Tuesday, December 30, 2008

What's Next - Part 1

What's next? A 3 month break to heal physically/emotionally and counseling with someone who specializes in infertility.

Over the last 3 years, my husband has always commented on how strong I am and how easily I bounce back from incredibly disappointing circumstances, but this last failure has taken a toll on me. I'm struggling with anger and frustration. I have so many questions that have no answers.

Despite my circumstances, I have been very blessed in the area of infertility over the last 3 years. How? Blessed that I am genuinely happy for those who conceived effortlessly and free, thank God they didn't have to endure the trials of infertility. Blessed that I have overwhelming joy when someone announces their pregnancy miracle. Blessed that I love to hear a friend's birth story. Blessed that I am able to serve in the nursery at church. Blessed that I can attend baby showers and children's birthday parties. Blessed that I can stroll through the baby department full of hope and expectation. Blessed at how much I enjoy receiving photos of babies and belly shots. Blessed that I can so easily ignore ignorant comments/advice.

I feel I'm losing a grip in a few of these areas as my fight with infertility continues. It's relentless and I know how fast it can take you down if you let it. I peed on one little evil stick and now all this...

I'm currently unable to attend baby centered gatherings. I don't hold any ill feelings towards the people living my dream, but being in this environment surrounded by the very thing that I can't seem to reach for the life of me hurts too much right now.

I had to temporarily step down from serving in the nursery. I felt it would be best for the parent to not witness my tears while holding their adorable baby.

I can no longer walk through the baby section without tearing up. Will I ever be able to walk through there and actually buy something besides a baby shower gift?

I suddenly struggle with unsolicited comments/advice. My husband keeps telling me to take the good, the encouraging and ignore the rest. I realize that those that have never dealt with infertility truly cannot comprehend but some people say the most hurtful stuff.

Speaking of unsolicited advice, just the other day a lady approached me and said she wanted to talk to me. She went on and on about what an amazing person I am and what an amazing loving person my husband is and how incredibly blessed our marriage is... I was wondering if she was confusing me with someone else, I'm just your average gal. I was just standing there smiling at her, having no clue what she was getting at... Then one sentenance later, the smile had faded. She told me that I should give up on having children because I'm blessed with a great marriage and how she has a really bad marriage and how I should just be thankful for my marriage. She then hugged me and said she just wanted to encourage me. I stood there dumbfounded. Maybe I should have told her that she should give up on her marriage because she's blessed with 2 handsome sons and 5 beautiful grandchildren. I don't know why I let it get to me, I guess because when you're already down, things affect you on a deeper level. She left me questioning myself, am I ungrateful because I want more than a great marriage, that I want a child with this person that I love? Sorry, rabbit trail, moving on...

It truly is a gift to be able to be genuinely happy for those who so easily obtain the very thing that you have been denied, your heart's desire, the thing that consumes your every thought, the thing you would give anything for. I don't want to lose this gift. Without this gift, there's jealousy, hurt, bitterness, anger, loneliness, depression, self destruction and separation. I can't go there, I will not go there, I cannot give this seed a chance to grow. So yes, I'm seeking help. Hi, my name is Jill and I'm a messed up mama-wannabe-aholic.

Tuesday, December 23, 2008

IVF#3 - Post IVF Consult

What happened and what's next? These are the 2 most frequent questions I've received and I'll address the what happened.

My beta was due on a Sun when the labs are closed, so I scheduled it for a Mon. The plan was to not test before the beta. Due to the torture of not knowing and some timing issues, we decided to do a home test after church on Sun. We thought for sure I was pg. We even went to Walmart and bought the digital test.

We each had our own cup of pee (both were my pee) and we each had our own pg test. I had the one with 2 lines and Kerry had the digital. We had the camcorder rolling. We dipped at the same time and just waited for what seemed like an eternity. I knew I would know before Kerry because his had a 3 min hourglass before showing the results. I was watching mine intently, waiting for that elusive 2nd line to appear... waiting... waiting... waiting... sweating... heart racing... you've got to be kidding me, where's the 2nd line???? Kerry's still oblivious watching his hourglass. I dropped mine and leaned over to watch his... tick tock tick tock... "Not Pregnant". Evil pee stick! I think I even heard it laugh at me. We sat there stunned. For the first 10 mins I was really impressed with how well I was handling it. Then a few tears... Then complete hysteria. I don't think I've ever cried that hard in my entire life. I can't believe it, I failed at the #1 clinic, what a blow.

The next day I had to go do my beta. We all know how that turned out. I faxed the results to CCRM. My backup nurse called to give me the results and then asked if I had any questions. I said, is this it? Do I get to talk to the doctor? She said of course and she took my file over to Dr. Schoolcraft.

Schoolcraft called me back within 20 mins, I was very impressed. He said he was sure sorry and that he thought for sure that one of the 3 transferred would take as they were great quality. He said that although it was a funky cycle, he felt it went much better than my previous cycles. He thinks there's an egg/embryo quality issue. I asked him would he do anything differently looking back. He said he would want to do CGH genetic testing on the embryos. He said that when I first came to him he wasn't sure that I would make very many eggs and that's why he didn't recommend it at the time. He feels we need to get the final question answered, are any of the embryos genetically normal. If there are normals, then it's just a matter of getting the recipe right. If there aren't, then it's time for donor eggs/embryos. I asked him if he would lower my stims any to keep my e2 from going so high and he said not initially as I start out fine, but then towards the end it goes crazy, so he would cut the dose down earlier after 4 or 5 days. I asked him if he would keep me on long lupron and he said yes, the only reason to not use it is if you can't get any eggs on it. I addressed my concern of an implantation issue, is it that my uterine environment is unhappy when jacked up on stims, or do I have an implantation issue? He said we would get to test the theory as my snowbaby or a CGH cycle would both be a FET cycle. He said all the standard tests don't point to an implantation issue as my tubes aren't blocked, the hysteroscopy and uterine bloodflow were fine and then all the ultrasounds showed my lining get to the right thickness with a triple pattern. He said the bigger arrow is pointing at egg quality issues as the embyos have struggled on all 3 cycles. He said if I wanted to unturn all stones, I could do the endometrial biopsy checking for the beta 3 integrin protein that assists implantation. The majority of patients missing this protein have blocked tubes or endometriosis. I've never been tested for endo, but I don't think I have it. We discussed natural vs medicated FET cycles and he said with me being in TN, it would be much better to do medicated as we would know the transfer date a month in advance vs 4 days. I asked if you take the planning aspect out of it, is one better than the other? He said they are about the same, but still recommended medicated and said it would be better to not chance that the cycle you go to do the FET your cycle hiccups and your hormones are out of pattern. He then said the other thing I could consider would be to do the CGH cycle first and then combine the embryos and have a better chance as we would have more to transfer. I asked if he felt confident that I would be able to get some blasts for genetic testing and he said yes, that if they would have cultured my 4 best embyros instead of just 1 (we transferred 3), he feels we would have had 2 or 3 blasts. I asked if he would test the embryo I already have frozen and he said no because he wouldn't want to put it through another thaw and refreeze.

For you CGH gals that are getting no results back, I did ask him what's that all about and he said they only remove 1 or 2 cells from the embryo and they have to amplify/copy the DNA about a million times to have enough DNA to analyze and if the reaction doesn't produce enough, the signal isn't clear. So the lab states that the signal wasn't clear and there just wasn't enough DNA and they don't feel comfortable saying if the embryo is normal/abnormal. He said he gives the patient the option if they want to transfer the no-result embryo.

I'll address what's next in my next post.

Sunday, December 21, 2008

I Want To See Miracles

Today was a challenge at church. It was the last week of the series on miracles. I followed the series intently as that's what it's going to take for me to become a mom, a miracle. During worship, we sang a powerful song that goes "I want to see miracles, I want to see the hand of God...". I stood there chanting to myself "don't cry, don't cry, keep it together". Well you know how that goes, the harder you try not to, the worse it gets. Eventally I lost and the floodgates burst. We were in the 2nd row, so there was no hiding. The tears rolled practically the entire service. The ending message was about not giving up and not being denied your miracle. So I left with 2 choices, defeat or to not be denied. I won't be denied!

Monday, December 15, 2008

IVF#3 - Beta

Negative, Not Pregnant!

Sunday, December 14, 2008

IVF#3 - Results

Emotionally, mentally, financially broken....

Saturday, December 13, 2008

IVF#3 - More 2ww Torture

Yesterday was horrible, I cried way too many times and was just convinced it was over for me. I told Kerry (who is out of town) that I was going to test in the morning and get the grieving over with. He begged me not to test while he's gone, but I was determined, I couldn't take it anymore. I woke up at 4am and peed in a cup and then went back to bed. I woke up again at 6:30a, temped and put in my next suppository. As soon as I saw my temp go back up and the fact that I have made it without any spotting/bleeding past the days I had started in my previous IVFs, I found new hope. I decided to not test.

Being on vaginal suppositories 3x/day, I have lots of leakage. I had to close all my blinds around the house because every time I felt any leakage, I stopped right there, dropped the drawers and took a peek to make sure it was white and not pink/red.

Kerry just texted me to see how I was doing today and said he got all choked up when he was telling some female co-workers how this just has to work and can't bare me going through another failure. Then he asked me to please not test without him. Gosh, I'm so blessed to have him. I just can't test without him. I'll see if I can talk him into testing together Sunday AFTER I work the nursery.

This will be our child:

Friday, December 12, 2008

IVF#3 - 2ww Blues

I'm feeling down today. My chart isn't looking so amazing and I just don't feel pg. I am so freakin scared. No, I haven't tested at all. Too scared. I think I would have caved if I had ever got that overwhelming feeling that I was pg. I thought about testing this morning, but can't because I have my annual review today, didn't think it would go over too well to be sobbing during that. I have a Christmas party to attend Sat and it's my turn to work the nursery Sun at church. So I just can't face a negative and be able to hold it together for any of these events. Maybe I'll test after church Sun, no one to face then.

Going by my last 2 IVFs, I would have started bleeding by today... so I'll be toilet paper watching all day. I think I'll lose it if I see red again.

Thursday, December 11, 2008

IVF#3 - No Symptoms

I'm feeling NOTHING! I have no clue which way this will go. I still have high hopes, but I know how devastating it's going to be if this fails a 3rd time, so I'm really dreading the beta.

Monday, December 8, 2008

IVF#3 - Snow Baby

I can't believe I have a whole week to go till beta, torture I tell ya!!!! I've been frustrated because I've been feeling great, but within the last hour I've been feeling mildly crampy, wahoo!

I just called the lab regarding my remaining embryos and I had one PERFECT day 6 embryo frozen!!!!!!!!!!!!!! I now have a backup or a future sibling!!!

For those that like the details...

This embryo came from the first batch, nothing made it from the second batch. Here's the stats on this embryo:
Day 2: 3-cell grade 4-
Day 3: 6-cell grade 4-
Day 5: early blast
Day 6: 4AA blast

The 4 is the development stage of the blast, which in this case is the stage right before it hatches out of its shell. The first A is the grade of the inner cells that will become the fetus. The second A is the grade of the outer cells that will become the placenta.

OMG, I am so excited I don't quite know what to do with myself!!!! I finally got a blast!!!!!!! This gives me even more hope for the embryos that are inside me since they were the best of the bunch!

They also used the new vitrification process instead of cryopreservation which has a near 100% thaw success rate.

I did have one other blast but they discarded it because it was 4BC. =(

AHHHHHHHHHH, someone just knock me out already, I'm too happy!!!

Thursday, December 4, 2008

IVF#3 - Photos

The triplets and I are doing well, but we're getting pretty bored stuck here on bedrest. We though we would share a few more photos from our trip here.

Feeding the squirrels at The Broadmoor, Colorado Springs:



Pike's Peak, Colorado Springs:



Garden of the Gods, Colorado Springs:



Kerry made me a snow belly:

Wednesday, December 3, 2008

IVF#3 - Day 3 Transfer

Sorry for the late update, we had to scramble to find some flights back home for this Fri.

I had my day 3 transfer today and all went well! I'm currently carrying TRIPLETS!!!!

Here's the details if anyone is interested...

I had b/w an hour prior to the transfer. They want your E2 to be > 1000, mine was 1670, so all good there.

I was admitted to the transfer room where I put on a gown and was given a Valium (oh la la!). The sonogragher came in and did an u/s on my belly to make sure my bladder was full. It was very full so they gave me a cup and told me how much I could let out. That was a relief. I went back to my room and layed down, felt a little dizzy and fell sound asleep. The sonogragher came in and checked my bladder again and said all was ready to go.

Dr. Schoolcraft came in to do the transfer. We were expecting the embryologist first to give us our embryo report. So at this point we still had no clue what we even had left. He said we had 3 great embryos he'd like to transfer but he needed to know that we were ok with the risk of triplets or twins. He also gave us the option of transferring just 2 or changing our transfer to a day 5 to see which embryos were the best, but that carried a risk of nothing making it. As much as I wanted a day 5 transfer, I just couldn't take that risk that nothing would be left and then I would have no chance. Our heads were spinning and he pretty much wanted an answer on the spot. Since we transferred 4 last time and ended up with nothing, we decided to just go for it and transfer the 3. Multiples may be scary, but not as scary as going home with nothing. He said there was a less than 10% chance of triplets and 20% chance of twins. Just the fact that we have a risk of multiples made us excited because that must mean we have a good chance of having one.

The embryologist came in wheeling in this huge incubator. There was a monitor on top showing our 3 embabies. Kerry took a picture of them but with the screen being out of focus and then not being able to use a flash, the photo isn't very clear, but at least we have a photo of them.

The embryologist loaded up the embryos, the sonogragher had my uterus on the screen and Schoolcraft threaded the catheter through my cervix. Within a min, it was done. I had to lay there for an hour and now I'm back at the hotel on 48 hrs of bedrest. Kerry has been taking great care of me, he's such an awesome husband!

Here are the embryo details:

CCRM grades their embryos on a scale of 1- to 4 with 4 being perfect. 4- would be less than 10% fragmentation.
Batch 1 (3 day old embryos, should be 4-8 cells):
Embryo 01: 9 Cells, Grade 4-, Transferred
Embryo 02: 8 Cells, Grade 4-, Transferred
Embryo 03: 6 Cells, Grade 4-, Transferred
Embryo 04: 6 Cells, Grade 4-
Embryo 05: 6 Cells, Grade 4-
Embryo 06: 4 Cells, Grade 4-
Embryo 07: 4 Cells, Grade 3 uneven
Embryo 08: 3 Cells, Grade 3

Batch 2 (2 day old late bloomers, should be 2-4 cells):
Embryo 09: 6 Cells, Grade 4 uneven
Embryo 10: 4 Cells, Grade 4-
Embryo 11: 2 Cells, Grade 4-
Embryo 12: 2 Cells, Grade 4-

OMG, I can't believe I had 12 still going in culture. I'm praying for a couple of snow babies as a backup or for a future sibling. Schoolcraft said not to hold my breath, but that it's not impossible. We will get a call Sun/Mon letting us know if any made it to freeze.

Gosh, I just really feel like this is going to work this time!!!

Here's my trips (they don't appear perfect to me, but CCRM said they were, so I'll trust them)

Tuesday, December 2, 2008

IVF#3 - Day 2 Embryo Report

I'm still bloated but getting better each day. I've eaten half of the salt provided in our room. This is pretty much how you can picture me in my room every day.


Ok, now onto the news you really want, day 2 embryo report!!!

As a recap, we had 13 mature on day 0 and 3 more that matured on day 1. I got better news, when they went to icsi the 3 late bloomers at noon, they found that 3 more had matured for a total of 6!!! 4 of the 6 fertilized normally!!! This also means that Kerry's boys survived in culture overnight! So that bumps our total mature up to 19 out of 23 and our fertilized from 7 to 11!!! Thank you God and the CCRM lab!!!

Then the embryologist asked if I'd like to hear the progress on my original 7 that fertilized. I lucked out as they don't normally give day 2 results. She said that they expect embryos to be between 2 and 4 cells today and that all 7 are progressing normally. I about fell over. Here are the details:

1 @ 4-cells, 2 @ 3-cells, 4 @ 2-cells

So definitely not perfect as they much prefer them to be at 4 cells by now, but there is still time to catch up and they could divide into 4 at any moment. I've never had anything over 2-cells on day 2, so I'm thrilled. We have already declared the 4-cell as our take home souvenir.

As far as quality, they don't grade them at this point, but she did say that all have less than 10% fragmentation, no vacuoles and no multinucleation. Yeah!!!

I have b/w tomorrow at noon to make sure my e2 is at the right level for transfer. My day 3 transfer is scheduled at 1p. I won't hear another update until then unless they find that my embryos are doing really well and decide to push me to day 5. I'm still holding out hope for a day 5 transfer.

Monday, December 1, 2008

IVF#3 - Fertilization Report

Some quick terminology for the family:
OHSS - ovarian hyper-stimulation syndrome
ICSI - Intra cytoplasmic sperm injection
SA - semen analysis
U/S - ultrasound
B/W - blood work
Multinucleated - each embryo cell should have 2 nuclei, one from each parent, multinucleated means there is more than one pair which is abnormal.

Last night was a little nerve racking as I bloated up to the appearance of 6 months pg and was having lots of sharp pains. I literally had to waddle. I showed Kerry my belly and he said "Good God! Are you going to be ok?". I listened to the nurses and ate tons of salt and protein and drank tons of electrolyte enhanced water. A normal blood pressure is 120/80, but I have a very low bp of 100/60, that's just what's normal for me. With all of this salt intake, I told Kerry maybe I'll get up to a normal bp.

I woke up feeling much better and about 80% of the bloating went down, the salt worked!!! I told the nurse that I thought salt caused you to retain water, but she said it works in the opposite manner with it comes to OHSS. OHSS causes all the fluid in your organs to seep out into your abdominal cavity causing the organs to be dehydrated, I guess the salt causes your organs to retain their fluid.

I had my u/s this morning to check for fluid. They did find some fluid around my uterus, but not enough to compromise my cycle. Thankfully all other organs like the lungs and liver were free of fluid build up. Yeah!!! I have to keep up the salt/water intake to keep OHSS at bay.

The embryologist called with my report. Here's the results including my previous cycles:

IVF#1:
Retrieved: 10
Mature: 4
Fertilized: 2

IVF#2:
Retrieved: 19
Mature: 12
Fertilized: 4 + 4 late (7 are multinucleated, so only 1 is normal)

IVF#3:
Retrieved: 23
Mature: 13 + 3 more today (will rescue-isci today at noon)
Fertilized: 7 (waiting to see if the 3 above will fertilize)

So as of right now we've dropped from 23 to 7, so it's a little sad, but it's still the best we've ever had, so it's also exciting. I can't tell you how nice it was to be able to get off that fert call and not be in tears!

Kerry's SA results:
Volume: 1.8ml
Count: 23mil/ml, 41.4 mil total
Motility: 5%
Motility Rate: 3 (1 being twitching to 3+ being fast)
Total Motile: 2.07 mil
OMG!!!! We have NEVER had progressive motility out of the 12 SAs he's had done!!! They said they were moving really fast, this is a total answered prayer!

Now we sit and do some more waiting. Tomorrow we find out if the 3 that matured late fertilize. We won't get a division report until day 3, but I'm hoping I can get some info out of them when they call in the morning. Division is where we have lost practically all of our embies, so say an extra prayer for us for our day 3 report.

Sunday, November 30, 2008

IVF#3 - Egg Retrieval

Day after trigger results:

E2: 6045 (up from 5519, really high, but much better than my last IVF where I went over 9000)
P4: 6.95 (I don't know what this should be but the nurse said it was good)
HCG: 284 (should be > 120)

I'm back from egg retrieval. Dr. Gustofson did my retrieval and he was great! We got 23 eggs!!!! (IVF#1=10, IVF#2=19) I was expecting a max of 19, so I'm quite pleased. Everyone was wonderful and it was a great experience.

The embryologist said the sperm wasn't too great and only had 5% motility. I'm hoping for a good mature/fertilization rate tomorrow. This is where we always go down hill fast. I'm praying they are able to work their magic in the lab as this is why we have come to them.

For those that aren't familiar with this process;
Day 0: Egg retrieval / Fertilization
Day 1: Embryos are 2 cells
Day 2: Embryos are 4 cells
Day 3: Embryos are 8 cells
Day 4: Embryos are called a morula
Day 5: Embryos are called a blastocyst

The standard is to do a day 5 transfer. This allows them to pick the best embryos and weed out the bad ones. It also allows you to transfer the embryos back in when they would naturally enter the uterus. Day 5 has a higher success rate. If the embryos aren't doing well or if there are only a few that made it, they will do a day 3 transfer. I was kinda bummed because they have already scheduled us for a day 3 transfer today, I guess based on our history, they really don't think we'll make it to day 5. Out of 29 eggs retrieved in the past, we have only had one embryo make it to 8 cells, all others were 5 cells or less. I would love nothing more than to finally get a blast. I'm still holding out hope.

I have an ultrasound tomorrow morning to make sure my abdominal cavity isn't filling up with fluid. I'll also get a call from the embryologist letting me know how many eggs were mature and how many fertilized. I'll send out an update with the results.

Thanks everyone!!! I'm off to bed for a nice post-anesthesia nap.

Friday, November 28, 2008

IVF#3 - FSH Day 11 Monitoring / Trigger

Today was a GOOD day!!! I got off the Kingda Ka and jumped on this one. I would be completely thrilled to stay on this one for the rest of the process.


I was so nervous at today’s u/s. I watched the screen intently watching the sizes flash on the screen. Within a minute I was able to take a deep breath and relax, my follies had grown and even made up for lost time. After my u/s, I talked to my nurse and asked her if I made the right decision to delay the trigger and she said with full confidence “Absolutely!!!”. That made me feel so much better. After seeing my follie sizes, I knew it is definitely time to trigger now. I asked her if I would tonight and she said we would have to wait and see what my e2 was. This made me a little nervous because if I don’t trigger tonight, my follies will be over mature.

I was due for my morning shot while talking to my nurse but I was out of Menopur. She went and got a vial of Repronex which is very similar to Menopur and said she would give me the injection. I didn’t realize until she started making the injection that it was a big intramuscular shot, yikes! She had me bend over and gave it in my hip.


Next I went to my 4th and final electro-acup appt.


The ccrm call always comes in around 3pm. But today, it didn't come till 5p. I was on pins and needles waiting to see if I would trigger tonight and it seemed like an eternity for that stupid phone to ring. It was the same nurse that I freaked out on yesterday. She started giving me instructions and wasn't saying anything about triggering. I was praying I wouldn't have to freak out on her because they weren't going to trigger me. Finally she said the magic words, we're triggering you tonight. Hallelujah!!!

I trigger tonight at 10:45p. Kerry will be giving me this honkin shot in the hip, our nurse gave him a target.


Here's my complete results from today (day 11):

E2: 5519 (up from 3896 yesterday, yikes!!!)
LH: 1.1
P4: 0.79
Lining: 9-10mm
Follies: 14.9, 15.5, 16.3, 17.5, 17.9, 18.3, 18.7, 19.3, 19.4, 20.0, 20.8, 22.7

CCRM is pretty concerned about my high e2 and are going to be watching me closely. They don't like it to go over 4000. I go in tomorrow morning for a blood draw to see how much my e2 goes up after trigger. Last cycle I went over 9000. My egg retrieval is Sun @ 9:45a. I will go in for an u/s on Monday to make sure I don't fill up with fluid. If they feel I'm at too great of a risk for OHSS, they will force me to do a freeze all cycle. This means they would freeze all my embryos and send me home. I would have to come back another cycle for a frozen embryo transfer.

After 3 cycles and having my e2 go out of control on all, I think I have proven that I am definitely not a poor responder despite my high fsh. It's frustrating that it took 3 cycles for them to come to this conclusion.

Thank you so much for hanging in there through all my ups and downs.

Thursday, November 27, 2008

IVF#3 - Trigger Panic!

Well today was NOT a good day for us. As I said yesterday, they completely took me off of Gonal-f and had me take only one Menopur. I went in for an u/s this morning and found that only a few of my follies grew, some stayed the same and some even shrunk. The sonographer and nurse both said that I would definitely not trigger tonight as the majority of my follies would still be immature. I addressed my concern to the nurse about my follies being smaller and she said let's see what your e2 is today, we just don't want it to plateau or stall.

I was back at the hotel sound asleep when ccrm called. I jumped up and answered it completely out of it. The nurse starts giving me instructions to trigger tonight. She might as well thrown a grenade at me. I panicked and said noooo, it's too early, my follies are too small!!!! I asked her who made this decision and it was Dr. Gustofson, not Schoolcraft. I begged her to let me talk to a Dr. because this is my last chance and I can't be triggered too early like I was on IVF#1. I asked if there was any way she could talk to Schoolcraft and make sure this is what he would do. She said she would talk to Dr. G as Schoolcraft is out and then call me back.

She called me back a few minutes later and said Dr. G was ok with me stimming one more night. He had made the decision to trigger me because my e2 had plateaued. It had only gone up by 96 to 3896. This was definitely a first for me, I've never had my e2 do anything but jump by leaps and bounds. So then I started panicking about that. Was I making the right decision to not trigger now. What does plateauing mean, have we starved my eggs, have they stopped growing because they died off??? The nurse said that the doctor would not have been willing to delay the trigger if he felt it would be detrimental to my cycle. My head was spinning.

I was instructed to take 75 Gonal, 1 Menopur tonight and 1 Menopur in the morning. I'm to come in for a day 11 monitoring visit in the morning.

The nurse called back a few mins later and said Schoolcraft had just called in and she discussed my situation with him. Schoolcraft said he understood why Dr. G wanted to trigger me and that he is fine with having me stim one more night. The nurse then reiterated that Schoolcraft would not have let me do anything detrimental to my cycle.

So now that weight is on me, did I make the right decision begging to stim another night? The fear has kicked in overdrive, I can't escape it. Will my follies be rescued by the stims tonight, what will I see on the u/s in the morning, will my e2 pick back up showing some growth?

This was not the Thankgiving I imagined. I've shed so many tears, I've hyperventilated, I've almost thrown up. There is just too much weighing on this, I've been through so much, all the injections, all the money, it just has to work!!! Please God, let me be a mom!

I was in no condition to go out to eat, so we stayed in as the hotel was serving Thanksgiving dinner. It turned out to be microwaved fried chicken and instant mashed potatos. It was pretty disgusting and I couldn't eat it. I ended up having an apple instead. On the positive side, at least I won't have to spend the next 3 months taking off the weight.

I guess the roller coaster has taken off. This has turned into a Kingda Ka ride. This is a roller coaster in Six Flags NJ. It is the tallest and fastest roller coaster in the world. It goes from 0 to 128 mph in 3.5 seconds and literally goes straight up in the air and then straight back down.


I'm a roller coaster buff and even I nearly dirtied my britches. See for yourself; I'm above the K on the left and behind the guy's hand on the right, Kerry is next to me:


I kinda resemble the guy from Scary Movie!
Here's my complete results from today:

E2: 3896
LH: 1.3
P4: 0.66
Follies: 11.2, 12.3, 12.8, 13.0, 13.8, 15.1, 15.3, 15.8, 15.9, 16.2, 17.3, 17.5, 18.8, 20.4

Trying to remain positive...

Wednesday, November 26, 2008

IVF#3 - FSH Day 9 Monitoring

Just got my results from today's day 9 monitoring.

E2: 3800 (up from 2386 yesterday, so much better than last 2 IVFs, but still creeping up there)
LH: 1.5 (good)
P4: 0.4 (great)

They counted 14+ follies at 12-17mm.

I addressed my concern of having a history of e2 going sky high at my appt. On the call, they said no Gonal-f tonight and drop down to 1 Menopur in the morning. Gosh they are on top of things here! I have a day 10 monitoring appt tomorrow morning. Looks like I'll trigger either Thur or Fri and have egg retrieval on Sat or Sun.

I was told to drink tons of water and eat lots of protein and salt. So we're going to a steakhouse tonight. They have live music and a dance floor which is just going to drive us bonkers to not be able to get out there and dance. Kerry said, you know it's going to drive me crazy to not be able to dance with you. I said, well, I can do a little dancing as long as I don't shake my egg makers too much. He laughed and said, yeah, instead of your money makers, or shall we say money spenders. He's got that right!!! We've already spent the kid's college and wedding fund before the little one has even been conceived.

Tuesday, November 25, 2008

IVF#3 - FSH Day 8 Monitoring

I had my day 8 monitoring appt and physical today. I'm starting to become pretty uncomfortable, so no more climbing for me. The sonographer only measured the biggest follicles which was 11 @ 10-17mm, but I saw quite a few more in there.

E2: 2386 (shot way up from 720, but still ok)
LH: 1.24 (great)
P4: 0.64 (great)
Lining: 11mm (great)

Last 2 IVFs my E2 on day 8 was 4245 and 4385, so I'm doing much better this time!!! I just hope it stays under control.

Tonight they are lowering my gonal-f for the first time from 300 to 150. They are keeping my menopur at 2 vials. I have monitoring every day from here until trigger. My tentative egg retrieval is Sat.

My date for the rest of the week...


This photo reminds me of a funny story from IVF#2. Kerry and I were sitting in the ultrasound room waiting for the tech to come in. We were talking about how unnatural IVF is and how you are robbed of conceiving through love. I then pointed to the wand and said, you've been temporarily replaced. Kerry then held up his hand and said, that's ok, you've been temporarily replaced too. We laughed so hard. When your circumstances suck, you just have to laugh at it.

Monday, November 24, 2008

IVF#3 - FSH Day 6 Monitoring / Rocky Mtn Nat'l Park

Sunday morning started off with a 7:15a ultrasound and blood draw. After my u/s, the sonographer pointed to a big basket of pads, liners and wipes and said help yourself to any of these. Most people get a sucker when they leave a doctor’s appt, I get an assortment of maxi pads and intimate wipes.

After monitoring we headed up to Boulder, then Estes Park and then spent the entire day in Rocky Mountain National Park. It was a great time, though extremely cold at certain elevations. We did some hiking and then we just couldn’t resist doing a little boulder climbing. As a youngster, you could always find me at the top of a tree or on the roof of a house, if it could be climbed, it was climbed. I was very careful to not jiggle my ovaries too much, but it was the best time ever, stress-free, no worries, just the two of us enjoying being a kid again. I thought I would share a few pics from our day…

Our view:


My hubby:


So excited to find something to climb:


Kerry becoming one with nature, he thinks he’s an elk:


Just a bunch of tree huggers:



9450 ft and oh sooooo cold!!!!



A view of the snow caps:


CCRM called with my results while we were in the park where I had no signal. The message only said to continue my same dosages and that was it, no results!!!! I finally just now got my results and I’m oh so happy!!!

Day 6 Last IVF:
E2: 1074 (way too high)
Eggs: 17

Day 6 This cycle:
E2: 720 (perfect!!!!)
LH: 0.58 (perfect)
P4: 0.2 (perfect)
Lining: 7.6mm (perfect)
Eggs: 19!!!! (Geesh, I did some serious growing from 10 eggs 2 days prior)


On another note, electro-acupuncture is going well, whew! It wasn’t painful at all, very relaxing actually. It feels a lot like the muscle stims they put on you in chiropractic. I have a 7:45a monitoring appt tomorrow followed by a physical. I’ll send another update as soon as I get my results.

Friday, November 21, 2008

IVF#3 - FSH Day 4 Monitoring

I’m in Denver!!!! Today was my first monitoring appt (Day 4).

As a comparison, this was Day 4 on IVF#2:

Lining: 6mm (good)
E2: 668 (way too high)
Eggs: 11 less than 10mm and 2 micros for a total of 13 eggs (good)

Here’s today’s results:
Lining: 7-8mm (good)
E2: 252 (good)
LH: 0.6 (good)
P4: 0.2 (good)
Eggs: 7 @ 8mm, 1 @ 9mm and 2 smaller ones for a total of 10 eggs (good)


I think I’m off to a great start and am very happy with the results! I have acupuncture tonight, it will be my first time having electro-acup so I’m a little nervous. My hubby arrives tomorrow morning, yippppeee!!!! My next monitoring appt is Sun. That’s it for now.

Monday, November 17, 2008

IVF#3 - Suppression Check

I am a dandelion. Remember the childhood rhyme we used to say before beheading a dandelion? “Mama had a baby and its head popped off”, then you popped the dandelion head off with your thumb and it would go flying. I feel like someone has popped my head off. Where in the world did such a morbid rhyme come from anyway?

What a crazy, crazy day! It started off with frantically trying to find someone that could do my ultrasound today, I had no luck. Then Kerry called back the clinic that had just told me they had absolutely no availability, he begged them and said “it will take you 5 minutes to wand my wife”. I immediately took the ostrich pose.


He actually got me the appt, now I would have to face them. Next I had to schedule blood work, no problems there, but I needed to get there like right then. My ob/gyn has bent over backwards for me throughout this entire process, I asked for it, she prescribed it. I just had to do something nice for them. So I ran to the kitchen and mixed up a batch of cookies, threw them in the oven and ran to blow dry my hair. As soon as the oven when off, I grabbed the cookies and ran out the door. I got my blood drawn and they were so thankful for the cookies. I rushed back home and worked for a few hours and then ran to my ultrasound. They were so nice, and thankfully I was so frazzled from the last few days that I totally forgot about my husband’s conversation with them.

So for my results…

Estradiol (needs to be less than 50): less than 20
Progesterone (needs to be less than 1): 0.54
Ultrasound: no cysts, 2 micro follicles

I faxed this off to CCRM and got the call that everything looks great and I can start stims tomorrow. What, tomorrow??? I busted my tush getting everything done today so I could start stims tonight and get off this lupron before it over-suppresses me. But they want me starting stims with a full day, meaning menopur in the morning and gonal-f/lupron/dex at night. Oh well, what’s another day at this point. This will be my new regime starting tomorrow and will continue for about 10 days:


Next I had to book all my travel and schedule my first monitoring appt. Thankfully this went well and I got some great deals considering this was last min. I fly out Thur Nov 20 at 6am and my first monitoring appt is 9:30a Fri @ CCRM. OMG, OMG, OMG, it’s finally here!

Saturday, November 15, 2008

IVF#3 - She's Here Uninvited!

AF showed this morning, completely uninvited, 1 day too late and 2 days too early. It's Sat so there is no one I can call to find out what to do now. I'll call CCRM first thing Monday morning and see what would be the best plan of action. I'm guessing my departure date will now be Wed or Thur but I can't make any definite plans until I have passed suppression check which is Tue.

Friday, November 14, 2008

IVF#3 - Or Maybe Not!

ERRRRRRRRR…. The ride has come to a screeching halt, they’ve kicked me off and sent me to the back of the line.

Auntie got revenge! I only wore that white outfit long enough to take a pic for a joke, well now the joke is on me, she in turn only spotted long enough for me celebrate and announce her near arrival.

I woke up this morning really hoping to find AF and instead I found that I still have a high basal temp (meaning my progesterone is still up there preventing AF). I took a pregnancy test this morning so I’m definitely not preggo. Once again I had to cancel my suppression check, now my travel plans are officially derailed. My next suppression check is scheduled for Tue Nov 18, this is the earliest I could get in. So now it’s time to switch gears. I need AF to stay away till Mon morning.

My goal is to just make it to Denver before I end up in a loony bin! Thanks for hanging in there through my crazy reality.

Thursday, November 13, 2008

IVF#3 - Calling AF!

Well I had to cancel suppression check today. Still no sign of Auntie Flo! Technically I'm not late according to my normal cycle, but I'm late according CCRM's calendar which is messing up my travel plans. I've found that delayed menses is a very common side effect of lupron, great. So now I sit at the mercy of my aunt, the one that has been nothing but a pain in my uterus since I was 13.

I do have another suppression check scheduled for tomorrow so I desperately need her to arrive by morning in order to stay on track.

Desperate times call for desperate measures... it's time to pull out the big guns... on my way to the mall. (That's a pregnancy test in my pocket)

IVF#3 - It Worked!

OMGosh!!!!!!!!! It worked!!!! I'm spotting!!!! Scooby Dooby Doo!!!!!! Now I just need to fully start by tomorrow morning and then I get to go to suppression check!!!

Wednesday, November 12, 2008

IVF#3 - Acupuncture Blooper

Today I went to my 4th acupuncture appt and I had this new guy who I’ve only seen one other time. In addition to the uterine blood flow points, he said he wanted to do several stress points because he could tell I’m stressed out. Then he asked me to undress down to my panties and bra and I said “are you SERIOUS???”. I’ve done acupuncture for a year now and have never been asked to remove clothing. He said that since I had stretchy pants, I could just pull the pant legs up but he needed to get to my entire back for the stress points. He left the room so I could remove my shirt and have time to lay on the table. I thought, well, I’ll be laying on my stomach, he’ll only see my back, so I took my shirt off. Then I had a panicking thought, when was the last time I shaved my pits??? I took a quick peek and Ohhhh H E double hockey stick NO, that shirt was going right back on. He walked in and I was lying on the table with shirt on but hiked up and I said, sorry dude, the shirt stays.

So tomorrow is my suppression check. This is where they’ll ultrasound my ovaries to make sure they are nice and quiet, no cysts. They’ll measure my uterine lining and hopefully count micro follicles. They’ll check my estradiol and progesterone. Estradiol should be less than 50 and progesterone less than 1. With this particular protocol, you have suppression check the day of or day after you start your period. I’m fearing this more than anything, getting wanded while on your period has got to rank up there on the scale of humiliation. I’ve chosen to view this as a warm up to pushing out a baby. If I pass, I get to start stims. One big problem, there is no sign of auntie flo in sight. I was thinking, they are putting my body in a menopause state, doesn’t menopause mean no period? For the past 3 years I’ve begged her to stay away, now that I’d appreciate a visit, she’s flown the coop. I’ve tried teasing her with the home pregnancy tests, that usually always gets her attention. I guess I need to put on my sexiest undies, some white pants and go to the mall with no protection. You know me, I have a backup plan. I have another suppression check scheduled for Fri in case auntie is late, but she’s pushing it because I need to start stims Sat in order to not interrupt my travel plans which is to depart Monday. I already have the hotel booked and have a travel agent standing by ready to book a last min flight/car as soon as I say go.

Tonight will be my 8th lupron injection and I feel pretty darn good. If this is menopause, yeahhh…I can handle it.

Hope to give you suppression results soon…

Thursday, November 6, 2008

IVF#3 - Addressing Some Opinions

There is something I need to address so that I can hopefully find some peace. As many of you know, I’m an open book, I will share anything and everything with you. I have shared the most intimate details of my journey and pray that I can continue to do so. The risk with this is that it opens the door to questioning/ridicule of my personal thoughts/decisions. This doesn’t apply to everyone nor one particular person, it applies to a combination of emails/posts received and to those that maybe have certain thoughts but refrained from vocalizing them. Please do not ask me to share what was said or who said what, my intention is only to let you see a little more reality into my world as opinions are being expressed without all the facts.

I have been left feeling condemned, I have had no sleep, this has caused me a painful amount of stress and I’ve been crying my heart out. Starting lupron was not something I took lightly. I spent hours researching every aspect of this situation, I consulted my ob/gyn, my IVF nurse and other IVF patients. My ob/gyn said my progesterone (aka p4) levels were on the high end of completely normal as did many lab references online. I found countless women that had elevated p4 that were not pregnant. P4 levels do not predict pregnancy especially before implantation. A hike in p4 induced by pregnancy can only happen after implantation has occurred and after it has secreted hcg to tell the corpus luteum to pickup its p4 production. My p4 was elevated before implantation was possible. If my p4 was elevated because of pregnancy, that would have meant an extremely early implantation that would have had time to spit out hcg to call for more p4 resulting in something showing up on the beta (btw was < 0.5). Some of the more likely causes, acupuncture/chiro that has increased blood flow to my reproductive system or possibility of ovulating more one than one egg. Also, since I’ve never had a baseline p4 done before, how do I know that this isn’t normal for me?

Now is it absolutely impossible that I could be pregnant? No, but highly unlikely. The only sign that pointed to a possibility of pregnancy was the elevated p4, one that has now been found as not an indication of pregnancy. I have never in my life been pregnant, we’ve tried for 3 years, we’ve failed 2 IVFs, Kerry has extremely weak sperm that are rated as twitchers and are covered in antisperm antibodies preventing their ability to swim or penetrate an egg. We were only together once this cycle and I immediately went to the bathroom if you know what I mean, it was also 4 days before ovulation which would make it even more difficult for Kerry’s weak sperm to survive that long. I could go on and on with all the obstacles against us but the point is, it would take a miracle for us to conceive naturally, a miracle that I would die for. So if this was God’s timing to give me that miracle, I don’t think he would have allowed the beta to be negative. I prayed all the way from the phone call to the beta that if I was pregnant, please reveal it to me through this beta before I start Lupron or guide CCRM to cancel me. I don’t think it’s his nature to perform a miracle and then allow everything to fall in place to blow right through it.

My previous email/post may have contained humor as I always try to make the best of the situation handed to me, please keep in mind that you did not experience the behind the scenes, the emotional roller coaster, the extreme stress, the research, the decision making. This was not a simple solution of just waiting a few days to make sure I’m not pregnant and then just continue on. If I wait, that means it will be Jan/Feb before I could cycle again. I have invested an incredible amount of time, energy and money into this situation. To someone who wanted to be pregnant 4 years ago, delaying is painful especially when my issue is age related. At the same time, the last thing I want is to Have to do IVF, pay all this money and go through all these injections and surgery, so I took this very seriously. The other issue is that no matter which month I do IVF, it will be the same protocol where I’m faced with starting lupron after ovulation.

This whole situation occurred because my IVF nurse had the responsibility to be overly cautious and she’s the same person that told me to go forward with the lupron, they would not have told me to continue if they felt that I was pregnant. After all that I’ve been through, who do you think would be the first person to be the most cautious/concerned about this situation, that would be me. I am so sad right now. I have this sick feeling like people think I’m out to abort my baby. I cannot bare having to deal with these thoughts in my head each and every night I have to inject. These are hard times for me, a time when I need your full support and comfort. My husband has assured me over and over that we made the right decision. Please let me know you are on board with me, I need to hear it. I want to be excited about this journey. Love, Jill

Wednesday, November 5, 2008

IVF#3 - Not Pregnant!!!

Weeeeeeee, that was a FUN ride on the kiddie roller coaster! [insert rolling eyes]

So my beta just came in and I’m NOT preggo, so if you’re holding your breath, go ahead and breathe again. My ob/gyn was completely baffled why they ordered a beta at this stage, even if I was preggo, it would be too early to tell because implantation hasn’t even had time to happen. I agree, I think my IVF nurse was just being cautious thinking that if my progesterone level was induced by pregnancy, then it would show up, plus Lupron is not safe for pregnancy.

Now I’m getting in line for the adult roller coaster, the one that ends in Denver. Just waiting to see what my IVF nurse wants me to do next.

Thanks for being excited for me even if it was only for a day. It was the first time in my life a doctor/nurse thought I was pregnant, so even though it was emotionally draining, I got to experience just a touch of what it would feel like for someone to say “you’re pregnant” and it was the most amazing feeling. Moving on and looking forward to hearing it for real.

IVF#3 - Lupron

I just got the email from my IVF nurse and I'm to start lupron injections and dex tonight. I will take these all the way to trigger. OMG, here I go! Gosh, what a mind shift...

I'm also doing chiro 3x and acupuncture 2x a week to resolve my low uterine bloodflow.

Two differences with CCRM over my local clinic:
1. They insist that the Lupron is name brand, local uses generic.
2. They use Dexamethosone, local does not. This prevents the excess secretion of male hormones from the adrenal gland.

This little tiny vial costs $497 and it's only a quarter filled, can you believe it? Fortunately because it has many other uses, my insurance paid for it and I only had to pay a $25 copay.

Tuesday, November 4, 2008

IVF#3 - Pregnant???

Ok people, I'm totally freakin out. I had my progesterone level this morning and if the level is >5, I start lupron and dex tonight. It came back 27 so I thought, great, finally I get to start the process. Well then I get a call from my IVF nurse and she tells me my level is really high and to not do any lupron/dex tonight and instead go get a pregnancy test first thing in the morning! I was dumbfounded to say the least. She said that a normal level is 5-15 and that mine was the level of someone who's pregnant. I'm just like, there's NO WAY! It's not impossible, but come on, me... preggo??? We didn't even try this cycle. I actually told Kerry that he better not knock me up because I would need to start lupron before a pg could be detected. Lupron is very dangerous and causes birth defects. So I really don't believe I am, but how does a girl in my position not overanalyze everything? I asked my nurse if it could mean anything else and she didn't have any other reasons for it. So now I get a beta in the morning and then wait till it comes back in the afternoon.

Please pray for me, this would be an incredible miracle.

Monday, October 20, 2008

IVF#3 - HSG/Test Results

Today was my HSG. For any of you that are not familiar with this, it stands for Hysterosalpingogram. They inject contrast dye into the uterine cavity through the cervix and watch to see if the dye spills out the fallopian tubes via x-ray. This is done to determine if the tubes are open or not. One might wonder what matters when doing IVF since you bypass the tubes. Well according to Dr. Schoolcraft, if the tube is blocked, it fills up with fluid and this fluid is toxic to an embryo and significantly impairs implantation.

They started out by taking an x-ray of my pelvic area prior to starting the procedure. The x-ray is live on a screen in front of me. I asked what I was viewing and the nurse pointed out my colon and said all the white areas are air. Oh dear Lord that’s a lot of “air” is all I could focus on. The doctor came in and prepped me while I prayed for no pain as I’ve heard way too many horror stories of how painful this procedure is. He threaded in the catheter and inflated a balloon inside the uterus, the pain was a little intense. I closed my eyes and started singing a song we’ve been singing at church and instantly all the pain went away. Now of course I didn’t sing out loud, I’m pretty confident the doctor would have inflicted pain on me if he had to listen to that. He injected the dye as I watched it fill my uterine cavity and flow out my tubes. He said all looked normal and my tubes are open!!! Yippee! They removed the catheter and took one more x-ray and that was it… and thankfully the “air” stayed put.

All of our tests are now in… here’s the remaining results:

Jill:
Female Antisperm Antibodies: negative (yeah!)
Communicable Diseases: all negative (no cooties!)

Kerry:
Semen Culture: negative (no infections)
Communicable Diseases: all negative (cootie free!)
Frozen Backup Semen Analysis:
Count: 18.8 mil/ml (below normal)
Motility: 11% (way below normal)
Motility Rate: Twitching (time to get these boys some swimming lessons!)

2 weeks till injections!

Tuesday, October 14, 2008

IVF#3 - Protocol/Calendar

AF arrived yesterday and I finally rec'd my protocol/calendar!!!! They are putting me on the standard long lupron protocol without BCP.

It's a little strange for me as the local clinic treated me as a poor responder twice and now I'm being treated as a normal responder. It will be interesting to see how this all plays out.

Schedule:
Oct 19-29 Doxycycline (husband & wife)
Oct 20 HSGNov 4 Progesterone Level, start suppression if level > 5
Nov 4-14 Lupron 10iu & Dexamethosone
Nov 13 Suppression Check (u/s & b/w)
Nov 15-23 Stims (2 Menopur am, 300iu Gonal-F pm, Lupron 5iu, Dexamethosone)
Nov 17 Travel to Denver
Nov 18-23 Monitoring (u/s & b/w)
Nov 24 Progesterone & Estrogen Level, start Medrol & Tetracycline
Nov 26 Tentative Egg RetrievalNov 27 Bedrest (Thanksgiving... I know what I'm going to be thankful for!!!)
Nov 29 Tentative Day 3 Transfer -- or -- Dec 1 Tentative Day 5 Transfer
2 days of strict bedrest following transfer and then head back home

3 weeks till injections!!!

Friday, October 10, 2008

IVF#3 - Chromosome Analysis

One more result has trickled in… the Chromosome Analysis. This tests all 46 chromosomes. You can have an extra, missing or out of place chromosome that doesn’t affect you, but will affect your offspring or your ability to become pregnant. They wanted to test me for this since I have never been pregnant and have produced poo-poo quality embryos.

Results: 46, XX

Translation: I’m normal!!!! (at least microscopically) Oh, and I’m a girl!

Thursday, October 9, 2008

IVF#3 - Test Results

Hello!

I finally got a few results back, nothing too exciting, but never the less, it’s a tiny step forward.

These are the results from my blood work at my ob/gyn’s office:

Varicella Zoster: I am immune to chicken pox… could have told them that, not easy to forget that poultry.

Thyroid: normal… Hooray because that would have held me up!

CBC (complete blood count): all normal except I have mild anemia. I missed the normal range by 0.8. I was shocked as I’ve never had it before and my prenatal that I’ve been on for 3 years has 167% iron. But after a little research I think I figured it out. I found that baby aspirin is probably the culprit. I’ve been taking one a day for the last 7 months as they say it helps blood flow to the reproductive organs. But since it’s also a blood thinner, it made my blood a little too thin. Out the window it goes. I think I could fill a landfill with everything I've tried to help get me pregnant!

It will probably be another couple of weeks for the chromosome analysis results. Oh I hope I'm normal!!!

I haven’t heard a single word from CCRM which has been very frustrating. While in Denver, we left a nice box of chocolates on my ivf nurse’s desk as a thank you... no acknowledgement, no thank you. Maybe she doesn't appreciate brown-nosers, but I’m down grading my love to just like.

2 weeks till the dreaded HSG (dye test to check tubes). It will be fun, it WILL be fun!

That’s it folks, I told you it wouldn’t be too exciting.

Thursday, September 25, 2008

IVF#3 - CCRM One Day Workup

Hello Everyone!

We just got back from Denver and what a whirlwind it was!!! Sorry for the late update, but I have been completely wiped out. I don’t know if it was the elevation change (4500 ft higher than home) or a 6 hour non-stop workup with no food/water, but both of us were pooped our entire trip.

My cd3 frozen blood serum made it through security and into the hands of CCRM, hooray! Can you tell I’m proud?

Our workup was Tue @ 8am. This is pulling up to CCRM, Kerry was getting a kick out of how giddy I was.

I guess when you’ve done the amount of research I’ve done on this place, it becomes pretty cool to finally see it in real life. This entire building (3 levels) is all CCRM, no IVF clinic has this size of a building without the success rates to back it up. It was beautiful inside. Here’s me standing by their waterfall.

We started off with the IVF nurse consult. As soon as they called us back, I proudly handed her my serum, mission accomplished! They assign a nurse and want you to build a relationship with them as you will be working with them throughout the entire process. I was hoping and praying to get a nurse that gives details. When my results come in, I don’t want an “everything looks fine”, I want to know my exact numbers etc. I’m anal and analytical and Kerry knows that about me, so he proceeds to tell our nurse Kathy our situation and how stressed out I get if I don’t get details and to please give his wife the details so that he can be spared. She then tells us that we are a perfect match because she’s very detailed and loves to explain everything thoroughly. I love her! We spent so much time gabbing that we got behind and she had to ship us off to our next appt with the business office. Here we basically signed over our entire 2009 income in 5 minutes.

Next they sent Kerry off for a semen analysis and an antisperm antibody test and me off to complete some procedures. I started off with an intra-vaginal ultrasound where she thoroughly looked at my uterus and ovaries. Other than a small cyst on the top of my uterus that wouldn’t affect anything, she said everything looked great. My left ovary was showing a 15mm dominant follicle that will ovulate soon. My antral follicle count was 10-12 total and she said that was really good considering my situation. She then continued with the Doppler blood flow test, still using the intra-vaginal u/s, she finds the uterine arteries and watches the blood flow to my uterus. All I can hear is this loud swooshing sound which was my heart beat. She kept coming up with different readings so she hung out in there for at least 10-15 minutes, I was about to charge admission. It was becoming quite uncomfortable as she moved the wand at different angles, not to mention all the pressure it was creating. I swore if she didn’t get out of there soon, she was going to get a little surprise. They want the readings to be less than 3. My left artery was 2.63 and my right was 3.43. She said it was borderline, I was happy with that. Next was my hysteroscopy with Dr. Schoolcraft. This would be my first time meeting the guy that I have done so much reading about. He was really nice, quiet and humble. The hysteroscopy was by far the worst part of the day, but very quick. He inserted a speculum, cleaned my cervix with iodine, injected some lidocaine, dilated my cervix, injected CO2 gas, inserted the scope, viewed my uterus and did a trial embryo transfer all in no more than 2 mins. I would have loved to seen the look on my face when he said he was all done, $625… 2 mins!!! The pain was a little intense but it was so quick that it wasn’t too bad. He said everything looked great. So which one of us, me or hubby, would you say got the crap end of the deal? You be the judge.

We then went to our regroup with Schoolcraft. It was nice to finally get to talk to him “face to face”. He had no test results at this time other than a great looking uterus, so we unfortunately did not receive the details I wanted like what protocol he would put me on. He did make the observation that I’m a bizarre case, not his words, but he said things didn’t add up with me. My husband could have told him that for free. He said with my high FSH and low ovarian reserve, he’s really surprised by the quantity of eggs that I produce and really surprised by my outrageous estradiol level. I basically have the diagnosis of a poor responder but respond very well. He reiterated a lot of what we discussed in our phone consult so there wasn’t much new stuff said. He did suggest some additional testing back home that I’ll need to complete before I cycle, oh yippee, more tests! He’ll have more answers after he sees all my test results.

We returned to nurse Kathy for our consult part 2. We spent the entire time going through paperwork and signing consent forms. It was a tornado of information and even I was overwhelmed. I cannot even imagine receiving all of this if I’d had not been through this 2 other times. Total info overload, but incredibly thorough.

Our last appt was with the lab to draw blood. They will be testing both of us for Hep B, Hep B Core, Hep C, HIV I&II, RPR (Syphilis) and female antisperm antibodies. We have already passed all this testing from our first IVF, but required to do it again.


Here are the additional tests I need to complete back home:

Blood work: Thyroid, Varicella Zoster (chicken pox), CBC (complete blood count), Fragile X (mental retardation) and a Chromosome Analysis to see if I can produce normal eggs.

Procedures: HSG (inject dye into tubes to make sure open), Mammogram and 8 sessions of electro-acupuncture to improve my uterine blood blow.

I suddenly feel overly compassionate towards lab rats.

Wed we treated ourselves to a vacation day. We went hiking in Red Rocks Park. It was beautiful. They have a natural amphitheater there that was really cool. The increase in elevation totally came into play here. We were so out of breath at the slightest incline, we felt fat and out of shape, great for the ego.





We had to return to CCRM today so that Kerry could give a semen sample for a frozen backup just in case anything would happen like missing his flight during egg retrieval. We then had to scramble to the airport. Kerry went on to Las Vegas for training and I came back home to Nashville. Ahhh, oxygen, I can breathe again!

CCRM called after I returned home and gave me a few of our test results:

Semen Analysis, reference range is in ( )’s:
Volume 3.3 ml
Concentration: 25 mil/ml (>20)
Total Count: 82.5 mil
Motility: 22% (>40%)
Motility Rate: twitch to 1+ (2-3)… this is the biggest problem
Morphology: 2% normal (>4%)

Antisperm Antibodies:
IgG: 44% head, 0% entire, 3% tail, 0% mid
IgA: 7% head, 0% entire, 1% tail, 0% mid
I don’t really know the difference between the G and A antibody, but head is the worst place to have antibodies. They said it was a very good thing that the entire sperm wasn’t covered in antibodies. I guess this adds up to 55% antibodies and they want it below 20%. His last ASA in Sept 2006 showed 64% antibodies, so I guess this is slightly better news. Fortunately IVF bypasses this issue.

CD3 Blood Work:

FSH: 12.1 (less than 10)… this is elevated, but I’m quite happy with it as it was 12.48 8-months ago, so very thrilled it hasn’t gone up!
E2: 26 (less than 50)
AMH: 2.0 (greater than 1.5)… this was a new test for me, it stands for anti-mullerian hormone, it’s a test for ovarian function. The nurse said 2.0 was great and means I will respond well to meds and therefore they can give me gentler dosages… yeah!!!! Guess this explains why I respond so well despite the high FSH. If only my local clinic would have tested me for this, they wouldn’t have put me on a bazooka of a protocol on max stims.

I’ll send out updates as I get in more results. If you’re still reading, I commend you for hanging in.

Wednesday, September 17, 2008

IVF#3

After a much needed break, I’m back! I apologize ahead of time at how long this is.

After extensive research, I’ve made my decision to go with CCRM (Colorado Center for Reproductive Medicine) for IVF#3. This is the #1 rated IVF clinic and lab in the US and has the highest success rates. They say if anyone can get you pregnant, CCRM can. I’m putting them to the challenge. Some of you may think we are crazy for going to this length to conceive, but if you could step into our shoes for just one day and feel the heartache we experience, you would understand.

I had my phone consult with Dr. Schoolcraft on Sep 10. $250 for 26 minutes, yikes!!!! Schoolcraft is known to be a straight shooter, he tells it like it is and doesn’t sugar coat anything. Many girls get the donor egg speech, so I was prepared for that. I think it went really well. He specifically said that he did not believe it was time for donor egg and felt I still had a good chance with my own eggs. *** Asked him to hold so I could do a cartwheel! *** He thinks the reason for my past 2 failures was too aggressive of a protocol and lower lab quality. Their lab really is top notch, I have read so many posts where the girl had multiple failed cycles locally and never had any embryos make it past day 3 (like me) and then went on to have multiple blasts (day 5 embryos) and sometimes even enough to freeze. So it will be interesting to see if they are able to get any blasts out of me. I asked him about my slow dividing and multi-nucleated embryos and he said that while it is possible that I just have poopy eggs, he feels it is probably more to do with the protocol and lab, some labs use too harsh of a culture medium. He couldn’t give me my chance of success until he runs some tests on me, but he thinks I have a good shot.

My next step, which is required for every CCRM patient, is what they call a one-day workup. It’s an entire day of testing for both husband and wife. They are very thorough and are adamant that their lab runs all of the tests. We have already done most of this testing, but have no choice but to repeat it. Our workup is scheduled for Tue, Sept 23rd. We leave the 22nd and come back on the 25th. This will be cycle day 13 for me and since FSH, LH and E2 hormone levels have to be tested on cycle day 3, they have you get that drawn locally after the workup and mail it to them. I decided to be proactive and get it done ahead of time so that it won’t delay me later and I can get my results along with all my other testing. Problem, cd3 fell on a Sat. Talk about jumping through fire burning hoops to get cd3 b/w on a Sat without a script and have the lab let me take the blood without running tests on it!!! But I prevailed! My ob/gyn was willing to do this for me, but they were closed on Sat. I found a paramed company that was willing to come in on a Sat and do it for me, but they didn’t have the right lab supplies. No one else would draw without a script or let me take the blood home. So on that Fri at last minute, my ob/gyn called and offered me the lab supplies if I could get there in 20 mins (it’s a 30 min drive). I hung up and drove like a maniac, praying that I wouldn’t be killed over cd3 b/w! I made it in 19 mins and got the lab supplies, I felt like I had won the lottery. The next day we drove to the lab that so generously did this for us for free. They were to draw 2 vials of blood (my ob/gyn gave us 4 vials just in case) and they drew 4. Thank God we didn’t give them more than 4 vials. We then waited for it to clot, centrifuged it, poured the serum into transfer tubes, put it in a cup of ice and rushed it to our freezer. 3 of the 4 tubes of serum froze within 2 hrs, the 4th very strangely took 24 hrs to freeze. I joked to my husband that they could freeze me and I would live, he said; no, only a fourth of you would live, he’s so funny. So now I just need to get that serum on the plane and kept frozen. I pity the poor TSA officer that gets in my way, that serum is going with me!

Thursday, August 7, 2008

IVF#2 - Beta

I got my beta results today, negative as expected. From quads to nothing, that was a big blow! It was a rough couple of days where I was so incredibly heart broken and boo hoo-ing uncontrollably. I've pulled myself together and I'm moving on. I cannot accept never being pregnant or being a mom, so I will continue to pick myself back up and try try again. Onto IVF#3. You probably think I'm insane, but this desire to be a mom is even more insane. I'm not exactly sure what my plans are, but I'm definitely moving onto a top IVF clinic as I'm not risking a 3rd negative at my local clinic. I'm leaning toward CCRM in Denver, Colorado or Cornell in NY. It's going to cost me dearly with travel expenses and a hotel for 2 weeks, but if that's what I have to do to give myself the best possible shot, that's what I'll do.

Tuesday, August 5, 2008

Monday, August 4, 2008

IVF#2 - Bleeding

I started having red bleeding tonight, just like last time. I've been crying hysterically. We're going to test at home in the morning due to the circumstances. We’re also going to schedule the beta tomorrow. Please pray for us.

Sunday, August 3, 2008

IVF#2 - 2ww

The IVF 2ww is the worst! I'm 11dpo and feel absolutely nothing, no signs, no symptoms. I have been praying/begging for this to result in a baby. I have no idea how this will turn out, it could go either way. I'll guess we'll all find out this coming week! Tick-Tock Tick-Tock....

Thursday, July 31, 2008

IVF#2 - Quick Update

Hello,

I thought I would send out a quick update:

Embryos in culture – none of them made it past 5 cells and all were discarded on day 6. So no snow-babies for a backup or a future sibling.

Progesterone level – I had my progesterone checked yesterday, they want it >30, mine was >80, so all good there and they want me to continue with the progesterone injections.

As far as how I’m feeling, totally normal. That’s great in the sense that I did not develop OHSS. Now I’m praying for sore boobs and morning sickness. One more very long week to go before I get the results, trying to be patient.

Saturday, July 26, 2008

IVF#2 - Day 3 Transfer

What a day of answered prayers and miracles!!! I'm currently carrying QUADS!!!!

On day 1:
4 fertilized

On day 2 (should be 4-cells):
4 developing slowly at 2-cells
2 hours after leaving me a voice mail, 3 more spontaneously fertilized!!!

On day 3 (should be 8-cells):
6 @ 4-cells
1 @ 8-cells

Now there is a downside to this, 6 of the embryos are multi-nucleated. What this means is that one or more of the cells did not divide correctly and contain more than one nucleus. The nucleus contains the DNA. Basically they are probably chromosomally abnormal. Multi-nucleated embryo transfers are generally avoided unless there are very few normal embryos available. These embryos are at very high risk of arresting or miscarrying. Around day 5 or so, the cells start to differ from each other, some will become the baby, some will become the placenta, etc. Now if the normal cells become the baby, a normal healthy baby can result. So these embies do have a chance of producing a perfectly normal baby.

Good news is that my 8-cell appears to be perfect and has great potential. This little miracle embie went from 2-cells to 8-cells overnight and is a so close to a perfect A that they graded it a B+!!!!! So I'm holding out hopes for my little miracle 8-cell embaby!

Transfer went well. I thoroughly enjoyed my Valium. I transferred what my doctor recommended, which was 4 of the best. Normally they would not have been willing to do more than 3 with me, but considering the above mentioned issue, they want to better my odds. We transferred the 8-cell B+, 4-cell B that jumped to 5-cells right before it was transferred, and 2 more 4-cell Bs.

3 are remaining in culture and they'll watch their development and report back to me. Most likely they won't make it, but you never know about my embies, maybe they'll pull another miracle and we can get some snow-babies out of them.

Here's embabies first photo:


Just three more hurdles to go, to get pregnant, stay pregnant and give birth to a healthy baby. This is the closest I’ve ever been, OMG, I’m a mom right now!!!!

Friday, July 25, 2008

IVF#2 - Day 2 Embryo Update

Here’s the exact message I received:

“I’m calling to leave you an embryo update. I wanted to let you know that unfortunately none of your embryos are growing at the rate that we expect them to, they’re growing, they’re just not growing quite as fast or as well as what we would expect to see today. We would expect to see a 4-cell grade B or better and all 4 of your embryos have a lower # of cells than that. Because of this, we feel it is in your best interest to have a day 3 transfer. We’ve gone ahead and scheduled your transfer for Saturday @ 10am and have cancelled your day 5 transfer on Monday. I will be working this weekend and I’ll come by shortly before your transfer with a picture of your embryos and try and answer any questions you may have. That’s all the info I have for you now, I’ll see you tomorrow morning.”

=(((((

Thursday, July 24, 2008

IVF#2 - Fertilization Report

Results so far:

19 Retrieved (Wahooo!!!)
12 Mature (Yes Yes Yes!!!)
4 Fertilized (Oh no!!!)

Last Cycle:

10 Retrieved
4 Mature
2 Fertilized
1 Divided slowly, transferred on day 3, didn’t implant

I started the dreaded progesterone injections last night, along with Tetracycline and Medrol. I put drug addicts to shame! They are a 1.5” intra-muscular injection that goes in the boo-tay via hub-bay. I numb up with lidocaine ointment, so it’s really not that bad, but it sure scares the poo out of me, so I have to close my eyes.

Tomorrow I will get a division report telling me how many divided, they should be at 4 cells tomorrow. There must be an egg/sperm quality issue as a 4/12 fertilization rate is very poor. Please pray for my little embies to grow and divide properly. Please pray for strength and peace for me as I wait for that dreaded phone call. I’m trying really hard to not be fearful… but I lost it this morning. I cried so hard I hyper-ventilated and almost threw up. My emotions and fears are compounded by large quantities of hormones, a vasectomy reversal, 2.5 yrs of trying on our own, 2 IVFs, $45,000 and not one pregnancy. I’m doing better now but feel like I’m standing on the edge of a cliff begging for mercy.

My IVF nurse called me to ask how I was feeling. She was trying to get a feel for if I was developing OHSS. So far so good, just cramps and bloating. Then she said my doctor wants to proceed with a fresh transfer this cycle as she doesn’t think my embabies will make it to freeze. Please pray that my uterine lining will accept implantation and that I will finally be blessed with motherhood.

Wednesday, July 23, 2008

IVF#2 - Egg Retrieval

Hello All,

I just got back from egg retrieval and wanted to get an update out before I drift off. Everything went really well! They retrieved 19 eggs, wahoo!!!! Last time they retrieved 10. The embryologist said he thinks about half of them will be mature just from first glance. They will be injecting one sperm into each mature egg today. I’ll get a voicemail tomorrow with how many are mature and how many fertilized. My doctor is leaning towards freezing them all, but hasn’t made up her mind yet. I’m feeling pretty crampy, but nothing unbearable, I’m doped up pretty well right now.

Kerry’s sample was better this time, here’s his results:

IVF#1
Total Count: 40 million
Motility: 3% grade B

IVF#2
Total Count: 60 million
Motility: 6% grade B

When I returned to recovery, there was a “Dear Eggs” letter waiting for me, encouraging them to become great embryos and letting them know they have wonderful parents waiting for them. So cute! It was from a good friend who just went through IVF 2 weeks ahead of me.

So nothing but good news, everyone is very happy with the results, all went perfect and we couldn’t be happier. I’ve been praying like crazy, all I can say is God is good and delivered!

Tuesday, July 22, 2008

IVF#2 - Night before Egg Retrieval

I just got my estradiol level back and it’s now 9029, zoiks Scooby!!!! I’ve been given instructions to stay very well hydrated and eat lots of protein. It won’t prevent OHSS, but will help with the symptoms. But since I’m NOT going to get it, it’s just a precaution. Egg retrieval is tomorrow morning. While I’m having surgery, Kerry has an appt with the Lazy Boy in the collection room. I'll ask again, how fair is that???

I talked to my IVF nurse today and got some more info. I asked her what will determine if they will go forward with a fresh transfer or freeze everything. One consideration is my insane E2 level, the other is she wants to see how many eggs fertilize and what the quality is. If I have a good count and quality, she feels it would be ok to freeze them and I could have a good chance with a frozen transfer later. If I have a low count or poo poo quality and freezing/thawing them would probably result in losing them all, she would rather chance the fresh transfer. So sounds like she wants to keep me safe but at the same time, really wants me to have a good chance at pregnancy. I’m at peace, whatever she decides.

I next asked about the frozen embryo transfer process (FET). If I have to go frozen, the real bummer part is that it will be 3 months from now before I get to transfer them, ugh. Did I mention I’m tired of waiting already? Well I am, let’s get me pregnant already! I would have to wait for this cycle to end, go through a normal cycle on my own, and then start the process the following cycle. The process is unexpectedly more than I realized. It is identical to going through IVF minus the stim injections and egg retrieval. It’s a 6-week process of birth control pills, lupron to shut down your hormone system, estrogen supplements, monitoring visits, transfer and progesterone injections. Basically it’s HRT (hormone replacement therapy). The scary part is that you can’t thaw the embies until you’re ready for transfer, so you have to go through the all the prep work before you even know if your embies are going to survive the thaw. I asked her how many they will unthaw. If they are frozen right after fertilization, they unthaw them all and see what develops. If they are frozen at day 3-5, they will only unthaw how many you want to transfer. They will keep unthawing one at a time until they have that amount or run out. The embryologist will determine when they think is best to freeze. I never thought I’d ever be at the mercy of so many people to get me pregnant. If anyone ever wants some advice on how to NOT get pregnant, I’m your woman! =)

I’m off to go take it easy before delivering all my little follies. =)

Monday, July 21, 2008

IVF#2 - Trigger

I'm officially triggered! I can soooo relate to women who are one week from giving birth right now. I am so bloated and uncomfortable, I cannot wait to give birth to these follies and get them out of me!

I don't know if it's 100+ injections in my stomach over the last 2 IVFs or my high E2, but wow is my skin getting tough to pierce. Thank God I'm done with injections, at least in my stomach!

Now I wait on pins and needles, will they choose fresh or frozen transfer?

IVF#2 - FSH Day 10 Monitoring Visit

I had my fourth and final monitoring visit today. I’ve been feeling pretty uncomfortable in my ovarian area. The ultrasound lady said “I can see why” as soon as she got a glimpse of my ovaries. Here’s my results:

Right: 10, 13.5, 15.5, 16.5, 17, 17, 17.5, 18, 18.5, 2<10.
Left: 10, 10, 11, 11.5, 15, 15.5, 16, 19, 20, 21, 2<10.

So I have a total of 23 follicles!!!!!!!!!!!!!!!! A max of 13 follies will have a chance of being mature at egg retrieval.

My lining is 8.9mm, much lower than last IVF, but still in an acceptable range.

I unfortunately do have some more bad news, despite reducing my meds twice, my E2 has sky-rocketed to 8380!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! It jumped by almost 4000 in just 2 days and it’s going to continue to rise over the next 2 days. Remember the highest they ever want it to get to is 4000. Peak E2 in a normal non-stimulated cycle is about 150-600, so as you can imagine, the body is not used to this extreme level.

They are having me trigger tonight at 9:30p with one and a half Ovidrels. Tue I go for one last E2 blood draw. Then Wed is my egg retrieval at 8:30a.

I talked to my doctor and she’s pretty concerned about me developing Ovarian Hyper-Stimulation Syndrome. I heard this is NOT fun at all. But I’m NOT going to get it, right!!!!! The excessively high E2 could damage the egg quality, boo! She is going forward with egg retrieval, will fertilize the eggs and then decide if she wants to do a fresh or frozen transfer. Based on impaired uterine receptivity to implantation, she feels I’d still be better off with the fresh over frozen. Based on the risk of OHSS, she thinks the frozen transfer would be much safer. The risk of OHSS goes way up if you become pregnant. I checked my clinics success rates for my age group and a fresh transfer has a 45% chance of resulting in a pregnancy and a frozen transfer has a 39% chance.

Prior to IVF#1, I was pre-diagnosed as a poor responder. After IVF#1 I was upgraded to a low responder. Today I was upgraded to a normal responder. So that’s some good news!

For those of you interested, here’s a recap of my E2 levels:

IVF#1
Day 5: 1640
Day 7: 3428
Day 8: 4245
Day 9: Trigger
Day 10: 6867

IVF#2
Day 4: 668
Day 6: 1742
Day 8: 4385
Day 10: 8380 (Trigger tonight)
Day 11: ?