a pic for you all to admire:


It is a cover up of my first tattoo. If you look closely you can see the outline of the old tattoo under the shamrock. She will put a couple more coats of color over it, and eventually you'll never be able to tell there was once a little black heart there. In the new heart we are going to put my family crest, and it will be metallic colors with shading to make it look antique. I can't wait to finish it, but it will take about two more sittings.

That is it for now. Nest up will probably be the report for our consult with Shady Grove. Wish us luck!

Adoption Info Session...

I was so excited to go to this information session with a local adoption agency, and honestly I was a little disappointed. It is an adoption agency that specializes in foster-to-adopt. This is the kind of adoption we are leaning towards, mostly because we don't have thousands upon thousands of dollars sitting around to use for domestic infant adoption. I am OK with the knowledge that we may never parent a newborn baby. It is something I am sad about, but not something I dwell on too much. I just want to be a Mom and how I get there or what age our child comes to us at is not all that important to me.

I knew going into this meeting that the parameters we have set up in our minds were going to make for a pretty long wait, and I was right. We would be looking to foster children between infant and 5 years old. We have several reasons for that age range, the biggest being that we are not sure we could handle adjusting a child to a new family and a new school at the same time. We would want at least a year to bond with the child before we had to deal with the whole school thing. We would also be open to sibling groups of 2 children under the age of 5. We are open to children with mild autism, ADD/ADHD, and some drug dependencies from the birth mother. Now, the one that will make our wait really long can be a controversial topic. Right now we are only open to Caucasian children. Again there are lots of reason for this. The two biggest ones are: 1) there is zero diversity in either of our families. Zero. And on both sides there are some prejudices in our extended family members. It is not something either of us are proud of, but it is reality and we can't change the way our cousins/grandparents think. Neither of us would want to bring a child into a family where it would be possible for them to hear negative comments directed towards them or their race, no matter how small that chance could be. 2) Raising children of a different race involves a whole set of skills we aren't sure we have right now. Maybe some day, but for our first child, when we have no experience with the foster care system, we think the best way to go is the way we are most familiar with.

When we talked about this with the woman we met with she was very negative. It was almost like she was guilting us for knowing what we can and can not handle. I am sorry, but we know we can not handle a teenager right now. Especially a teenager that has been through half the things a typical foster-child has been through. Honestly sometimes the idea of a 5 year old that has been taken away from it's family scares the crap out of me. I understand that foster care professionals are probably pretty jaded towards people like us. We come in wanting to adopt a young, white, basically healthy child when they have so many children looking for homes that are the exact opposite. It must be incredibly frustrating.

But the way this woman talked to us was upsetting. She kept referring to domestic infant adoption as "buying a baby." As in "if you want a baby you will have to go buy one." I haven't even really started the adoption journey and I know that is horrible language to use. Also she kept cussing. She wasn't dropping f-bombs or anything, but she did toss around a couple other choice words like it was nothing. Don't get me wrong, I can cuss like a sailor too, but there is a time and place for language like that. And a first meeting with a potential client is not one of them.

With all that said, I am not discouraged, and I actually think Garry walked away from the meeting feeling a little bit better about the adoption option. He still isn't there yet, but he is considering it more now. I told him that the ball is in his court, by the start of our next cycle I want him to be able to definitively say "yes I am OK with adoption" or "no, I am not OK with it, if this doesn't work we will live child free." I can't go into our last IVF not knowing where we go after that. I will drive myself crazy.

Next up is our cycle wrap up meeting with Dr. F on Monday the 11th. We will most likely not be cycling with him again, but there are still lots of things I want to discuss with him, and I do still value his opinion, even if I no longer think he can help us.

Not this time...

Tomorrow morning I will make the 45 minute trek out to my RE's office for a 5 minute appointment to get my blood drawn for a completely pointless test. I am not pregnant. I know this. 3 First Response Tests have confirmed this. But I can't officially close the books on IVF #2 until that little vial of blood gets filled and analyzed.

This hurts. A lot. More than I thought it would. I tried to talk myself into not being optimistic this cycle. I knew the odds were just as good for failure as they were for success. But still my hopes were raised, and once again I have to deal with the crash.

One of the down sides of having everyone in my life know about our struggles is that I have to tell everyone when another cycle doesn't work. Having to make the same email, text, phone call over and over just drives it home even more. And I have to listen as they tell me it will be OK, maybe it is too early, the next one will work, etc. I know everyone means well, but they don't know my reality. My reality is that I have one more shot at becoming pregnant, and then we are done. If we use my sister's eggs for our next cycle then I have already lost my chance of having a child that is half me, half Garry. Sure I will still be in the genetic mix, but losing that chance of the perfect mix of myself and the man I love in one perfect little wiggly package is a loss that two years ago I couldn't even imagine.

Honestly, right now, the idea of cycling ever again is enough to bring tears to my eyes. Even with my sister's eggs. I am not sure I can handle having the hope that I can never quite suppress ripped away again. If I had to make the decision right now, I would want to start the adoption process without ever doing a third IVF. I know that adoption provides a set of problems, heartaches, and frustrations all it's own, but at least there wouldn't be the stress to my body. I wouldn't be injecting myself with drugs that give me headaches, acne, mood swings, and bruises dotting my stomach, legs and butt. I would be able to make phone calls, fill out paper work, actively work towards this goal of parenthood while still feeling like myself, not a Zombified version of me. But I can't make that decision on my own. My other half has to be part of it. And I know he wants to do our last IVF. He wants to explore every option to have a child that is at least partially biologically ours before we seriously start the adoption journey. If we start the adoption journey. He still isn't 100% sold on the idea.

But even with the extreme heartbreak I am feeling today, I know there is still work to be done. Getting that work done is what is keeping me going right now. I have to settle up my accounts with my current RE because we will most likely not be cycling with him again, as much as I like the guy. And we will be getting a sizable refund from him. I am making appointments with a larger clinic to get our options for a final IVF cycle. I have gained about 10-15 pounds back over the past 4 months, I need to get back to work on losing that weight, and I want to get under 250 before we cycle again. That is about 40 pounds and six months away.

I also made an appointment with a local adoption agency to get some information. Thankfully Garry is OK with going in for a simple information gathering session. If we go the adoption route our house will need a lot of work done to it before we start a home study, so I will slowly be checking things off that list as well.

Garry and I will also be going to counseling starting in a few weeks. We need to talk through both of our feelings about adoption. I won't lie, I am hoping I can sway him to my way of thinking, that adoption can be just as beautiful as giving birth. I am hoping therapy will help him to see that any child could be our child, not just one genetically linked to us. I also need to talk through my depression over the knowledge that I may never care for a newborn. If we do adoption we will go the foster-to-adopt route because of finances (we don't have $30k+ to spend on domestic infant or international adoption). That means that we will more than likely parent a child starting between the ages of 1 and 5. I am basically OK with this, but I will admit I am sad that I may never get to experience the cuddly newborn stage when they aren't running away from us.

No matter what route we eventually choose, no big decisions will be made for the next4-6 months. I need a break, physically and emotionally. We will re-evaluate in November and see what we want to do then. We probably won't do our 3rd and final IVF till January. In the meantime I will get healthy again, and Garry and I will continue to focus on being happy with only us, just in case we end up living child-free.

Pregnant Until Proven Otherwise

The transfer went great yesterday. We put two blasts back. My clinic grades blasts on a scale from A-D; A is the worst quality and D is the best. My RE said 'D' and 'C' graded embryos have the same pregnancy rates. We had one Grade C and one Grade A. He also said it is possible for the grade A to turn into a better quality blast in a few hours, so not to count it out of the equation. I go back for the pregnancy test on July 1st, but I will most likely start testing a few days before then. Here are my little embies which I am refering to as Thing 1 and Thing 2:
Thing 1: Grade C Blast


Thing 2: Grade A Blast


Our other two embryos stopped growing at 4 and 6 cells so we don't have anything to freeze, but we are ok with that since we have the two best at home with me.

In other news: I can't wait until Monday when I get to finally clue Garry in on our mini-vaca to Atlantic City. We so need this time alone together away from worrying about work and cycling and family. I can't wait, and he will be so excited when he finds out where we are going.

Four!

As of Sunday evening we have four embryos growing! I am shocked and so excited that we have so many going. It makes me feel a little better about the embryologist's decision, but I still think I should have been included in the decision making process, and I am going to have a talk with the RE tomorrow before the transfer.

So last night we had our original two embryos going strong at 8 cells and very little fragmentation, and two others that fertilized late and were at 5 and 4 cells. I can't wait to go in bright and early tomorrow and see how my little clumps of cells are doing. Hopefully at least two will be at the blastocyst stage for transfer. Then I will be on bed rest for tomorrow and just taking it easy on Wednesday.

Wish me luck, and commence all sticky vibes please!

So so confused...

I hope this makes sense to everyone, because I am so confused right now I am not sure I can even put everything going through my head into writing.

First the good news: I have two embryos that are growing strong. The embryologist checked them twice today and the last time she checked they were both at 2 cells which is great for Day 1. She is also still watching two eggs for signs of fertilization. Apparently they were immature at the retrieval yesterday and they may have matured overnight and fertilized, but I won't know if they turned into embryos until she calls back Sunday night with an update. The transfer will be Tuesday, 5 days post retrieval.

Now the confusing part. I was under the impression we were doing ICSI again this cycle, that is what Dr. F and I talked about at my WTF, and he never mentioned the possibility that we wouldn't do ICSI (for those who have forgotten ICSI is when they take a single sperm and inject it directly into a single egg). Apparently the embryologist did not ICSI my eggs. Not one. She simply placed the eggs in a dish with the sperm sample and let them fertilize naturally. I don't totally understand why she did this.

Here is what she told me (paraphrasing): Last time she ICSIed one egg and it did not fertilize. Two of the immature eggs (which can not be ICSIed) were left to mature and fertilize normally, one of those fertilized abnormally and one normally. The one that fertilized normally was the one we transferred. So since the fert rate was better when she let the eggs fertilize normally on IVF #1, she decided that should be the route we take this time.

The thing I am having trouble with is this: You can't know off of one egg not fertilizing with ICSI that all of my eggs won't fertilize with ICSI. That could have been a bad egg. I could understand if she had ICSIed half and left half to fertilize normally. But she decided to just let all the eggs try to fertilize on their own. Now we have two embryos growing, and two eggs that we don't know if they fertilized or not. I can't help but feel like if she had done ICSI we might have more embryos now. I even asked her if she could have tried doing rescue ICSI on them (ICSIing the eggs that did not fertilize by the next day). She said she considered it, but ended up not doing the rescue ICSI because if she had done it on an egg that had already been fertilized by a sperm, and wasn't showing signs of fertilization yet, then that embryo would have been essentially destroyed (two sperm can't fertilize a single egg and turn into a healthy embryo).

The thing I am having the hardest time with (and the thing that is making me want to cry every time I think about it) is this: we will never know. It is possible if she had ICSIed every egg we would have ten embryos right now. It is possible we would have zero. If she did half and half we might have a couple more, or we could have the same results. We'll just never know, and if this cycle doesn't work I will also think that had she done it differently it would have turned out differently. That thought is going to keep me awake for the next two weeks.

Now I am honestly not sure I can trust my RE's embryologist. At the very least I feel like the possibility of not doing ICSI should have been brought up at some point before the retrieval so we could all make the decision together. Now I feel like this whole process is even more out of my hands than it already was. I feel like they went behind my back. I just want to cry.

Quick Update...

I am currently resting up at my Mom and Dad's house, and being very well taken care thank you very much. The retrieval went great, they got 10 eggs! I could not be happier! I never thought we would get that many. When I let my mind wander a little and be optimistic I would think about getting 7 eggs, never ten. I am ecstatic, and truth be known, so so hopeful. I have all the excitement that was missing for this whole cycle rushing back today. This could actually work... Wow saying that is very scary.

So now I just wait (and try not to bite my nails down to the quick) for the call tomorrow from the embryologist telling me how many embryos we have. I am trying to keep my expectations realistic despite today's amazing out come. I will be over joyed with two great quality embryos to transfer. More than that will just be icing on the cake.

Follicle Check #2

I was pleasantly surprised at my second follie check. The u/s tech measured 12 total follicles, some of them will be too small to matter, but i will take it after I thought we would only have 5 after the first u/s. I have 7 on the right ovary all between 12mm and 17mm, and 5 on the left ovary between 10mm and 15mm. I really wish the lady that does the checks would tell me the measurements of each follicle, but she doesn't and when I ask she always makes an excuse. Oh well.

I did my last injection of Gonal F this morning, and just in the nick of time because it was the last does in the pen and I have no more refills left. Altogether this cycle I took 4200 iu Gonal F, wowza! I do my 20,000iu trigger shot tonight at 10pm, and the retrieval will be Thursday morning at 9:30am. I am finally starting to get excited, all of a sudden I have some actual hope. I am trying to temper it will a healthy dose of reality, but for right now I want to feel optimistic and happy that things seem to be going a little better than the last cycle.

I hate my ovaries...

I am about half way through stimming for IVF #2. I know I haven't been writing much about the cycle this time around. I think that is because I am just so 'blah' about the whole thing. I have no excitement, and very little hope, which translates to me not having much to say about the whole thing. But I will try and eek out a half decent post here.

I thought that the massive increase in my Gonal F dosage would equal way more follicles this time around. Not so much. I have been on 525 iu Gonal F (300 in the morning, 225 in the evening) and 75 iu Menopur a day for five days now. When I went in for my first follicle check this morning I had 5 measurable follicles growing; 4 on the right and 1 little 10mm follicle on the left. Let's do a little time warp back to the first follicle check from IVF #1:

"My right ovary has 6 follies between 10-13mm and few that were too small to count yet. The left was being a little bitchy and wouldn't come out from behind my bowels. The ultrasound lady said she thinks she saw four on there, but she could only measure two. So I am counting that as 8 definite with 2 maybes."

That's right, despite doubling the dose of Gonal F I have less follicles in contention this time then IVF#1. To say I am disappointed is a gross understatement.

I hate to admit it but on the drive home for the appointment I actually started thinking about what we could do differently for our next (and last) IVF. I am just going through the motions at this point. I am trying very hard to stay some what optimistic and upbeat, but in truth I am just over it. I know logically that there is still time for the smaller follicles to catch up, and that it is possible that all five of those follicles could have fabulous eggs and make 5 rock star embryos, but I'm not counting on it.

The plan for the weekend is the same as the past week. 300iu Gonal F in the morning, 225iu Gonal F and 75iu Menopur in the evening. I will add in Cetrotide tomorrow evening to prevent the eggs from ovulating on their own. I go back on Monday for another ultrasound. My nurse seems to think I will be triggering that night, but I am not so sure. We shall see...

Deja Vu

Good ole' Aunt Flow arrived today. Tomorrow I will go in for my baseline bloodwork and ultrasound. IVF #2. I really never thought I would be here. I am in this very weird state of calm right now. I am not excited for this cycle, but I am not dreading it either. Mostly I just feel "Oh, this again, ok."

I am not very hopeful, though I do have my moments of optimism. Yesterday I caught myself daydreaming on the treadmill about what it would be like to see a heartbeat on an ultrasound. And a few days again while Garry and I were in Target i caught myself looking at hooded towels that looked like a penguin. Garry caught me and we mooned over how cute it would be for our eventual babies. But those moments are few and far between.

I am curious about how the new med dosage will effect me though. I will be on 525 iu Gonal F and 75 iu Menopur to start out with. That is a lot of hormones. I am hoping I won't be a giant raging bitch, and maybe if we are lucky I will produce a few more mature eggs this time around. We shall see. Here we go again...

Gearing Up

Things have been very quite around my world lately. I admittedly gained some weight back in the past two months. It was so easy going from eating perfectly healthy every day to eating like crap again. Turns out it is a lot harder to go back to eating really healthy again. For the past week I have been trying to get it back under control, and working out everyday. but it doesn't seem to be making a huge difference, which is frustrating.

But regardless I am still under my IVF weight, and things are lining up for starting IVF #2 in June. We are ordering the meds and waiting for the calendar from my IVF nurse to see what we are looking at as far as timing goes. I am excited to get started again. Mother's Day was hard for me, and it seems like everyone around me is giving birth or announcing their newest pregnancy. I am beyond ready for it to be me.

I am also very excited because I have a little surprise lined up for Garry at the end of June. I won't go into much detail because I don't want him to find out, but it is something we really need, and it will be a good way to either celebrate IVF #2 working or drown our sorrows if it doesn't work. I'll clue you all in when I clue him in. We are also going to get our portraits taken by a friend who is also a wonderful photographer. I have always hated our engagement photos, so these will take their place. It is all part of my plan to concentrate not just on trying to have a baby, but also to make sure that no matter what we are as tight a couple as we have always been.

It may be slow around here until IVF #2 actually gets going because I have a lot of work responsibilities coming up, and I have several photography projects of my own coming up as well. Enjoy the Spring people!

Just Relax...

It is National Infertility Awareness Week. If you are one of my Facebook friends you already know that, and have been reminded about three times a day with all my posts. Now it is time to sit down and write my official NIAW blog challenge post. The blog challenge this year is to bust an infertility myth. I decided to write about the myth that annoys me the most: Just relax and you will get pregnant.

Oh, how I wish that were true. I would love nothing more than to go on a vacation have a few Margaritas (on the rocks, with salt on the rim) go back to our hotel room, get our groove on and nine months later pop out our little souvenir. Unfortunately that isn't how it works for us, and for a lot of people just like Garry and I. For us it takes a lot of hard work, pain, and sadness.

I think a lot of people in our lives just assumed we were over reacting when we started seeing a Reproductive Endocrinologist. They thought we were jumping the gun and were just impatient to have it happen. They didn't know we had been trying to get pregnant every other day for a whole year. So I would explain about the charting, the temperature taking, the inspecting of cervical mucus, the lack of any menstrual cycle for half of that year. Then they immediately decided that my uterus was just too tense. We needed to relax... take a vacation... get drunk... have you tried having sex in the back of your car? It works for teenagers!

Once you have heard these things from every close family member, friend, and coworker you start to feel ashamed and hurt. These people that you rely on for support and kindness every other day of the year now choose the hardest time in your life to give you the worst advice possible. When I was diagnosed with Crohn's four years ago no one was telling me to just relax. They all encouraged me to get more testing, try different medications. But when I tell them I can't get pregnant they insinuate it is because we are doing something wrong, we are thinking too much about it.

That isn't how it works, especially when you have gotten to the point that you are seeing an RE. Once you start doing things like Clomid, IUI, and IVF a lot of the process is taken out of your hands. Your entire reproductive system is being controlled by outside sources. Your doctor determines when you ovulate, the timing for insemination, they determine where your hormone levels should be and control them through various injections, suppositories, and patches. All you really do at that point is show up for the appointments and take the medications.

The truth is I relaxed a lot when we started seeing a fertility specialist. Finally we were getting some help, we had some hope again after a year of disappointment. An yet, a year and a half after our first IUI we still have no baby, no baby bump either. After our first IVF failed my Mom called and apologized for ever saying we needed to just relax. She realized now that we actually had something that was physically keeping us from getting pregnant. She also saw a story on Good Morning America that told of a study showing relaxation had no impact on the out come of A.R.T. It took a failed IVF and the morning news team to make her realize that this wasn't in our heads.

This is why we need more awareness. We need people to know that infertility is not a state of mind, it is a disease. If you want to learn more about infertility and the impact it has on couples and families here are two places to educate yourself http://www.resolve.org/infertility101 and http://www.resolve.org/takecharge.

What The F*ck

In the infertility world "What The F*ck (WTF)" refers to the consult with your RE after a failed cycle. I had mine today, and I am really really happy with the outcome.

I am one of those patients that most doctors get annoyed with. I research everything (Dr. Google is my BFF). I make lists of questions and I will sit there and go through every single question until I am satisfied I understand the answer and the reasoning behind the doctor's answer. One of the many reasons I love Dr. F is that not only does he put up with my questions, he encourages patients to do research on the Internet. So, instead of just sitting here with one long run on paragraph about the appointment I am just going to list my questions here and give his answers. Then at the end of the post I will tell you all what the plan is from here. So if you don't care about my questions just scroll to the bottom.

- In your experience at this office, do more people get pregnant on the second time? Or are my chances decreasing as we go? the pregnancy rates for IVF #1 and IVF #2 are pretty equal. The fairly straight forward cases tend to get PG off the first IVF, the cases where we find something during the coarse of the cycle that we didn't know about (like we did with me) have increased odds for #2 to work after a few adjustments. But if IVF# 2 doesn't work odds do start going down with every cycle.

- Lining: How has my lining been in the past, what should it be? Have I ever had the triple stripe? How can I improve my lining? (never knew the stats on my uterine lining always just heard "it looks good") Dr. F actually went and got my u/s pics to look at instead of just looking at his notes. Lining was great with IVF #1. They like to see it above 6mm, mine was 12.5mm, and the three stripes were clearly visible. He said we couldn't have asked for a better lining.

- Was I on BCP too long? Could I have been over-suppressed? Dr. F is in the school of thought that BCP does not do a lot to suppress your ovaries, it just syncs you up with other patients to streamline things (different REs have different opinions on this). However I will only be on BCP for 3 weeks before the next cycle which makes me feel a little better since I was on it for 7 weeks the first time around.

- Can we test my AMH? At this point AMH would only be useful if I was trying to decide between using my own eggs and using donor eggs. Since I know I want to use my own eggs for IVF #2 it is a non-issue. My FSH has always been fine, and he suspects my AMH would be as well.

- Would taking DHEA be beneficial for me since I seem to have some egg quality issues? Dr. F does not buy into the DHEA hype. He says that there are conflicting studies and information about DHEA and he prefers to err on the side of better safe then sorry, so we won't be using it for now.

- After my response during IVF#1 is my diagnosis the same? Do you think I have a diminished ovarian reserve or just egg quality issues? It is possible I have a slightly diminished reserve, but he wouldn't put the label on me yet. He thinks I am a "weird responder" My follicles grow great, but 50% of them were empty, and even though the follicles were the size they want them to be for ER, 75% of my eggs were immature. He thinks we need to have a big burst of FSH right at the beginning of stims, then step down as needed. He also believes my eggs are good quality, but we need to get more mature eggs to be sure. He plans on letting my follicles grow a little bigger than he normally would to try and get more mature eggs.

- Will the protocol be the EXACT same? What will you change? Higher doses? We are going with MUCH higher doses next time. The first IVF I was on 225iu of Gonal F and 75 iu Menopur, which was appropriate for the response they saw on u/s and in blood work. Knowing now that I produce a lot of empty follicles he wants to put me on 525iu Gonal F from day 1 and then step down as the cycle progresses.

- Given my horrible response should we consider the Estrogen Priming Protocol? How does the EPP work exactly? No, he does not want me on the EPP. He said EPP is for women who have issues with their lining development and who have trouble with their estrogen levels. On both accounts I am good, and increased estrogen when it is not needed can actually impede follicle growth so he thinks it would be a bad idea for me.

- Are there other methods of stimming that could help me get more eggs of better quality (ie step down vs constant)? Yes, we will be doing the step down method of stimming.

- I was on 10,000 iu HCG for my trigger, I have read that obese women should be on double the dose. Would this be an option for me? He said it could be possible that increasing the HCG trigger shot would help mature my eggs more so we will be doing 20,000 iu HCG next time.

- Do you think the fertilization rate was a egg quality issue or could there also be a sperm quality issue. Would a SCSA/DFI be use? He said my fert rate wasn't as horrible as I thought it was. This is kinda interesting actually. I only had 1 mature egg, they performed ICSI on that egg and it fertilized abnormally (had 3 pronuclei instead of the normal 2). I had 3 immature eggs. When they retrieve immature eggs they can not ICSI them because it requires stripping cells off the egg that could help it mature the rest of the way. So instead they left the immature eggs alone and put the sperm in the dish with them. Our embryo came from one of those immature eggs that matured and fertilized without help. He said there is no indication that Garry's sperm has any quality issues, and it would be a waste of money at this point to do the tests.

- Considering I am already diagnosed with one auto-immune disease (Crohn’s) would it be smart to test for other immune problems such as Reproductive Immuno-Phenotype, Anti-Thyroid antibodies, Thrombophilia, and Repeated Loss Testing (NKa etc.)? He said it is possible I have more immune issues and we are running all of the tests I listed plus some more that he added. I should have the results back in 2 weeks from those tests.

- What do you think the odds are of getting pregnant with my own eggs? He said he doesn't like putting odds on cycles, but he thinks I have a good chance of my response being better this time around, which will in turn increase my odds that it works.

- Would my sister be a good egg donor? How would that work with my insurance? What would she need to have done as far as testing to become a donor? We didn't talk too much about the possibility of using my sister as a donor, but he said that from the basic information I gave him about her it sounds like she would be a good donor for me. If IVF #2 doesn't work we will get all the testing needed for my sister to be my egg donor and then make a decision from there.

The Plan: I am taking all of April off from any drugs other than my vitamins. As soon as my next cycle starts I will call and they will have me start the Pill on CD 7. In the beginning of June sometime we will do the baseline US and blood work and I will start on 525 iu Gonal F and 75 iu Menopur. Normally you trigger when your lead follicle reaches 18mm. That was the size my follicles were at trigger, yet only 1 was mature, so this time we will wait until my follicles reach 20-21 mm to trigger in the hopes that we will get more mature eggs. The trigger dose will be doubled to 20,000iu HCG. He wants to do everything we can to push it to a 5 day trigger this time around. We both agreed that if I have 2 good embryos growing we will put both of them back, but neither of us are comfortable with 3 embryos at this point.

I am also thinking about getting a consult with a Reproductive Immunologist. Unfortunately the only one near me is almost 4 hours away, so I am hoping to get a phone consult with him sometime in the next month. Hopefully running some tests with him will shed some light on whether or not I have more issues than we currently know about. I have no faith in my immune system at this point (thanks Crohn's).

I am excited to get things rolling again, but but also terrified that I am setting myself up for another failure. But I trust my RE and really believe he is doing everything he can to get me knocked up, and at this point that is all I can ask for.

In other news: I made a decision about the Facebook coming out issue. We have decided to come out on Facebook (well I will come out, Garry doesn't want the people he works with to know yet because he barely knows most of them). However, I am not going to take the blog to Facebook. I don't want everyone in my life to know exactly when we are doing everything as far as treatments go. And since I don't want to cut down on the details or number of posts on here, I am just going to do a very generic outing. Maybe if I get pregnant I will eventually post this on Facebook because I do think it would be helpful to others going through all this, but that is down the road.

It's Official...

I waited till I got the official results back from my RE to post, but I am writing this the day before I go in for my beta. It is over. It didn't work. I am not pregnant. I am heartbroken. There is no accurate way to describe how sad I am right now. How do you mourn something you never really had? I feel broken and empty, and it feels like it will always be this way.

I feel bad for Garry too. He has no clue what to do or say to make me feel better. Probably because there is no way to make me feel better. He keeps saying it will work next time and we still have two more shots at IVF. But it isn't that easy, right now all I see when I think about our next cycle is more disappointment and pain. I don't think I will ever get the optimism I had for this cycle back. I have heard stories of women doing 6 or 7 IVFs before they got their take home baby.

I keep trying to imagine our lives without children. And as much as I love Garry with everything I have, the thought of the two of us puttering around our house alone with our dogs for the rest of our lives makes me want to curl up in bed and sleep for as long as is possible. No kids waking us up at the crack of dawn on Christmas morning to go open presents, no first trips to the beach, no reading books before bedtime. Just the two of us watching TV and going to the movies every date night for the rest of our lives. I know eventually I could be happy and not feel like we are missing out, but right now I don't even want to try and imagine how it will feel.

Progesterone In Oil is the Devil

Overdramatic? Maybe. But true. First of all the side effects of PIO exactly mimick the early symptoms of pregnancy. So while you are trying to find hope in everything your body does it could all just be PIO tricking you. I have been on the injections for 9 days now and I am exhausted. I can't remember ever being this tired before. Not even before I got diagnosed with Crohn's and couldn't sleep through the night because of all the pain I was in. I slept 8 hours last night and yet right now I feel like I could sleep another 8 and still feel tired. It is noon and I am honestly thinking about taking a nap before work.

Every single muscle in my body aches. It feels like I worked out a little too hard and now everything is protesting. The worst is without a doubt my boobs. Just putting on a bra is pure torture. And those are just a couple of the side effects I am feeling. There is also the crabbiness, the headaches, and the slight nausea. All side effects of PIO, all symtpoms of being pregnant. It is a serious mind f*ck.

One week until my pregnancy test. I can make it till then, and this will all be worth it if it comes out the way I want it to. Ok, nap time.