Jun 28, 2012

Important Dates

I took this from http://ivf.ca/duedate.php and love getting an idea of all of the milestones my baby has coming up!

My doctor did first beta on June 20, so June 22 was actually my second beta.  But other than that first line, I find this pretty cool.

As a pregnancy newbie, I had no idea that the date of trimester switch could be so controversial. 

The website explains that "by development" uses the 40 week pregnancy cycle, starting on that date of the last menstural cycle.  The first trimester ends at 12 weeks, when the major structural development is complete, and the second ends at 26 weeks, when the baby is considered viable and will then spend the third trimester growing bigger.  "By gestation" also uses the 40 week pregnancy cycle, but divides the 40 weeks into three equal length periods.  The "by conception" also divides into three equal periods, but uses a 38 week pregnancy beginning from the date of conception.

Moms out there: which method do/did you use when telling people which trimester you are in?

Jun 27, 2012

Good News (x3!)

 First the good news: We have three snow babies.

All three of our remaining embryos survived and are now frozen! We have three little snow babies currently being cyro-preserved to use for future family expansions.

 Now the great news: I'm still pregnant.

Beta One (8dp5dt or 13dpo): 186
Beta Two (10dp5dt or 15dpo): 367
Beta Three (today! - 15dp5dt or 20dpo or 4w6d): 2,860
That puts my doubling time at about 40 hours. The hope is for a doubling time of 48, although anything under 72 hours is considered healthy. 40 hours is great! Now that my Beta has crossed 1,000 we can schedule our first ultrasound for Tuesday at 5w5d. At that appointment, the doctor is looking to see the gestational sac and possibly the yolk sac.

And for good measure...

 A bit more great news: My OHSS seems to be resolving.

In the past 36 hours I have lost 6 pounds, been hungry, been thirsty, and (TMI alert) finally started peeing in amounts that coincide to how much I'm drinking! I feel so much better. I can look down at my still swollen tummy and I know I have a long way to go, but Praise the Lord I never fully crossed over into severe OHSS and I am getting better! My RE warned me not to get too excited because I could still have some bad days before it completely goes away, but I've been cleared to drink liquids other than Gatorade although I'm not allowed to completely give up the Gatorade yet. I am out of the danger zone and getting better! Let's hope that the rest of this pregnancy is uneventful!

Jun 25, 2012

Dealing with OHSS

When I announced that Casey and I are expanding by two feet, I mentioned that we are not out of the woods yet. Until the end of the magical first trimester (12 weeks) the risk of miscarriage remains high.  Miscarriage isn't the only risk we are facing.

 Last Wednesday, I was diagnosed with Ovarian Hyper-Stimulation Syndrome (OHSS).

OHSS is a complication that sometimes arises with IVF. It is classified as mild, moderate, or severe. It can either be "early OHSS" and appear immediately after retrieval or "late OHSS" and express during the early stages of pregnancy.  Many patients who undergo stimulation will experience mild early OHSS and it is not considered serious. Symptoms of mild OHSS include enlarged ovaries, bloating, and mild abdominal discomfort. It typically does away on its own within a few days. Moderate OHSS can get more serious with symptoms including high weight gain (greater than 2lbs per day), increased abdominal girth, bloating, nausea, extreme thirst, and decreased urine output (despite drinking large amounts of fluid - see extreme thirst). In its severe form, OHSS can cause nausea, vomiting, respiratory distress, lows blood volume, low blood pressure, severe weight gain (5+lbs per day), decreased urine production, and dehydration (despite drinking large amounts of fluids). Severe OHSS typically requires hospitalization to get the abdominal cavity drained and IV drip to keep fluid levels up.  Late OHSS only occurs in patients with increased beta levels (so patients who are pregnant!) and can last through the entire first trimester.

 After that brief description of the symptoms, here is what it is:

During IVF, the stimulation medications cause the body to create and grow many follicles (versus the one a month a woman's body produces without medical intervention). As these ovarian follicles grow, they release a number of different substances, the most important of which is estrogen. This estrogen allows the lining of the uterus to thicken so that the embryo can implant and snuggle in. Once the follicles have reached maturity, an IVF patient takes a "trigger" shot of HCG to cause ovulation. Harvesting of the follicles for eggs is now done (I wrote about my retrieval here) and the follicles are aspirated with a needle, releasing all of the fluid. After this, huge amounts of estrogen-rich fluid pour out of the swollen and enlarged ovaries and into the abdominal cavity. Many women will then experience some mild OHSS symptoms (bloating, some abdominal discomfort, etc.) after retrieval.

After retrieval, the follicles refill with fluid and are called corpus luteum, because they contain large stores of cholesterol that are used to produce the steroid hormones estrogen and progesterone. In addition, the follicles start to produce a number of other growth factors and chemicals like vascular endothelial growth factor (VEGF) and kallikrein-kinin, which then coat the lining of the abdominal cavity and cause it to become leaky. This is called ascitis. Fluid literally pours out of bloodstream into the peritoneal (abdominal) cavity because of the leakiness of the lining. The ovaries balloon in size and the abdomen swells.

Now onto my OHSS experiences:

I had my first check up with my doctor two days after retrieval.  At that time, my ovaries were quite enlarged (big enough that I was put back on bed rest after we got our fertilization report), but I wasn't really in any pain and I was totally unaware what this could mean for me. I had no idea that the enlarged ovaries Dr. Pinto saw on the ultrasound were a sign of mild OHSS.  

While I did have this one symptom, my OHSS did not fully develop for a few more days and is classified as “late OHSS.”

A few days after transfer (on Monday at 6dp5dt to be exact), I started to notice that I was fairly rapidly gaining weight in my abdomen. None of my pants would button, and even my stretchy waist pants were feeling tight. I was uncomfortable and felt quite a bit of pressure. On Tuesday night, the pressure was making it uncomfortable to breathe, laugh, or sneeze and I could feel it pushing up on my abdomen. We considered called the emergency line at the doctor’s office because I was uncomfortable, but we had no idea it could be anything serious and I had an early appointment Wednesday morning so decided to wait it out.

Wednesday morning when I went in for blood work I spoke to my IVF nurse and told her how I was feeling. She said it was a good sign and predicted my beta would show pregnancy, because the symptoms I was describing indicated an elevated HCG.  She added a number of tests to the blood work and also took my blood pressure and heart rate. My blood pressure was low, and all of my symptoms matched with a progression of OHSS from mild to moderate.  My hematocrit level (blood volume level) was taken and came in at a healthy level, although my estrogen was elevated.  At this time, I was put on restricted activity and told to take it easy.  I was also told to drink LARGE quantities of Gatorade to restore electrolytes, fluid, and sodium into my body. 

At my appointment on Friday, it was confirmed that the moderate OHSS continued.  Luckily, the swelling seemed to have settled a bit lower and was no longer pushing against my diaphragm and making breathing difficult! 

 As of this morning, I am up a total of 21 pounds (I’ll say since transfer 13 days ago - which is when I felt the weight gain sneak up, but the last time I was on a scale was the morning of retrieval so perhaps saying since retrieval is more accurate).  My symptoms have frequently danced the line between moderate and severe, but haven’t actually crossed it.  I have decreased urine output, but it hasn’t stopped.  I have dizziness from low blood pressure, but it comes and goes.  I have had discomfort from breathing, but never bad enough I’d call it trouble.  I had a few days where I gained 4lbs, but I’ve never gained 5 in a day. 

I called my RE this morning to ask questions and get some assurance that I’m okay and he did really make me feel better.  My overall takeaways from the conversation:

(1)   Keep drinking Gatorade.  Lots and lots and lots of Gatorade.  He isn’t concerned with what I eat (or even if I eat) and would rather I give that stomach space over to more fluids.  If I have to choose a meal or a drink, I should be drinking.  I should also continue to be a lazy lug and not do much activity at all.  I’m getting good at sitting around doing nothing.  Does anyone want to come over and do nothing with me?

(2)   It is unusual to hover right at that line between moderate and severe for so long and he wants to do a full abdominal check and measure the amount of fluid I have, but didn’t feel like I needed to schedule an additional appointment for it.  He said the appointment I already have for Wednesday should be soon enough.  The fact that he is willing to wait until Wednesday to see me makes me feel a lot better!

(3)   He thinks the reason I am dancing the line between moderate and severe and not crossing over is because I am literally drowning myself in Gatorade.  He basically told me to keep doing what I am doing!  I like that kind of affirmation.

Many people do weekly or monthly “belly shots” to document a pregnancy.  I’m not sure I’m up for doing that given the already HUGE size of my belly.  I haven't been a skinny-minnie with a perfectly flat stomach in years, but my stomach has always been a great asset and given me an obvious hour glass figure.  I carry my weight in my hips, butt, and things.   Until recently that is.  So, in an effort to be completely open and honest, here is my gigantic stomach:

Huge OHSS belly.

Jun 24, 2012

Thank You!

Thank you so much for all of your kind words and prayers! Casey and I really are so grateful for all of your support. It's really hard to believe that after so much heartbreak and trying for so long, we are pregnant!

Despite medical opinions putting our chances of success from IVF at 5-15%, we have made it this far. Casey and I truly believe that this has only worked out so well because of the amazing power of your prayers.

God truly is good!

We are so incredibly blessed to have so many people praying for us and for our tiny human. Please continue to keep us in our prayers as this little one grows and we get passed the largest miscarriage hurdles and as I continue to struggle with excess swelling from OHSS (post on this coming tomorrow I promise!)

One of the things we have learned during this process is just how many people struggle with infertility. Many are people that you may know and are choosing to keep quite about their struggle (there is still a huge stigma to infertility treatments!). Please consider adding these couples to your prayer list as well. Infertility is hard on a marriage, on your confidence, and on your relationship with God.

We truly believe prayer can make a huge difference and hope that you will continue adding your voice to our choir.

Jun 22, 2012

4w1d: Results Are In

We are pregnant! It is VERY early (4 weeks) and we have a lot of obstacles to get through before I think either of us will be comfortable saying "We're Pregnant" but right now all the signs say we are expanding by two feet!

But, I have a confession to make.  We've known since Sunday, or, at least, we've suspected since Sunday.

I swore up and down that I wouldn't take a HPT (home pregnancy test). I planned to wait until our Beta and let the doctor tell me the news. Well, on Sunday morning I woke up nauseous (stupid progesterone!) at about 4:30 and couldn't get back to sleep. I got to thinking how AMAZING it would be for Casey to find out on Father's Day that he is going to be a Dad.  If we hadn't had all of the complications, our original IVF calendar had our first Beta the Friday before Father's Day so I had already had the perfect images of Casey being a Dad-To-Be on that day in my head.  At 4:30 in the morning, I wasn't capable of logical thought or reasoning, and for some reason POAS seemed like a good idea.  It didn't matter that I was only 5dp5dt and it was only 10dpo and too early for most HPTs to detect anything.

After I saw the (very very faint) second line (seriously I saw that elusive second line I've been chasing after for 2.5 years!), I wrapped up the stick in a gift bag with the card I had for Casey. I gave it to him when he woke up and we snuggled and celebrated together. I haven't seen Casey smile like that since our wedding day!

Casey's "First Look" at Alexis

Our celebration was fairly short lived. The line was just so faint. Maybe it wasn't even really a line. We weren't sure we trusted it. So we waited to celebrate when the doctor gave us official results.

At 8dp5dt (eight days post five day transfer or thirteen days post ovulation) the doctor looks for a Beta of 30+ with an expected range of 30-50. Ours came back at 186! Such a beautiful number!  So high! So positive! Again we celebrated and snuggled and then called our families to share the good news.  We also stopped for a minute and to be excited, because, no matter what, at least for a little while, I was pregnant!

Our next hurdle was determining if it is a viable pregnancy.  They do that by looking at the "doubling time" of your Beta HCG.

Today was my second Beta. This time they were looking for the number to go up. Ideally the number will go up by at least 60%.** My number increased by 97% to 367! At 1-2 weeks post conception (which at 13 days I am) this number typically ranges from 40-300, which I am above.  367 is also a beautiful number!

Now I feel like we are able to celebrate! We are pregnant! We are having a baby!

There is a bit of scary news: I have been diagnosed with moderate OHSS, which can be a scary and life-threatening complication of early pregnancy after IVF if it becomes severe. My doctor is being very cautious and monitoring me very closely.  This post is about the AMAZINGNESS of our pregnancy announcement, so I'll do a post next week on OHSS and what it means.

Seriously though.  We're pregnant!!  I don't know how to be pregnant!  I know everything there is to know about trying to conceive, but I have no clue how to be pregnant!  But I am!!

** For the other IFers, many REs look for it to double in 48 hours, but most are testing just a few days later. At 15dpo doubling time can be as high as 96 hours and still be okay. I was nervous when we first got our results because it hadn't doubled, but that's because we are still so early.

Jun 21, 2012

9dp5dt: Reminiscing

No baby news to share today, but I am pleased to announce that today, almost six years after our wedding, I finally finished our wedding album!   I need to go through it carefully to make sure I don't have any typos or other errors and make sure I am completely satisfied with the photos on each page, but overall I am really happy with it. 

I chose to go with AdoramaPix for the photo book because I love the leather cover, foil engraving, and lay-flat pages.  I didn't love the online editing software (biggest gripe: it couldn't edit photos at all!  I had to edit them and them re-import them). I am excited to order the book and see the quality.  The book is quite a bit more expensive than one from Shutterfly or similar sites so the quality will have to pretty impressive for me to use it again!

Jun 20, 2012

8dp5dt: Beta Blood Draw

Today was my blood draw for my first Beta HCG. After we hear results from the doctor, we will take the rest of today to celebrate/mourn together and inform our families. If the result is good, we will have a blood draw for a second beta on Friday which will help determine if the (possible) pregnancy is viable.

We will wait until Friday to post an announcement to the blog so we can either have time to mourn privately or we can have the results of this second beta test before sharing.

Thanks for respecting our privacy.

Jun 18, 2012

6dp5dt: To Tell or Not to Tell

I find myself in a really uncomfortable position.

I have been really open and honest throughout this IVF journey. I have shared everything. I've gotten (mostly) very positive feedback and have been astonished by the number of women I know who are silently fighting this same battle. I've been humbled to hear from many women that my openness about my journey has been inspirational for them. Your comments, tweets, Facebook messages, emails, and texts have encouraged me and lifted me up so much. Casey and I both truly believe that your prayers are the reason we have had the success we have had so far this cycle. The amazing feedback and some of the incredible infertility and pregnancy loss stories that have been told to me in confidence make me want to continue to be open and honest here on the blog.

But (you knew there was a but right?)

I have always silently judged people who publicly announce pregnancies before the end of the first trimester. Especially girls who post a picture of their pee stick on Facebook the day they take the test. At least tell your family first! And no one wants to see your pee stick! Words will do! Miscarriage is such a real fear that I've never understood why someone would announce a pregnancy to the world before getting past that largest period of risk. One in three pregnancies end in miscarriage! The idea of retracting a pregnancy announcement and having people who don't see the retraction ask about pregnancy progress makes me feel ill.

So here I sit. On the one hand, your amazing comments and feedback leave me wanting to swallow my words and my previous pregnancy announcement stance and tell you all. On the other, I just don't know if I am strong enough to tell people about a miscarriage and have well-meaning folks making comments and asking about the then-over pregnancy.

To many of you, the fact that I am this worried about miscarriage must seem overly pessimistic and maybe even crazy, but we have truly struggled to get pregnant and because of my diagnoses I am at a much higher risk of miscarriage than the average woman. I am so excited to see the elusive second line on a pregnancy test and to get the call from the REs office telling me my beta HcG level is elevated and I am pregnant. But I am also terrified. Terrified of being pregnant but not becoming a mom.

And so, I am really struggling to announce this. I will have blood drawn on Wednesday to tell us my Beta level (learn more about beta HCG here and about doing home pregnancy tests after IVF here) and find out if I am in fact pregnant!

I have really debated not coming clean about the date of Beta so that I could have some time to process whatever information we get, good or bad. But, I can't write about the booty shots, suppositories, and invasive-all-up-in-my-business ultrasounds and not write about the results of my first Beta Test. I have been forthcoming and honest thus far, and I will continue to be.

Don't expect the post to be written on Wednesday afternoon after I get results, but sometime this week my blog will announce if I am in fact pregnant.

For now, I remain PUPO (pregnant until proven otherwise).

Jun 17, 2012

5dp5dt: Father's Day

prepared myself all week for Mother's Day and the storm if emotions I knew it would bring, but somehow, Father's Day just snuck up on us.

Friday night during dinner, I asked Casey how he felt about Father’s Day coming up over the weekend.

Hs response?

"It doesn't bother me. I'll celebrate my Dad and my two brothers and the great men and Father's they are. Why would I be bothered by it? I have no reason to celebrate it now, but I will someday."

I thought of Mother's Day in terms of my loss and what I didn't have. He is thinking of Father's Day in terms of the great examples of father's in his life. The rest of it just doesn't apply to him yet.

This is why Casey is a better person than me.

My heart breaks that because of me and my ancient ovaries Casey isn't a Daddy yet. There is nothing in the world I want more than to see him wrapped around our baby's little finger. I know he will make an amazing Dad and will act as a spiritual leader, raising our baby to be a warrior for Christ.

Today, I am grieving for Casey and all of the other Daddies-in-Waiting out there. I'm also wishing we knew if these little buckaroos had implanted because how awesome would it be to tell him we're pregnant on Father's Day!

Sadly, still too soon to test.

Jun 16, 2012

4dp5dt: IVF Gift

I truly love my husband. He is thoughtful, patient, understanding, considerate, loving, strong, spiritual, and the man I adore above all others. Throughout this process he has held my hand and reminded me I am not alone, counted cycle days with me, hugged me and let me cry, encouraged me in my faith and to remember God is on the journey with us, gone to doctors appointments to see follicles, called to check on results, learned more about female anatomy than I imagine he ever wanted to know, been left in the waiting room during surgery, brought home flowers to brighten the rough days, reminded me that we are strong and we can do this, prayed with me and for me when I couldn't do it alone anymore, been my rock and my strength, pre-loaded my iPad with books and movies for bed rest, always been ready with an "I love you", and waited on me hand and foot. As if he hasn't been amazing enough throughout this IVF process and my bed rest confinement, last night he reminded me again of just how wonderful he is.

Last night, Casey gave me an IVF Gift to thank me for all of the junk I am putting my body through, for the shots I give myself, and for being willing to take this journey with him.


A better man doesn't exist anywhere! We are one step closer to our dream for our family and Casey has been there every step of the way as my rock and my strength, comforting me even though I know he is hurting too. Just like me, Casey is waiting and hoping and praying. I feel like it should have been ME giving HIM a gift this weekend (especially since it's Father's Day weekend!), but as I said - he is just amazing!

I show you my pretty new necklace, with one sparkly diamond and a blue topaz (my birthstone):

Relatedly, in about an hour we head to the doctor's office (which means I get to leave the house!!) to have blood drawn and check in. They want to ensure my hormone levels could support a pregnancy if the bugger(s) decided to snuggle in. As long as everything looks okay, they'll take me off of bed rest today!

Jun 15, 2012

3dp5dt: Our Embabies First Photo Shoot

They say a picture is worth a thousand words:

But maybe just a few words to go with it...

Top left: Casey wore an attractive onesie over his clothing so he could go into the surgery room with me. I was on valium which made me silly and giggly (or maybe that was nerves) but I thought his onesie, hairnet, and booties was the funniest thing!

Right: Our two beautiful blastocysts. Please snuggle in little buckaroos!

Bottom left: Casey and I right before the transfer procedure. So excited! I made fun of Casey's hairnet and booties, but I was wearing them too. Along with a very attractive open-back gown and my warm and lucky bright blue lacoste socks.

Middle left: This is a picture of the ultrasound during transfer. The black area at the top is my very, very full bladder (48 ounces of water in an hour). The white snakey line is the catheter they used to place the blastocysts. The blastocysts are too small to see with a naked eye, so they put two air bibles around them in the catheter so the doctor can see the air bubbles going into the uterus. I circled the two "flashes" which are the air bubbles and represent the two blastocysts being transferred into me.

Jun 14, 2012

2dp5dt: Useless on Bed Rest: Hail, Shattered Glass, and a Pantry Bug Infestation

They say when it rains I pours, but here in Dallas it hails!

Yesterday when I posted, I was feeling a bit sorry for myself. The progesterone is making me sick and making me crazy. I thought it was the worst part of bed rest.

It isn't. The worst part is feeling useless.

Last night we had baseball sized hail that cracked all six skylights in our house! On three skylights it only cracked the outer cover of the skylight, but on the other three the hail went all the way through both skylight layers and right on into our house.

It happened just a bit after six while Casey was trying to cook dinner. Poor Casey was running around the house moving rugs, moving furniture (including moving the pool table by himself - strong man!), placing trashcans and pots to hold water, all while trying to cook dinner. He got the water/shattered glass situation under control and returned to dinner prep.

Then, he found pantry bugs in the macaroni noodles (Seriously?!? Now?!? Apparently I now have plans for my first day off bed rest - cleaning out the pantry!) and left the fish in the oven until it dried out while he was on the phone with the adjuster and the roofer. We decided it was a pizza night (Dallas folks - if you don't know about the Papa John's rangers7 code you are missing out!).

It gets worse.

When Casey walked out to his car to go pick up pizzas, the windshield was smashed through and it looks like someone beat it with a hammer. Apparently we are buying two cars this summer not one because I have a feeling the insurance company will total that one. One good thing about me on bed rest: Casey can just drive my car for a few days.

Through all of this, I had to lay in bed/on the sofa and be a bystander. I haven't seen all of the damage to the house or car yet, although Casey described it and took a few photos for me. I felt so useless and so helpless.

Casey and I are a team and watching him struggle through this alone was so hard for me. I wanted to be there to help him and support him and run around fixing things with him. Instead, I laid in bed and prayed our little embryos would snuggle in. I know (and Casey reminded me) that I was exactly where I needed to be doing exactly what I needed to do. But I still wish I Casey didn't have to deal with so much alone.

Eye on the prize. He dealt with all it alone to protect these two beautiful blastocysts. He did it to give our future babies a better shot.

Snuggle in little ones! Your Mommy and Daddy love you already.

Jun 13, 2012

1dp5dt: Progesterone

The egg retrieval process affects many aspects of a woman's body and leaves many patients without enough progesterone or estrogen to support a pregnancy. Per my protocol, I am getting estrogen through a patch on my stomach. easy-peasy. The progesterone is not so easy and is taken in the form of progesterone in oil (PIO). The day after retrieval I began injecting a 1.5" 22 gauge needle into my hip each night. I'm now 5 days into the fun of booty shots.

These shots are perhaps the most intimidating aspects of IVF for many women. The needle is huge, I mean really, really long. I use smaller nails to hang pictures. The PIO is an incredibly thick solution so even after stabbing an inch and a half of needle into your booty, you still have to push the syringe. The PIO is so thick you can see your skin expand to make room for it. Painful doesn't begin to describe!

I have always heard that progesterone is the worst part of the two week wait. I thought it was because of the shots. Perhaps for some women it is.

Well, not for me. Just like the progesterone in the form of a suppository I took during IUI, PIO has left me constantly queasy. So far no actual nausea (praise God!) but sometimes I wonder if actually getting sick might make me feel better. I'm also, of course, emotional and tired.

The emotional I understand. Right now, I am "pregnant until proven otherwise" with two beautiful little embryos hopefully snuggling inside of me for a long time. In two weeks, we will know for sure if either one has decided to hang on. Until then, I am in a state of uncertainty. Hopeful, but afraid to hope too much because I don't know if I can take the disappointment. Terrified, because I don't want to do anything at this point that could potentially harm implantation.

Anyway, back to my point: Progesterone is making me crazy.

Its side effects can mimic early pregnancy — tender breasts, nausea, slight uterine cramping — but of course, it is far too early for me to experiencing any pregnancy symptoms. Those won't start for at least two weeks. But, any any moment after embryo transfer (including today 1dp5dt -- shorthand for one day post five day transfer) any physical sensation can as easily be attributed to progesterone as to pregnancy or AF. You can think you're pregnant when you're not even close. Or you can think your period is imminent when you won't get another one for months - nine perhaps :).

In short, I'm screwed and can't count on my bodies cues for anything at all. And at any moment I'm sure I'm going to start losing my cookies. And I'm on bed rest.

It sounds like I'm whining a bit. Actually, it doesn't just sound, I am whining a bit. But the reality is, I would inject myself with 100 needles a day and let the queasy go full-blow nausea if it would help one or both of these little embabies to snuggle in.

Jun 12, 2012

Transfer Day

Today we transferred two beautiful Grade 1 blastocytes into me.

I could write a huge blog about this, but really that sentence (and the photo which I'll have to get Casey to post later because I'm struggling from the iPad here) tells it all!

We also have 3 blastocytes that will be frozen for future babies. Our God is so good and so loving and so powerful. Our first doctor told us not to bother trying IVF and to go straight to donor eggs. My diagnosis of diminished ovarian reserve left us uncertain if we would ever make it to transfer.

And we did!

We better than made it. We did a day 5 transfer of two beautiful grade one blasties and have three left for future attempts or siblings someday.

After the procedure, our RE shook Casey's hand and said: "We've do e all we can. Now it's in God's hands."

Comforting words! Now it is all up to God.

Come on little blastocytes -- snuggle in!

Jun 9, 2012


Things are going really well for Casey and I. Of our 11 retrieved eggs, NINE FERTILIZED!

Seriously - NINE! NINE!!!

Today, we went in for an ultrasound and blood work and everything looks great. My ovaries are still quite swollen (more so than the doc would like to see) so I was told to spend today hanging out in bed and resting and drinking plenty of fluids. I've spent the day watching Downton Abbey and I'm almost finished with season one. It's been a pretty great day!

We will get a call tomorrow morning from the embryologist letting us know how our little embabies are getting on and telling us the final decision as to our transfer day.

Transfer will either be on Sunday (tomorrow!) or Tuesday!

Jun 7, 2012


This morning Casey and I arrived at the surgery center bright and early for my oocyte retrieval procedure at 6:30AM. Most people call it egg collection or retrieval, but all of the signed release forms and paperwork referred to oocyte retrieval and I'm digging the phrase.

Our end result is amazing!! God is truly listening to our prayers! Right now, about a mile from our house, an embryologist is looking through his microscope at a small zygote that will grow into an embryo that is part Casey and part me. No matter the outcome of this procedure, I will always know that for at least a little while, a perfect mixture of he and I existed in the world. It is truly a mind-blowing thought. Every time I think about it, the happy tears start flowing. I love that man with all of my being and thinking of a child of our own hearts and formed of our love is the most amazing dream.

The surgery is relatively simple (although certainly not painless!) and only took about 30 minutes (plus about an hour in the recovery room). For the procedure, a transvaginal ultrasound allows the doctor (our RE, Dr. Pinto) to see the locations of each ovary and each follicle inside each ovary. Once he has a clear view, he uses a needle to go through the vaginal wall and into the ovarian follicle. When the needle is inserted properly, the follicle is aspirated. This means that the follicular fluid is sucked up using a suction device attached to the needle. Inside that follicular fluid is the oocyte, which has been loosened by the "trigger" shot of HcG I took Tuesday night. This process is repeated for each follicle and then repeated on the other ovary. There is typically one oocyte, or egg, per follicle, and typically about two-thirds of the eggs are viable. While I was in the operating room, Casey performed his part of the procedure (why is my part painful surgery and his part just himself alone in a room?).

All of the follicular fluid and the sperm sample then go to the embryologist who separates out the eggs and gets ready to start fertilization. In total, we collected 11/12 eggs!! I'm ready to throw a little oocyte party because that number is incredible! Before starting IVF, we were so worried we wouldn't even get the six follicles needed for the procedure - and we doubled it!!! God is so good! If walking wasn't so painful I would be doing a happy dance! Of the 11/12, they think 8 or 9 are viable, mature eggs!

Right now as I speak, the embryologist is potentially fertilizing 9 eggs and creating 9 little zygotes that will become our embryos. We will get a call tomorrow to let us know how many of them fertilized! For now, we are waiting and praying.

We are praying these eggs mingle with the sperm and create perfect little zygote mixes of he and I. We are praying the little embryos are strong fighters and survive in the petri dish long enough to grow and divide. Ideally, on Sunday we will have eight-cell embryos that the doctor will transfer back into me! Grow embies grow!

As a side note: Would it be weird to ask the embryologist to take a picture of our embryo? My baby would have the worlds coolest baby book if it started from zygote and went all the way through!

Jun 4, 2012

Stimulation Day 10

Today was my last scan before IVF retrieval early Thursday morning!

They measured 15 follicles - 5 on the right and 10 on the left!! The RE says with confidence that any follicle over 15mm contains a mature egg - and I have 9 of those! I have four that are above 13mm and so may contain an egg (and could still grow a bit before Thursday). I am over the moon! We spent so much time worrying if this IVF cycle would ever happen (see previous posts for the crazy number of obstacles) and then worrying I wouldn't get the necessary six follicles to continue with retrieval. But everything has worked out! God is so good! He is sufficient and provides what I need. Overall, all looks good and I will trigger tonight!

At my women's bible study this morning we discussed God's sovereignty and His plan in everything. It was a really comforting discussion for me this week as I begin to fret about the next steps.

Ecclesiastes 7:13-14
Consider what God has done:
Who can straighten
what he has made crooked?
14 When times are good, be happy;
but when times are bad, consider:
God has made the one
as well as the other.

The "straight" times are the times of peace and joy. They are the times when it is easy to sing God's praises, "and everything fits together nicely." In the "crooked" times, everything still fits together according to God's plan even though we can't see where all the pieces go. I bring lots of "crooked" into my own life, but even the bad I heap on myself can is used by God for His glory and His plan.

Certainly this infertility journey, a "crooked" that comes from God and is part of His plan will be used for His glory. God is in control of all things, including my future family, and will do everything to His purpose and His plan. By His very nature God is love and so I know His plan for me will work for good and love: And we know that in all things God works for the good of those who love him, who have been called according to his purpose (Romans 8:28).

I know this because I know: This God -- His way is perfect (Psalms 18:30)

God's way is perfect. God's way is sovereign. Nothing I do, even the "crooked" I bring on myself can thwart His will.

God -
Bless my crooked life and decisions. Tonight I will take my trigger shot and prepare for retrieval on Thursday. Give me an awareness of your sovereignty and let me experience the peace that comes from knowing Your will will always be done. You are in control. And because I know You and love You and trust in You, I go forward into this process comforted by Your presence and majesty.

Stimulation Day 9

Today marks stimulation day 9 and I had another scan this morning.  I had 10 follicles on the left, ranging from 10mm to 20mm and 5 on the right ranging from 12mm to 20mm.  Six of the follicles seem to be growing together in the biggest clump and 10 are currently large enough to be considered "mature."  My lining is in good shape at 13.6mm.  My estrogen is at 2,177.

I didn't get a photo of the screen today because the screen can only show 13 follicles.  So when the nurse left the room so I could sneakily photograph the display it was on page 2 and only showing the size for two small follicles.  The rest were on page 1 and I didn't want to touch the fancy computer and risk messing anything up.

Once the largest follicle reaches 21mm it is time to trigger and wait for retrieval so we should be triggering tomorrow and scheduling retrieval for Thursday.  This should give plenty of time for some additional follicles to cross the 13mm "maturity threshold" which is the estimated size a follicle needs to be to contain a mature egg. 

We are moving forward!!!!  I am walking on air today!

Jun 2, 2012

Stimulation Day 7

Today is the day our original IVF calendar had retrieval scheduled.  Obviously we are no longer on that track  -- but we did get good news today at the appointment and it looks like everything is going well.  Casey was able to go with me this morning to the RE and see my little follies as we wait for them to grow and mature. 

This appointment was with the actual RE and he didn't measure as many of the follicles.  He only measured nine of them and said the rest looked to be under 10mm and so too small to bother measuring.  He measured 6 good size follicles and three smaller follicles.  My estrogen is up to 1,333.

It looks like retrieval will be on Thursday, but we will know more after my day nine scan on Monday!

Now off for an afternoon of errands, napping, and maybe even a movie tonight.

Jun 1, 2012

Stimulation Day 6

My additional supply of Bravelle was supposed to arrive from Medco (well from Accredo, which is a specialty pharmacy that is part of Medco) by noon today.  I spoke to the pharmacy on both Wednesday afternoon and Thursday morning confirming this.  Both times I was assured my order was being processed and they would call soon to collect payment and arrange shipping.  Both times I was assured it would arrive by noon on Friday, in plenty of time to use.  I will run out of Bravelle at my 8PM Friday night injections and not have enough to do my Saturday injections.

I called Accredo again this morning (at 9:15) to find out what is going on only to learn that my order still hadn't processed!  After an hour on the phone, the good folks at Accredo had nothing for me.  They said it looked like a "computer error." The only information they could give me was that  Accredo was going to work with a team of supervisors and call me back if they could determine a solution. 

After getting off the phone with Accredo, the pharmacy Medco was requiring me to use, I called Medco.  Medco didn't have any local pharmacies with Bravelle in stock that they consider in network and will cover.  They found Bravelle in stock at two in-network pharmacies: one in Austin and one in Chicago.  The woman on the phone didn't understand why I didn't want to pick up and drive to Austin because "they are both in Texas so it has to be close."  Oh people!  Texas is a HUGE state!  My amazing husbands response to this when I called him "I'll start looking at flights to Austin.  Worst case scenario I'll fly down for the afternoon.  Maybe you can come too and we'll make a night of it!"

I hung up with Medco and called my REs office.  They at least had a partial solution: two boxes of Bravelle available at their office which I could borrow until mine arrived.  Sadly, two boxes only gets me until Sunday morning.  I still needed my shipment to arrive before the weekend ended.

It was now getting close to noon and I had done nothing all morning but try and find this medication.  Did I mention that I am taking high doses of hormones?  That are causing crazy sharp pains in my abdomen (near my ovaries)?  That make me really emotional? 

When I spoke to Accredo again at 11:41, I was literally bawling on the phone from the frustration and the emotions and the fear that without these drugs we might have to cancel the cycle.  They attempted to assure me a solution would be found and once again said they'd call back.

When they finally called back they had a solution!  I am at this moment all praises for the folks at Accredo pharmacy!  My medications will be flown to Dallas and then couriered to my house.  They should arrive at 11:30PM tonight!

This IVF path is most certainly not for the faint of heart!