December?!

I thought I would attempt to make at least one post during the month of December!  So here it is.  I haven't written since the last ICLW a month ago.  Yikes!  Where does the time go?  I've spent the last 4 weeks working like crazy (why can't yearend not be at Christmas time?), shopping for gifts like most of America, and trying to enjoy the holidays in my spare time. I still have my little Maya dog that I mentioned in a previous post.  She's quickly becoming a permanent part of our family rather than a temporary, foster dog. I think my husband learned a lesson: don't bring a dog home unless you expect to keep it forever!

I, along with my mom, did a volunteer stint at the local Goodwill annual Shoe Party.  I took a few hours out of my precious Saturday last weekend to fit underpriveleged kids with new, donated shoes. Then they got cookies and punch.  They also had crafts and face painting. My mom and I were in charge of fitting the shoes in the boys section.  The mostly 5-8 year old boys were so cute, and so appreciative.  It was sad when the shoes that they walked in with were 4 sizes too big and just slipped off their feet or when their old shoes had huge gaping holes.  They each got 2 new pairs of socks and new shoes.  I'm not sure who was in charge of the sock section, but a lot of those poor boys ended up with manly size socks!  Anyway, it felt really good to help out.  It makes me appreciate what I could provide to my own child someday.  We might make this an annual volunteer experience. 

Gearing up for the holiday weekend, I had today off of work!  I slept in, worked out, cleaned the house, and caught up with the blog.  A full day!  Tomorrow is Christmas at my parents house.  Saturday is Christmas at my Grandma's and possibly a stop at the in-laws (it's still to be scheduled, apparently) and Sunday is a short visit at my other Grandma's. And you wonder why I haven't blogged in a while?!

On the infertility front, I'm still on the birth control and still waiting to start IVF #2.  My new insurance starts in January, so I'm dealing with getting that all figured out with my favorite billing manager at my clinic.  My insurance requires that I use a "specialty drug" provider who will then have to ship my drugs to me.  I'm used to picking up my drugs right after my appointments.  Not sure how that will all work out or how much of the drugs will actually be paid for (I have low expectations), but I guess we'll find out very soon.

Happy ICLW, happy holidays, and happy new year!

BCPs and Hope

I received a call from a nurse at my fertility clinic today.  They are [finally] putting together the January IVF schedule and now I'm officially on it! I need to start the fabulous birth control pills 3 days after I get my period.  It's crazy that this seemingly routine and mundane phone call can start my brain and my heart to getting all excited with the anticipation of maybe getting pregnant very soon.  I've been waiting so patiently (at least I think so) these past 4 months since our unfulfilled first IVF (not to mention 4 years).  I've somewhat tried to turn my brain off to pregnancy and babies and infertility.  It was the only way I could do it.  Tricking my brain into not thinking about it.  It is so hard to believe we're gearing up to do this process all over again. Like life, the time went by very slowly and very quickly all at the same time.  So far, I'm scheduled to start stims on January 10th with a possible retrieval date of January 18th.  Still a good 2 months away, but we're getting there.

I want this second IVF to work so bad, I can taste it.  I want to see a positive pregnancy test.  That's one test I've never passed.  It is hard to put into words what I'm excited for.  It's actually not the birth control, though that is the start of it all.  It is definitely not the 4 hour round trip drives to the clinic during winter, although I do enjoy the me-time and the radio sing-alongs.  It is definitely not the daily injections of hormones.  So what is it?  I think it is hope.

I am thankful for hope because that's all I've got.  Happy Thanksgiving!

It's a Girl!

It's a girl!  Ok, maybe she doesn't have my DNA.  Maybe she doesn't have any arms, but has 4 legs instead.  Maybe she's a little hairy.  Maybe she's not a human girl, but she is actually a bitch - a female dog, that is!

My husband and I have been thinking about getting a second dog.  Our hesitation has mostly been because our dog, Morgan, is about as perfect as you can get.  She's [mostly] trained (potty and otherwise), but can be a handful at times.  Why mess with that?  Also, if we ever do get pregnant would 2 dogs be too much to handle in our little house?  Not sure.

Anyway, DH went to a friends house to watch the Husker game (imagine that!).  By halftime, he had texted me a picture of a dog.  He called to ask if I wanted her.  They call her 'Shorty'.  She's a one year old, Corgi-Chihuahua mix about 10lbs or so.  Not potty-trained.  The friend said that they rescued her when she was less than 10 weeks old from an abusive home.  Now, she is not getting the attention she deserves in a house with 3 other dogs and several children.  If we wanted her, she was ours.  No charge.  We could even give it a 'test run' and if we decide we don't want her, we can give her back.

So, needless to say, DH brought 'Shorty' home.  She hasn't been here 24 hours yet, but has already made herself at home.  She has been playing and fighting with Morgan for the prime real estate on my lap, and she has pissed once on my newly shampooed carpet (after Morgan basically destroyed it and I felt comfortable enough getting it professionally cleaned).   She is a very good dog and so well behaved so far.  Still not sure if we'll keep her for the long haul, but we'll definitely enjoy her company through the Thanksgiving weekend.

Collections & Insurance Hassles

The other day I got a bill and a letter in the mail from my fertility clinic.  It said they were planning to send us to collections for the balance of our bill ($1,300).  This wouldn't irk me so much if 1.) the IVF had worked ,2.) if I actually owed it in the first place and 3.) I didn't want to be on the clinic's "good" side for our planned IVF in January - I don't want to be known as the patient that doesn't pay her bills.

Technically, we do owe the $1,300.  This was the balance of all of the ultrasounds and bloodwork prior to retrieval.  I had hit the infertility max on my health insurance with the first visit, so after it was all said and done, I had to pay 100% of the costs, minus the in-network provider discounts.  Why does bloodwork cost so damn much?!

But then we did the retrieval and paid a hefty $6,000 that day.  That was the "retail" price of the retrieval.  I asked to submit it to insurance so we could still get the in-network provider discounts even though we had hit the infertility max.  The billing manager -lets call her Jo - said it wouldn't do any good and that there would be no discounting.  So we paid in full.  We got a receipt.  Then after the whole debacle failed, I decided to call the insurance company to see if Jo was right.  She wasn't, per the customer service rep.  The insurance company even mentioned that it would be "fraud" to not submit the claim.  I told them, I would work with the billing manager again before they sent the network after the clinic.

I talked to Jo.  She still insisted that the discounting would not apply.  I told her that I would like to submit the claim anyway.  She wouldn't do it for me, so I said I would submit the claim to insurance on my own.  After getting all the information, I faxed the claim to the insurance company myself.  After it processed, the explanation of benefits showed that I would have gotten a $2,000 discount!  That means the clinic owes me $2,000.

Now, I'm not a math wiz by any account.  But I do know that $1,300 minus $2,000 equals a refund for me!  So I haven't paid the invoices that have been coming each month.  So after I got the nice, little collection letter, I called Jo.  We played phone tag a couple of times - she left messages saying I had hit the infertility max.  No kidding?!  I already knew that.  So I left a very detailed, but nice, message basically telling her that they owe ME money!  That was last Monday, November 1st.  I haven't heard back from her since then.

I'm debating calling Jo back or just waiting for the next invoice to show my refund!

*UPDATE*: A day after this post, I called Jo to see if she had gotten my message and what she had done with my account.  She said that she had 'resubmitted' some claims (which I'm not sure what else could be claimed) and that she credited my account.  Based upon this, I owe about $100 instead of $1,300.  Definitely progress....but not exactly what I was looking for.  So I told her I would wait for the next invoice to see the detail.  As of 11/21, I'm still waiting to see this invoice!

Welcome ICLW!

If you're stopping by from ICLW, welcome!  If you just stumbled across my blog, also welcome!  If you're a more regular visitor or a follower, welcome back!

Here are our facts (in case you were wondering):

Me: 30, work in human resources, benefits and payroll for an insurance company, have my MBA, loves dogs, loves to read and play volleyball
DH: 33, works for an eye doctor as a paraoptametric, loves Husker football (actually ALL football) and is a bowling enthusiast
Us: Live in Iowa, dated for 6 years, then married for 6 years, TTC for 4 years
Morgan: female minature rat terrier, 4 years old, energetic, loves people, going for walks, and playing ball

Infertility Journey: Over 4 years TTC, including 6 IUIs with OB and Clomid, 3 IUIs with RE and injectibles, 1 IVF but no transfer, all BFN
The 'Plan': IVF #2 in January 2011, waiting for insurance coverage to change so that IVF is more affordable, crossing our fingers and being as patient as humanly possible!

Happy Friday and Happy Weekend to come!

What is Wrong with Our Generation?

I told my 65 year-old co-worker about a friend of a friend who tragically lost her 4 and a half month old baby boy to SIDS.  This same co-worker knows about my infertility struggles and IVF failure.  She knows about a good friend that lost her baby prematurely due to early labor.  She knows about another friend of mine that is going through infertility treatments.  Her question was "what is it with this generation"? 

I've wondered the same thing.  Is there something truly wrong with our generation, or is it that more people are talking about their infertility struggles rather than keeping them a secret?  Is it because of the reality television shows featuring multiples or dramas and sitcoms that feature infertility as part of their plot lines, the headlines with high-order multiples, or the many celebrities that have twins from infertility treatments?  Or is it a real biological issue and change in our society coming to the forefront? 

One of my junior high teachers was married and in her 40s or 50s when I had her as a teacher and she did not have any children.  A married co-worker from my previous job was in her 40s and never had any children.  I never asked them why they didn't have any children.  I assumed that they didn't want them (which I didn't quite understand).  It didn't occur to me at the time that maybe they had tried to have children biologically and just couldn't.  Inftertility treatments for them were either nonexistent or relatively new for them, not to mention ridiculously expensive.  As is adoption.  I never asked these women why they didn't have any children, adopted or otherwise.  In retrospect, I'm so glad I didn't ask them because, as I know now, that can be a hard question to answer.

I heard or read somewhere that the average sperm count of men in the early 20th century was about twice as high as it is now.  How true this statistic is, I'm not sure.  Does that mean that the fertility of women is half what it once was, too?  Conception seerms to be more difficult to achieve, pregnancies seem harder to maintain, and little babies do not always make it through their first year of life.  Does God want to reduce the over population of the world by putting these widespread biological hurdles into place?  These are the questions that keep me up at night.

blah, blah, blah

I'm in this wierd zone of nothing. Nothing to talk about, nothing to write about, nothing infertility related to report. It is kind of nice to try to just 'live my life' with the beautiful fall weather. I'm focusing on work, which is pretty busy right now and won't slow down until February. I have been trying to work out more, eat better, and lose the 10 pounds of weight I gained during my July IVF cycle. Football season has begun and my husband is very preoccupied with his NFL fantasy league and the new Direct Ticket we got from Direct TV. So, with him monopolizing the TV, I've been reading a lot for pleasure - no infertility books and no textbooks. I read 3 books (three!) last week. And, go figure, each randomly chosen book that I read had pregnancy and/or infertility in it. Free to A Good Home by Eva Marie Mont is about a woman that can not have children. Great read, and very quick. I won't talk about the other two since the pregnancy thing would kind of give away the endings. Bottom line: Even when I'm trying not to, babies and pregnancy-related thoughts for myself are in the back of my mind. I can't get completely away from it if I tried.

Today, our work sponsored their annual book fair. I'm not sure where this book company comes from with all of their stuff, but it was very disappointing. First of all, there were NO adult novels. There were some non-fictional stuff, but who wants to read about Kramer from Mad Money? Not me. There were tons of cookbooks, but alas, I don't really cook. And then, there were rows, and rows, and rows of children's books for all ages, toys, games, puzzles, etc. Great if you have kids or have to shop for a lot of kids. Needless to say, I didn't buy anything. Just another sucky reminder that I don't get to shop for that kind of stuff.

We're just waiting, waiting, waiting (again) for the next IVF cycle.

Old Habits Die Hard

My period is due any day now. Why is it that I can't help but hold out a twinge of hope that it WON'T come? Old habits die hard. How many natural cycles of "trying" have I done? Too many to count. How many multiple (expensive) OPKs, or failed pregnancy tests have been peed on and analyzed? A small fortune. Should I know better by now? Yes. My brain knows that it won't happen. I won't get pregnant on my own. But every day that I get closer to my period, I want to believe that by some miracle I'll actually "miss" it. So many people say they know someone that has gone through infertility and then spontaneously became pregnant thereafter. Well, I've done the time. I've put in the effort. Can't I get a miraculous pregnancy, too? Probably not. I have about 2 or 3 more natural cycles before I go on birth control pills again in preparation for IVF #2. Couldn't one of those be "the one"? One can only hope.

Post-Vaca

North Carolina was a great vacation. It was quick, but nice to getaway. We flew on Friday and came back on Monday. Thankfully, our flights were actually effortless and on time. I finished an entire book and even bought a new one for the flight back home.

We got into Raleigh on Friday night, and we ate at a restaurant called "The Red Room". The room was actually red, and the restaurant serves Spanish tapas. Tapas are basically mini-meals. So we all ordered 2 or 3 and shared the amazing food. And the sangrias were equally fabulous!

On Saturday, we woke up early and drove the 3 hour drive to Carolina Beach. Myrtle beach is further away and more touristy and crowded, so Carolina Beach was perfect. My sister-in-law drove the mini-van with us and her brood. In tow, were her 3 boys - A four year-old, a five year-old, and a six year-old! They are very well behaved (for boys!) and so cute. They say the funniest things! I still think SIL is crazy for purposely being pregnant for 3 years straight, and I'm still only slightly jealous that attaining pregnancy was so irritatingly easy for her! But, I can't hold it against her or her cute kids now. We only talked about our IVF and infertility a little bit. I'm not sure if SIL could ever understand the difficulties that we and many others have in getting pregnant, especially considering it was so easy for her. I told her the IVF story in a very concise way: "DH's sperm isn't great. There isn't really anything that they have found wrong with me (per se). My eggs didn't do what they were supposed to during the IVF based upon the drugs I took. The doctors say the next IVF should produce better results with a different drug protocol." End of story - at least until January.

We spent about 6 hours on the beach enjoying the fried seafood, drinks from the cooler, and big waves from the Atlantic ocean. Let's just say the wave pool at our nearest water park does not hold a candle to the ocean. Saturday night we went to a restaurant where DH had the best crab legs ever! Sunday, we drove back to SILs and hung out - spending time with the boys, ordering pizza, and playing a little guitar hero.

The only regret I have of the weekend is that I forgot to make DH put sunscreen on my back (I had covered my legs, arms, chest, and face with 30 SPF before we left the beach house). Needless to say, I was a tomato and in PAIN the rest of the weekend. Sleep has been very difficult all week - as I am NOT a tummy sleeper. But all in all, the burn was worth the day at the beach - but I won't forget the sunscreen again!

Weekend and Anniversary

It is the end of the first great weekend in a long time. My brother and his wife were in town from AZ. I don't get to see them too often and we were able to spend some time together. I took Thursday off of work and we all went to lunch. And on Friday night, our families went out - having pizza and beer. Next weekend, we are going to NC to visit DH's sister and go to the beach. So looking forward to two weekends in a row of spending time with family and having some fun!

Our 6th wedding anniversary was Saturday, the 14th. DH got me flowers and a gift card to Starbucks. But for as much as that man can aggravate me throughout the year, we both agreed the gift was well deserved! I still felt bad because I didn't get him anything! Then we went to our first 3D movie matinee (Despicable Me), had some drinks, and then to dinner. It was a great day!

I tried not to think about where I thought we would be on our 6th wedding anniversary. I didn't think we would have all the time in the world to have date night. I thought there would be babysitters involved. I thought we would have not just one child - but two - by now. Here we are with nada. If things has gone as planned, I'd probably have a 2 or 3 yr old. I'd probably have an infant, too, or maybe one on the way. Of course, we're not giving up on that dream yet, but the wait and the delays are incredibly frustrating. Especially now that we have to sit back and wait for 5 more months before we can financially do another round of IVF. (Why can't IVF be cheaper or at least be covered by insurance?) I can only hope that by our 7th anniversary, I will be pregnant. That is something to hold onto.

Conversations and Chit-Chat

After a setback like a failed infertility, IUI or IVF treatment - especially after 10 times - some conversations that may never have bothered me before, can annoy the heck out me now. I'm sure you've heard some version of them before:


"Soooo, when are you having kids?"

My usual answer, "Uhh, I dunno. Someday."


The evil part of me would like to say, "We're not. We don't like kids." And then wait for the reaction! My opinion is that if you don't know me well enough or it doesn't come up in normal conversation or if you are just trying to make idle chit-chat, asking about if and when I am having children is none of your damn business. Prior to my knowledge of my infertility, I would not have thought twice about this question. I've probably even asked it. I thought it would be a natural question to ask - especially after a couple gets married. Anymore, I would NEVER ask when someone is having a baby. How do they really know, anyway? Same goes for - "when are you getting married?" or "when are you going to have another baby?". I try to butt out of the major life decisions of others.



"At least you don't have kids...my kid does this or that or I have to do this or that because I have kids. You're so lucky that you don't have to do this or do that..."


If I were childless by choice, I might actually join in this pity-party conversation. I might agree that "I'm lucky". But frankly, I don't feel sorry for anything you say when it comes to your kids when you start the conversation with "At least you don't have kids". It's not like I feel lucky about my situation. The fact that you are having a bad day with your kids does not give me a silver lining. If you want to vent, go ahead and vent. I'll listen and empathize. But leave me and my 'luck' out of it.



"When you have kids you won't be able to...." or "When you have kids you will have to..."


First of all, if you don't know about my infertility or my decisions about having or not having kids, please don't assume that I will ever have kids. If you do know about my infertility, don't assume that all of my efforts will work and I'll end up with a baby any time soon. Positive thinking is one thing, but sometimes these comments can be a slap in the face because you're trying to remind me of what I don't have. I don't like to assume my pregnancy attempts will work - because, after 10 major attempts at a BFP, it simply hasn't. I don't mean to be overly negative, but please don't get my hopes up any further than they already are or make me realize what I'm missing every day. Secondly, I do not have kids now. I can watch as much television from my DVR, as I want to. I can go to a movie, go shopping, or leave my house at the drop of the hat, if I want to. I can spend money the way I want to (if I have it!) I can go out, get drunk, and then sleep in until noon with a major hangover, if I want to. Please don't knock my extracurricular activities (or lack thereof) because I can (or can't) do them if/when I have kids. Also, I do not need any practice changing diapers or cleaning up baby puke or feeding your kid. If I want to, I'll ask. But until then, I don't need the practice, and please don't remind me that I don't have kids. I already know.



"For someone that doesn't have any kids, you are right about that!"


This comment was made to me just last week. I was at the lunch table in the cafeteria at work, talking about how given too many choices, people have a harder time selecting just one. It's some sort of psychological fact that I probably learned in one of my dozens of courses over the years. I said that if you're giving a little kid the choice of 5 movies to watch, you'll never get a straight answer. But if you give choice A and B only, it will be a lot easier for the 2 year old brain (not to mention an adult brain) to pick one. Lessen the choices. After that comment, a gal with 5 kids made the above comment to me...for someone that doesn't have kids.... Really? Apparantly, I surprised her with my childless insight into the kid psyche. Just because I don't have kids, doesn't make me dumb. It doesn't make me stupid about children or child development. (I did my fair share of baby-sitting over the years ). I know I am missing out on something special, but I'm not an idiot because of it.



"It'll be worth it. They are totally worth it. When you see your baby sleeping or smiling or giggling. Just wait."


I know. You don't have to remind me. I know that kids are worth it. I wouldn't do this if I didn't have to or if I didn't think it was worth it. Lucky for you, you didn't have to spend your entire life savings to get one. Lucky for you, you didn't have to puncture yourself with needles every day for weeks on end. I already get it. In the end, they're worth it.



"Maybe you'll get pregnant on your own."


No. I won't. I know this happened to your co-worker's friend's sister after they adopted or did an IVF treatment or 'relaxed'. But it probably won't happen to me. Don't count on it, and don't try to get my hopes up.


Also, to the people that do not know me, our situation, or that we are desperately trying to have a kid, please do not think that I am selfish because I do not currently have children (not that I think that they are reading this). Sometimes I feel that people think that I do not have kids because I would rather spend time on myself, spend money on myself, travel, enjoy leisure time, sleep a full 8 hours every night, etc. etc. And, yes, I enjoy being able to do those things, but I would give it all up to get one of those cute, squishy, little human babies...

Regrouping

Today, I regrouped and called the clinic. My doctor called me back and we had our "discussion" about WTF happened with our first IVF cycle and why we didn't make it to transfer. We talked about the 3 IUIs with injectibles that we did under her care over the past year. We talked about how I responded to the drugs in each of those situations:

• IUI#1 - May 2009 - I did Femara on days 3-7, and then did one vial of Menopur (M1) to stimulate. The way I responded was "progressive" and "IVF worthy" this time around. At baseline, my follicles were 9, 8, 7mm. Pretty big to start with.
  
• IUI#2 - August 2009 - similar to IUI#1 and I was ready for trigger on Day 12. I responded well, and this is a pretty early trigger without much for meds. At baseline, my follicles were 7, 5mm.

• IUI#3 - February 2010 - did Femera on different days and started M1 early. Triggered on Day 9. Really early. At baseline, my follicles were 8, 9mm.

Based upon this, my protocol for IVF was structured based upon my quick response to stims during my IUIs. The goal with IVF is to stimulate eggs to maturity in a way that isn't too quick and in a way that doesn't take too long. We also want to evenly grow a lot of eggs rather than focus on only a handful like you do with an IUI.

With my IVF, my baseline ultrasound had many follicles and the potential was there. However, the follicles started out much smaller than with my IUIs. They were more like 4, 3, 2mm. This was most likely due to the fact that I was on birth control prior to IVF, but was not on birth control prior to my IUIs. I had a lot further to go with the IVF. So even though I did respond with the given protocol (M2), I stalled out a bit and had to go double the dose (M4) to get the follicles going again. We ended up stimming 4 days later than a typical IVF protocol. Possibly too long for my little eggies. Of course, these realizations are all in hindsight.

Again, 12 follicles were retrieved and 9 of those were mature. The doc thinks that the mature eggs were "exhausted". The nucleus of the eggs were mature enough, but maybe the surrounding cytoplasm was at a different stage, and therefore the eggs were a little lopsided because of the way they were stimulated. The clinic rates the quality of mature eggs on a scale of 1 to 10 with 1 being the perfect egg. Most of mine were 3's. My average was 3.8. Not awful, but not great either. I didn't have any 1's or 2's.

Lastly, many would dispute trying to do a 5 day transfer instead of a 3 day transfer when only 2 embryos fertilized. On day 3, the two little guys looked good - and would have been worthy of a 3 day transfer. But then they just stopped - which is indicative of egg issues. The doc said that around day 3, the DNA of the egg and the sperm quit telling the embryo what to do and let the embryo grow on its own. If the embryo doesn't do what it's supposed to on its own, then it just quits. The doctor's theory is that the embryo wouldn't know how to grow on its own inside or outside the womb, and its better to know if the eggs will make it prior to transfer. If a 3 day transfer was done, they would never have know what had happened to those so-called "perfect" eggs. And, personally, I would have been out $3K, another week of PIO shots, and still had a BFN at the end of the day.

I asked if there was anything we could have or should have done to prevent this. She said there wasn't. It was out of character for me to respond the way I did to the Menopur, and there was no way to tell that I would respond as slow as I did in the beginning. The quantity of eggs came to fruition, but it wasn't until the eggs were retrieved and evaluated and the fact that only 2 fertilized after 24 hours shows that there were egg issues. The doctor said I actually do have a good quantity of eggs in my "ovarian reserve" and that there definitely decent quality potential. With better stimulation protocol, she thinks that there were be a better quality of egg.

With a 2nd IVF, the plan would be to start me at M4 instead of M2. This may depend upon my baseline ultrasound to make sure they don't push the follicles too hard either. That's basically it. Everything else would be about the same. I told the doc that we couldn't afford another round until January - when my insurance changes. She said to call the clinic when I get my period in late October/early November to get on the January schedule and to start BCPs again.

Gosh, November seems so far away...at least it's August already.

Perfect End to a Perfect Weekend

After our bad news on Friday that there would be no transfer and that every single one of our eggs and embryos didn't make it, needless to say, we were pretty upset. DH was pretty strong about it, but I would go five minutes of being okay and then suddenly burst into tears. Anything could set me off. A kind word from someone, sympathy from someone else, a song or commercial, or just my racing, random thoughts.

On the drive home from the clinic, I suggested driving to Chicago for the weekend - right then and there. Just to get away from everything and everyone. I didn't want to deal with anything. I knew that wasn't realistic, but it sounded good at the time. However, I settled for going to a movie instead. We went to an Adam Sandler comedy, Grownups. It was very funny, and it took my mind off of things for the most part. There were only a couple of parts in the movie that made me cry for my own situation. And so, we left the movie in a more cheerful mood than when we arrived. Until we got to the car and there was a $30 parking ticket on the windshield. The wind was sufficiently knocked out of our sails. However, we couldn't have been too surprised. DH insists on parking in that spot each time we go to that theatre - even though we're a little too close to the no parking sign. Oh well - par for the course. We ended the evening by having a couple of drinks at home.

Saturday was better. We slept in late. I tried to enjoy it, and then I had a thought as I was sleeping in: if I had kids, I wouldn't be able to sleep in...ugh. Turn my mind off! Mom called to make sure I was functioning. The rest of the day I cleaned. A good, theraputic cleaning. I vacuumed and picked up the entire house of its clutter I had been neglecting for the past month. I took all of the bags of syringes and needles, and alcohol wipes that were in the middle of the kitchen table and threw them in a box in the corner of the spare bedroom. Don't need them any time soon. Then, I cleaned the refridgerator. Fun, right? The in-laws stopped by to make sure we were still functioning. I took the dog for a walk and then went to the gym to work out. I don't think I cried all day.

As I was cleaning the basement on Saturday, I told DH to call his friend to come over sometime to put up a light fixture in the basement...the key word was sometime. However, DH called the friend immediately (which he never does anything immediately!) and invited him, his wife, and 1 year old kid over to our house at 10am on Sunday morning to put up the light and to eat breakfast as an incentive (that I would cook). Ugh. I didn't mind making the big breakfast of eggs, pancakes, bacon, sausage - it's kind of our thing to do on Sunday mornings. But I wasn't sure if I was ready to entertain (not to mention showering or putting a bra on!). We realized we only had 3 eggs left as we were getting ready for bed and would have to go to the store in the morning for more. Hmph - even as I write this - only 3 eggs left. Not enough eggs. How ironic.

So, Sunday morning arrives and as I'm waking up, I'm making a mental list of breakfast items to get at the store. DH was going to go to the store, but I decide to go instead and let him sleep in. I did what I do practically every morning of my life: I go to the garage, open the garage door, get in the car, start it, put it in reverse, and hit the gas. But this time, 'clunk'. I had just rammed my crossover SUV into my husbands little 4-cylindar car. Yup, I did. Couldn't believe it. Perfect ending to my perfect weekend. Scratched the bumper of my car, and made a pretty nice lip-dent in the hood of my husband's car that will most likely cause a lot of rusting as soon as it rains. DH was forgiving - as I am apparantly the worst driver ever. My excuse is that I've had lot on my mind lately.

Luckily, the friend came over to fix the light, but didn't bring the family. The wife is doing the HCG diet and didn't want to be tempted by the food. Hmph. So breakfast was good and the light got fixed. Laundry got done; I took a long nap (which involved a lot of just lying there and thinking), and even studied 2 chapters for my next test that I'm doing for work. Only had one spontaneous cry today. Monday we start all over again. Back to work and back to our reality.

Disappointment

Doing the 2 hour drive this morning, we were full of hope for our transfer. We should have took the heavy rain as a bad sign. We had received no calls the last two days that would make us think that our final 2 embryos didn't survive. I held my pee (a full bladder ready for transfer) as I paid the receptionist our final [big] IVF payment. We waited. The nurse called us back and sat us down to wait for the doctor. Bad sign. The doctor came and immediately said she was 'sorry'. Bad news. The two embryos quit growing after day 3. Day 5 looks like day 3. Done. No transfer. No baby. No more money. The doctor kept talking about our situation, eggs, blastocysts, sperm, etc, etc. I kept holding my tears (and my pee), and I tried to listen. We can call her this weekend once we have re-grouped to ask questions and actually have a 'discussion'. But, what's there to talk about? I don't know.

Still Cookin'

Got the call that our two little embies are still cookin' as of this afternoon! Sigh of relief....they are both 6-cell at this point. I don't know much more than that, however. Nor do I know if they will make it to my Friday 9:30 a.m. transfer appointment. The clinic doesn't give any odds, but, so far, so good! Sheryl and I agreed that regardless of the embryos' fates, we will still go to the appointment on Friday to talk to the doctor directly, in more detail. Until then, I do NOT want the clinic to call me. Fingers-crossed. My heart pounds and I jump out of my skin every time my cell phone rings!

Also, a brief shout out to my dear friend (IRL), who sent me beautiful 'cheer me up' flowers today at work. My last post must have been depressing or scary enough to prompt some necessary sympathy flowers! Sorry for that - but the flowers are amazingly beautiful and bright! And just what I needed. Thank you, thank you.

One Minute

One minute, I'm fine. The next, I'm crying in the bathroom stall at work.

One minute, I can not possibly imagine my life without a child to love. The next, I think I could be at peace without one.

One minute, I'm completely positive; glass half full. The next, I'm completely negative; glass half empty.

One minute, I think it is my destiny to have a child of my own. The next, I think it is not meant to be.

One minute, I am full of hope. The next, I am full of despair.

These are the random, rollercoaster thoughts going through my brain every minute, every hour, of every day. These, by far, are the longest days of my life. No phone calls from the clinic today tells me that 'the twins' are still thriving in their little incubater 2 hours away -at least for another day - waiting for me.

Two

I received "the call" this afternoon. Not the best of news, I must say. Out of the 12 follicles retrieved yesterday, 9 were mature enough to do ICSI. Out of the 9, four of them didn't fertilize at all. Of the 5 remaining, only 2 are left fertilized as of this afternoon. Two. Really? Two. Our chances of freezing embryos for later is completely out the window.

Sheryl said there seemed to be some "egg issues". They degenerated or didn't have all their egg "parts". I'm not sure what that all means. I'm not sure if my eggs are just retarded (and have been all along) or if the protocol that was used for me wasn't the best. Sheryl hinted that my doctor was going for a certain result with my protocol based upon my past experience with the drugs I used. I tended to develop follicles quickly in the past. But, of course, this time around, I didn't. Everything was slower to develop. Does that have something to do with it? I don't know - they don't know. It's too late now.

Anyway, Sheryl will call me on Wednesday to set up the blastocyst transfer appointment on Friday. She will only contact me before then if one or both embies I've got decide to die/degenerate. Until then, no news is good news. Trying to re-assure me, Sheryl said "it only takes one". So, in the end, I hope my twins make it to Friday so that this whole thing isn't a total bust.

IVF Retrieval - 12 follies!

On a Sunday, there is really a skeleton crew at the clinic. Our appointment was at 8:30. We got there at 8:15, but had to wait in the parking lot for one of the nurses to arrive to open the front door. DH got called back at about 8:30 or so, and he was done with his business and back in the waiting room before they even called me back for retrieval. His mission accomplished, he gets the whole waiting room to himself and starts to watch "Cat in the Hat" the movie on TBS (my idea). Then, they call me back and DH gets to watch the whole movie while he waits. He mentions that he doesn't care to ever watch it again!

I went into a drug-induced sleep at about 9:00 am and woke up about 45 minutes later to find that 12 follicles had been removed from my ovaries. (Can I just say that anasthesia is awesome?!) I was very relieved - I'm always nervous that I give myself too much hCG and I'll throw the whole timing off and ovulate too early or something. But they caught the little suckers before that happened! At first look, the doctor said 7 of the 12 seem of really good quality/maturity. I feel pretty good, physically. The nurse taught us to do the Progesterone shots, and we were back on the road by 10:45a.m. I'm tired and a little crampy, but otherwise, I'm very excited to find out how many of our combined reproductive products actually fertilize. Not looking forwart to progesterone shots.

The doctor said that the actual fertilization/ICSI process would begin in the lab this afternoon, and I should get a call Monday morning to find out how many they tried to fertilize. Apparently they will not try to fertilize the eggs that aren't good enough or mature enough and, of course, those follicles that don't even have eggs in them won't go through it, either. And then, of course, we'll find out how many of those actually did fertilize. Fingers crossed, there will be at least 2 good ones that make it all the way to Friday's 5-day transfer. And maybe even a couple more for freezing, would be nice. It's going to be a very LONG week!

Drug of the Day - hCG

Today, I don't have to take ANY drugs (besides the baby aspirin and prenatal vitamin!). I'm pretty excited about this. I don't think I'll get that lucky for awhile. Last night at 11:00 p.m., I took my “trigger” shot of 5,000 IU of hCG (human chorionic gonadotropin). In my case, the brand name is Pregnyl. This drug is derived from the urine of pregnant women. And, of course, I used hCG last night to induce my ovaries to ovulate within 24-36 hours. For IVF, my eggs will be retrieved at about 36 hours after injection, a few hours before the eggs actually would actually be released from the ovary.

Besides being used for fertility purposes, this drug also is used for:

Weight loss: Low-dose daily hCG injections (125 IU) used in combination with a customized ultra-low-calorie (500 cal/day, high-protein, low-carbohydrate/fat) diet can result in a loss of adipose tissue (fat) without loss of lean tissue. I’m not a particular fan of this use because it leads to shortages of hCG at the pharmacy and increased prices for the drug itself.

Anabolic Steroid Adjunct: In males, hCG helps restore and maintain testosterone production in the testes by mimicking LH and triggering the production and release of testosterone. hCG is commonly used during and after steroid cycles to maintain and restore testicular size as well as normal testosterone production. Professional athletes who have been caught using hCG have been temporarily banned from their sport. Also, not a fan of this use!

Tumor Marker: A subunit of hCG is secreted also by some cancers including seminoma, choriocarcinoma, germ cell tumors, hydatidiform mole formation, teratoma with elements of choriocarcinoma (this is rare), and islet cell tumor. For this reason a positive result in males can be a test for testicular cancer.

During Pregnancy: hCG natually interacts with the LHCG receptor and promotes the maintenance of the corpus luteum during the beginning of pregnancy, causing it to secrete the hormone progesterone. Progesterone enriches the uterus with a thick lining of blood vessels and capillaries so that it can sustain the growing fetus. Due to its highly-negative charge, hCG may repel the immune cells of the mother, protecting the fetus during the first trimester. It has also been hypothesized that hCG may be a placental link for the development of local maternal immunotolerance. It has also been suggested that hCG levels are linked to the severity of morning sickness in pregnant women.

All-in-all, hCG seems to be a pretty amazing drug. I will be enjoying my drug-free day as much as I can. Walking the dog, cleaning the house (not much though), doing laundry, went to Olive Garden for lunch, and even possibily going to a concert tonight (Smashmouth!). I gotta be in bed early, though, so we can be on time to our retrieval appointment tomorrow!

IVF Ultrasound #5 - Ready to Retreive!

I was waiting for the nurse to call me back for my 5th ultrasound and bloodwork for IVF today, and a friend of ours came into the clinic. I hadn't talked to her in probably 9 months, and knew that they were seeing the same RE as us. I had heard through the grapevine that she had miscarried earlier this spring. I chatted with her for awhile and found that they had done their first IVF earlier this year, got their BFP, and then miscarried in April at 9 weeks. Luckily, they had 6 frozen embryos to use later. She was in the office today to do their FET. So we will only be a week apart! We compared notes regarding our doctor and our clinic. It was nice to talk to someone going to the same clinic for virtually the same thing. If only I had known, we could have carpooled today!

After spending over an hour in the waiting room (highly unusual for my clinic), I finally was called back for the ultrasound. I was hoping for huge eggs all over the place - ready for the plucking. And there were some, just not as many as I had hoped. When all was said and done, we have 11 follicles measuring more than 14mm. Only 2 of those were at the ideal goal of 18mm. The rest seemed to be between 9 and 13mm. I was hoping that there would be a whole bunch at 18mm, but I guess you get what you get. They asked me if I felt bloated, and I said I didn't think so….who knows?! Maybe a little - but I could still be constipated, too?! As for my lining, it is still "gorgeous" and "awesome" measuring at 15.5mm. At least my uterus knows what to do and is ready to take on some eggs!

I asked if I would need more drugs to make the follicles a little bigger or if we were ready for retrieval. After discussing it briefly with the doctor, we're going ahead with retrieval on Sunday, 07/25! My bloodwork came back and that rose from 754 to 1,672! This is also good and we've got "great momentum". This means that the only concern they have right now is overstimulation - as my follicles will continue to grow through Sunday. Sheryl mentioned that the doctor would monitor me on Sunday, and assess my risk for hyper stimulation. If needed, they will give me a different drug to keep that risk at bay. But for today, I didn't have to make a stop at the pharmacy!!

My schedule is to take 5,000 IU of HCG tonight at 11pm sharp. This is half the vial. Saturday night, the anesthesiologist will contact me to go over the procedure. I am not to eat or drink anything after midnight. We are to be at the clinic at 8:30 am on Sunday morning. This means I have to get up by 6am on a Sunday morning to make the drive. Yuck! Then on Monday, I will start the progesterone, which is used to help prepare for and then maintain pregnancy. I have a choice on how to take this. I can either do it by oil, intramuscular injection (lower back/hip) once per day at the cost of about $4 per day. Or, I can take a newer drug called Endometrin. This is taken vaginally, 3 times per day, at a cost of up to $18.00 per day. Mind you, I would have to take this for up to 6 weeks. $168 vs. $756. We're going to go with the injections…at least to start...DH would have to give me the shots though - I'm a bit nervous for that. On Sunday, they will let me know how many are retrieved. Sheryl will tell me on Monday how many are fertilized. Then on Friday, 07/30, I'll find out how many made it to the blastocyst stage, and we'll do the transfer.

Anyway, it's all very exciting, and it should be an interesting weekend!

Drug of the Day - Ganirelix

I will take 3 doses of Ganirelix during this IVF cycle. I took one yesterday at the clinic, I took one this morning (at work!), and I'll take another one tomorrow morning. So now I'm up to 2 injections per day! Ganirelix comes in a ready-to-use pre-filled syringe, which makes it easier to administer because mixing isn't required. However, I gave myself a big ol' bruise yesterday. Ouch! I must have hit something...I think it is because the needle is bigger than what I was used to. Also, one good thing is that I already had 2 doses left over from my cycle in August 2009. They were almost expired! But I got to use them and only had to pay for one more new one ($87). One pre-filled syringe contains 250 micrograms of ganirelix acetate. Now a little bit about the drug of the day:

Ganirelix Acetate is a gonadotropin-releasing hormone (GnRH) antagonist that is used to suppress premature luteinizing hormone (LH) surges. This prevents eggs from being released prematurely. Women who are using an injectable gonadotropin, (like Menopur), may also be prescribed Ganirelix because drugs like Menopur, stimulate the growth of multiple follicles, which can cause an early rise in LH. Ganirelix is effective in preventing LH surges and rapidly acts to prevent the LH surge after its initial injection.

Ganirelix is given on average up to five days mid-cycle (so far, I've only needed 3). This translates to several benefits:

•Shorter treatment days. (not really in my case)

•Lesser total medication is used. (not really in my case)

•Fewer injections are needed. (not really in my case)

Like the Menopur, OHSS is a possible side affect of using Ganirelix. This possibility is pretty slim, though. One more dose for me at tomorrow's ultrasound!

IVF Ultrasound #4 - Gaining Momentum

I had my 4th IVF ultrasound today. We're making progress and gaining momentum, but not as much or as fast as I had hoped. My largest follicles went from about 11mm to 14mm in 48 hours. They're growing, but not fast. During the ultrasound, Sheryl had a hard time finding or seeing all of the follicles. She thought there may have been some bowel obstructions to her view. I told her I wasn't surprised at that because I've felt constipated the last couple of days (I know this is TMI!). This usually happens to me mid-cycle, close to ovulation. No fun. But anyway, Sheryl was digging around pretty good to move things around to try to see things better. It was not comfortable, and she apologized for it. I was glad when it was over.

So, again, the doctor (a different one this time - the same doc that removed the polyp) took a look at my scans. Basically, it is a repeat of my last visit on Monday. I get two more days of Menopur at the 4 vile dosage each night and will go back on Friday morning for yet another ultrasound. I dropped some more money at the pharmacy - they should know me by name by now! The doctor also said I needed to take a shot of Ganirelix before leaving the clinic. They didn't want to wait for me to take it when I got home. This drug will prevent me from ovulating. I'll take another one of those at the same time tomorrow. We're trapping my follicles inside my ovary until they get big enough to retrieve. At this point, this might even be on Sunday.

The good news is that my uterine lining is, and I quote, "gorgeous"! Apparently, it is nice, thick, and juicy! My lining was 12mm, and the clinic aims for at least 8mm. I, at least, passed that milestone! My bloodwork showed an estrogen level of 754. It more than doubled from last time, so that is a good increase. I would guess I would be above the 1,000 mark by Friday. Sheryl also said that my progesterone and LH levels were down - which is what they want at this point. The lower levels indicate that I'm not yet ready to ovulate.

So, all in all, we're moving in the right direction. This IVF process is so frustrating though. I can't wait for the injections to stop and the driving and the ultrasounds to stop. This is a wait-and-see game and much longer and scarier than my IUIs were. I have no motivation to do anything else but think about my next dose of meds or my next ultrasound. This process consumes your life and every waking moment. I'm constantly thinking about how my body feels and how I'm responding. Is that a side affect? Do I feel bloated? Am I feeling the way I'm supposed to feel? Are they growing? Is that headache related to the meds, or do I just have a headache? Am I going to poop today so my scans are easier to read?! (I did make a #2 this afternoon! whew.) Ugh.

DH agrees that this is a frustrating process, and he can't wait for the IVF cycle to be done either. I can't imagine how frustrating it is for him, as he doesn't get to do anything at this point in the process. I feel bad. At least I feel like I'm accomplishing something with every injection, every drive to the clinic, and every ultrasound. He just waits for my call with the news of the latest ultrasound. However, he might go with me for Friday's appointment. He wants an excuse to be off of work, and it would be nice to not have to drive myself.

IVF Ultrasound #3 - Stalled!

My follicles have "stalled". What does this mean? I had my 3rd ultrasound and bloodwork today, and my follicles have grown, but not much. Often, IVF cycles aim to get the follicles to between 14 and 20mm for retrieval. My clinic wants them to be 18mm. The largest that I had today was only 11.5mm. Since I had a later morning appointment, the doctor (whom I rarely see in person) was there to review my scans right away. She decided that I probably would need another couple of days of Menopur - double the dosage. This means that I will be taking 4 viles a day! This is quadruple the amount that I took for my IUIs. This also means I just doubled my cost of meds for this cycle. I'm dropping about $270 with each injection I take. Ouch.


At the appointment, they mentioned that my estrogen levels were low at the last appointment, but that's to be expected after taking Femara. The clinic called this afternoon and let me know that my levels had rose from 53 pg/ml on Friday (less than 60 is typical at baseline) to 351 pg/ml today. Sheryl said this was a good increase, but we're sticking with the protocol for the next 2 days. Peak levels of estrogen at trigger should be between 1,000 and 4,000 pg/ml. I got a ways to go...but as I've always said with this process - one day can make a BIG difference - especially with the "numbers". My next appointment is Wednesday morning. Another 4 hour round trip...yeah!

Drug of the Day - Menopur

Tonight I take my last dose of Menopur before tomorrow's 3rd ultrasound appointment. Menopur (a.k.a. menotropins) is a preparation of gonadotropins (extracted from the urine of postmenopausal women!) which has undergone additional steps for purification. Each vial contains equal parts of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). My body already makes these hormones naturally, but we are bringing in reinforcements with this drug. The additional FSH and LH will help the ovaries to make eggs.

I am taking Menopur through subcutaneous injection. For IVF, I mix up two viles of Menopur to one mL of saline (this is twice the dosage that I took with my IUIs). Then, I inject it into my belly. I've been going back and forth between each side of my belly button. I don't think it makes a difference, but in my mind, I want to be fair to both my left and right ovaries! I've also been trying to take it at the same time each day. Again, I don't know if that makes a difference either.

I haven't had any problems giving myself injections. A little over a year ago, we did our first IUI with injectibles. Then, I was scared about doing the injections. Needles -ick! My mom (who is a nurse) came to my house and helped me do the very first one. After that, I've been doing them myself. In an attempt to involve DH a little more with this process, he did one injection. Let's just say there was bleeding and bruising, so he was fired from that job! Now, 3 IUI cycles later, I feel I'm an old pro at this injecting thing. No biggie.

There are side affects of using Menopur, but I haven't had any (that I know of). The scariest side affect is OHSS (Ovarian Hyper Stimulation Syndrom). Like it sounds, the ovaries go into overload and this can be very dangerous, and even deadly. I'm not too worried about it, since I'm being monitored so closely, but it's definitely something to be aware of - especially if I start feeling sick.

I'll find out at my next appointment if my 23 follicles are still all accounted for. I'll find out which ones grew like gang-busters thanks to the Menopur and look like they are going to make the cut! I should also find out, if I need to continue with more Menopur, or if we are ready for retrieval.

IVF Ultrasound #2 - Follicles!

I had my 2nd ultrasound for our IVF cyle today, 07/16. It was an early morning, an 8 am appt, and I could barely keep awake on the 2 hour drive to the clinic. I think I'll change my next appt to later in the morning. I made sure to drink lots of water so my blood would be easier to take. So, of course, I had to GO as soon as I walked in the door - even before I checked in with the receptionist. I do my business and check in. The receptionist then tells me that they have to take urine today, so I better drink up. Really? - I just went! So I proceed to guzzle about 3 glasses of water before they call me back.

The tech takes my blood, but it doesn't want to come out. She only got one vial and decided that since I have my appt on Monday, the remaining blood tests could be run at that time. So all the water didn't really help - but at least she found a vein!

They take me back to the ultrasound room, and I realize that now I have to pee. I hold it, but wonder if the U/S will be any good if my bladder is full. Usually, they want it to be empty. The nurse comes in and reviews my chart. Sheryl is awesome. She's done my ultrasounds in every IUI with this RE, and is super nice. She mentions that my protocol doesn't involve too many drugs - this is good, I think, but also strange to her. I told her that the doctor wanted this IVF cycle to look like my first IUI (actually IUI #6) with the RE. I tell her I've taken 5 days of Femara and only one injectible of Menopur so far (starting last night). She reviews my chart and seems to agree with the doctors protocol this time around....Sheryl uses her magic wand to check out my ovaries. She mentions that I must "have to GO". My bladder is big and obvious on the screen! She said it doesn't bother her or the pictures, but it may be uncomfortable for me. I was a champ and held it some more. The nurse proceeds to take pictures. They kept coming, one after another. Measuring, and measuring. Every time she moves the wand, more little black dots show up on the screen, she takes a picture, and measures them. Lookin' good!

Sheryl finishes up and leaves the room. I get dressed and go find my pee cup. I do my job, hand over my [very clear] pee, and then go to the nurse's station to find out what are collectively cookin' in my ovaries. The Femara seems to have done its job! Sheryl took pictures of and measured 11 follicles in the left ovary and the right ovary has 12 follicles! 23 is a pretty good number, I think.

I'm pretty happy with the result of this appointment. We are on the right track. The doctor's instructions for me is to continue with 2IU of Menopur over the weekend and "we'll see you on Monday". Fingers crossed!

Drug of the Day - Femara

I didn't realize that there were so many different drug protocols for infertility procedures. Up until this point, I have just taken my medicine like a good little girl, and hoped for the best. I haven't questioned what I was taking or really understood what these drugs might be doing to my body and to my hormones. So, in honor of my first (and hopefully only) IVF cycle, I thought I'd educate everyone and myself about the variety of drugs that I am taking for my particular IVF cycle.

Of course, I've already done birth control pills and anti-biotics. I won't go into those things as I'm pretty familiar with both. I was on birth control for 10 years - but who knew I didn't really need them?! DH and I both took anti-biotics back in May as part of the IVF regimen. However, we didn't have to do that over again when we got delayed to July.

Today, I took my 5th and final pill of Femara. This tiny, yellow, 2.5 mg pill is also known as letrozole. It has been widely used in women with breast cancer. Since breast cancer grows under the influence of estrogen, letrozole helps block tumor growth. One good thing about this is that since one of the main uses is NOT infertility, my insurance covers it for a co-pay. However, many pharmaceutical companies are trying to get FDA approval to market it specifically as a fertility medication. Until then, my five little pills of Femara cost a $25.00 co-pay instead of $40.00. Gotta save where you can, right?!

Now a little bit about the ol' letrozole: It belongs to a class of medications known as 'aromatase inhibitors'. Aromatose is an enzyme that is responsible for the production of estrogen in the body. Letrozole works by inhibiting aromatose thereby suppressing estrogen production. (Clomid works by blocking estrogen receptors). The result is that the pituitary gland produces more of the hormones needed to stimulate the ovaries. These hormones, FSH and LH, can cause the development of ovulation in women who are anovulatory or increase the number of eggs developing in the ovaries of women who already ovulate (me!). Some studies have suggested that Femara pregnancy rates far exceed those with Clomid!

Like any drug, there can be many side affects of taking medication. Luckily, I have not experienced any issues while taking Femara. The side affects can be similar to Clomid with hot flashes, headaches, or breast tenderness. There also can be allergic reactions, chest pain, or vaginal bleeding. The biggie with Femara is to not take this medication if you are pregnant. Before pregnancy = ok. While pregnant = bad. It can cause fetal death and birth defects.

Basically, Femara is tricking my brain into making less estrogen which tells my hormones to put my ovaries into egg-making overdrive. I have my next ultrasound and bloodwork tomorrow, 07/16. I should hopefully find out how many follicles I have cooking, and to see if the Femara pills have done their job.

IVF Ultrasound #1 - All Systems Go

Today, I drove the 4 hour round trip to the clinic to have my baseline ultrasound (again) for our first IVF cycle. I went by myself, so had a fun time singing out loud to the radio. At the appointment, the doctor did the ultrasound. There were no polyps to be found, my ovaries were "in hiding" but had some tiny follicles, there were no cysts (luckily, I've never had one), and my uterine lining was thin and "good". So no more birth control pills for me! I went to the pharmacy and purchased my drugs for the rest of the cycle (Whew. $$). I'll start Femara for 5 days on Sunday, the 11th and then I'll start the Menopur injections next Thursday, the 15th. My next ultrasound and bloodwork appointment is the 16th.

All systems are a go!

Happy 4th!

Today is the 4th of July. It is not only Independance day, but also my husband's 33rd birthday. He is a firecracker baby and isn't shy about telling everyone that it is HIS day! Yesterday, we went to his cousin's farm to sit by the pool, hang out, and have a pig roast. It was fun, but it was humid and mosquito ridden! Both DH and I got bug bites on our cheeks which have swollen our face right below our eyes. It looks like we got punched! There was one little girl there that must have gotten attacked by a swarm of mosquitos. She looked like she had a very bad case of the chicken pox. Crazy!

DH's cousin had her 5th child seven months ago. With her kids, my 5 nieces and nephews, and various other children, there were 21 kids under the age of 10 at this get together. Needless to say, it was kid overload. It made both DH and I want one of our own even more. So, we took advantage of it and held the babies (got puked on) and played with the kids helping them do smoke bombs (by the way, kids will do ANYthing you say if you're about ready to light a smokebomb!)

And, just like DH is not shy about telling everyone that it is his birthday, he also is not shy about telling his family about our infertility struggles. So, I got approached more than once last night about our upcoming IVF cycle. The way they ask about it makes me not know what the heck they are talking about. A suggestive, "How is IT goin'?". How am I supposed to know that I'm supposed to respond more than just, 'fine' or 'good'? It's like they expect me to say, "It worked! I'm pregnant right now!". And, of course, I'm not.

So, because most do not know what IVF stands for, let alone how it works exactly (because why would anyone have to?), I have to simplify our process for them: "I will take drugs and have ultrasounds on July 8th, 16th, and 19th. Then they take out my eggs and inject his sperm. We go home for up to a week while the eggs fertilize, and then we go back to get them implanted. We wait a couple of more weeks to find out if it worked (meaning, pregnant). We won't know if it worked until the first or second week of August." This is my why of saying - don't ask me until at least the end of August. Ah, well. Everyone is well-meaning and they all hope for the best for us.

Happy July! I hope, I hope, I hope.

Tragedy

Tragedy - it's the only word to describe it. One of my best friends in the world (in real life) has gone through a tragic nightmare. After struggling with infertility and going through the rollercoaster ride known as IVF, she had the feeling of pure bliss at a positive pregnancy test, the joy of hearing and seeing a tiny heartbeat and feeling the growing new life inside of her. Facebook friends celebrated her joy and saw the ultrasound pictures of her precious baby girl. The baby shower invitations went out and we talked of baby shower games, food, and fun. Nothing could put a damper on her happiness. However, my dear friend and her husband (also a dear friend) have experienced their (and my) worst fear. At almost 23 weeks pregnant, she went into early labor and lost her little one. Weighing in at a little over one pound, this tiny medical miracle left the world as quickly as she entered it.

Utter sadness does not describe what I feel for my friend. I wish that there was more I could do for her during this difficult time. Her experiences with infertility and pregnancy up to this point have mirrored the hopes I have for myself. There is no way I could possibly understand what she is going through now after this tremendous loss, but I feel like her pain is also my pain. My fears personified. Rebecca is a beautiful blogger and has eloquently told the birth story of Lillian Grace: http://roadlesstraveledblog.blogspot.com/. I'm keeping her and her family in my thoughts and prayers.

No Patience

My heart has beat up my brain and won the fight, yet again. Like most of us with infertility, I have lost the virtue of patience. I'm done with it. We're always waiting. Waiting for the next cycle, the 2ww, the next appointment. Ugh. We have decided that we are going to proceed with IVF, as planned, in July. I simply can not wait all the way until January 2011! To DH, it was a no brainer. Why would I even consider waiting? He didn't really get it.

Even though spending the extra 5K to do IVF 6 months earlier does hurt the ol' pocketbook, there were a couple of financial perspectives that came from talking to family and friends. My mom said that if the top range of the cost of a house you could afford to buy was $195,000 and then you found your absolute, perfect dream home selling for $200,000 - you probably would still buy the dream house for the extra $5K. The extra $5K isn't that much in the long run. My friend with 2 children in daycare commented that $5,000 wouldn't even cover 6 months of daycare for her. So, I'll just pretend that I have a $200,000 house and that I already have a kid that requires daycare. That might satisfy my brain for awhile. My heart, on the other hand, is getting excited to get this IVF stuff started already!

What would you do?

I found out today that my fertility benefits at work are changing January 1st, 2011. The good news is that the benefit is increasing. Currently, the infertility benefit is 50% coverage up to $3,000 lifetime. Next year, it will be $5,000 coverage each calendar year, subject to deductible and coinsurance. This is significantly better, in part, thanks to healthcare reform (got rid of the lifetime max).

Oridinarily, this would be great news for me. It would have been nice to have this coverage 3 years ago...However, after 3 years of infertility and all my fun IUIs, I'm about out of my $3,000 of infertility coverage for 2010. We have scheduled (for the second time this year) our first IVF in July 2010, and because we will be hitting the lifetime max, we will have to pay for the entire thing out of pocket. This is about $10,000 for us - give or take - including drugs. We are financing this endeavor through a home equity line of credit, and have been prepared for these costs for the past 4 months.

We have been waiting for what seems like FOREVER to get on an IVF schedule that would work for us (since March), not to mention waiting FOREVER to even get pregnant. My heart is very impatient - telling me we need to just DO this IVF thing ASAP. I'm not getting any younger, ya know! I'm [now] 30 and DH is almost 33. However, my brain tells me to be patient for the financial aspect. If we could wait just another 6 months and do IVF in January 2011, it would cost us less than $5,000 out of pocket and I could flex $2,500 of that. The rest would be covered by insurance. DH is definitely not a patient person and doesn't care much about money or having to spend the rest of this future child's college fund on his/her conception. That tells you he sides with my heart.

Are the 2011 cost savings too significant to ignore - should we wait? Or do we go ahead with our July IVF - pay the extra $5,000 - because we are already prepared for it in mind and in spirit - knowing that if IVF does not work the first time (God forbid) that we will still have the 2011 coverage for a 2nd go at IVF next year? What would you do?!

Birthday!

Yesterday was my 30th birthday. Ahhh! Wow! Where does the time go?

I had a great day yesterday (for a Wednesday, work day). My co-workers are fabulous and brought so many treats and goodies to work. I had many visitors to wish me a happy birthday, telling me how young I am (most of my co-workers are 40 or older), and I became very full of chocolate cake, chocolate cupcakes w/ chocolate covered strawberries, chocolate cookies (do you see a pattern here?!).

I told my husband that all I wanted for my birthday this year (besides a baby-but that's obvious) was a fabulous birthday cake that was professionally made. I wanted to put ALL 30 candles on it and blow ALL 30 candles out - burn the house down, so to speak. I came home from work (still full) and there was my husband and my pretty cake. Marble cake with thick, white frosting. 30 frosting candles around the outside and 30 real candles on top. Sugar overload for sure. We did our celebration with the cake, but I was too full to have a piece until today!

For the past few weeks, I've been counting down the last days of my twenties. I'm sad to see them go, but looking forward to what my 30s may bring. In my 20s, I had school, school, and more school. No more of that! In my 20s, I was primarily worried about being able to drink, getting carded, getting married, and then getting a job. Don't have to worry about that so much now. By my late 20s, having babies became my concern with 9 IUIs. No more IUIs now! My worry about making babies hasn't gone away, but I do have hope that I won't have to worry about that for much longer with my upcoming [successful] IVF. I might be putting all my proverbial eggs into one basket, but what else am I gonna do?

So, as one of my bestest friends wrote in her sweet birthday card to me, I "can't wait to see what the future brings".

Surgery and Starting Over

My surgery on May 21st went well. It was quick and painless. And may I just say that anasthesia is so cool! One minute you're awake, wondering when you'll fall asleep and the next its all over with. It seems like just 30 seconds in my mind, but it was really more like an hour. My little 1cm polyp is gone - and we even got pictures to prove it.

So now we're starting over, it seems. The doctor told us to call the office in one week to let them know how I was doing (so I wouldn't have to make the 2 hour drive for a post-op appointment), to check on the pathology report, to figure out when to start birth control again, and to find out if we would start our IVF cycle (again) in June or in July.

I called the office on Friday to let them know that I felt fantastic. It was like I didn't even have surgery - no pain, no bleeding. The worst part was the big ol' bruise where they stuck me with the IV the first time. The nurse was digging for buried treasure in my right hand. Then she gave up and nurse #2 started digging in my left wrist. Then nurse #3 slipped the IV in my left hand, no problem. Why couldn't they give me nurse #3 the first time!?

The office told me that the polyp was cancer free and we're good to go with IVF. They couldn't squeeze us in for June IVF, so now we have to wait for July. A long wait. Anyway, I started BCP again today. I'm on a different brand than I was before, so hopefully I won't have that breakthrough, midcycle bleeding stuff. Annoying. The office will call me next week to give me the specific IVF schedule.

It is Memorial Day weekend, the unofficial start of summer, and I love this time of year. So even though I have to wait for late July to do IVF, I don't want it to get here too fast, because I want to enjoy the next 6 weeks - slowly.

Complications and Delays

I just got home from our base ultrasound appointment. I was expecting a routine check up. Bloodwork, vaginal ultrasound, a couple of follicles, and a beautiful uterine lining. So uneventful and routine, in fact, that the visit to the clinic and the pharmacy were going to be just a small part of my day off of work. As I lay in those fabulous stirrups and the nurse is looking at my uterine lining, she notices a small little "bump" or something that would not normally be there. At this point in my cycle, my uterus should just look like a long, thin line - like a deflated balloon - on the ultrasound monitor. There was something stuck in my deflated balloon! The nurse went to consult the doctor.

The nurse came back in the room and said that the doctor wanted to see me and that we should do a Sonohystogram right away to get a better look at my uterus. I've been here before. A little more than 1 year ago, back in early 2009 when I was new to the clinic and to my new RE, I had my first sonohystogram. I am proud to say, I had a beautiful uterus at that time! So, on the fly, I get to do another one of these things today. Basically, for those novice infertility people out there, a sonohystogram involves putting a catheter into the uterus to inject saline (basically water) into my "balloon". It fills up the uterus to find out if the lining is smooth. It gives a more 3D look to the ultrasound picture. It is not the most comfortable process in the world. A little cramping, but no residual effects for me. I get to take antibiotics for another 5 days though!

As the doctor (not my RE) is doing the procedure, the screen is filled with a picture of my now inflated uterus. It should be a big, black blob. And it is, except for this little round thing on the edge. The doctor thinks she can maybe "wash" this blob away (think shooting extra saline in there - ouch), but no can do. It seems to be a polyp - about a 1cm polyp in a 3cm cavity. Argh! I just did an IUI in February. Did it just start growing since then? Or is the polyp that I had removed in July 2008 growing back? How did we not notice this until today - I've been in stirrups every other month for 2 years!! Double argh! Unfortunately, the doctor didn't have any answers to these questions.

The doctor recommended that the polyp be removed before we start the IVF cycle. Polyps are normal. Some women are more prone to get them than others, and many women conceive naturally with them all the time. It might not make any difference to remove it, but when you're spending bookoo dollars on IVF treatment, you don't want anything in the way that may hinder implantation or the process in any way. A polyp the size of the tip of my pinkie finger should be able to be removed in a simple office procedure. Unfortunately, this is not the case. The removal requires a small, same day surgery where they completely knock you out. The surgery itself takes about 30 minutes, but the anesthesia makes things more complicated. I would know, I did this same exact thing almost 2 years ago with a darn little polyp the size of the tip of my thumb. De ja vu.

So to get the surgery done as soon as possible, we scheduled it for the day after tomorrow, May 21st. Luckily, the doctor had an opening so soon. Then, allowing for healing time, and then to get back into the regimen/schedule for IVF, we're looking at late July now. Two whole months from now. Summer will be half over. Crazy frustrating.

Although the delay is a major bummer, and I'm none too happy about it, there are some upsides to the delay. (I don't want to be a total downer on this post!) I will be able to have fun this spring/early summer without worrying about IVF and early pregnancy.
1.) A good friend is getting married in early June in between the time I would have had retrieval/transfer.
2.) My 30th birthday (Ahhh!) is coming up, and a much needed girl trip is happening in June.
3.) My husband's birthday is the 4th of July, and of course, we celebrate a lot at that time for many reasons.

On another happy side note, I did buy a new dining set today that will be delivered in 2 weeks. Gotta be excited about that! And the dive, diner, drive thru place we went to today was a sports bar themed, burger and beer place. It was oh so greasy-good!

Antibiotics Begin

There isn't much new on the homefront lately. I'm still taking the birth control pills (through May 18th), but had the thrill of starting antibiotics today (don't worry, ladies, I stocked my fridge with yogurt!). Both DH and I get to take 100mg antibiotics twice daily for 10 days. Even though it is a precautionary thing and really has nothing to do with procreation itself, I think we both feel that we're one step closer to starting this process and one step closer to being parents with every 100 mg. And I think DH feels that he is contributing something other than just sperm by taking these little blue pills (not viagra)!

On May 19th, we have our [my] baseline ultrasound and RE appointment to officially kick off the IVF process. We are both making the 2 hour drive to sign all of our consent paperwork. Apparently we get to sign away all of our rights and give the clinic a license to do what they will with our reproductive products. We'll probably also get the opportunity to give a right arm (or two) to pick up all of our necessary drugs for this process.

As an added bonus, we are taking the whole day off of work that day and doing some shopping for a badly needed kitchen table. (I refuse to roll a highchair up to the old brown table that I had when I was a kid that is currently coupled with three mismatched, plastic patio chairs). Then, we have decided that every time we make the trip out of town to visit the clinic together, we will visit a "dive, diner, or drive thru" for lunch. Last time, we went to a great, little taco place that was featured on the show of the same name on the Food Network. The show is hosted by that guy named "Guy" with the blond, spiky hair. [He is also currently the host of Minute to Win It. You know who I'm talking about.] It's fun to try new places to eat, plus I simply love to eat. And it keeps both of our minds occupied on things other than this IVF process.

Breakthrough What!?

Warning: this blog entry may be TMI for some - but, really, aren't most IF topics TMI? What with all of our talk of ovaries, uterus, sperm, vaginal probes, etc...that this post is actually pretty tame in comparison, but I thought I'd put the warning out there anyway...

One thing that I didn't expect (or remember) when I went on birth control again for the first time in 14 years was this little thing called "breakthrough bleeding". Yuck. Basically, I've had my period twice in a little more than 2 weeks. What is with that?! Have I not been punished enough!?

I got my 'real' period on a Saturday, and the doctor told me to start BCP on Monday. No problem. 12 pills later the spotting started. No big deal. Then, within a couple of days, it became like a full-on, bright red period (but luckily without the cramps that I'm used to). So, I worried. DH told me to call the doctor. But I hate calling my RE's office and being forced to leave a message for a call back because they never actually let me talk to a nurse the first time. When they do call back (usually within a couple of hours), I'm always at work. The last thing I want to do is talk to a nurse about my mid-cycle, birth-control induced bleeding with my work people listening in. Just not comfortable with that - probably ever.

Instead of calling the doctor, I did what every red-blooded, American female does when they have a perfectly weird question that they don't want to vocalize: I Googled. And I found out that apparently, this mid-cycle bleeding can occur during your first month (or three) on the pill, especially if you start taking the pill mid-cycle. Good to know. It also can occur when you would have typically ovulated....hmmm, yup, that's me. And, it can be more than just a little spotting. Duly noted. So, I'll ride this crimson tide (pun definitely intended!) for the next couple of days. If it doesn't clear up, then I'll suck it up and call the doctor. But since when has Google ever let me down before?!

Evolution of Mommyhood

I remember when I was a little girl being asked by my mom what I wanted to be when I grew up. She was filling in the memory book that chronicled my school days. Each section was a different year of elementary and junior high school (mom gave up on it after awhile though - let's just say the earlier years are much better filled out than the later years!). The book had that year's school picture of me and a series of the same questions to be answered for each year. As a kid, I didn't really know the answer to what I wanted to be when I grew up (heck, I still don't know what I want to be when I grow up!). In some entries, I chose teacher. However, at 6 years old, I think I chose that because I didn't know what I didn't know about my options of career choices. But, a lot of the entries included being a mother. I'm not sure if I was just not that creative, or if I thought being a mom was a given. In any event, having kids has always been something I thought I would do at some point without issue.

Without knowing it though, I've been practicing being a mom my whole life. In junior high, I babysat the kids in my neighborhood all the time (which living in the country was a 15 mile radius of my house - I definitely got around!). I enjoyed the good kids, and I dreaded the bad kids. I've changed diapers, burped babies, I've chased after 2-year olds and watched a heck a lot of Barney, Disney, and Saturday morning cartoons. But, I'm not sure if I babysat because I love kids or because I just needed the babysitting money. I do think it made me realize that I truly only wanted to be a mom when I was completely ready to take on that challenge 24/7.

So, in high school, being a mom was the last thing I wanted to be at that time. I, being an abnormally responsible teenager, went on birth control on my own before even having sex(thanks Planned Parenthood!). There was no way that I was going to get "accidentally" pregnant. I didn't go off of the pill until 10 years later!

So, ever since, the evolution of becoming a mom has been in the works:

• College - check!


• Husband - check!


• House with a yard - check!


• Good job with a steady paycheck that I don't mind going to every day - check!


• Grad school - check!


• Houseplants that are not killed instantly - check!


• One fabulously cute (at least to me), live-in, four-legged child named Morgan that has been my so-called baby for 4 years (ok, so she's a dog - but still very much my child) - check!


• One year of baby-making with timed sex, standing on my head (literally), ovulation kits, and basal temperature taking month after month - check!


• One year of testing and 6 IUIs with my OB (three too many, actually) - check!


• One year of testing and 3 IUIs with my RE in a city that is a 2-hour drive away - check!


• Finally, IVF - almost check!

I think I'm ready...This IVF thing better work...

Keeping It All Inside

Tonight I just flipped through and scanned "Conquering Infertility" by Dr. Alice Domar. My good friend who recently became pregant through IVF borrowed it to me. It gives a lot of advice on the Mind/Body connection to fertility and coping with infertility. It's about the ups and the downs, the depression you might not realize you have, dealing with the negative pregnancy tests month after month, and dealing with the relationships around you while going through infertility.

Up to this point, I'd like to think that I have dealt pretty well with this infertility thing - all things considered. I have done 9 IUIs, and I have never been pregnant. I guess I would prefer this to have had positive pregnancy tests that end in a chemical pregnancy or miscarriages each time. I probably wouldn't have dealt with that nearly as well. However, each time I saw the blank test sticks and the BFNs, I couldn't help but feel a little bit crushed. For the most part, I am a master at hiding it though. Each IUI was different though.

During our 8th IUI cycle in September 2009, I had a pre-planned trip to Europe that happened to fall during the 2 week wait. My mother and I were visiting my cousin , JK, in England and then we all took a weekend holiday to Italy. The date that I was scheduled to take the pregnancy test, my mother and I shared a room in a little bed & breakfast in Italy. I was on vacation in a beautiful and historic country, and I still had to constantly think about my infertility and this upcoming pregnancy test - nestled in my carry-on bag next to my makeup and tampons (that I hoped I wouldn't need). That ill-fated morning, I woke up early to use my first morning urine to take the test. Of course, it was negative (my mind wondering if the test could be wrong - maybe, just maybe?...). My mom knew before the trip that I would have to take the pregnancy test during our trip, but maybe didn't know exactly when I was taking it. She's good at not asking questions (sometimes), or pretending not to notice. I tossed the negative test into the garbage (after hiding it in some toilet paper), took a shower, and went about my day and my vacation like nothing had happened. That day we hiked through the Cinque Terre villages right along the Mediterranean Sea. Simply breathtaking - and a fabulous distraction.

That night, I silently cried myself to sleep so my mom would not hear. I still don't know if she heard me.

2 days later, back in England, on our last night of our vacation, my mom and I had a quiet dinner with JK before our journey back to the States. JK, who is a year younger than I, is single and dating, working in the Air Force (thus her fabulous England living situation), has travelled the world, and her fertility is only a thought for the [probably] distant future. Like most family members that do not know our specific situation, she asked what everyone asks in casual dinner conversation - "when are you guys having kids?" - or something similar. That was it. I broke down in tears right at the dinner table. It brings me to tears just thinking about how sad I was in that moment.

As I was crying, I told my story to JK and to my mom (who knows our situation but probably not the emotional toll I had been keeping inside). I told them of the negative pregnancy test in Italy. I remember JK saying that she had no idea that I was going through that in Italy and that I was just like the rest of our family in that I could put on a good face and not let on what was going on emotionally. That made me feel strong, proud, sad, and stupid all at the same time. We all talked and cried and talked some more. We talked much too late in the night to be able to wake up at 4am to catch the bus to London Heathrow. But we did - and I felt much better after I had let it all out.

It was 5 more months before we did another IUI after that. A much needed break. That 8th IUI cycle was some sort of turning point in my mentality though. I realized that it is okay to be upset when things don't work out as planned. It left me more determined to bring on my 9th and final IUI before moving on to IVF. Infertility IS a big deal, but IVF may not be as scary (or impossible) of an option as I had initially thought.

IVF Prep 101

Many sources say that in order to prep for IVF treatment, the nutritional, the physical, the mental, and for me, the financial aspects need to be addressed.

Nutrition: I am now on Day 2 of taking birth control pills in preparation for our first IVF treatment starting in the end of May. I thought I would never have to take another one of these little, tiny hormonal pills. But here I am. I'm also taking a 81mg baby aspirin. This is apparently to increase the bloodflow to my uterus. I am back on the regimen of taking daily pre-natal vitamins. I've had a "prescription" for these for over 3 years, but haven't always been very consistent in taking them. I'm also cutting back on caffeine. My doctor didn't specifically said I have to do this, but what can it hurt? Also, I've said good-bye to alcohol and cigarettes/smoke. I'm no fun anymore!

Physical: Being underweight or overweight can hamper the success of IVF treatment. I am happy to report that after losing 25 pounds in the last 6 months, that I am now in the "good" zone for weight. I am working out about twice a week. I'll have to ask the doctor about what I can and can't do for exercise once we start the drugs, the retreival, and the transfer.

Mental: This has to do with the all of the emotional ups and downs that infertility brings. We have been 'dealing' with this for 3 years. Most have been emotional downs - another semen analysis, another ultrasound, another round of drugs, another IUI just to get another negative pregnancy test - and utter disappointment. These are the things that I have faced for a long time. Now, IVF gives me hope that pregnancy is still attainable for me. However, I don't want to get my hopes up too high - just to have them dashed if IVF doesn't work. I consider myself a "glass half full" type person, but on some level I feel you have to play mind games with yourself to prepare yourself against potential devastating news.

Financial: I added this section to IVF Prep 101. You have to know how you will pay for treatment. If you don't, this can affect the mental aspects of infertility. Many - if not most - states do not require insurance companies to pay for infertility treatment. My company pays for 50% of the cost up to $3,000 lifetime. Not terrible, but I've already used up everything but $750 as we go into IVF. Next year, I will not have any coverage. Therefore, a lot of our treatment will be straight out of our pocket. So faced with this harsh reality, my husband and I visited with our bank yesterday to apply for a Home Equity Loan. This is a nice way of saying that we need to take a 2nd mortgage out on our home to pay for a lot of our IVF treatment. We called it a loan for "debt consolidation" and "home improvement". We'll find out in the next week or two what we qualify for. Any bit will help, but if we can get enough to also get new windows out of the deal, at least that's a guarantee of something to show for our efforts!