The little eggs that could

Day one: We got the call that even though we only retrieved two eggs, both eggs fertilized. 
Day two: We got a call from the nurse in the morning saying that both eggs were "cleaving" nicely and we had one two cell embryo and one 3 cell embryo, and the expectation was to have between 2 and 4 cells.  I was on cloud nine.  Later, the doctor called and said that in the best case, she would like to see a four cell embryo with less than 10% fragmentation.  We had one embryo that was 3 cells with less than 5% fragmentation and a  2 cell embryo with less than 15% fragmentation.  She was hesitant about how the embryos would progress and said that she thought I would have "one fair and one poor" embryo to transfer on day three.
Day three:  The doctor performing the transfer let us know that embryos are graded as good, fair, and poor and we had two "good" embryos to implant.  One embryo was 6 cells and the other was 7 cells.

I wanted to jump up and down and do a dance, but my bladder was so full in preparation for the transfer that I had to dance in spirit only.  Today, two embryos were transferred.  I never thought we would make it to this point.  I know that there is still over a 60% chance that this doesn't work, but I feel like I just won the Superbowl.  This is the closest we have been to a successful pregnancy in a long time. 

I visited my acupuncturist yesterday and determined that I need to go see him more often, and I need to adopt his mindful flow.  He suggested that I visualize being pregnant and I act pregnant.  He said to "be a flake" for the next two weeks and don't do anything that stresses me out, take some days off work, and otherwise let everything go.  He reminded me to breathe, rest, walk in nature, and eat well.  I have been afraid to be excited or hopeful, I didn't want to visualize because it seems so painful to have hope and then have hope squashed.  He reminded me that the pain is there no matter what and I have to live with intention while simultaneously surrendering to God.  He told me not to run from the emotion, but to breathe into it and ride it through, acknowledging it without becoming attached to it.  I am so glad I went to see him the day before my transfer.  It was just the hope, refocusing, and calming influence I needed.

Now I am on strict bed rest for twenty-four hours and then modified bed rest for another 24 hours and only light activity for several days after that.  As I lay on the couch now, writing this blog, I am excited to rest, excited to read, excited to dream and hope that these two little embryos develop into healthy babies.

We cleared the first hurdle

I just got a call from my nurse at the fertility clinic.  Even though I only got two measly eggs from my IVF egg retrieval yesterday, both of those eggs were mature and both fertilized!  I understand that studies indicate that close to 50% of fertilized embryos do not make it to pregnancy.  I understand that even if those two little fertilized eggs make it to transfer day, they still may not implant.  I understand that even if they do implant, they may not turn into healthy babies.  I have had two miscarriages, I am aware that I will likely not breathe until I see a healthy strong heartbeat after 12 weeks...but for today, I am going to tuck that all away.  Today, I am going to gloat.  Today, I have two little eggs...correction, today I have two little embryos.

It takes two to make a thing go right

Two years of trying.  Two miscarriages.  Two failed IUIs.  Two months of an IVF procedure.  Two weeks of shots. And today, Two Eggs.  After all that, two eggs.  My first IUI on Clomid, I had two eggs.  My second IUI, I had three to four eggs.  Today, after the maximum dosage of fertility medications for almost two weeks, I had two eggs retrieved.  Tomorrow I will learn if they fertilized.  I would like to write about how I feel, but frankly, I am too tired, too dejected, too disappointed, too sore, too hollow, and too everything else to write it down.  Let's just hope that Rob Base was right~

No More Shots!

Whew...I have finally made it.  No more shots (for now).  I got three phone calls yesterday from the fertility center making sure I understood all my directions for the HCG trigger shot.  While most people don't have to continue their medication, I was told that I needed to give myself one last shot of the Menopur and Gonal-F.  Now, here comes for the funny part of all of this.  My entire family attended a football game yesterday, myself included.  I had to take my last shots of stimulants at 6:30pm and my trigger shot at 8pm. 

We arrived to the stadium at 6:30pm.  Everyone hopped out of the car and I scurried around to the other side so no one could see me, unzipped my pants, looked around in that shady, nervous, drug addict type of way, and quickly gave myself my last two shots.  Once we got in the stadium, my husband and I missed the action of the first quarter because we were whispering back and forth about where we could do the trigger shot at 8pm.  It is the only shot I needed him to help me with, and we just so happened to be in a place with absolutely no privacy and a strict no re-entry policy, so we couldn't even take a trip back to the car. 

Starting at 7:30, my husband asked police officers and other staff if there was any place we could have some privacy to administer the shot.  He stood in line at the concession stand and when the guy asked what my husband wanted, I saw my husband lean in and whisper to him...and then the man looked horrified and ran away to get a female worker.  She walked over to my husband, who again leaned in an explained the situation.  She gave the same look and walked away to check with someone else.  The concession stand was swarming with people and those working the stand were flying around as fast as possible trying to serve people, and we were holding up the line.  I was sure we were going to cause a riot.  The woman very nicely offered to escort us to the woman's bathroom where we could use the handicapped stall.  On the way in, a police officer confronted my husband, thinking he was a pervert trying to peek in the ladies room. 

We rushed into the stall and immediately began fumbling with the materials.  First we had to mix the shot.  It wasn't so easy with no clean surfaces.  We balanced on each other and tried to move as quickly as possible, but this was our first experience with this shot, and we wanted to get it right. Because the needle was so long, it took several tries to extract the liquid from the vial without getting mostly air.  We were whispering to each other and scurrying about while women chattered on about lipstick and shouted about nothing important in the neighboring stalls; I couldn't help but feel like I had stumbled into the underbelly of some nightclub.  Once the shot was ready, I had to disrobe enough for my husband to administer the shot, which was quite a feat given that I had on a dozen layers of clothing to keep warm, and again-no clean surfaces to put the discarded clothes.  I clenched my jacket between my knees and fumbled with  my pants, Under Armour tights, and underwear trying to expose the upper part of my backside.

My husband never gave me a signal that he was ready to give the shot, he just plunged in.  At first I flinched because I wasn't expecting it, but there was no pain and no burning.  In just seconds, it was over.  This isn't the usual way pregnancies are started in public bathroom stalls, but it felt momentous all the same.  I wanted to have a toast, a long kiss, something to mark the occasion, but we had no time to waste celebrating because the poor woman was still sitting outside of the stall, waiting to escort us out of the bathroom.  I zipped up quickly, panties twisted and bunched under my tights and made a quick escape. My poor husband had to endure the stares of horrified women as we left the stall.  Seconds later, we were back on the sidelines watching the game as if nothing had happened.  All in all, it was a fairly easy shot-no pain, no burning.  I just hope we did it right. 

Tomorrow we have to be at the fertility center at 6:30am for our 8:00am egg retrieval.  Today I celebrated with sushi.  I hope it is the last sushi I will have for many, many months.

Black Friday, Green Light

On Thursday (Thanksgiving Day) my follicles were 16mm, 16mm, and 10mm.  My E2 number was 425.  According to some research, E2 numbers should be at 150-200 per follicle in order to indicate a mature egg.  I was told to continue medications as usual and return at 8am on Friday morning for further monitoring.  Every day I hold my breath and hope my cycle doesn't get cancelled.

This morning, Black Friday, I got my good news.  In just 24 hours, my two larger follicles grew from 16mm to 20mm. Typical growth is from 1 to 3mm per day, so my eggs must be over-achievers (that or they just feel bad for my pin cushion stomach and decided to save me a few more days of injections).  The technician didn't even measure the other smaller follicle.  I was told to wait for the nurse, who would be providing me with information on administering my HCG trigger shot this evening.  As of now, I will go in for my egg retrieval Sunday morning.  My follicle numbers seem very low and I am happy that I will be allowed to continue with the cycle.  I am concerned that I have had some fluid in my uterus which may impact implantation (if any eggs reach that point).  I have been told not to worry.  These lovely ladies at Shady Grove Fertility Center obviously don't know me. 

Right now is the calm before the storm.  I am not worried about the trigger shot or the retrieval.  I am bummed I will miss my nephew's birthday party, but we have waited so long for this moment, I would miss anything to have this opportunity.  I don't feel anxious or sad or nervous.  At this point, I can't do anything else except wait and hope for good results.  It is so relieving to finally be at this point.  It feels good to breathe.  It feels good to relax. I might even take a nap.

More disappointing news

injection bruising

Today I went in for my IVF monitoring appointment after being on eight days of stimulation medication, 10 days of shots.  Today, they only saw three measurable follicles at 8mm, 12mm, and 13 mm, which is down from four follicles seen just two days ago.  The call from my nurse indicated that cancelling the cycle is possible because of such a poor response.  I have to go back on Thursday, Thanksgiving Day, for more monitoring.  If the smaller follicle hasn't caught up by then, or if other follicles don't show up, it is likely that my cycle will be cancelled.  I asked about increasing medication to make the other follicles pop and I was told that I am on the maximum dosage of IVF medications and the meds can't be increased any more.  The nurse is very surprised at my poor response because my antral follicle count (the amount of little "possible" eggs measured before starting IVF) has always been decent and I should have had better follicle growth.   The nurse believes the treatment may have "over-suppressed" my ovaries.  I hate it say it, but I am not surprised.  I warned the nurse and the doctor before I started birth control pills that I don't respond well to birth control.  I not only have terrible side effects, but it seems to take months for them to get out of my system once stopped.  I am exhausted.  I am tired of being sad, tired of disappointment, tired of crying, tired of not sleeping, tired of shots, tired of bruising from blood draws and shots, and just plain tired. Every morning I wake up and try to focus on the positive and with every monitoring appointment, I am hopeful that things have turned around.  The fall from possibility to reality hurts more every day.  I am bruised and sore and aching-in my heart, in my body, and in my mind.

And the hits just keep comin'

So I went for my first monitoring appointment on Friday.  I was hoping that after several days of multiple shots, I would see eight to ten follicles, as suggested by my doctor. That number is lower than they would like, but still enough to have IVF.  I had four.  I was so dissapointed that it took all of my energy to hold back tears until I got to the car, at which point I let go and cried all the way to work.  Four.  Four is borderline for cancelling a cycle or switching to IUI, which I already know doesn't work for me.  I got it together for work, but continued to stand on the line between "together" and "sobbing uncontrollably" all day.  I wanted to go home and crawl into bed, and might have taken that option if I didn't have to make a presentation to fifty people, including several of the big guns, at the end of the day.  I called my nurse and left a message telling her how upset I was.  While we didn't connect in person, her voicemail back to me was very reassuring.  She said that the birth control pills may still be suppressing my ovaries and they fully expect to see more follicles pop by my follow-up appointment on Sunday.  She also said that my estrogen was low (64) and they were increasing my dosage, which seems impossible given how much medication I am already taking.  So, I increased meds and crossed my fingers for better results on Sunday. She also said, "we don't want to see one follicle get bigger than the rest, so it's good that they are all developing together."

Today is Sunday and this morning I went in for my second monitoring appointment.  First, there was still only four follicles and second, one is measurable and the rest aren't-so it seems that one is growing faster than the others.  Needless to say, I cried all the way home. With every appointment, I get more discouraged. I  am so mad at my body and so frustrated that it isn't working.  I am frustrated that my stomach is covered in tiny bruises and pin pricks, I have constant headaches, my face is breaking out, and I feel bloated and gross all the time, and yet, I only have four follicles. I am also really struggling with coming to terms that my fertile days are behind me and I am not entering the "grandma" phase of life.  I am only 38, way too young for menopause, and yet, my body is sending me the message that it is right around the corner.  I have never minded aging.  I got gray hair at a young age, I have some wrinkles, and my body doesn't look like a 24 year old's body.  I have always been okay with gentle aging.  This feels different.  This feels like a club to the head.  I am so sad.  Now is the waiting game.  The nurse should call later with the results and future plans.  I don't know what to expect, so I will just wait and see.

Sunday night: I went outside for two seconds, and of course, missed the phone call from the doctor's office.  The message said my estrogen level was 134 and I should continue the meds and have another monitoring appointment in two days.  I can't help but think that this number seems incredibly low.  I guess I will wait and see.

Lessons learned: I am not a fan of this process.                          

I woke up this morning and felt pretty good about myself.  I got dressed and looked at myself in the mirror and thought I looked great. I felt less bloated than I have in a long time and my face seemed to have returned after it's brief debut in the Macy's parade. My backside even seemed smaller. I strutted through the day feeling full of myself.  I had a brief period of panic when I wondered if I was administering the medication correctly because I wasn't feeling full and bloated.  Other than some headaches, a few hot flashes, and injection soreness and bruising, I have been feeling pretty good.  I spent about two minutes worrying about whether I had any eggs and if they were growing, and then I moved on because I had things to do.  Thank goodness for work. Without it, I would spend too much time surfing the Internet and obsessing about this whole process.

At the end of the day, a work colleague asked me if I was pregnant because I looked fat in my face and round around the middle. The smile on my big fat float face instantly deflated. I don't know what hurt more-being called fat or being called pregnant and wanting it to be true so badly.  I should have skipped dinner and worked out.  Instead, I went home and made gluten free pizza and stuffed my face.  I then did three loads of laundry, picked up the house, checked the kids homework, and put everyone to bed before sinking into the sofa in a big, round, squishy ball of self-loathing for about three minutes before it was time to return to the other things on my "To Do" list.  I could be mad at my colleague, but I'm not because she's right. By the end of the day, my stomach had puffed up and I felt bloated and sore.

Bottom line is that I have a love/hate relationship being fat and squishy, bloated and sore.  It means the medications are working, and I love that.  I also hate looking like a moose all the time. I have cleaned up my diet and added walking a few times a week to my schedule, so I know the added fullness is related to the medication and so I refuse to be too mean to myself, at least for the time being.

Lessons learned so far: I am more capable than I thought when it comes to giving myself shots.  I am getting quick and fluent with the mixing and administering of all the medications. I even administered the shots in the public bathroom at my daughter's lacrosse game last night  .I am surprising myself.   I am also being much nicer to myself than I ever have been before.  For the first time, I am trying to give myself a break.  I am trying to embrace all that I am, including my "flaws" of not being physically perfect. I am resting when I am tired, crying when I feel sad, and not beating myself up later for being weak or less than perfect.  IVF stinks, but it has it's benefits.  Whether or not we ever have a baby, maybe I will learn to like myself more, flaws and all.

And We're Off...

I have successfully completed two days of Lupron shots, 20 microunits in the morning and evening...yay me!  I am not thrilled about needles, and really not thrilled about having to poke myself, but I did it.  The first shot was not so bad.  I made my husband look over my shoulder to make sure I was doing it correctly, but in just a few seconds, I had given myself my first shot, and it didn't even hurt.  The sensation of the needle breaking the skin is odd, but there was no pain.  After the shot, I had an itching and burning sensation at the spot for a little bit, but it was not a big deal.  The interesting part was that thirty minutes after the shot, I started to have some menstrual bleeding.  It subsided throughout the day and then shortly after my second shot, the same thing happened.  I also had some intestinal issues the first day.  I am not sure if it was from the shot or because I chose to reward my efforts with some comfort food that maybe didn't quite agree with me.



Evening Injections

The second day of the shots, I  felt like an old pro.  The morning shot hurt more; I think the needle may have been a tad bit dull.  I experienced the same burning and itching sensation, but no other side effects.  I am still bleeding, but I am starting to think this is nature and not a side effect of the shot.  By the evening shot, I was such an old pro that I was able to rush upstairs to my bathroom and give myself a shot while dinner guests were getting ready to be seated in my dining room below.  About half way through dinner, I started to get a headache.  By the end of the night, my head was splitting, with a lot of pain around my eyes.  It could have be a side effect of the medicine, but it is more likely that I was winding myself up about having to give myself FIVE shots the next day.  While I was feeling confident about two, five felt closer to a thousand than to zero.  The headache continued all night and the next morning.  I also am on the verge of tears all the time, but again, I am not sure if it my body's response to stress, or a side effect of the hormones.  Even as I am writing this, I can feel the tears brimming just under the surface.  Fighting off the emotions makes me tired, which of course, leads to tears.  It's a vicious cycle.

This morning, I added 225m of Gonal-F to my regimen.  The needles seem to be hurting more with every treatment.  I am not sure if my brain is catching on, or if my skin is just getting more sensitive.  I am now a pro at the Lupron shot.  I tried to put the needle in one area and it hurt, but a slight movement of the needle to a new spot and all went well.  The Gonal-F is a pen.  I hate the pen.  It seems easier in theory, but pushing in the plunger is much more difficult with the pen, causing the needle to wiggle under the skin which leads to some minor discomfort.  The plunger clicks at set intervals of medicine to indicate how much is being injected.  The clicks are unnerving and makes me feel like the injection is a much bigger deal than it is.  Once the injection is finished, the needle must remain for a few seconds to make sure all the medicine gets under the skin. I hate this too.  I would really love to get the needle out as quickly as possible.  The needle is very thin and tiny and so it doesn't hurt, but the wiggling and waiting isn't great.  It's the same burning during injection, but less itching.  I still have a terrible headache and my eyes hurt to move around in my head, but again, it is likely that I have stressed myself into a migraine and the headache really has nothing to do with the medicine.

Tonight I will add Menopur to the Lupron and Gonal-F shots.  This is the shot I am most dreading.  There is lots of mixing and I am nervous to do it wrong. 

Here is what I know so far-I can give myself shots.  The needles are tiny and barely hurt, or only hurt a little.  Even though they are tiny, they are hurting more every day, so I need to get my head in the game. Anyone can do anything for a short amount of time, and I have managed must worse.  Finally, I would hate to be diabetic and have to do this all the time, so I think I will actually try to add more vegetables to my diet and walk more...for real this time.

Phase One Complete

I was in the middle of a blogging rant about my excitement about being finished with birth control pills when my computer shut down for no good reason. My immediate response was to throw the computer across the room and fall into a puddle of tears on the floor.  Right now, everything seems difficult.  Of course, it could be the perfect storm of a very busy and stressful time at work, the introduction of the holiday season, lack of sleep, hormone fluctuations, a little family chaos, and a few other things sprinkled in....or it could be that I am a total nut case on birth control pills.  I vote for option two.  I am frustrated that I am a bloated, overly emotional woman with no libido. I hate looking at my fat face and puffy tummy every morning.  I am frustrated that I know this is hormone related and I can't control it-it is just one more thing about my body that I can't control.

 But today, I took my last birth control pill.  Words cannot express how thankful I am that this phase of IVF is finished.  Of course, this isn't the worst phase.  I know there are more hormones to come in massive doses.  I have been stressed out all week about giving myself shots.  I am not thrilled about the needles, but the needles aren't what scare me.  I am terrified to mix the medicines wrong or forget to get rid of air bubble and somehow kill myself or zap my ovaries forever.  I am terrified to go through all of this to have the cycle be stopped because I don't get enough eggs, or because they are poor quality.  I am afraid of it working, afraid of it not working.  Every time I have foolishly convinced myself that I don't want another baby, I have to spend time with a pregnant woman or a newborn, which leads to me crying silently into my pillow.  It is pathetic and weak, and I hate that about myself.  Mostly, I hate that my hard work and perseverance isn't resulting in a win for me.

Almost There

It is hard to believe that I have been on the birth control pills for two weeks already.  Just one more week and I start the dreaded five shots a day. I am looking forward to the shots just so I can get off the pill.  I am watching myself bloat up like a balloon, despite the fact that I have been SO CAREFUL about my diet and water intake. I have had heavy breakthrough bleeding and clotting for a week, headaches daily for months (due to all the IUI hormones and now BCP hormones), and my blood boils at the slightest little thing.  I am aware of my irritation and it takes a lot of energy to keep my emotions in check, especially at work, which leaves me exhausted by the end of the night.  I would like to apologize in advance to anyone I may snap at in the next few weeks.  I wish my body handled hormones better, but my poor interactions with birth control date back to my very first experiences as a teenager.  The good news is that I know that I am only trying IVF two, maybe three, times and so all these side effects are time limited in the grand sceme of things.

We have a friend who's wife did IVF and they recently had twin girls very prematurely.  I have been watching the pictures on Facebook every day as they get bigger and healthier.  Yesterday, their feeding tubes were removed for the first time.  I think they are a little over a month old. They are still in the hospital, which would make me so sad, but they look healthy and beautiful.  It gives me some peace to see that they were so little and they are doing so well now.  One of my biggest fears about IVF is the possibility of twins.  All of my children were born close to 4 weeks early as singletons and so I am terrified what that would mean for the health of twins....plus, it's twins, YIKES!  Of course, at this point, we would feel so blessed with whatever gifts God gave us.

I am sure this next week will fly by.  This time next week I will be at my monitoring appointment, hopefully getting ready to get this whole thing rolling.