a little scared

13w 2d

Last Tuesday I had my last appointment with the FC and we got to see this:

Twins

 

Twins

Baby A

Baby B

Then on Thursday at 5 pm I started seeing red, blood that is.  It was very scary.  I got up from my chair at work and felt wet so when I checked (I was alone in the office, everyone else had gone home by that time) my finger came back bloody.  I immediately called the midwives emergency line.  They told me that if the bleeding got worse or I started cramping, to go to emergency at the hospital. Otherwise they would set up an ultrasound for me on Friday. I was told to relax for the weekend and not do any housework; curl up on the couch, watch Christmas movies and just rest. By the time I got home the bleeding had stopped and was just spotting. So I called in sick on Friday and went to the ultrasound and got to see the babies again:

Twins

Baby B

Baby A

Everyone was doing fine, wiggling around, and waving and turning over with strong heartbeats!  The official ultrasound report didn't get to the midwives until Monday, but everything was "absolutely perfect" and they couldn't find any reason for the bleeding.

Fast forward to yesterday morning, just after I got out of the shower, I started bleeding again.  This time was the exactly the same as last time, it only lasted about 20 min then stopped and turned to spotting.  Again I called the midwives, but they didn't send me for another ultrasound this time.  I'm still spotting a little today, but I'm taking it easy and trying to rest as much as I can.

The possible reasons that the midwife gave me that I could be spotting/bleeding in a simple increase in the amount of blood in my body.  Also I'm just extra vascular at this point and a simple bump to my cervix, even inadvertently, could result in spotting.  If it continues to be an issue they will consult with an OB and possible send me for another scan.  I'm not going to bother calling them if it happens the same way again.  My next appointment is Jan 7th, if there are any more episodes, I'll let them know then.

11 Weeks

11 weeks

Sometimes I still can't believe I am 11 weeks pregnant.  I've seen the babies twice now and my belly is growing, but it still seems so unreal!

Last week I got a new job, I start on Dec. 17.  My replacement starts on Monday and I have a week with him to train.  So today I moved all of the files to his new cubicle.  I may have over done it a little even though I was using a cart to move everything, it was still a lot of bending over and repetitive motions.  By the time I was done, my lower back was pinching every time I bent over.  Then after lunch we decorated the office for Christmas.  It's the most I've done since becoming pregnant and now I'm exhausted and I have a headache.  I had to run out to pick up butter to make cookies tomorrow and for the first time ever I parked in the expectant mothers parking space and didn't even feel guilty about it!

I realized today that I didn't come back with pictures from the last ultrasound!  Without further ado, here is the first family photo (9w4d):

Aren't they cute!

So far I haven't had too many symptoms.  I've had some nausea in the evenings, mostly around dinner time, and my boobs have been really sore in the middle of the night - it hurts like hell to roll over!  I've already had quite a few aches and strains.  At one point I thought I was having a gallbladder attack; I even had an ultrasound and everything; but that wasn't it, I just hurt.  My chiropractor thinks it was a rib and when he adjusted me, there was a loud crack in the area of the pain and I haven't had any pain there since.

Last weekend I woke up at 7am on Saturday morning because my back hurt so bad that I made D go mattress shopping that morning.  Our new mattress gets delivered on Sunday - I can't wait!!  Last week I started seeing a massage therapist to help with these pains and the headaches I've been getting. 

My mom said all her headaches went away while she was pregnant, but that hasn't been my experience.  I've been getting more than normal, it sucks and D is getting tired of giving me neck rubs - too bad, I gave tons to him while he was sick, now it's time to return the favour.

I had a midwife appointment yesterday.  It was pretty uneventful, except that I got to hear one of the heartbeats!  It's still pretty early to pick up a heartbeat on a Doppler, but since there are two, one of the babies was up out of the pelvis enough to be heard.  The other one would not stay still long enough and was very low and behind the uterine artery, so while she could hear it in the background, she couldn't pin it down on the Doppler.  Other than that, this was my physical appointment so she checked my liver and kidneys and listened to my lungs and heart.  Every thing is a-okay!  Since I'd already had a PAP this year, we skipped that and the FC had ordered blood work so they didn't have to do that either.  It was a pretty easy appointment. 

I get to have one last ultrasound with the FC on Tuesday and it can't come soon enough.  After that I don't know when I will have one next, but it will be too far away whenever it is!

No Words

7w4d

I had my ultrasound this morning. 

Amazing

No Words

Well, maybe a little.  D couldn't come with me today so I brought my mom.  She didn't know about the twins so it was a big surprise for her. 

The ultrasound consists of two parts, an abdominal ultrasound and an internal ultrasound.  During the first portion mom kept trying catch a glimpse of the screen.  I told her she couldn't peek bcause there may or may not be a suprise for her at the end.  The Tech told her that once she was finished her measurements she would bring mom over to have a look at the screen and show her what's going on.

After she brought her over, she turned the screen in our direction and pointing at the screen she said "This is the first baby.... and this is the second baby..."  We both waited for mom reaction.  The tech said she could tell by my surprise comment that mom didn't know it was twins.  Of course, she started crying :)  She is so excited!

And now for what you've all been waiting for... Pictures!!

Twins:

 

 Baby A:

Baby B:

As you can see, Baby A is measuring slightly behind Baby B at 6 weeks 5 days while Baby B is 7 weeks 2 days.  The DR.s don't seem concerned about it though, they said that the difference in their sizes was within their margin of error.  I don't know why, but ever since the ultrasound, I've been referring to Baby A as "she". I don't have a gut feeling about Baby B yet.

I go back in 1-2 weeks for another one!  I can't wait!!

Double tired

6w5d

The last two weeks has been pretty busy and add to that my exhaustion, I haven't had any time to update.  I've been hitting the hay between 8:30 and 9:00 every night instead of my usual 10 or 11.

I left off two weeks ago requesting luck for my 3rd beta after my 2nd came back with a low number.  The 3rd beta was 2166!! Which is more than double the 2nd beta (899) and more than quadruple the first beta of 489.  I was so relieved.  It was a very tense week waiting for those results.

We told  D's parents last 2 weekends ago because they were going away and my parents last weekend because they were too busy the weekend before. We told both sets of parents the same way.

I made a couple of thank you cards because they had both significantly contributed financially to our IVF cycle. Inside the card I wrote a little not expressing our thanks and asked that they accept this gift as a token of our thanks. I gave them a picture frame that I had picked up a while ago on sale at Walmart. On the frame it said "Grand kids complete the circle of life" and inside I printed a sign, kinda like yellow diamond construction sign that said:

Baby Under Construction

Est. Completion: June 28, 2013

Pretty much everyone had the same reaction "Really???"

My Uncle G, who is staying at my parents house, was the first to get "Congratulations" out. My mom came over and gave me a hug and cried. For the rest of the night she said she couldn't concentrate on the conversation, all she could hear was "baby baby baby? Baby baby-baby baby. Baby." She tried to get my dad to get down the cradle that she has above the garage but I told her I didn't want anything until after Christmas. She is not allowed to do anything until after Christmas - including tell anyone! That is going to be hard for her.

 

H wasn't there when we told my parents but when she got there, my mom showed her the frame (with my permission) and H jumped on couch were D and I were sitting, in between us, and gave us each a big hug. Her dog was going a little crazy because he couldn't figure out why she was so excited and he kept trying to get to her by climbing over me.

It was almost the same with D's parents, his mom cried a little when she opened the frame. His sister kept asking "is this what I think it means? I dont' want to make any assumptions here." I told her to make assumptions and yes it means what you think it means. She went all red in the face and started crying too. They were having company over for dinner and they were expected any minute so I had to tell L "Ok, now get over it, they can't know!"

 

In other news, last Friday (6w0d), I woke up feeling short of breath.  I couldn't walk up my stairs without feeling winded and I couldn't speak a full sentence without taking a deep breath.  I called the FC first thing in the morning to let them know what I was feeling so they could reassure me that it was normal and not a sign of OHSS.  I had also been very bloated so I was concerned that my abdomen and lungs were full of fluid as a result of OHSS.  If this happens it has to be monitored very closely to make sure it does not need intervention.

 

D came with me to the clinic that afternoon and they did an ultrasound on my abdomen including up around my rib cage to check my lungs.  They didn't let us see anything but we met with one of the RE's right away.  She told me that I do not have OHSS and in fact, I am out of the woods at this point for developing it.  That would have been a good thing to know before we down there, it would have saved us a trip!  She said that the symptoms I was experiencing - the bloating and the shortness of breath - is a  result of the progesterone in my system.  Also, that those symptoms were probably exaggerated because the ultrasound tech could see two yolk sacks in there.

 

IT'S TWINS!!!!

 

It's still pretty early, so anything can still happen, but I feel like crap most days so I'm counting that as a good sign!

Beta

4 weeks 6 days

Three days ago I had my first blood test (called a beta test) to confirm this pregnancy!

I was so excited to get that phone call from the clinic to tell me that I am in fact officially pregnant.

The beta level on Monday was 489.7.  This is an excellent number, not too high, not too low.  A low number (below 100) would be worrisome as that could mean the pregnancy wasn't viable or not progressing.  A really high number (over 1500) could be evidence of twins or it could also be evidence of an ectopic pregnancy (pregnancy in the fallopian tube).  Yes, even with IVF it is possible to still have an ectopic pregnancy, although it is rare. The nurse asked me to come back in on Wednesday for a second test to make sure the beta levels are rising appropriately. Ideally, beta levels will double in 48 hours.

Yesterday I went in for a 2nd test. The results were 899.  The test was taken exactly 48 hours after the first one, but it didn't quite double.  They were looking for results closer to 1000 (489.7 x 2 = 979.4). 

It may not be anything to worry about, but I am.  According to what I've read and from what other people have experienced it could be nothing, everyone is a little different and every one's levels increase at different rates.  I was only off by 80.4, but I just don't know what to think.

I'm going in again tomorrow morning for another test. I've been trying to keep busy and occupied last night and today so I don't worry too much about tomorrow. 

The good news is that my symptoms have continued to increase.  I've never been so excited to feel like crap!  The morning (all day) sickness is starting, and I'm completely exhausted all the time.  I attended a training workshop today and fell asleep during the presentation and again in the car on the way back (no I wasn't driving!!) and then had a nap for about an hour once I got home. 

Now I'm off to bed.

Wish me luck tomorrow.

More Pink

9dp3dt

A little more pink entered my life at 4:15 this morning.

After yesterdays breakdown after seeing pink I had a similar one after seeing this pink:

Once I realized that second line was appearing I woke D up and made him look at it.  He was really worried when I shook him awake and he realized what time it was.  He kept asking if I was ok, is something wrong?  I just kept repeating, everything is fine, I just need you to come look at something.

When we got tot he bathroom I shoved the pee stick in his face and asked "what do you see?"

"Pregnant"

Once I had him convinced that a line of any shade, no matter how light, is a positive we had a big hug and a little cry in the bathroom.  He asked "so what does this mean, you're a little bit pregnant?"

No dear, there is no such thing as a little bit pregnant, there is pregnant or not.  That is all.

I think I will keep taking tests every morning to make sure I'm not just in some kind of dream.  It's all very surreal!

We have not told any of our family yet.  I want to do that in person and D wants to wait until after we get the official blood test from the FC on Monday.  I'm not sure that is going to work out as his parents are going on a  big trip starting Tuesday.  So either we tell them this weekend, or not till they get back in November.

I'm on call this week so I'm not supposed to leave town, but I think I can make this exception to leave town to tell my parents that after 2 years, 9 months, 2 days, 2 surgeries, 33 cycles, 4 rounds of Femara, 2 failed IUI's, 72 injections, hundreds of blood draws and internal ultrasounds, I am FINALLY pregnant.

Spotting

7dp3dt

Today I am 7 days past (7dp) my 3 day transfer (3dt) or 10dpo (days past ovulation). I swore that I wouldn't test until Wednesday but this morning I broke down and tested.

BFN

Not surprising as its still early. Many people don't get a BFP until 14dpo so there is still a chance. Or at least that's what I told my self this morning and what I truly believed until I got home from work.

When I went to the bathroom after work, there it was, plain as day... Pink.

Pink, right there on the toilet paper.

Now, this can mean one of two things;
1- AF is coming
2- AF is not coming

Confused?

Me too.

Normally, without any drugs, I have an LP (days between O and AF) of between 12-13 days. This would mean I would normally expect AF on Wednesday of this week.  And normally, I spot for 1-2 days prior to AF. So if I "expect" AF on Wednesday then I spotting today would be normal.

But this is not a normal cycle. This is a cycle on steroids. Ok not steroids literally...  The progesterone supplements that I'm on now have the potential to lengthen my LP so who knows when I can actually "expect" AF.

So if this is not AF spotting then what is it?

Implantation spotting is the other option. Implantation spotting occurs when the embryos implant into the uterine walls, this sometimes creates a little blood that eventually makes its way out. This usually happens around 7-8dpo or in my case 4-5dp3dt; 7dp3dt is a little late for implantation spotting but not unheard of.

What is my spotting today?  I don't know and there is no way of knowing other than to wait it out.

I'm not feeling very positive right now. To me, the timing if the spotting is more indicative of AF. I feel it's too late for implantation spotting.

When I came out of the bathroom I was bawling, D immediately knew that something had happened and let me cry into his shoulder for a while. I swear I heard him choke back a sob or two as well.
We are heart broken, but still hold that sliver of hope that this could still work out.

Although I don't see how.

Transfer Day

Today was transfer day!!

Sometime I still can't believe we made it here.  It's surreal.

This morning D and I drove down to the FC for our day 3 transfer.  When we arrived, we were taken back to the same prep/recovery area that I was in for the retrieval on Friday.  We were the only transfer this morning so it was pretty quiet in that area.  At our retrieval, there was one other couple back there with us but I don't know what stage they were at... maybe they were doing their transfer that day?  Either that or they didn't make it to day 3 or they have amazing embryos and went to day 5!  I really hope for them it's the latter.

Anyway, it was quiet... 

After I changed, we were brought into the same procedure room as Friday and the nurse checked to make sure my bladder was full enough.  It probably could have been a little fuller as they were still having some trouble getting a good picture of my uterus because of my enlarged ovaries.  A few minutes later, the RE came in.  This is an RE that I'd never met before.  He explained the procedure to me and what would be happening step by step.  He then had a conversation with the Lab tech and the nurse to confirm identities and an embryo information and generally make sure that everything is food to go.

In the procedure room there is a window, almost like a take-out window with shutters that connects to the lab.  During the ER,  the contents of each of my follicles were passed through this window and the lab techs confirmed the presence of an egg.  This time, the lab loaded 2 of our embryos into a catheter and handed the catheter to the RE.  The catheter was wrapped inside a paper package with my name on it and I was asked to confirm that it was in fact my name.

It was.

Phew!

Next my legs were put up into stirrups and the procedure began.  First a warmed speculum was inserted.  Side note: why don't all doctors warm speculum's???  They are always freezing! Anyway, it was nice that is was warm...  Then, the RE and the nurse worked together to track the insertion of the catheter through my cervix and into my uterus.

D and I were both able to see the ultrasound screen which was really cool!  They stopped a couple times to take some measurements, and when he found a nice cozy spot in my uterus he stopped and gently pushed the embryos from the catheter to nestle in my uterine lining. 

It was THE most AMAZING thing to see.  I wish I had taken a picture.  No, you can't actually see the embryos, they are still microscopic at this point, but they put them between 2 air bubbles and you can see the bubbles.  As the bubbles were released from the end of the catheter, they shone so brightly on the screen, like sparks of light!

Sparks of life!

D and I watched those little sparks for as long as they were on the screen before the nurse took instrument off my belly.  The catheter was removed and handed back to the lab where they inspected it under microscope to ensure the embryos are no longer there.  When we got the all clear from the lab (literally, they called out "All clear"), I was released from my stirrups and allowed to get dressed and go home.

While I was changing, the nurse brought out a copy of our Embryo Transfer Record.  Today we transferred two 8 cell / grade 4 embryos.  That is the highest day 3 quality you can have.  We are very hopeful that this will work.  The remaining 8 will be frozen for future use.

For freezing:
1@ 8 cell / grade 4
2@ 8 cell / grade 3
1@ 10 cell / grade 4 - this one is slightly over developed for day 3, that's why this wasn't used today.
1@ 9 cell / grade 3
1@ 7 cell / grade 3
1@ 5 cell / grade 4
1@ 12 cell / grade 3

I really hope we don't have to use these.  At least not anytime soon...  maybe to give this little one a sibling?

Today, I'm just thankful to keep my little sparks safe and happy in my tummy.

Happy Thanksgiving!

Yesterday's Report (Fertilization Report #2)

I realized this morning that I didn't update with yesterdays lab report.  I looked forward to that call so much yesterday morning.  I got up early and made coffee and sat watching the phone with my fingers crossed.  Luckily they called really early again so I didn't have to wait long.  All 10 made it through the night again!  The nurse who called didn't have a detailed report but said that they are of mixed quality. She put me on hold and talked with the lab techs and they said I'd be transferring on day 3 (today).  Apparently I didn't have enough high quality embryos to qualify for a day 5 transfer.

There is a significant increase in success rates when transferring on day 5 rather than on day 3.  In our IVF teaching the statistics they quoted were 60% success rate on day 3 transfers and 80% on day 5 transfers. 

So you might ask why do anything other than day 5?? 

The reason day 5 transfers are so much more successful is because they were already strong enough to make it to day 5 outside of their natural environment.  Not many embryos are that strong, and there is a risk that you could lose all embryos before getting to day 5 and have none to transfer.

Embryos flourish in their natural environment - the womb, so if they are not doing so great int he lab, it's better to get them back in their natural environment as soon as possible.  Before day 3, the embryos have not developed enough to properly judge which ones are developing better than the others which is why they wait until the 3rd day so they can choose the best to transfer back.

Originally I was hoping that I'd be able to do a day 5 transfer so that I'd be confident in that 80%.  It would also mean that I had a bunch of amazing looking embryos; so many that I could afford to take the risk.  But that's not the case.  Mixed quality meant that of the 10 I had, some were really good and some were only ok.  If I pushed for a day 5 transfer, I could be risking losing all of them.  I'd rather have them safe in my belly were I could nurture them and keep them safe instead of in a lab.

Generally with a day 3 transfer, they transfer 2 embryos to increase chances of success.  With day 5, the will only do 1 except in extenuating circumstances; eg. over 40.  Transferring more than 1 embryo on day 5 does not increase the chance of success, only the chance of twins.

D and I had a discussion last night and both agreed that the risk of twins was acceptable on a day 3 transfer and would transfer two if that's what the RE recommends.

I'll be back later with a transfer day post!

Fertilization Report #1

This morning D and I were woken up by an amazing phone call!  The FC called before 9am this morning to give me my fertilization report.  Of the 12 eggs retrieved, all of them were mature.  This is important because only mature eggs will continue to develop and that's why the FC will only ICSI mature eggs.

ICSI (Intracytoplasmic Sperm Injection) is where they select 1 of D's sperm by microscope and inject it into one of my eggs.  Because all of mine were mature, were all fertilized by ICSI. 

It is normal for some of the embryos to stop developing at some point in this process.  After all, they are out of their natural environment... Anyway, one little guy didn't make it through the night, but 11 did and that's amazing!

If the FC is going to call before 9am tomorrow morning, I'm going to have to get to bed early tonight!

Now that the "fun" injections are over I'm entering a whole new era of fun in the form of progesterone suppositories!!  Sound exciting?  They're awesome.

Not so much.

Definitely better than injections, but still...  I'm not looking forward to the wonderful side effects these are going to give me because they will mirror all early pregnancy signs - just to screw with me. 

I'll be back tomorrow with another update/

Retrieval

CD16~18

Yesterday was a really busy day getting everything at work ready for me to take a week and a day off.  Work is busy right now so that was a little difficult.  Earlier this week I had to go to my boss and move my vacation from Wednesday to Friday.  He looked at me a little funny so I explained that I was having a procedure and it kept getting pushed back.  He agreed to move my vacation but said "I'm rather to change things around for people who are going on vacation, not staying in a hospital... that's not a fun time off"  Then yesterday when I handed in my time sheet (it was due today) he came back to me and said "now you have me confused... I thought you said this was for medical reasons, why are you using vacation days??"  So I had to explain that yes, it was for medical reasons, it's two procedures a few days apart but I wanted to make sure I had plenty of time around each day to relax so I'm using vacation.  What I didn't tell him is that I didn't want to have to get a Dr.'s note in order to get that much time off.  The note would have had the name of the FC on the letterhead and that would have given me away.

Last night before bed I took an Ativan to help me sleep.  I was surprised that it also took a bunch of the pain/uncomfortableness away that I was feeling in my tummy as well it was nice.  It wore off about 4 am and I woke up when the pains came back. Boo.

We got to the clinic around 8:00 am and since we were a little early we went for a drive to get some ginger ale and Gatorade for afterward before going to wait in the waiting room.  We were only waiting for a few minutes until the nurse came to get us.  She brought with her a brown paper bag containing an empty bottle for D to leave his sample in and directed him to the collection room and I was brought back to a different area to get changed.

I put on two hospital gowns; one forward and one backward so that I was completely covered and I was allowed to keep my socks (Yay! - my feet are always cold so I was happy I could keep my socks).  Just as I was getting set up for my IV, D was brought back to me.  The IV went in without a hitch and they started the saline.  A few min later they took me to the washroom before going to the procedure room.

Once in the procedure room, they set my legs up in stirrups.  She kept asking if I was comfortable... no I'm not comfortable!  My legs are twisting out at odd angles and you have a direct view of my vag! But I have no pain so I consider that as 'comfortable' as I'm going to get.  They then gave me two different drugs in my IV line and that's when things start to get blurry.

I could still feel most of the needle sticks as they were poking around my ovaries and even through the drugs they gave me, it still hurt and I turned into a big ball of wimp and started crying.  Part of it was that it hurt, but the other part was just the emotional aspect of it.  They upped my drugs part way through, but the procedure was so quick that they didn't really take into effect until after it was over so by then I could hardly get up off the table and I was sleeping in the recovery room instead of getting ready to go.

We got home around11:30 and I've been sleeping on and off ever since.  At one point I attempted to text my friends to let them know I was fine and the results but I was so out of it couldn't figure out how to send the text!  It was hours later after I woke up from a nap that I thought it was strange that none of them had texted back and I went looking for the text in my sent items and it wasn't there!  It took another 20 min or so to figure it out!

Overall, today was a success and they retrieved 12 eggs. - A perfect number!

I will get a phone call tomorrow to let me know how many of those 12 are mature and now many fertilized.  Fingers crossed we don't loose too many over night.

Trigger Day

OK, A quick summary of the last 3 days.  I went to the clinic every morning and this is what my number were:

Monday October 1, 2012
Right: 13,12,11,11,5@10,3@9 = 12
Left: 11,9 = 2
Total = 14
E2 (Estrogen) = 9,192

Tuesday October 2, 2012
Right: 16,15,15,14,14,12,12,4@11 = 11
Left: 13,12,12,10 = 4
Total = 15
E2 = 13,435

Wednesday October 3, 2012
Right: 21,18,17,16,16,15,15,14,14,12,11 = 11
Left: 18,17,15,14,14,14,12,11,10 = 9
Total = 20
E2 = unknown

If you remember from Saturday my numbers were:
Right: 14, 13, 12, 11, 10, 10
Left: 12, 10, 10
So when I went in on Monday and none of the follicles were any bigger I was a bit worried.  I was concerned that not only had they not grown, they appeared to have shrunk.  Yes there was more of them, but I still needed them to get bigger.

When I met with the RE Monday morning he thought he might have to increase my Puregon dose since nothing had grown.  But when the nurse called me in the afternoon, they lowered it instead!  I was shocked, but apparently an E2 level of over 9000 is really high at that stage.

Tuesday morning I felt better when I saw that there was some growth and my E2 level didn't raise too much so I was left at the the same dose for another day.  Before he had the results of my E2 test the RE mentioned that we were walking a fine line between encouraging growth and risking cancellation because of a high risk of OHSS.

This morning I was really happy when I saw significant growth over yesterday.  The RE said two things could happen depending on my E2 levels today: One, I continue stimming for one more day to try to get a few of the smaller ones (under 15) a little bigger; or two, trigger today.  It turns out that my E2 levels were high (although I don't know the number) so I am triggering today!

The trigger shot is designed to  time ovulation for between 36 and 39 hours after the shot is administered so timing is critical.  I must take the shot at exactly 9:00 pm tonight and my egg retrieval is booked for Friday morning at 9:00am.

I happy, scared, excited, terrified...

The other good news is that tomorrow is needle free!  49 needles down, 1 to go!

And they're off!

Today's clinic visit was short and sweet.

Bloodwork - check!

Ultrasound - check!

Meet with RE - check!

Right: 14, 13, 12, 11, 10, 10
Left: 12, 10, 10

If you're counting along, that's 9 follicles! Right on schedule :)  We;re moving along nicely.  There is still a real possibility to over respond but we're keeping a close eye on it. I was concerned that I since I had never taken suppressants I would over suppress and not grow any follicles, so I'm glad that's not happening.

I go back on Monday to check again.

Look beside you

CD9~CD11

First let me explain today's Cycle Day (CD) number.  Normally, CD1 is the first day of AF and stims or other drugs start on CD3.  However, because this is an IVF cycle, and my body procrastinated with AF, things happened a little differently.

My calendar told me to start stims on Sept 20th no matter what day AF started and since AF started the same day as I was to start stims it was kinda like CD1 and CD3 at the same time (i.e. CD1~CD3).  This was ok because of all the other drugs I've done so far (OBC and Suprefact).  Those got my body to essentially a baseline zero and would have kept me there whether I started stimming on CD1 or CD7, it still would a been a forced 'CD3'.  If that makes any sense...

My FC refers to my CD as the later day (CD11) but in my head it's still really early and feels like CD9 so I'm counting both.

My first visit back to the FC since I was given my calendar almost a month ago was on Tuesday (CD6~CD8).   [See, this is why I've been double counting - on the first FC visit this cycle I was still bleeding and that's not usually the case.]  Anyway, Tuesday's visit was pretty uneventful.  I had the standard U/S & BW and met with one of the RE's and a nurse.  There was no measurable growth yet.

I'm not worried and as the RE pointed out, they want to make "wake up" my ovaries slowly so that I don't overstimulate in order to get the highest quality eggs.  He did say that if my E2 (estrogen) levels were low he'd call in the afternoon to raise my Puregon dose.  I didn't receive a call so I continued at 100 units for Tuesday and Wednesday night.

I went back to the FC yesterday morning (CD10~12) to check follicle sizes and E2 levels and things are finally starting to grow!

Right: 10, 10, 9, 9
Left: <10 p="p">
Well, at least the right side is growing.  Lefty is still lazy!

I go back tomorrow morning to check again.

Yesterday was a busy day.  Not only did I visit the FC, I also had a consultation with a new Naturalpathic Doctor.  While I liked my ole one, she just didn't have the experience with fertility issues or the availability that I need.  This new ND had done lots of research on infertility and has even spoken at a meeting of the local infertility support group.  Not that I have ever been to a meeting, but I read their blog.

I'm happy that I will be able to have 2 more appointments with her before Egg Retrieval.  The first will be to complete a physical before she can officially treat me and the 2nd will be for acupuncture.  The FC said that if I could find an acupuncturist who can see me on the day of transfer both before and after transfer, that it has been proven to increase the odds of success.  I'm really happy that I can get at least one session in before retrieval and possibly be able to book the two appointments on transfer day.  I'll try for it, but I won't get upset if it doesn't work out.  The ND doesn't seem to thing it's as necessary for it to be on the same day, the next day would be just as good.

********

Part of my job is to attend to tenants units with contractors if the tenant is not home.  Today I had to babysit a contractor in a number of units while they worked for hours.  I forgot to bring my Ipod with me so I wrote this post while I waited.

In one of the units, there was a piece of art on the wall that had a great saying.  I wish I had my Ipod because it would have been a good instagram (which I just started using) but a good "old fashioned" digital photo will have to do.

Procrastinator

Even my body likes to procrastinate!

A couple of days ago I mentioned that it felt like my period was going to start and I was happy that it was going to be on time.  Well... it didn't start.

I was told to call the clinic on Wednesday (today) if AF hadn't shown up yet before I could start stims on Thursday.  All day yesterday I felt it coming on, and I was spotting; all day today too, but nothing!Since the clinic is only open until 4, I called around noon to let them know that I still hadn't started.

The nurse told me to make an appointment for tomorrow morning to come in and have some blood work done and have an ultrasound to find out what was going on.  She mentioned that the couple days of spotting I've had could be it, all I was going to get, but that I should come in just to be sure.  

She also said that if my period should start tonight or tomorrow morning, I can call and cancel the appointment and go ahead and take the drugs as originally scheduled tomorrow.

I've been going to the washroom every few hours to check and still nothing all day.

All day that is until about 5:30.  Finally a little more than just spotting!  I'm not calling to cancel just yet, but it looks like my body was just waiting until the last possible minute, just to screw with me!

It feels like the first time

I'm trying to go to bed early tonight because I'm still dead tired from J's awesome bachelorette on Saturday night but for some reason this time of night is when I do my best thinking and writing.

As I was getting ready for bed tonight, I discovered that I'm spotting. This probably means that my period will start tomorrow, right on time. I was told I'd get a period between 3 to 5 days after stopping the pill. Tomorrow will be 4.

Upon this discovery, I went down stairs with a big smile on my face and told D that AF was starting. This is not how I usually look when I tell him that do he was a little confused!

"Is that a good thing?" he asked.

"Yes" I said. "this could be my last period for a long time"

"I hope so" he said.

It feels wired and kinda scary to have this feeling again... Hope... Real hope.

For all we know this could actually be the first time we've ever had any chance at success. This is like our first time (hence the cheesy song title).

Hope is a pretty scary thing, but without it, we couldn't go on. A little hope is a good thing. A lot of hope is terrifying... In my experience, with infertility, the higher your hopes the farther you fall when you fail.

There are still no guaranties with IVF. This could still fail. I could still fail. There are still many hurdles to get over before we even get to transfer. I don't want to dwell on the negatives. But sometimes I have to remind myself not fly too close to the sun or I could get burned.

That glimmer is just so attractive...

That glimmer of hope.

Birth Control

Birth control and I have a long and sordid history.

I first started taking it when I was 16. I still remember writing to Jules and asking her what she thought of the idea. I believe it was her who reminded me that I could go to the Dr. and ask for it and he wouldn't be able to tell my mom. I took her advice and went to my Dr. He gave me 3 months worth of free samples and encouraged me to talk to my mom.

After a few months on the pill I lost my virginity to my high school sweetheart. With my next period I had the most painful cramps I'd ever experienced. I thought I was dying. My mom took me to the hospital and of course the ER doc had to ask all of those standard questions...

"Are you on any medications?"

Me in a whisper "the pill"

Oh did I mention my mom was still in the room with me? Because yes she was.

"Are you sexually active?"

Me in a whisper "yes"

And right there I died of embarrassment!

The good news was that my mom could not be mad because how can you be mad when your daughter is lying in pain in the emergency room?

It turned out to be a cyst that ruptured on my right ovary. I still wonder to this day if it was the trauma of that day that caused the damage and blockage of my right tube. Anyway, for the next few years the pill and I got along just fine. I went to university and in my second year I started to notice a change in my moods. I broke up with my previously mentioned high school boyfriend and started on some antidepressants. I did a little research and found that one of the common side effects of the pill is depression. Since I no longer had a boyfriend I figured I could experiment a little and go off the pill and see if that helped with the depression. It defiantly did. I was able to go off all other medication cometely and felt more like myself than I had in years.

Over the next few years I went back on the pill a couple of times while I was dating someone but hated every minute of it. When I started seeing D, he was terrified of the fact that I wasn't on any birth control. I agreed to go on it but warned him of the massive mood changes that were to come. He agreed that if they were really that bad he would find a way to be ok with out me taking it. I was only on it for 1 month before he came over to find me crying in bed because my boss was mean. Granted, my boss at the time was a class A jerk face but this was an extreme reaction. I stopped taking the pill and both D and I have been happier ever since.

That is until this business with infertility.

Who would have thought that part of the treatment for infertility would involve taking birth control pills! I mean, every one knows the firsts step in trying to get pregnant is to go off the pill. I have now been taking the pill as part of my protocol for IVF for the past 16 days. I have definitely noticed a change. I was really scared of this part, but it hasn't been as bad as I feared. Yes, I've been crying at stupid things on tv. And maybe I over reacted about the comment from my chiropractor... But I was afraid that I would be inconsolable when ever I thought too much about our situation. I wasn't and for that I'm happy.

I am ecstatic to say that tonight was my last BCP!

I'm so happy to finally be done with it! I'm also hoping that this heartburn I've had for the last week will finally go away now...

1 down... Around 45 more to go

Today was my first injection for IVF. 

Of course I've done injections for other cycles, but this is a new medicaiton for me and is a diferent type of injection.

The injections I've done before have been a drug called Puregon.  It comes in a pen form.  You put on a fresh needle, dial up the dose, inject the needle and press a button to release the medication.  I will use this drug again later in my cycle (next week actually), but this drug I'm using now is different.

This drug is called Suprefact.  It is used to suppress my own natural horemones so that my RE has complete control of my horemones through drugs.  It comes in a vial and I have a bunch of regular syringes that I have to fill from the vial and inject into my stomach.   The way you hold the pen is much different from the way you hold a regular syringe.  For the pen you just have to press the button, but for the syringe, you have to push down on the plunger.  The needles on the pen are also a lot thiner and therefore pierce the skin easier. This morning I wasn't sure if it was going to go through or not!

 The only side effects I've had so far was some redness and itching around the injection site, but that went away within a few minutes.

Random Conversations

It's amazing how in topics completely unrelated to fertility you find yourself in an awkward situation and completely off guard and unprepared for the questions.

I went to the chiropractor yesterday and when I walked on he was in discussion with another patient about an old disney movie. He asked me if I knew of the movie, which I did not, and I mentioned that I started a Disney movie collection when I was in high school. I have around 25 disney cartoons, some of which are still in the original packaging.

Chiropractor: "either you or your sister are going to have to have kids soon to use those Disney movies. Ha ha chuckle chuckle. I bet your mom says that all the time! chuckle"

Me: "actually no, not any more. We are in the middle of fertility treatments, so she doesn't say that any more."

Chiropractor:"oh really?! That's exciting!"

Me:"It's really not, we're going on two and a half years now so the 'excitement' has worn off."

I have told him in the past that we are going through this, apparently he hasn't paid attention. He is an extremely religious person and I haven't wanted to discuss this with him at all because I worry he doesn't believe in ART.

I think it might be a good time to switch chiropractors...

Up

The Protocol

I went to the clinic this morning and met with my nurse.

My nurse.

Yes I have a dedicated nurse at the clinic for my IVF cycle.  Lets call her Red. She is who I call if I have any questions about my cycle.  Of course she doesn't work 7 days/week, but there will be other nurses who would be able to answer too.  It will be nice to have a constant nurse through this process who is there looking out for me in addition to my RE.  I can call and talk to Red but I can't call and talk to the RE.

After the usual u/s and blood work, Red came in and when over how the IVF cycle works.

Starting tonight (in about 20 min) I take the Birth Control Pill (BCP) every night until September 14th. 

Three days before I finish the BCP, I also start taking a drug called Suprefact.  The purpose of the Suprefact is to ensure that my own hormones stay suppressed and won't interfere with the what the drugs are doing.  This is an injection that I have to do every morning until they tell me to stop (probably around retrieval)

Once I stop taking the BCP I will get another period. On September 20th I will add in the stimulating drugs.  There are two, both injections. (If you are keeping track, that's 3 injections per day!!!)  The first is the same drug as I've used for both of the failed IUI's and the other is a micro-dose of hCG.  The micro-dose hCG is intended to improve egg quality.

My next appointment is September 25th and at that point I should be able to start seeing growth.  I'll go back in every other day for a few times and then every day until retrieval.  Retrieval is expected to be in the first week of October.

I'm nervous and excited and scared and happy and and and.... all at the same time!

Let the craziness begin!

On Thursday last week I started spotting.  I thought for sure that AF was on her way because I usually spot a little before hand, I figured on Friday she'd be here with full force.  Well, Friday came and the spotting stopped. Saturday, nothing.  Sunday, nothing.

I started letting my mind wander...

What if that was implantation bleeding??

Is it possible that I am one of cases that suddenly gets their BFP right before starting their first IVF??

No... that can't be...

But we did have that little jaunt in the woods while on vacation...

No... stop thinking like that, it's stupid.

But M spotted for one day and got a BFP...

All weekend this went on and on in my head... what if???

Finally on Monday morning I broke down and tested. I figured two things... One, I would know and stop this crazyness in my head, and two it would bring on AF because she always shows as soon as I test.

Of course the test was negative!  I mean, really, what was I thinking?

And first thing this morning my period started!

The good news is that I am finally starting my first round of IVF.  I'm realizing now that it's been three quarters of a year since we found out that IVF would be our only/best option, so this is a long road coming.   I go to to the clinic on Thursday to get my drugs and my calendar and then I can finally, hopefully, plan the next few months of my life.

I other news, my blog was spammed yesterday!!  I wonder how they got here in the first place...

Neglect

I have been a little neglectful of this blog recently.  I can't explain why.  Yes, we have been on a break, but it's not like there hasn't been anything going on.

Anyway, let's catch up...

We had an appointment with our RE to sign out consent forms for IVF on August 14th.  The appointment went as expected.  We were brought back into one of the exam rooms and given the forms to read over.  There were a few decisions that I wasn't expecting to make... like what we agree to do with any 'leftover' embrios and what would we do if either of us die.  They were tough decisions and I'm glad we were left alone in the room to discuss them.  These are very personal ethical decisions which are the decision of D and I alone so I won't elaborate here.

Now I am just waiting for my next CD1 which should be any day now, and then I will be officially beginning my IVF cycle.  The IVF will take about 6 weeks, 8 weeks till testing, but for the first 4 I am on my own taking BCPs and suppressants.  They need to shut down my ovaries before stimulating them to ensure that all of the follicles grow at the same rate to the same size.

I've been feeling pretty crampy over the last few days but AF has yet to start, she's toying with me!  If she would wait until tomorrow, that would be perfect timing.  It would mean that my next period (yes, I will have one more before this is over) would be after Julia's wedding and my egg retrieval would be more likely to be on a weekend.  But I'm impatient, and I want to get started now!

In other news, August 23rd seems to be a pretty popular birthday.  Two of the three pregnant people around me gave birth that day.  Both little boys.  My cousin had a C-section after a long labour and gave birth to O.wen.  And a friend gave birth to her third, Ry.ker, at home (her second homebirth).  I'm glad it happened that way, get them all over with.  Quick, like ripping off a bandaid.  The next hurdle is meeting the babies for the first time, hopefully I can put that off for a bit. Maybe until after IVF...

Wishing Star

I was out for a walk with the dog just after sunset tonight and I looked up at the sky looking for a wishing star like I do every night and started thinking about this song.

Strangely enough, it hasn't made me cry like it usually does...

Come out moon
Come out wishing star
Come out
Come out
Wherever you are

I’m alone here in the dark
All alone and wide awake
Come and find me
I’m empty and I’m cold
And my heart's about to break
Come and find me

A need you to come here and find me
Cause without you I’m totally lost
I've hung a wish on every star
It hasn’t done much good so far
I can only dream of you
Wherever you are

I’ll hear you laugh
I’ll see you smile
I’ll be with you just for a while
But when the morning comes
And the sun begins to rise
I’ll lose you

Because it’s just a dream
When I open up my eyes
I’ll lose you

I use to believe in forever
But forever is to good to be true
I've hung a wish on every star
It hasn’t done much good so far

I don’t know what else to do
Except to try to dream of you
And wonder if you are dreaming to
Wherever you are

Wherever you are

Of course, in my head it's always Pooh singing it.

End of the ride

We are officially cancelled.  The risk of higher order multiples and OHSS was just too high.  I have an appointment with my RE Aug 14 to sign consents for IVF.  We will take next month off to give my over stimulated ovaries a rest and start bcp for IVF in September/October.

That just seems so far away...

UP, DOWN, UP, DOWN

I'm getting dizzy!

So as of this morning IUI could be back on on Monday... It will depend on my E2 levels today, and how many follicles mature for tomorrow. I guess they had some trouble seeing my ovaries yesterday (or maybe my body just went crazy last night) but yesterday on the L there was 12, 10, today there were: 16, 14, 13, 13, 11, 10, 10!!! Add to that on the R there is: 19, 15, 15, 14, 14, 13, 13, 11...

The nurse this morning looked like she was going to hyperventilate when she saw all of those. When I told her that my R tube was blocked she calmed down some, but the possibility of 4 mature on my good side still makes them nervous.

They weren't sure if I should coast for another day or if I should take another 25IU of Puregon tonight. The concern with coasting is that my E2 levels could start to drop and nothing would mature further, but taking more drugs could cause all 4 to mature and that would be too many... In the end they decided to have me do more drugs tonight and we will see what happens tomorrow morning.  We are hoping to see that on the left, the 16 and 14 have grown, but the rest have stayed around the same.  If both of those 13's grow I will likely still be cancelled.  The risk of quads is just too great and I don't want to be the next Kate...

One option they gave me was to convert this cycle from IUI to IVF.  Since I have so many follicles, I would be a good cantidate.  But the success rates aren't as good as regular IVF.  It is less $ than regular IVF because it's considered a treatment for a complication from IUI but it's still expensive and in my opinion not worth it if the chances of success are lowered. 

With IVF, the ovaries are suppressed so that all of the follicles start growing at the same rate and theoretically they would all be around the same size and the same maturity at retrieval.  Since I do have one lead follicle on the R (that 19 one) it is possible that the others wouldn't be fully mature.  If they did the retrieval for IVF, I would have less mature eggs to choose from than if I started IVF from the beginning.  Therefore less chance for success.

I'm taking this day by day and will see what tomorrow brings...

IUI #1 Take 3??

Left side shrunk, right side grew... dammit!! Cancelled again :(

I am still going to continue with the injections and go back to the clinic tomorrow morning because I'm still going to trigger this cycle to release the eggs... I didn't last month and ended up with 3cm cysts because of it, I don't want 5 of those, that sounds painful!

We have to make a decision about what to do next cycle. We could do IVF, but if DH looses his job in Spetember, we would have no savings to get us through until he finds a new one... Or we could attempt another IUI, but really what's the point?? Or we could do nothing...

The really craptastic thing about this is that because of the timing, I will likely have to cut my vacation in half if I want to cycle again. I leave on Aug 4 for the cottage for a week and that will likely be CD3 or 4... This happened last year too.

Fuck.

Update

CD11

I started going into the clinic for monitoring on Monday morning.  They take some blood to check my hormone levels and do an internal ultrasound to see how many and how big my follicles are growing.

On Monday, my cysts from last cycle appeared to have shrunk some, I don't know how big they are, she just said "smaller". The bad news was that I only had growth on my right (blocked) side, there is one at 10mm and one 11mm. Nothing on the left. It was still early, but I had a feeling that I'll be cancelled by the end of the week.

Yesterday morning went in again and I started to have growth on the LEFT! There is more on the right, but there were 3 on the left and  1 of them was dominant, so that is good! They called me yesterday afternoon because my E2 levels were really high and they wanted me come back today instead of tomorrow.

This morning I had 5 follies on the R (15, 13, 13, 11, 10) and 2 on the L (14, 13)... Mature is 20. They asked if I wanted to consider converting the cycle to IVF since I have so many. But we just don't have the $ for that right now. Yes, 7 follies is a little scary for IUI, but we can ignore the 5 on the R due to the surgically blocked tube, so really it's only 2.

My injection dose has been decreased from 100IU to 50IU and I go back on Friday for more monitoring.

I'm trying not to get my hopes up, but it's hard, this may be the first time we've had a real chance in 2.5 years...

Roller Coaster Day

CD3

I had a bit of a roller coaster ride this morning... I went in for my CD3 BW&US and they found two cysts on my R ovary. Those are the 2 follicles that I had from last cycle, only now they were 3cm each! The nurse said it might cause this cycle to be cancelled as well, but it would depend on what my blood work came back at and they would call me and let me know later today.

I was so bummed when I left the office this morning thinking I'd have to wait another full cycle to see if they resolved themselves. But then around 1pm I got a call from the nurse and my levels are low so I am good to go! I start stimming tonight at 100IU Puregon. Yay!

When I got back to the office, I was at one of the buildings when I got the call from the clinic, the roller coaster ride continued.  I found out that my friend M started spotting this morning.  She is 8 weeks pregnant.  Within the hour, the spotting turned to bleeding.  It looks like she is going to loose the baby :( 

I'm devastated for her.

If I could be happy for her and sad for myself when I found out she was pregnant, I can also be sad for her and happy for me that my cycle is continuing while her pregnancy is not.

I'm so happy/sad/happy/sad/sad/confused....

That was Quick

CD19 CD1

When my cycle was cancelled last weekend I looked to the internets to find information on what would happen now.  I didn't know anyone else who had stopped taking the drugs before O.  How would my body react to that?  Dr. F said that sometimes any follicles that were created with drugs that weren't released, would just shrink away and I likely wouldn't O. 

OK. 

That's fine, since they were on the blocked side anyway it didn't matter if I O'd or not.  But what would happen then?  My biggest fear was that after they shrunk, my body would still look to O naturally and I would have a super long cycle while my hormones sorted themselves out.  If I had a super long cycle, or even if it was just a couple days later than normal, that would result in having to go to the clinic for all of my appointments during my vacation! 

Crappy!!!  I wouldn't be able to go to the cottage and I REALLY need that!

Luckily, that's not what happened at all!  I had a pleasant (?????) surprise this morning when I went to the bathroom first thing and there was AF!  It's only been 1 week since I stopped the drugs and it's only CD19... Well I guess it's CD1 now...

Normally I hate seeing the wicked witch, but having her come sooner this time means  I can get started again sooner!  And I will be done with all appointments by my vacation!

In fact, (If I actually get to do the IUI this time) I will be at the cottage for the last week of the TWW. Which will hopefully be a good distraction.

I am still considering this IUI#1 since I didn't even get to the IUI stage last time. 

I guess this is IUI#1, Take 2.

Cancelled

CD12

We are officially cancelled.  Still no growth this morning on the L side and they aren't sure that what was on the R was actually a follicle, it could have been a cyst.  So... not even halfway through the cycle and it's failed.

I will start the next cycle at 100iu and hope for at least 1 on the L.

Now I just have to wait forever for my period to start again.  This is going to be a long 20 days...

Bust

CD 10

This morning I went in to have a look at what's growing.  The good news is that I have have one follicle at 12mm.  The bad news is that it's on the R side.  Once a follicle takes the lead, it asorbs all of hte hormones and the others stop growing. (That's why 26 on CD3 was not a concern...)

What does that mean?

It means that I will release a mature egg from my R side.  That's the side where I just had hte tube removed.  With no tube, there is no way for the egg to reach my uterus and become fertilized.  Yes, there are miracle stories about the tube from the opposite side picking up the egg, but the fact in with my endo, that just won't happen.

Isn't there anything we can do?

I met with Dr. F this morning and she is increasing my dose from 66 to 100 in a last ditch effort to save this cycle but she doesn't hold much hope that it will work.  I go back on Sunday to see if makes a difference and after that, we wait until next month.

CD8

CD8

This morning I wend for bloodwork and ultrasound to see how my little follies are growing.  As far as appointment go, it was pretty uneventful.  Last week when they took blood I bruised so this week when they did again, it hurt like hell! But that was all the excitement. 

There is no growth yet. 

They only start measuring and counting once the follicles are at least 10mm.  The only thing they could tell me was that at least 1 measured 10mm on the R and all on the L were under 10mm.  I have to continue with 66IU of Puregon for now and go back on Friday for another look. 

Hopefully I will see some growth then.

See Spot Run

CD7

TMI WARNING!!

For about the past 20 years my period has gone a little something like this:

2-5 days of light to dark spotting
2-3 days of heavy flow
1-2 days of light flow
2-5 days of dark to light spotting

Yes, on average my period would last from 7 to 15 days! Usually about 10 days most months. Some months it seems that I had my period for longer than I didn't!

And then I had my first LAP surgery in December...

And nothing changed.

Then I had my second LAP surgery in May...

And the spotting stopped!

This was my 2nd AF since the surgery.  The first one would have still been affected by the trauma of the surgery so that one was closer to my old 'normal'.  But this one!  This one went a little something like this:

1 day of extremely light brown spotting in the morning turning to pink by bedtime
3 days of heavy flow
1 day of light
1 day of extremely light brown spotting
1 day of nothing

That's right nothing!  No spotting today at all whatsoever!  I'm not sure, maybe it's the puregon injections or maybe it's the surgery, I don't know... I'm hoping it's the surgery so maybe this will continue.

Ouch!!

CD3

This morning I had my first monitoring appointment with my new clinic.  After telling the receptionist know I was there I went and sat in the little waiting room.  The blood nurse called my name and I had one vial of blood taken.  I miss the blood nurse from my old clinic... she never hurt or bruised me.  Not that this one particularly hurt, and my bruise is not very big, but it's tender.

After that I went back to the little waiting room until it was my turn for an ultrasound.  First they did the regular abdominal ultrasound and then they did the trans-vaginal aka cooter cam.  This was the first time it was almost painful.  I'm not sure why that was, but I hope it was a 1 time thing.

Today they were looking for what's called Antral Follicle Count (AFC).  This is the number of follicles present at the beginning of a cycle.  These follicles are all very small and in a normal cycle, only one will grow to maturity and the others will disappear. 

In an IVF cycle they try to get as many of those Antral Follicle to grow as possible aiming for between 10-15.  Too many can lead to complications too.  In an IUI cycle, like we are doing now, they want less than that but still more than one.  In my case, they want to make sure that at least 1 or 2 of those are on the L because my R tube is gone.

I had 11 on my L and 15 on my R.  Those are good numbers.  Like I said, only a few of those will mature.

After my ultrasound, I met with a nurse and one of the other RE's at my clinic.  He was super nice and funny.  Dr.F had left instructions on my file regarding the dose of Puregon I should be on (66 mg)  but he didn't agree with her at first.  He said that I have a high AFC and that using that dose may result in too many mature follicles and I should only take 50 mg.  Then he read my chart further and discovered that I only have one tube and decided on 58 mg.

The nurse then showed me how to work the puregon pen.  Partway through the instruction, the RE popped his head in the room again and changed my dose to 66.  He said he didn't want risk not developing any of the follicles on my L side and have to cancel the cycle as a result.

I then went to the in-clinic pharmacy and picked up my puregon.  It comes with a little pouch to carry all the supplies in and another pouch to keep the used sharps.

I have to take the shot at the same time every day.  I chose 9:00pm just in case we go out for dinner or something one night, that way I don't have to worry about bringing it with me and injecting myself in a public washroom...  I was so apprehensive about sticking my self tonight that I ended up pricking my self twice because I chickened out a little too late once before finally going through with it. 

No side effects so far, fingers crossed it stays that way.

A Fresh Start

CD1

Today I was finally able to call into the clinic to start my very first IUI cycle!  I haven't been so happy to see AF in a really long time.  It means we get to start trying something!  I'm still nervous about the injectables, but I know I can do it.

I will do anything for this.

I am not looking forward to the next 8 months at work... or in general.  A co-worker has announced her pregnancy.  I don't work real closely with her, but she is part of the group that I go scrapbooking with.  I would go scrapbooking to avoid doing things with pregnant people, and now I've lost that escape :(  Also, my friend and co-worker M just found out she is expecting.  She is filling in for T while T is on mat leave.  There must be something about that office... the one right outside mine... where I can hear everyone drop by and say congratulations every 5 min...  She hasn't announced yet, she's only 5 weeks along, so I have another 2 months before that starts again, but I feel like it finally just stopped when T left.

Another one bites the dust.

M was also struggling to conceive.  They started trying around the same time as we did, but they took a couple of breaks because they weren't sure they really wanted it.  They started seeing Dr. M after we did and I felt really bad when I left the clinic after referring her there.  They decided to try a couple of cycles with the same drug that I used, and were successful on their 2nd month.

I am the only one left. 

My entire circle of friends in Guelph (not that it is very big) is either pregnant or has kids except me.

It still amazes me how quickly some people forget their struggles. Every day for lunch M and I would get the same thing, a turkey sandwich with a side salad.  Well, now that she's pregnant she can't eat lunch meat and has had to find something else to eat.  And more than once she has commented that she is jealous that I can still eat our lunch.  Really?? I finally said to her on Monday "I hope you'll forgive me if I don't feel sorry for you..."  I tried to say it really nicely, but I hope I made my point.  We haven't had lunch together since so it remains to be seen.

Anger

I haven't written about this yet because I am very shameful about it.  I feel terribly guilty for feeling the way I do.

I have another pregnant cousin.

This time it's not just a close friend of the family that we call 'cousin'.  It's my actual cousin.  My mothers sisters daughter.  My Aunt also suffered from infertility and my cousins were adopted.

She is 5 years younger than me.

She is unmarried. Not that it really matters to me what comes first.  They own a house together, like D and I did before we were engaged.  I always said my engagement ring had a foundation and a roof over my head. The same thing applies to them.

She never completed any post-secondary education.  Neither did her fiancee.  Yes, he proposed when they found out they were expecting.

She smokes.

I was told on New Years Day.

Happy New Year...

Growing up, I was always very close with my cousins.  She is the same age as my sister, and her brother is a year younger than me. We spent a lot of time with them.

I always assumed that because I was the oldest of all my cousins, I would be the first one to have a baby.  I wasn't.  The youngest of us did.  And now the 2nd youngest of us is pregnant.  During the baby shower for the youngest she said to me "Who would have thought that he would be the first one to have a baby..."  I told her "I don't want to talk about it." and I thought 'At least I will be pregnant before you...'

But then I wasn't.

The only thing I feel is anger.  I do not feel happy for her.  I hope she felt like crap fighting morning sickness and nicotine fits at the same time.

I have avoided family functions when I knew she would be there.  I am sticking my head in the sand and pretending it's not happening.

But it is.

When my grandmother was cleaning out her garage she wanted one of us to take a wicker bassinet and store it for the next generation.  This was a bassinet that I had slept in as an infant.  I don't know if my sister slept in it or if my cousin did becasue they are only 9 days apart.  I took it, after all, I was going to be the first to have a baby. At the time I was the only one with a house, I was engaged, I was the only one to be completed with university, I was all set.

On Monday this week, my aunt, her mother, called me to see how I was doing.  Although she insists that she did not call to ask, at the end of the call, she asked if she could have the bassinet.

My bassinet.

The one that I was going to put my baby in.

What could I say?

No?  I'm not using it.

I won't be using it for a long time still.

It hurt.

It still hurts.

I cried for hours after I hung up.

I'm crying now.

It should be me.

It should be me.

Canadian Infertility Awareness Week

May 20 to May 26 is Canadian Infertility Awareness Week (CIAW).

I know that 1 in 6 Canadian couples will experience infertility. 

And I know that I know more than 6 couples.

So why does it feel like I'm alone?

(not all the time)

I know that I'm not.

I know 4 other couples that have also experienced infertility.

Past and present.

2 of them adopted.

They are now divorced.

1 has two beautiful children conceived naturally after 10 years of trying.

10 years.

Ten. Years.

And 1, like me, who is still struggling.

So why does it feel like I'm alone?

I'm not.

It's just that nobody talks about it.

I don't talk about it (anymore).

It's private.

And yet I'm seriously airing it all on Facebook.

I've already changed my profile pic.

I doubt anyone will open the full picture to find out what it's about.

I am trying to gather the courage to post this video.

Maybe my courage will help my friends?

Maybe I will be judged.

Maybe I will be pitied.

Maybe I will be avoided.

Maybe I will be loved.

I look at some couples I know.

They have been married for years.

Yet they also don't have children.

Is it by choice?

Or do they feel as alone as me?

There is still 3 days left in CIAW.

I still have time.

It will be OK

Today my sister and I took my mom to a movie for mothers day.

Yes, I know it was two weeks ago... but since I had just had surgery, and for personal reasons in my sisters life, we postponed it.

We went to see The Best Exotic Marigold Hotel.  It was a really nice movie and it really made you think.  One line from the movie resonated with me. 

Everything will be alright in the end.

If it's not alright, it's not the end.

This is not the end...

Mother's Day

"Happy Mother's Day”

It comes around every year;

but when you have empty arms,

it's very hard to hear.

It's a day to celebrate a mother,

for all the trials she overcame;

and a reminder to an infertile

of her loneliness and shame.

But what really makes a mother,

Is it just conception and birth?

Or is there something more,

that shows a mother's worth?

It's putting your child first,

in everything you do;

it's sacrifice and determination,

and love and patience too.

An infertile woman makes all her plans,

around a child not yet conceived;

she loves them even though they aren't here,

more than she ever could have believed.

She appreciates and understands,

what a blessing that children are;

she works hard for just a chance,

that motherhood is not that far.

All odds are stacked against her,

and yet she still has hope;

everyday is another struggle,

finding ways to help her cope.

So even though her arms are empty,

she can still be a mother too;

So say a special “Happy Mother's Day”

for those waiting for their dreams to come true!

LAP #2 part 2

When I woke up in recovery, I was freezing, as usual, and they gave me a bunch of warm blankets. I was shaking from the anesthesia wearing off and that made my stomach hurt so they gave me more morphine. Once they gave me 18 something (I don't know what morphine is measure in) of morphine the nurse said I was prescribed 20 so she would just give me the last of it. A few minutes later she was at my side telling me to take a few deep breaths, over and over, she kept repeating that. Then she said she would have to decrease the morphine because I kept forgetting to breathe. Oops! I guess that is kind of important...

After I became more stable, you know... like remembering to breathe... they gave me a banana Popsicle.  It was strange to eat it because normally I have very sensitive teeth and I can't bite into ice cream or Popsicles etc. but because of the morphine, I couldn't feel it at all so I chomped away at that Popsicle.  It was delicious!

While I was in recovery, Dr. F went and talked to D to let him know what happened during the procedure.  She was not able to remove my right tube without damaging the ovary and impairing ovarian function so she clamped it.  She also laserd off a bunch of endometriosis.  Again, she could only do so much with out damaging ovarian function.  I was diagnosed with moderate to severe endometriosis.  I am so glad to FINALLY have a diagnosis of something I have suspected I've had since puberty.  An explanation for the pain and cramping I have every month.

I slept for most of the rest of the day; in the 2nd recovery area, in the car, at home.  I woke up only to eat a little something and go to the washroom.  Around 10 I woke up and then couldn't get back to sleep until about 1am - of course!

I have been recovering well.  My naturalpath gave me some homeopathic remedies to help me reduce the amount of pain killers I've had to take.  It seems to be helping, I've been managing with only 1 T3 every 6 hrs whereas last time I was taking 1 every 2-3 hours. 

Another thing that might be helping in that respect is that the location of the incisions is different this time.  With my first LAP I had two incisions, one in my belly button and the other just above my pelvic bone right at the hair line.  It was that second incision that was always so painful.  They didn't shave the area before putting the tape on and I don't think it held properly because of that.  This time, I have more incision points, but 3 of them are off to the side so it's not so painful to use my stomach muscles and sit up.  I have one point in my belly button, 2 on my right side and one on my left.  I am going to look like I've been a knife fight once they are healed.

No more bikini's for me.

The only real major pain I've been having is from the gas.  During the surgery they pump CO2 into my abdomen to allow them to get a better view of everything using the small instruments and cameras used during laparoscopic surgery.  They try to remove as much of it as they can before closing the incisions, but ultimately some gets trapped.  It will eventually work its way out but right now it's settling in my shoulders when I sit and around my lungs and ribs and it's quite painful.  A heating pad helps the most.  I feel a little bit like I'm wearing a bib with the heating pad tucked up under my chin, but oh well, I'm not trying to win any fashion shows here.

LAP #2 part 1

Yesterday I had a second laparoscopic surgery. After the first one, I was looking forward to having surgery with a Dr I had more faith in.  Still obviously very nervous, it is surgery after all, but this time it would be at a great hospital and with a better Dr.

I arrived at the hospital at 7am and registered.  My parents met me there at registration and kept D company while I was in surgery. I was impressed at how well everything ran. There was very little waiting between each step.  After registering, I went down to the same day surgery waiting area.  A nurse came and took me to a little room where she took my vitals and gave me a gown and housecoat to change into. 

I was so excited to get to keep my own socks on throughout the surgery!  It's a little thing to be excited about but I remember how cold I was last time and the though of my wool socks was comforting.

Once I was changed, I was set up with an IV.  The nurse had some trouble with my IV and she poked around for quite a bit before she got it in.  When she finally had it, blood went all over.  After the blood was all cleaned up, she went and got D to sit with me while they gave me saline and an antibiotic.  Once the antibiotic was all done I was taken to the surgery ward.  my parents got to walk down there with me but they had to wait in another waiting room until after I was done.  I said good bye to them there and went with D to another waiting area.

This area had boxes on the walls with different Dr's names on them and we went and sat in the chairs under Dr. F.  There, we met with the anaesthesiologist and the nurses and residents that would all be helping Dr. F in the OR.  I also got to meet with Dr. F briefly before I went in.

There was a little confusion about whether a laser would be used or not.  Dr.F doesn't use the laser, but there is another Dr who helps with it and he was able to be there.  Just before I was put under, they had me initial a change to my consent to include laser.

Once the consent was changed, they put the oxygen mask on and added a new drug to my IV and I felt the warmth spread over my head and I was out.

Surgery or no surgery?

This past two weeks have been a bit of a roller coaster with good news and bad news and confusion all around!

Last Tuesday I had my pre-op appointment with Dr. F to sign the consent for surgert and go over the risks etc.  With Dr. M, he tested my tubes last May and it showed they were open, then during the surgery he declared them both closed, but he did not perform another test. Dr. F is not really comfortable taking the word of Dr. M when his reports are conflicting so she ordered another test; a more accurate one than the one I did last May.  It's called a hysterosalpingogram (HSG).

During the HSG, a contrast dye is inserted into my uterus and forced through my tubes while images are recorded on an x-ray. As it turns out, my left fallopian tube is open! But my right is still blocked with nice fat hydro. The image below is NOT mine but it shows kinda what mine looked like.

Notice on the left side that the dye looks like smoke, but on the right it is more solid? That is because on the right the dry is being trapped and contained rather than being released into the abdomen. There was a slight anomalie with mine. At the base of the right one there was a small area that also looked like smoke. This meant that my right tube, while diseased, might possibly be open too. If both tubes are open, then I wouldn't need surgery!

Because the test on my right tube was ambiguous, Dr. F got a second opinion from one of the other RE's at the clinic. They agreed that the tube should be treated as closed because the area of 'smoke' was so small.

What does this mean?

Basically, since I have one open tube, I actually have a chance at a successful Intrauterine Insemination (IUI) which is much much cheaper and less invasive than IVF. If I choose to do IUI, then I don't need to do surgery.

With the blocked tube, there are studies that show IVF is more successfull if the tube is removed. However, there are no studies on IUI and blocked hydro tubes, so she can not say that removing the tube would be beneficial.

If we are going to do IVF, I should have the surgery. But if we would rather do IUI, then I would't need to have the surgery. However, if we try IUI and it doesn't work and we want to persue IVF, I would need to have the tube removed at that point. So, we need to make a decision.

IUI has only a 10-12% chance of success and a 5-10% chance of ectopic (pregnancy in the fallopian tube) whereas IVF has a 60-70% chance of success. And we can only do IUI on the months that I ovulate on the left side since that's the only tube that's open. And those percentages were before I asked her about D's SA results. OF course, he was out walking the dog when I was talking to her so she couldn't give me the numbers, but his count is low so our chances are probably a little lower than 10%. We figure we will likely end up doing IVF eventually, but it's really hard ignore the fact that IUI will cost $350, while IVF will cost $10,000.

I have decided to go ahead and do the surgery on May 9 as planned and we will have to think about whether we want to do an IUI or two before IVF. A successful IUI would be like winning the lottery, and you can't win if you don't play. We are thinking about buying one 'lottery ticket' before going all in with IVF. I keep second guessing that choice though.

Technically we have some time, I'm turning 32 next month and D is the same age. The only thing that puts us into a time crunch is that D is supposed to be on a drug to supress his immune system a little so that he doesn't develop a resistance to Remicade (the drug to treat his Crohn's Disease) but he's not taking it while we TTC. His GI says it's safe, but everything I've read says there is a risk of major birth defects if the male partner is taking it and both RE's that we've had say it's not safe. So he has not been taking it for 2.5 years now and I'm constantly worried that he will build up a resistance to his miracle drug. (You should have seen him before he got on this, he was sooo sick and in sooo much pain all the time I can't watch him go through that because my body is screwed up and can't have babies).

But really, what's another few months for a chance to "win the lottery"?