Pre-op Easter. 

Infertility doesn't close down for any occasion. Saw dr Riggall this morning again. He did the scan yesterday and went over our pre-op instructions as well as post op expectations. We will in fact freeze all the embryos as my wild estrogen level doesn't promote a happy environment for implantation. Fun fact: each follicle secrets estrogen... Over 30 large follicles = extremely high estrogen. We learn something new every visit. So I will have a period and then consult w/dr. Loy about doing the frozen transfer. We'll have different meds to take but thank God no stims! Most are oral meds and I already have the progesterone oil for intramuscular injections (booty shots) and the crinone (vaginal progesterone suppository). 

I feel so confident in this route. We'd hoped for a frozen cycle and my high estrogen in forcing that. Hooray! 

Tomorrowrow morning we arrive at 9. They'll get me prepped. Chad will do his part. Usually retrievals take 20 minutes. Dr Riggall said he thinks that mine will take about 45 b/c of the amount of follicles. Which means we will be charged like an extra $150 for ever 15 minutes they go over 20. Lawd have mercy! 

Also we made it official that we want the icsi procedure to be done. Paid an extra 1750 to confirm that they'll do icsi on at least 10 eggs and the rest will be fertilized (hopefully) in a dish. 

Tomorrow 4/1 we'll know how many eggs they are able to collect. On Tuesday 4/2 we'll know how many fertilized. Can't believe it happens that quickly. Praying we get a bunch to day 5 (blastocyst). 

Last night at 10pm sharp i took the trigger shot (lupron). I held it in my hands for a minute or 2 before I injected and prayed and pleaded for it to do its job and for all this effort to be successful. It made me so nauseous! I was spinning for about 2 hours just laying there waiting for my stomach and that lump in the back of my throat to calm down. It was terrible. Today though I feel better than I have in over a week. Big relief. More tomorrow or Tuesday depending on how lucid I am after I come out of anesthesia. 

Pulling the trigger and taking no prisoners (Fresh vs. Frozen)

So I've touched on this in a prior blog I think from after the ivf seminar. Dr Loy said frozen has better implantation rates that fresh. His theory is that fresh may fail more often b/c of all the hormones that have been stimulated to create a ton of eggs for future family planning. With the frozen cycles the embryo is placed back in when the woman's body is back to normal. Why am I telling y'all about this again?

My estrogen levels are through the roof! Because of this we will most likely freeze everything and skip the fresh cycle completely to get my body back to normal before embryo transfer. I'd mentioned asking the doc if we could go that route initially but I never did b/c we wanted to follow his suggestions every step of the way. Selfishly I'd like to just get that embryo in me ASAP just to get it over with but that doesn't sound like the most practical route now. What's a few more weeks right? My goal is to do what has the best chance of working. We don't have disposable $$ to just throw around. 

All of this will be confirmed tomorrow at post-op. that's right I said it! We are finally to post-op! I take my trigger shot (lupron) tonight at 10pm sharp. Tomorrows visit they'll check my blood to make sure the shot was absorbed properly and we'll sign paperwork. Ill be put under anesthesia so there are consent forms and protocol ill need to be instructed on. Monday morning (yes, April fools day) we go in for the retrieval at 10am. So exciting! We'll know by the time we leave the office how many eggs they collect and then we pray pray pray for the embryos to form perfectly. Also now that we won't do a transfer 3-5 days later we'll pray that as many as possible make it to day five (in ivf days retrieval is day 0 so day five would be Saturday 4/6) and then all will be frozen. More will be revealed as its revealed to us (tomorrow). 

A part of me is bummed that my estrogen is going to prevent a fresh cycle attempt but I'm resolved to think that this small detour will prevent great heartache and get us to success just a mere few weeks later. My heart is still calm. I am feeling a little more stress as the follicle stims are coming to a close and each step is being crossed off the list. Nervous anticipation no doubt.

Trigger shot change up

http://www.advancedfertility.com/lupron-trigger-prevent-hyperstimulation.htm

So my Rx is for Noverel which is HcG. Due to how well I've responded to the stims I'm at risk for hyper stimulation (not good). To prevent this I will take lupron to trigger ovulation rather than HcG. The site I included goes into significant detail on why the switch.  In a nutshell HcG stays in the system for 10 days causing the follicles to continue growing even after retrieval. Lupron is out of the system quickly and has the same effect for ovulation minimizing the scare. 

Thankfully they had lupron at the office so we were sent home with it w/the wait and see instruction that we may trigger tonight!! We will find out for sure upon the phone call after blood work is in (for estrogen level). If we trigger tonight then retrieval is Monday! Oh my goodness I'm so excited. Most likely we will go back tomorrow morning for pre-op instructions. More later. 

Over 30 years, over 30 follicles

Another early morning yesterday. It went well. I met Dr. Jaffe. She is extremely cut and dry. She is not Dr. Loy which makes me thankful for Dr. Loy. She said immediately that my ovaries are responding extraordinarily well to the medication and I have a ton of eggs. She counted over 30 follicles! The biggest ones are at like 15 1/2 and 16 (getting so close). When they are at 18 we'll take the trigger shot. 

Wendy our favorite nurse called around 1:30 to let me know that I can add dial down that the dosage of the menopur (by half) and the follistim to 75mgs (started at 175 then 125) which is nice because I am so uncomfortable! my poor little ovaries are enormous and I can feel them inside. It feels strange to slouch.  I don't know if that makes sense but i just feel like everything's cramped in there. Yes, I realize that has nothing to do with how crowded it'll feel when there's a baby in there (by this time next week hopefully).  The wild part is that they said they estimate egg retrieval for Monday or Tuesday!!

 I just hope and pray that this all works.  Every step is as important as the last step. I'm staying calm. Focusing on the positive. I'm extremely tired with having waking up at 5:30/6 o'clock in the morning and then go work a 10 hour day. It's stress on my system but it's keeping me busy and my mind trained on on other things. 

Speaking of other things, I accepted a new position at GEICO which some would say is bad timing but it actually was perfect. The training as been an excellent distraction. The day I started the stims was the day I was excepted for the position. What's wonderful is this schedule/manager is extremely flexible and I won't have to take time out or file for FMLA. My new manager is going to let me take off the days I need and swap them to come in on my day off.  So if I go in for egg retrieval on Monday (which is a normal day i work on) I'll work on Wednesday (which is a normal day i have off). Same rules will apply to the embryo transfer. Some of you know i'm anal about being dependable at work so this is such a huge relief. Had i not taken the position i would have to file for FMLA and that begins the stress of fighting with the  HR department for the next month. I'm so relieved and thankful for the perfect timing in this. 

Next visit (scan/blood) is Saturday (tomorrow) morning 8:30. Wendy said all of my results were excellent I'm doing as I should. I was a little nervous this morning because I had so many follicles. I asked if that was good and thought the doctor said "no".  I  thought that was weird because the more follicles that are growing the more eggs they'll be  sucking out of there.  I'm thinking why would it not be good but I'm sure I misheard because the other two nurses today tell me that everything looks excellent.

 I told my manager I am clearly dumber on this medication and I assured her that once it's out of me she'll have a whole new agent! Tough thing is right now I'm having to learn a whole new application and relearn some things. So it's not the best time to learn something but they say I'm doing great so far. My knowledge of the product is solid so it won't take long for me to learn. Yesterday was my third day and they let me jump right in w/o being watched so I guess that means  I'm doing well.

I'm just ready to get these eggs out of me! My stomach is so bloated and I'm  bruised from the last couple of shots that I've taken. My belly is sore to the touch. Haven't slept well in days. It's strange... I could fall asleep sitting at my desk and then as soon as I get into the bed I lay down I close my eyes I'm wide awake and thinking. I'm not anxious but I'm excited. It's like when I was a kid, excited about waking up for Christmas morning. It's a not a bad stress rather its an anticipatory stress and I'm happy. today i plan to just relax all day. I don't have plans and hope that will enable us to not have to do a whole lot. I'm becoming physically weary so today I hope to regain some strength. 

 I asked Chad to start going with me to the next however many appointments  from now on. It's getting so close to retrieval that i want him to see what i get to see on the monitor. Along w/my brain not firing as clearly as I would like it to be  I need him to be there now for that extra mind support. I've been driven crazy by both my mother-in-law and my mother to have him attend each and every visit (which for me hasn't been necessary. I'm my own chauffeur).  Believe it or not it's a nice drive in the morning early early on I-4. It isn't busy. It's dark and I can pray, think, vent, and most importantly sing at the top of my lungs w/Whitney Houston. I can release my feelings of love, disdain, black, white and gray out in the universe and hope to find some sort of flow in that. I feel like my drive helps me to reach that flow. Some of you understand what that means. I don't think everyone does but I do love my independence. It is hard for me to disconnect from that desire to take care of myself.  I realize too that with pregnancy and with Ivf this is not a one-man band. I am not able to do this on my own (clearly). From now on because I am on crazy meds that are putting me in a sort of fog he will be at my side. I don't feel emotionally drained,  just mentally and physically.  I need Chad to drive me there and hold my hand. That will be great.. just driving and holding hands.  Just us. I know that it's real to him what we're doing however I think that it will become far more real when he gets to see the follicles. That's part of the reason why I wanted to go on Saturday it's one thing for me to tell him it looks like I have huge clusters of grapes inside of me but it's another thing to see those suckers. You see them and know that inside each and everyone of them is the potential egg that will make up half of our kid. It's so exciting for me and it needs to be something that he gets to see before they retrieve.

Our mothers will be ecstatic he's going to be at all of the next visits that we go to. 

He's been kind and gentle this entire process. I've had a few moments of emotional out bursts. Cried singing w/Whitney on my drive on Tuesday and cracked myself up. Someone on Facebook told me I was beautiful and it made me cry. We celebrated chady's 35th on Wednesday and we are there w/18 people that we love and I just felt like a fish out of water. Large groups have never been my jam but I felt extremely alone that day. Tis the way it feels to be the woman in ivf. This to shall pass. What a day it will be when we find that our efforts to bring baby k into this world were not in vain. I'm so tired. It's 2:15pm and I think a nap is in order.

My every other day commute to O-town.

I'm so tired! Still haven't been mean. Had a little attitude earlier this evening but chad and I both caught it immediately and dismissed it on the meds. 

I woke up at 6am to travel over to winter park for a follicle scan and get my blood work done. It's wild how many follicles are growing. I'm used to seeing just one or maybe 2 and those suckers look like a cluster of ripened grapes. I couldn't even count them all. They said the headaches and potentially nausea are going to get worse from here as the follicles continue to grow and I keep injecting the stims. It's all worth it. My mind is very tired but not stressed. I'm calm and centered even though I haven't gotten to exercise in almost a week. It's just that ready feeling. Ill do what it takes and everything they tell me to do. 

Anyhoo, the scans and blood work were perfect per my favorite nurse Wendy. You can tell she likes chad and me. When she called she said to tel him hello. She instructed me to start a new shot ganirelix  along with the same menopur and a slightly less dose of follistim. The ganirelix is to prevent my LH from surging which would cause premature ovulation. It's amazing how it works. It'll prevent that lh hormone so that all the follicles will catch up to each other with out the biggest ones releasing the egg too soon. Pretty amazing stuff. 

I go back on Thursday morning. Dr jaffe will do my exam and ill get instructions from there on what happens next. Ill be taking the trigger shot soon!

Hormone queen

Actually I've not yet turned into the Incredible Hulk. I started stims (menopur and follistim) on Thursday 3/21/13 and its now Saturday night. the only side effect is a persistent headache. I'll take headache over meanness and mood swings any day. I was so worried that given my horrible side effects from clomid upping the anti to FSH would be an obvious emotional onslaught but I'm good. Feeling even, balanced and calm. I wasn't mentally or spiritually in the same place 2 years ago so perhaps the clomid effects hit harder b/c I was standing on the edge of the cliff so to speak. I was running emotionally hot and heavy and I had sever anger rise up in me like I've never felt before. Chad was literally afraid of me and I didn't blame him. I about lost my mind and all the while we're supposed to be having sex to make a baby while I'm picking on him every time he breathes off rhythm. Damn you infertility and your irony... So headache? Yeah I can deal with that! 

Went in bright and early this morning for blood work. Nurse called back and said at this point my levels should be b/w 100 and 150 and mind were 151 (score!). She said to stay the current course dosage wise and give myself an A+ for good hormone levels. I go back Tuesday morn 3/26 to have more blood work and a follicle scan (ultrasound) they'll count em up and measure. 

Here's the wild part that I'm still in awe about. I've been taking the stims for 2 days and my estrogen was at 151. Back when we were doing letrozole for the IUI's they'd do blood work and follicle scans on about day 13 and hope for the range to be b/w 75-100! I'm at 150 on day 3! These meds are no joke. I'm just shocked at how quick they take hold. Excited to get to see the follicles on Tuesday for sure. That will be a thrill. Potentially we could be doing an egg retrieval by next weekend. Wildness. Excited and Confident. 

I was discussing my hearts thoughts with a dear friend who has gone through all the same things we have and I was telling her that this is not like anything else on the infertility ladder. One must start with confidence and hope that it works on attempt #1. With the iui's being unsuccessful that felt very similar to trying on our own and not getting pregnant. This is a whole different ball game. Not only are we hoping we get knocked up on the first cycle but all this prep is about our future family planning too! It's for a brother or sister in a few years. Obviously we want every part to be as successful as possible so this process doesn't need to be revisited. Clearly it's important that all goes well from a emotional, spiritual and financial perspective.
Below is a pic of the meds that my dear husband laid out for me so when I got home from work I could see that all were accounted for and double checked by chad. It was the nicest gesture. I was flipping out about getting them in the mail and he knew he needed to go through each one, take inventory and check each for their refrigeration needs. Though that spread looks like a lot there was more in the fridge (I had earlier cleaned out a "fertility droor" for the ones that need to be kept cold. He's a good man. 

I'm hopeful. We are keeping busy. Re arranging our house majorly for as cheap as possible (thank God for ikea). I'm not allowed to excercise which hasn't yet driven me nuts so I imagine there are more people than I even realize praying for our minds and hearts to stay calm and at peace. We are feeling good. Ready for the next phase. 

Come in with a full bladder

Part of the final consult is to do a mock transfer so dr Loy can map out where he'll place the embryos and ensure easy passage of the catheter. I was instructed to start drinking water at 11:30 (appt was at 12:30). ... So on the drive I started drinking and drinking... Then we hit I-4 traffic not for one 30 minute slow down but 2. Now as expected I always rush to get out the door for these appts 30 minutes ahead of time to allow for I-4 to be predictable and haven't been late for an appt until TODAY when my bladder is BURSTING. It's been hours and its still not funny to me yet. I haven't had to pee like that since I was a kid on family vacation in the mountains. They let me pee a little when I got there but I didn't get to go enough (clearly) and the mock transfer was so painful and uncomfortable I almost couldn't stand it (those of you that know me well know I can take quite a bit of pain but this was something new). 

Just laying down to put my feet in stirrups was painful b/c my bladder was so full. When he got the ultrasound in there to check my uterus and ovaries he said, " whoa! Now that's a bladder, you must be dying! You get an A for full bladder. " still not funny.... Just give me a day. I'm sure it'll be comical tomorrow. 

So as expected we will do a single embryo transplant. I was instructed to quit birth control tonight. The meds have been ordered and should be here by Monday or Tuesday. I start taking them on Thursday night via injection. Saturday morning ill go in for bloodwork to check my estrogen level and they may tweak the meds depending on the results. We keep taking blood every 2 days plus ultrasounds every 2 days (to measure follicles) from then on until they get big and beautiful. At this point they will instruct me on exactly what time i need to take the trigger shot to tell my follicles to release the eggs (similar the ovidrel but fancier). Clearly we don't want the eggs to actually be released so it will be timed so that once the shot is taken they go in right before they are released to suck them out (egg retrieval morning...iv and  Anesthesia for me and sperm collection for chad). I will then start taking shots of progesterone in my booty for I can't remember how long and about 17 days after egg retrieval I get a blood test to see if we are pregnant. 

In the meantime they'll introduce the eggs and sperm and those embryos will grow and grow. The hope is that they do the embryo transfer on day 5 which is called blastocyst. Depending on the number, quality, and growth of all embryos they may do the transfer earlier if there aren't many. They will transfer one back into the old unicorn and freeze the rest for future kostella family planning. 

Can't believe ill be taking the stims in less than one week. Certainly excited. Scared about the emotional side effects from all the hormones but know that it's temporary. Ill need to keep mindful of that. Luckily the doctor said I don't need as much medication as the average bear because I'm in great shape. All that running I do for a peaceful mind pays off. Thing is I've been instructed not to run any more due to how big the ovaries will get from the stims. They can get twisted if they bounce around too much causing obvious pain but more devastatingly damaged follicles/eggs. The nurse said that because I'm thin ill be noticing the growth of the ovaries almost immediately. Yikes. 

I read a book recently that discussed excersize. It suggested no hard core running like i was doing but walking 30 mins a day is recommended. I'm already transitioning. It's hard to not run but now I'm committed to walking. 

I'm having the pharmacy run the meds through my insurance first to see if anything is covered. I don't expect it to be but I should find out Monday. Then they'll overnight them soon as i pay and ill go into crazy organization mode once they arrive. Some need the fridge some don't. Ill be anal about it at first but plan get into a groove quickly. 

Still having those fun twinges of excitement. That may not translate into the blog right now because I'm trying to keep my blog organized at this point because I want a good history to look back on. We are cautiously stoked. I'm hoping the meds get here soon so that's one less thing to stress over. Praying this is the one cycle that does the miracle making. 

Post hysteroscopy... Pre final consult

So on Friday at 12:30 we go for our final final consult. Yes I meant to put an extra final. My hysteroscopy went well. Dr did an X-ray while I was under to get a good idea of my uterus capacity. It's certainly smaller than average but he is confident that one baby is possible. The risks are the same... Pre-term labor, c-section, breech baby, and possibly 2nd trimester miscarriage. There is a possibility that ill need a pregnancy to stretch the uterus prior to carrying a baby full term. That scares me. It's like pregnancy one makes a way for pregnancy 2. We may be mourning one loss and celebrating birth of that babies sibling. Wildness. I pray we don't have to travel that road. Thing is the dr said the only way we know is by getting pregnant and seeing how far my unicorn stretches. Unicorns are magic. We need some magic. Big time. 

Side note... While in recovery I was thanking the nurse for her role in my becoming a mother. She thanked me but I could tell she was not taking me seriously. I became super concerned that all the staff that I had repeatedly thanked w/every sincer fiber of my being thought it was just the anesthesia talking. I'm still frustrated about that. Maybe ill write a letter. So they know I'm lucid and grateful!

Friday Chady and I both go in. We'll see dr. Loy. He'll tell us what we do next. Then we'll meet w/the nurse to go over the meds. Then financial person to find out how much I need to write a check for.  I was instructed to keep taking birth control.. I will skip the placebo pills so I won't get my period. I'm to arrive w/a full bladder so I assume they'll do an ultra sound to make sure all is quiet in my ovaries prior to shocking them w/meds that will put them in overdrive. 

At this point it's all assumption. I'm definitely excited. The surgery was the last big hurdle to jump that could have caused the process to stop completely so we are both relieved that literally everything and more has been looked at by the doctor. He has seen every millimeter of my reproductive system inside and out. That's comforting to know that we still have the green light to pursue a biological child. 

I've been asked why not adoption. 6 months ago before we knew we couldn't have a bio kid w/o ivf we had talked more about adoption than ivf. We never needed ivf b/c there isn't anything wrong. That news changed our thought process. God has blessed us with the means to do ivf at least for 2 cycles w/o going into debt. For that I can't express in words how thankful I am that a way is being made. From a financial standpoint ivf may allow us to have more than one child at a lower cost than one baby via adoption. The gamble is in the number of attempts. No one knows the answer there but we have to keep taking steps towards this desire. Doing nothing does nothing. One must have faith in any step. I truly believe that there is no right or wrong choice here. I also believe that there is nothing wrong with wanting a bio baby. I'd be kidding myself  if I said it doesn't at this point make a difference. I think there is a huge chance that  we will adopt one day still. Maybe not a newborn. Maybe we'll know when it's time just like we know that it's time right now for ivf. So that's that. More once we have the final consult.