Wednesday, April 29, 2009

IVF#4 - 1 Week!

OMG, 1 week! In 1 week I'll be lighting a fire under my ovaries. I cannot believe it, does not seem real. No BCPs/Lupron before hand has really messed with my head. No ramp up period, I'm just going to jump right into the fire. I keep forgetting how soon this is coming up. I've even had nightmares that I had already moved into next cycle and completely forgot to start stims. Crazy huh!

Today I booked my tentative departure flights based on a guess of when AF will arrive. Not only is AF arrival up in the air, it's still unknown if I'll do my cd2 suppression check locally or in Denver. I'd rather do it locally as it would save me quite a bit on travel expense, but it's a matter of if I can get an appt at the last minute locally.

I booked a flight for May 5 that will put me in Denver on an estimated cd1 or cd2. This flight is in case I do the cd2 suppression check in Denver. The downside to this is that I won't need to be at CCRM again until 5 days later, which is a lot of extra hotel cost.

I also booked flights for Kerry and I for May 9 which would put us there a day or two before my first stim check. This flight is in case I do the cd2 suppression check locally. I'll cancel whichever flight I don't need. Once I know for sure which date I depart, I'll then have to scramble to book hotel and rental car.

Oh gosh, I just realized I still need to order my meds! This is all just way too much fun. You know, I really miss that innocent excitement I used to get right before an IVF cycle. I'm not excited this time, not in the least bit. 3 failures was a big enough reality check for me that IVF does not always work. I'll remain positive and hope for the best, but it's just not fun anymore.

I also know I'm starting on an uphill battle. The unknowns of how I'll respond to this new protocol. Knowing that I'll come home without my embabies, ie no chance of pregnancy. The challenge of growing my embryos to blast and biopsied for genetic testing. Waiting 6-8wks for genetic results. The desperate hope of having any normals available for transfer. Oh, I shouldn't leave out the best part, the part where it costs $25k for all this fun. What a deal! So yeah, this is a lot to deal with and takes a little bit away from being excited about it.

Some may be wondering about now, why is she even going through this then? Because I'm willing to do anything for my little K&J and if I have to go through hell and back to bring the little one into this world, that's what I'll do. I love my child this much, even though we've never met.

On a completely different note, I thought I would tell you about my time in Walmart last night entertaining their guests. I was in an aisle with a few other shoppers picking up some neccessities when Kerry called my cell. Now my cell has a very loud obnoxious ringer. The longer I take to answer it, the more loud and obnoxious it gets. I searched my purse, my cart, my pockets... I could not find my cell. By now everyone is quietly starring at me as if I was an exhibit at the zoo. I swear I can hear it coming from my pant side pocket, but after 3 checks of patting myself down, I couldn't find it. So I start over again, go through the purse, the cart, pockets again... now I'm even looking on the walmart shelf for it. At the last second I discovered it and exclaimed to my audience; "Oh, it's in my hand!". I gave everyone a good LOL and then proceeded to get out of there as fast as I could.

Sunday, April 26, 2009

Yikes! Summer Is Here!

Hello Peeps!

Just a friendly reminder... SUN SCREEN!!!!

This is from being outside noon-1p. ONE hour! Don't be stupid like me!


Thursday, April 23, 2009

IVF#4 - Prerequisites

My IVF nurse has given me a few prerequisites that I need to complete before cycling.

1. Pap
Check, did that last week. I've been nervous because of all the hormones I was on for 3 IVFs and all the spotting I've had. The results came in yesterday and I'm happy to report all normal, wahoo!

2. Mammogram
Check, did that a couple of days ago. This was my first mammogram and let me tell you, I was terrified! My friend sent me a forward with the following comics the day before my mammo (she had no clue I was getting this done).

It created quite a bit of anxiety. So I arrived at my appt and filled out the paperwork. The form asked the standard questions that access your risk of having breast cancer; Have you ever had breast cancer? Is there a history of breast cancer in your family? Do you have any lumps, pain or discharge? I was happy to answer No to all. Then I got to the last question; Have you used hormones such as estrogen? Oh crap! Well, uh, yeah, and then some, like all last year!

I was then called back. I was asked to remove any deodorant with some baby wipes and put a gown on. The lady took me to the x-ray room and asked if I had any questions. Only one, is this going to hurt? She said no, it will just be a little uncomfortable. She had me slip my arm out of one side of the gown and she proceeded to put my boob in the machine. She pushed a button and the machine started to compress. She then manually turned a knob to compress a little bit further. The plate is clear plexiglass, so it was quite a sight to see one of my girls flattened out. She had me hold my breath and took the x-ray. There were 4 x-rays total. 2 for each girl, one horizontally and one vertically.

I'm very relieved to report that it was a piece of cake! I wouldn't even call it uncomfortable. I hope this helps anyone out there having the same anxiety I had. Now I anxiously wait for the results. I wasn't scared of the results until the question on the form about taking hormones.

3. Communicables
Lastly, Kerry and I need to update our communicables. CCRM requires communicable testing on all patients and it expires after 6 months. Ours just expired, booo! I begged them to let us do our communicables with an in-network lab but they said it could only be done at their lab because they consider embryos to be human donor tissue and that requires a special FDA approved lab. How convenient! Why doesn't any other IVF clinic have this requirement? I can't believe Quest or LabCorp are unqualified to test us for cooties. I told my nurse that by time I'm pg, I won't be able to afford to raise the child. She said if there were any loop holes, she would have let me known. Oh well, what's another $620... insert rolling eyes.

So my nurse wanted to send me a blood shipping kit so Kerry and I could get this done right away. I think the kit costs around $80 if I remember correctly. I did not see the point in this since we would be in Denver soon anyway. She hesitantly agreed to let us get our blood drawn when we arrive. Considering that these expire in 6 months, I want to wait as late as possible so that I'm not nearing expiration during my FET(s). Also, what if I'm cancelled at suppression check? So I'm dragging my feet trying to extend this 6 month start date as late as possible.

As far as timeframe, I ovulated 2 days ago and am waiting on AF. It is going to be here before I know it and honestly, it hasn't even hit me yet. I think it's because there's no BCPs or Lupron suppression before everything kicks into high gear. No low gear with this protocol. As soon as I start, it's instant high gear. Ugh, I'm not ready!

-------- Update --------
Mammogram came back normal, wahooooo!!!!

Thursday, April 16, 2009

IVF#4 - Protocol

Alrighty folks, here's the details, and lots of them! (Family, I apologize as this may get pretty techie)

Back in December when I failed IVF#3, I had a phone consult with Dr. Schoolcraft. You can read all the details from that consult here. In summary, his recommendation if I were to cycle again was to do another long lupron protocol but add CGH genetic testing. He said the only reason to not do long lupron is if you don't produce enough eggs on it, I produced 23. He thinks we have an embryo quality issue and that genetic testing would give us the answer of whether to continue with our own embryos or move onto donor/adoption.

Last week my IVF nurse put in a protocol review. Schoolie came back with the Antagonist protocol. This really caught me off guard and scared me as I've heard this is not his favorite protocol. While I trust the wizard, he does pioneer IVF protocols, it's just my nature to need to completely understand why I'm on this protocol when spending this kind of money. So I spent the next few days researching this protocol as I have never done it before and did not know what to expect from it.

While researching, I noticed that the few patients he has put on this protocol, he combined it with estrogen priming protocol (EPP) suppression. I researched EPP and found it to be quite interesting. Apparently, women who have elevated FSH (that's me!) tend to start recruiting follicles before cd1. This is bad because it can create a dominant follicle issue significantly decreasing your chance of success. In IVF, if a dominate follicle is allowed to develop, that follicle can take over and suppress all other follicles. In a natural cycle, this is how your body prevents you from ovulating more than one egg each cycle. The EPP suppresses the FSH prior to cd1 preventing any follicles from taking the lead. This keeps all follicles at the same size and ready to go when stims start. Sounds great to me!

My nurse never mentioned EPP for my protocol. After a phone call to go over my calendar, I discovered that Schoolie did not include EPP and instead wanted me to do the plain vanilla Antagon protocol with no suppression at all. I peppered my nurse with questions regarding why I was or was not being put on EPP, and how/why Schoolie came up with this protocol. She had no answers and I left the call feeling very unsure of going through with this cycle. No suppression really concerned me as I felt that put me at great risk of the dominant follicle issue.

The nurse suggested I do a regroup with Schoolie to get my answers. It would cost me $85 to speak to him. The principle of this urked me because I feel if I'm going to spend $25k+ at his clinic, I ought to be allowed one phone call when starting a new IVF cycle. You even get one phone call in jail. I whined about it and then she offered to see what she could find out for me.

The nurse called me back a couple of days later with some answers, hallelujah! She had talked to Schoolie about my concerns/questions. He said that EPP is for poor responders and considering that they got 23 eggs out of me last time, he feels that I respond very very well. He said that I can do EPP if I want to, but he honestly felt I'll do fine without it. He said my issue isn't response, it's embryo quality.

His reason for selecting this protocol is that he wants to trigger me with lupron to help with quality and you cannot do that with a lupron protocol, therefore he had to go with antagon. He actually wants me to trigger with lupron and hcg. I've never heard of doing this before, but I would think that would give an extra egg maturation boost. He's really going after quality over quantity.

I addressed my concerns of getting a dominate follicle with no suppression and she said that the doctors are very good at tweaking the meds/timing and will sometimes let the dominate follicle over-mature in order for the smaller ones to catch up. I struggle with this as my theory is that the dominate follicle has the best potential since it proved to be the strongest from the get go.

With lupron based protocols, the lupron shuts down your pituitary gland preventing ovulation. With antagonist, there is nothing preventing ovulation until they start antagon. When they see your lead follicle hit 14mm, you start antagon injections. She said that antagon is really an art, where timing when to start the antagon is very critical. If they start it too soon, they stunt the growth of the smaller follicles resulting in less mature eggs. If they start it too late, they risk you ovulating.

I asked if I get 23 eggs on long lupron, what should my expectations for be antagon. She said I could expect less, but that this is all about quality over quantity, and that even though I got 23 eggs last time, look at the final outcome.

He also wants me to do genetic testing on the embryos. This tests all 46 chromosomes. They will culture the embryos to day 5, biopsy them and then vitrify (flash freeze) them. This is incredibly frightening to me as my embryos are always slow and poop out before day 5. I've only had 1 embryo ever go to blast. But of course, I always transferred my best, so hopefully I can get a few more. The genetic results take 6-8 wks. After the results come back, they prepare you for an FET. This is perfect as I'm unwilling to do another fresh transfer anyway. I truly believe that none of my 8 transferred embryos implanted because my body was so jacked up on stims. Waiting on the results gives my body time to recover between retrieval and transfer.

Since there is no suppression, I’m med free this cycle. I’m just waiting for AF to show. On cd2, I’ll go for an u/s and blood draw and if all is good, I start stims on cd3. I’m doing 2 menopur in the am and 150iu gonal at night. The good part of no suppression is that my med doses are dramatically less, saving me quite a bit of moola.

In summary, my last 3 IVFs were all lupron based protocols with suppression, triggered with hcg and were day 3 fresh transfers. This time I will be on an antagon protocol with no suppression, triggered with lupron and hcg, will be genetically testing the embryos and will be doing a frozen embryo transfer. So we’re definitely changing everything up. In one sense, I’m scared to death of all these unknowns, it could turn out to be the best I’ve ever done, or a complete disaster. On a positive note, I’m very excited to be trying something new as obviously nothing has worked in the past.

To answer a few questions from my last post:

My field of study is computer science. The class that I was giving examples from was concepts of programming languages. 4 more classes and I'm done, but at the rate I'm going, that may take me 2 more years. My final exam for this course is right after stims start, so I’m cramming like crazy trying to get this course completely done before then. IVF and final exams mix about as well as drinking and driving.

Saturday, April 11, 2009

Taxes, College and IVF, Oh My!

I finally finished our taxes, wahoo!!! I'm such a procrastinator! I do our personal and Kerry's business taxes, so it's quite a bit of work. Took me 3 solid days. The sad part is that 2 days of it was all dedicated to consolidating our medical expenses and mileage. I knew the figures were going to be crazy... In 2008, I had 58 doctor visits, all fertility related. Our out of pocket medical expense came to $52,110. Good gravy, there went our future kid's college fund.

Thanks to IVF, we are getting a $5k refund. =))) Thanks to IVF, it will be eating our refund for a snack. =(((

Now I need to get caught up on my college course. Yep, I've been procrastinating on that too. If you knew what I'm having to study, I think you would procrastinate too. Let me give you just a taste of what I'm having to deal with...

Axiomatic semantics, correctness proofs, predicate calculus, weakest preconditions, inference rules, theorums, etc. A few examples...

{P1} S1 {P2}, {P2} S2 {P3}
{P1} S1;S2 {P3}

{P3x2-->E2} x2=E2 {P3}
{(P3x2-->E2)x1=E1 {P3x2-->E2}

You had enough? That's just one chapter. I swear my head is going to explode. I have got to get my rear in gear and not only catch up, but get ahead. My final exam is due on my tentative 3rd day of stims, so ya see, I have got to get er done A S A P.

So IVF#4 is coming up soon. I still can't believe it, #4, wow! I remember saying just over a year ago; "I will never do IVF!!!". Har har! I have my protocol, calendar and Schoolcraft's thoughts. Next post, I'll layout all the details. To answer one of your questions, yes we are going back to CCRM.

Thanks everyone for all your support, you have no idea how much it means to me!

Tuesday, April 7, 2009

What's Next - Part 2

Finally, part 2 of what's next. I've been dragging my feet hoping I'd never have to write this post, but alas, it's time. We're not getting anywhere on our own and we're definitely not getting any younger.

Having to make this decision basically turned my life upside down for a few days. I was struggling with anger, I was irritable and snappy. I cried more times than I care to admit. The happy me that I had just uncovered was gone.

But not to worry, I'm back. Now that the decision has been made, I'm content and at peace with it. We are going for IVF#4. If your eyes just bugged out and your mouth hit the ground, don't worry, I had the same reaction.

Some were wondering why my decision needed to be made so fast. Mostly because I drug my feet until the last second. If we did decide to do another IVF, you have to let the clinic know on cd1, which gave me 24 hrs. Also, the lab shuts down twice a year and if I didn't get going now, I would be delayed another couple of months.

The decision was easy for Kerry, he had already decided that we should do another IVF back in Dec when we got our BFN. His take is that we have invested an incredible amount of time, energy and financial resources into this process. The doctors have learned a great deal. If we were to give up now, it would be like throwing all that in the trash. It would be different if we weren't making any progress, but we have, and hopefully we're on the verge of a break through.

I totally agree with Kerry and to give up now would leave regrets and what ifs. IVF is many times trial and error. We now have lots of valuable data and that increases my chances that they will get the formula right this time.

The decision for me was much more difficult and emotionally draining. I'm sure a big part of it has to do with it being me that will endure all the poking and prodding, hormonal craziness and surgery. I really wish surgery was all it was, just go in, get knocked out and when you awake, wa-la, you're knocked up. But it's not, it's a long drawn out process and with that comes stress, anxiety and a lab rat quality of life. It's not fun, no one wants to do IVF.

I also found myself getting really mad about what this is going to cost us. While Kerry isn't too happy about it himself, he is able to look past it and say it's just money, we'll pay it off some day. He keeps telling me to take the financial factor out of my decision. When I do, IVF is a much easier decision, but still, I'm just pissed at how much this costs with no guarantees. Conception should be free! It will all be worth it and I'll never look back if this works, but if it doesn't, there's no way around it, it will be devastating. Yes, we are willingly taking this risk.

I did get the usual comment from a lady at church; "have you thought about adoption?". Hmmm, no, I would have never thought of that! The truth is, we're not there yet. While we're open to adoption, it's not time. We wish we could have adoption going on in the background, but we are unable to afford adoption and IVF at the same time. Since we're not ready to give up on our dream of having a little K&J, we went with IVF. It's our dream, our fairy tale ending and we will continue to dream as long as we can hang on.

Friday, April 3, 2009

Fruitless in Laguna, Decision Time

We were hoping to bring home a souvenir, ya know that kind that results in 2 lines? Let's just say that I was very fertile in Laguna, there was no stress and timing was perfect. I just knew it was our time. But sadly, it was not. I guess that was pretty naive of me to think that I could actually conceive naturally. Dang hope, always breaking my heart.

Back in December, I had written a post titled "What's Next -Part 1" with the intention of writing part 2 soon thereafter. For awhile I was recovering mentally, emotionally, physically and financially. I was taking some time away from being defined by IF. Although I never escaped any of this completely, I at least got to a level where I could function normally and have fun again.

My plan then was to take a 3 cycle break, hoping and praying I would be one of those lucky women that conceived miraculously after failing IVF. If my luck didn't pan out, I was going to start IVF suppression on my 3rd cycle. I'm already past that point, I'll be starting my 4th cycle very soon, probably today.

I had held off on starting any type of treatment and gave myself 1 extra cycle of trying naturally. I put all my hope and faith into it. I was excited, confident, everything fell perfectly into place, well except that I didn't conceive. At least it was a very fun month and not in vain.

To this day, I still don't know what's next but it's decision time and I need to make one fast. I've been dreading this decision. IVF, CGH, Donor Cycle, Adoption? There is no easy path, no matter which decision I make, they are all long, emotionally draining, expensive, risky paths with no guarantees. The alternate path of just giving up... well, the tears just started rolling at the thought of that, I can't even go there. To be continued...

Wednesday, April 1, 2009

Vacation: Laguna Beach

After a very tough 2008, we decided we needed a warm, sunny beach vacation and what better time than during our 7th anniversary and Kerry's birthday. We looked into the Caribbean islands, but with flights alone starting out at $1100, it was too expensive. As many of my blog friends can relate, 3 IVFs in one year can knock out your entire income pretty fast. We had earned free flights with Southwest, so we decided to stick with their destinations. That landed us in Laguna Beach, CA. We went el cheapo on the hotel and rental car, so it was a bargain of a vacation.

Here's a photo blast of our time in California...

Day 1:
Happy 43rd Birthday DH!!! I can't believe you're 43 already, you old fart!

We started our day in New Orleans, awoken by 3 different alarms at 4:45am. Maybe a little overboard, but we did not want to miss our flight.

During our long layover in Houston, I surprised Kerry with a new iPod nano as his was stolen. I had preloaded it with all his favorite songs and also made a playlist of all "our" songs. I had a Y connector with me, so we hooked 2 sets of headphones to it and bopped through the airport listening to our songs.

We arrived in San Diego and drove to our Laguna Beach destination. To our shock, it was in the 50's here while in the 70's back home. So much for our warm beach vacation. We were pretty zombiefied from the time change and long flights. We choose to just chill in our little Laguna Beach Inn and enjoy some down time. Sorry, no photos to share from day 1.

Day 2:
The majority of our plans involved the beach. Now that that was pretty much out of the question, we decided to chill and just play it by ear.

This is the lovely painting of Eve that we awoke to each morning! Kerry commented that Eve must not have been a natural brunette based on her blonde area below, LOL.

Our little Inn, right across the street from the ocean... but of course you can't see it because it's cold and foggy.

Our first stop was the mall to buy me a winter coat. Uh, the new swimwear we brought, staying in the suitcase.

This was one of our last minute excursions, a catamaran dolphin safari. It takes you dolphin and whale watching, which is one of my favorite things to do.

Hello cone head! Don't you love it when your dh lets you walk around looking like an idiot and never says a word?! We were freezing but so excited at the possibility of getting to see a whale that we weathered it for 3 hrs. Other than a few dolphin, we didn't get to see much. It was one of those rare trips where the sea creatures were just not interested in checking us out. While a disappointment, it was still fun getting out on the ocean.

Day 3:
We're headed to Hollywood! We really had no clue what all to do, so we just bought a city pass and did the tourist thing. We did the Hollywood walking tour, celebrity home tour, wax museum and Kodak Theater tour. We visited the Hollywood sign on the hill, Rodeo Drive, Beverly Hills, Bel Air and the Hollywood stars on the sidewalks.

The day started out rainy and chilly, you can start to see the ocean.

A view of Los Angeles... I had no idea this place was THAT big. You can't really tell in this photo, but LA is huge and goes on forever.

Baby Jesus goes to LA... will there be some fruitfulness in Cali??? (if you missed my last post, this won't make sense)

Our last stop was to see a movie at the El Capitan theater. This 1926 theater was restored to its original design by Disney.

30 mins before each movie, this guy plays this incredible organ like they did back in the day. He played all the Disney theme songs as Kerry and I sang along.
Zip-A-Dee-Doo-Dah, Zip-A-Dee-Ay
My, oh my what a wonderful Day
Plenty of sunshine heading my way (Where???)
Zip-A-Dee-Doo-Dah, Zip-A-Dee-Ay

This one cracks me up!!! We attempted to get a photo of us with our 3D glasses. What's ironic is the movie was about aliens... I think we fit right in.

Day 4:
Our last full day here. The weather was finally warming up and it was time to hit the beach. While we finally got to put on the swimwear, we ended up buying a huge beach towel before we even finished our walk from the car to the beach as we were shivering. We walked barefoot along the beach wearing the towel as a blanket. We attempted to get our feet wet, one time was all we needed to decide that there would be no swimming this trip.

Heading out to lunch before hitting the beach.

We so enjoyed this path leading to the ocean from our hotel. It was really neat to see all the painters out painting the ocean landscape.

Some fun in the sand.

Our shoe prints.

We ended our evening with a really nice sunset dinner at The Beach House right on the ocean.

Finally, I thought it was time for Eve to put some clothes on.

Day 5:
Time to go home. =((((

Our last few moments before heading back to San Diego to catch our flight.

Our favorite scenic photo.

Despite the rare chilly weather, we had an awesome time and can't wait to go back. I could totally live there! Love was in the air and it was like a 2nd honeymoon.