The Part of the Story Where I Wish There Was a Better Ending

Oh, how I wish I had better news for this post.  But sadly I don't.

To recap:

Two weeks ago Saturday, we had our retrieval.  We ended up with 8 eggs.
Good, not great, based on our doctor's predictions.
But I'll take it.

The next day we get a call from the nurse.  Six of the eggs were mature enough to fertilize.
Five of them take.
Five feels good....enough for multiple tries.
Maybe even multiple babies. 
(Oh, dare I hope?)

Lots of prayers are uttered on Sunday as we simply await Monday's transfer.
Lord, please protect our babies.

Bright and early Monday morning we make the 2 hour trek to our reproductive endocrinologist's office.
Our spirits are high and we're feeling hopeful.
We are prepped and brought into the transfer room.
The doctor comes in and tells us that only ONE embryo continued to develop through the night.  That the sperm was just "no good" this time around.
One.

We are disappointed and discouraged.
And yet, we have HOPE.
This one, sweet little embryo.
The doctor tells us that this little one is healthy and that we have a chance - about a 40% chance.

Forty percent is great in the fertility world.
In the real world though, it doesn't feel as great.
The big, gaping 60% is staring me right in the face.

But we're grateful for anything at all.
And we know that our God is a God of miracles.
That with Him, numbers and chance don't matter. 
"Insurance" of extra embryos means little.
It's all God.
We choose to hope for the best, knowing that we are in God's hands now.
That's a good place to be.

We spent the past two weeks waiting. 
Mostly we stay strong.
But as the day of the pregnancy test nears, I am feeling more discouraged.
Any symptoms of being pregnant (most likely brought on by the HCG shot in the first place) have disappeared.
I know there is still a chance, but I'm worried.

Today was the pregnancy test day.
I woke up to spotting.
My gut is telling me that it's just not going to happen this time.

I go ahead and get myself and the boy out of the house and over to the lab.
I cry all the way home.

We wait all day to hear from the nurse. 
I'm still spotting, and I know in my heart that I'm not going to hear happy news today.

I'm right. 
The nurse finally calls around 4 to let me know that the test results are negative.
And she's so very sorry.
So am I.

Then I have to break the news to the Mr. who arrives home from work shortly after.
He has a glimmer of hope in his eyes, and I know that he thinks that it was a good sign that I didn't call him earlier.
Like maybe I wanted to surprise him with good news.
I hate to be the one to give him the news that breaks his heart.
This sucks.

We decide we need a distraction, so we head out of the house for awhile. 
Treat ourselves to Cokes and greasy restaurant fare.
"Comfort food," we say.
But we both admit that we'd give up Coke for the rest of our lives, if we could have a baby.
The Mr. says he'd even give up his computer for the rest of his life in exchange for a baby.
And if you know him, that's really saying something.

There is grief and disappointment and frustration.
There's confusion and asking "Why?"
But there's also comfort in knowing that God holds our future in the palm of His hand.
We are grateful for friends that are lifting us up even as I type this.

The Mr. reminds me that we have so much to be thankful for.
And it's true.
We just wanted more.

So what's next?
We really don't know how to answer that question.
And that's okay, because we don't need to right now.

I hate to think about never using my baby clothes again,
or never having a chance to dust off the old baby swing.
My heart longs for more children to fill our home.
And yet I am eternally grateful for the one I have.

We'll see what God has in store.

Retrieval Day!

Phew, we made it!  I'm happy to say that I am on the other side of the retrieval.  We reported to the doctor's office at 7:15 this morning for an 8:00 AM retrieval.  The nurse prepped my IV and I met with the anesthesiologist.  Things got going just after 8. 

The sedation worked like a charm.  Once I got in place in the procedure room, the anesthesiologist gave me some oxygen and asked me if I was starting to feel fuzzy.  I said "No,"...and that was the last thing I remembered!

Unfortunately, after the procedure I woke up to quite a bit of pain because I was cramping like crazy.  It lasted the better part of an hour but progressively got better as the tylenol (and later, the ibuprofen) kicked in.  I went home and slept most of the afternoon and now I feel like a new person.  I am still quite sore in the abdominal area, but I think that I'll be feeling back to normal tomorrow!

And...the results.  Well, we continue to be cautiously optimistic.  Based on ultrasounds, the doctor was expecting to retrieve 15-18 eggs. We were to the point that we were thinking that we would need to limit the number that we had fertilized.  But for whatever reason, there weren't eggs present in each of the follicles that he aspirated.  This seems to be a repeating pattern for me in these IVF cycles, and we're not sure why.  But we ended up with 8 eggs, which is still a good number.  The last few days we have been praying over the number of eggs, that God's sovereignty would cover whatever decision we made with our limited knowledge and perspective.  Now we need to trust that this is the perfect number for us, and hope that God will choose to bless us in this process.  It only takes one embryo, after all!  (Although we are certainly hoping for a few more!)

Tomorrow we will find out how many of the eggs they were able to fertilize, and what time to report on Monday for the transfer (God willing!).

Tonight I am feeling thankful and am feeling at peace for the most part.  We hope to get great news tomorrow, but we know that we are in God's hands, and that is a good place to be.  May He give us grace for whatever the outcome!

Thanks to those of you who have walked with us, prayed for us, and encouraged us through this process.  We love you and are thankful for each of you. 

The Beginning of the End

It's been quite a week!  I saw the doctor Saturday, Monday, Wednesday, and today.  Things are progressing really well, and at this point I'm feeling cautiously optimistic that this cycle may end much differently than our one in April...and that is a good thing.  There's been a lot of activity in my ovaries (meaning lots of follicles growing, and I have some huge ones!).  I'm hoping this means that we'll be retrieving some nice, big, healthy, mature eggs.

Speaking of which, my retrieval is scheduled for Saturday morning at 8 AM.  I'm feeling nervous and hopeful, but mostly I'm just eager to have it over.  It's the beginning of the end, and it's scary.  So much is going to happen over the next few days.  Overall this cycle seems to be so much better, and we're actually having to discuss whether or not we want to limit the number of eggs we have fertilized...we have the potential to have THAT many.  It's so hard to know what to do...on one hand, we hate to limit and then wish we had done more.  On the other hand, we do not want to be in the position of having too many embryos.  Praying that God gives us wisdom on this one, and that He will give us the perfect number.

If all goes according to plan, transfer will take place on Monday.  And then we wait!  It's almost surreal that we're at this point again.  I am thankful.

And speaking of thankful, I am SO incredibly thankful for the excellent customer service I have received from my specialty pharmacy over the past week.  We have had one heck of a time getting refills on my meds this past week thanks to superstorm Sandy.  There was actually one point on Monday afternoon that I got a call telling me that those meds that I had to have delivered the next morning?  Yeah, that wasn't going to happen, thanks to the weather.  (The pharmacy is stationed in Pennsylvania.)  I tell you, I nearly broke down and cried right there on the phone.  Being in the middle of the cycle, I could NOT go without these refills!  But we worked together, and in the end they managed to get my stuff shipped to me overnight night, from Texas (I live in the Midwest).  Phew!  Thank you God!

Another thing to be thankful for...the boy and I have been staying with my aunt this past week in order to be closer to my doctor's office (I live 2 hours away from my fertility specialist).  We have had a good week together.  Tonight the Mr. joined us; I'm happy to have our family all under one roof again.  And I'm especially thankful that my aunt so generously opened her home to us this week!

And one more thing.  Two of my husband's brothers, their wives, and their families (along with several of the Mr.'s aunts, uncles, and cousins) live on the east coast.  They are without power, but they are safe and their houses are fine.  We are so grateful.

I hope you all have much to be thankful for this week as well!
 

Hanging in There!

Hi friends!

I thought it was time for a little update on how things have been going this cycle.  I am doing well.  Today I had to give myself FIVE shots, which has got to be some sort of record.  Plus I got my blood drawn.  So yes, I would say things are in full swing around here!  I'm starting to feel like a pin cushion and have a few nice bruises to show for it, but really I am tolerating the meds quite well, and I am thankful for that.  I'm a little extra tired these days and at times feel a little "off" - sort of nauseous but not sick to my stomach, but overall I am well. 

Things seem to be running smoothly for the most part.  We have only had a couple of bumps in the road, and none of those have been too serious...

• The first night I went to do my shots, I realized that the nurse and I totally failed to discuss how to administer the one new drug I am using this cycle.  Shoot!  And of course it's 7:00 at night, so I can't call her.  I end up calling the answering service, who pages my doctor (who happens to be the one on call that night).  I absolutely HATE the idea of disrupting his evening, but what else can I do?  He graciously helps me figure out the answer (he ends up having to call the nurse himself, which is what I thought would happen).  In the end, everything works out fine, but not the most stress-free start!
• On Thursday I visited a clinic a little closer to my house for a monitoring appointment.  The Mr. and I have been there before for a consultation, but I've never driven myself.  It is in a large, downtown area that I'm unfamiliar with.  My appointment is at 8:10 which means I find myself in rush hour traffic as I get closer.  I'm doing well until I suddenly find myself stuck on an exit only ramp that brings me onto another highway altogether and right into the heart of downtown.  CRUD!  That would have to be the day that I forgot to grab the GPS out of the Mr.'s car!  I spend a few minutes in utter panic, then drive around and finally manage to get myself back where I came from.  I arrive at the clinic with a few minutes to spare.  Phew!  I'm glad they didn't take my blood pressure that morning!  :)
• This morning I had a monitoring appointment scheduled with my fert doc.  His office is 2 hours away from my house.  In the past, I have done monitoring appointments at a local clinic that works with his office, but this time around we both decided that it would be better to have more appointments at his office.  Plus, his main office is the only one that is open on a Saturday, so I have no choice but to make the drive.  My appointment was scheduled for 10:00 AM.  So I'm thinking that I'll leave the house by 8, home by noon...no problem!  The Mr. will spend the morning with the boy, and while it's an inconvenience to drive 4 hours round trip for a measly 20 minute appointment, I try to stay positive.  Around 11 last night, I decide to charge my cell phone to make sure I have it for the trip the next morning, and I see that somehow I missed a call.  I listen to my voicemail, and it's my nurse telling me that she's very sorry but my appointment had to be changed, and now they need to see me at 7:40 AM instead.  WHAT?!?!?  So I set my alarm for 5:20 and am out the door by 5:40 this morning.  I practically need toothpicks to keep my eyes open on the way there; it is pitch black, and since I'm warding off caffeine, well YAWN... 

But seriously, if these are my only problems, then I'll take them!  As long as I am responding to the meds as I am supposed to, then I can handle the little annoyances.  My doc wants to see me again on Monday for another monitoring appointment, and as we get closer to retrieval time, I expect that I'll need to be seen more frequently at the main office.  So the Boy and I are going to leave tomorrow evening to go stay with my family who live much closer to my RE's office.

I'll try to update later in the week!  Hope you all have a good rest of the weekend!

Update

Went back to the fert doc this morning for a follow-up ultrasound...and the cyst was gone!  Yay!  

So we're on track to get things rolling.  Today I had my first blood draw, and then I plunked down a big chunk of change to pay the balance due for this cycle.  Injectable meds start tomorrow night - beginning with the follicle stimulating hormones (FSH) and the growth hormones (GH).  The plan is to see the doctor again on Thursday for another ultrasound and blood draw. 

Feeling thankful today for answered prayers!  

Irony

Remember in the last post when I said I never had a found during my pre-IVF ultrasound? 

Well, scratch that.

I think I jinxed myself!  I went in for my U/S on Friday, and sure enough, there is a cyst on my left ovary.  D'oh!  I'm not super freaked out...obviously this type of thing is pretty common, since they do a special ultrasound just to check for them.  And there is a good chance that once AF arrives, the cyst could be reabsorbed.  If it remains, though, it looks like we'll have to delay a month.  So we'll see what happens.

Praying that the cyst clears up on it's own in the next few days.  But if it doesn't, I'm going to trust that God's timing on all of this is better than mine. 

IVF

I can't believe the whole IVF process will be starting up for us in about a week or so!  To quote my dear sister-in-law: "Deep, cleansing breaths!"

I realize that not everyone reading this blog understands the process of IVF, and so I'd thought I'd describe the process for those who are interested.  If you dislike medical talk or are at all squeamish, feel free to pass this post right on by!  :)

Here's a description of a typical "fresh" IVF cycle:

Initially, you go through some tests - bloodwork, a hysteroscopy (scope of the uterus where they inject saline to make sure the fallopian tubes are clear and also check that the uterine wall look healthy), and a mock embryo transfer - where they actually go through the process of inserting a small catheter into the uterus and pretend they're transferring an embryo to make sure that everything can be done smoothly when the time comes for the "main event." 

When you get your period, you go in for a general ultrasound to check the lining of the uterus and to make sure there are no cysts on the ovaries.  Cysts are not uncommon during menses, but the hormones injected during IVF could cause the cysts to grow, or the cysts could affect the ovary's ability to produce eggs, so if cysts are present, then usually they make you wait a month (this hasn't happened to me).

If everything looks clear, they bring on the drugs.  Generally, you first have an injection that shuts down your ovaries (this is actually started before you get your period and then is administered throughout the IVF cycle).  They do this because they don't want you to spontaneously ovulate on your own; they want to control everything themselves.  This drug is called Lu.pron (or leuprolide acetate = generic).  Sometimes you can be on this a week or two, with one injection each day. 

Then, around Day 3 of your period, you add a second drug that grows the follicles called an FSH (follicle stimulating hormone).  The job of this drug is to grow the eggs in the ovaries.  The ovary is made up of follicles.  In a normal cycle of ovulation, just one follicle of the ovary will produce an egg.  The goal in this step of IVF is to stimulate multiple follicles to grow eggs.  Each follicle has just one egg growing inside of it.  But since the ovary is made of many follicles, the ovary will produce several eggs on this medication.  (Last cycle I have 8 growing on my right ovary and 9 on my left.)

As the eggs get bigger, a second medication will be added to the FSH; basically it's job is to help the eggs mature before retrieval. 

The patient is monitored very closely during this process.  Every 2-3 days, ultrasounds are performed to measure the size of the eggs and blood is drawn to check estrogen levels.  They monitor your estrogen very closely because they don't want to overstimulate you, which can have some pretty awful side affects, and in very rare cases, can put you in the hospital. 

Trigger: usually around Day 12 (give or take a few days). Once a certain number of follicles reach a certain size (I believe it's around 15mm or so), you get a butt shot of HCG (Human Chori.onic Gon.ad.otropin) to trigger ovulation.  This releases the eggs, and exactly 36 hours later they are ready for retrieval.  After the trigger shot, all other injections are stopped as well.

Retrieval:  This is scheduled for exactly 36 hours after the trigger shot.  The patient takes valium to relax and is offered IV sedation.  A needle is inserted through the vaginal wall and up into the ovaries.  The end of the needle is hollow.  The needle aspirates each follicle and sucks the eggs out.  It usually takes between 20 and 30 minutes.

That same morning, the husband gives a semen sample (they have it sooooo rough, don't they!?!? Ha!).  After the retrieval, the lab fertilizes the eggs.  In our case, because of the male factor infertility with compromised sperm count and motility, we do an additional procedure called ICSI - an acronym for some very long name that means that instead of putting the eggs and the sperm together in a petri dish and letting nature take its course, the lab specialist picks out the best looking sperm and injects one into each of the eggs, thus improving the chance for fertilization.  This is often recommended for patients who have low sperm count or low motility.     

Once the eggs are fertilized, the cells start to divide.  The lab grows them for 2 days to see which embryos continue to develop.  Then you return to the office for an embryo transfer (usually 1-2 embryos), and if you have any leftover, they are cryopreserved in order to use later in a frozen embryo transfer. 

The transfer is easy-peasy.  They insert the catheter and drop those little babes off where hopefully they decide to nestle into that nice cushy uterine lining for the next 9 months or so.  :)  On the day of the transfer, you start taking a dose of progesterone.  This is either a butt-shot once a day, or a vaginal suppository 3x a day.  Also, after the transfer, the patient is on bedrest for 2 days to encourage implantation.

With the exception of the the Lu.pron and the pre-cycle testing, the whole process takes about 2 weeks.

About 12 days after the transfer, you have a pregnancy test with a follow-up test 2 days later.  If you are pg, you stay on progesterone through the first trimester.

So, that's IVF in a nutshell. 

This time around our experience will be a little different than I described above:

• We'll do a slightly different protocol, called the antagonist protocol, where I won't take Lup.ron to shut down my ovaries.  Instead, on Day 8 of the cycle, I'll start an antagonist drug called Gan.i.relix that will keep me from ovulating.  
• My doctor is also adding an additional daily injection of a growth hormone that has been found to help eggs mature more successfully with no adverse side-affects.  
• My doctor really wants to grow my eggs much larger than we have in the past - triggering when follicles reach closer to 22-24mm.  Oooh, boy.  I am going to be uncomfortable!
• Because we're pushing my ovaries further, my doctor wants to avoid the risk of hyperstimulation.  One way to do this is to use Lu.pr.on for the trigger, along with a small dose of HCG.  Yup, two butt shots...nice!  Don't ask me why this works, but it does apparently.
• We've also decided that for this cycle, I am going to be put under general anesthesia for the retrieval.  For me, each cycle's retrieval has become increasingly more painful and difficult, so I am thankful for this option.  Not everyone has the same experience with this, so if you are someone facing IVF, I'm not trying to freak you out!  My first times were difficult, but not nearly as painful as it was when we did it last April.  We do have to pay for an anesthesiologist, but I'm glad that this is even an option because enduring another retrieval very well could have been a deal breaker for me.

So for nearly two weeks, I'll be injecting myself 4 to 5 times on a daily basis.  I'll have at least a half-dozen blood draws.  And yes, there's that lovely needle used during the retrieval.  Needless to say, I'm going to feel like one giant pincushion by the time this is all over!!!

For those reading this blog who are considering IVF, I do feel that it's important to mention one other aspect that is significant to this process: cost.  IVF costs us thousands of dollars, because sadly our insurance company does not cover any costs related to IVF.  This is fairly typical for those going through this treatment. So if you're considering IVF, I encourage you to do lots of investigating ahead of time as to what may or may not be covered.   And while I'm incredibly thankful to be in a position where we even have the option to do this, I do have to admit that it's still hard to spend so much money on something that the majority of the population gets for free!  :)  

Still worth it though.

And one more thing.  God is teaching me so much through this journey.  Something that I have to keep reminding myself of is that ultimately I can't put all of my hope and trust in the medicines, the doctors, and this process.  Rather, I need to put my trust in the One who have given me the medicines, the doctors, the process.  Any time a life is formed, it is Creator God who is breathing life into that tiny being.  And while I'm incredibly grateful that God has given us skilled doctors, researchers for medical advancements, and all of the resources needed to help us have a baby, ultimately it is He who will give us this gift of life if that is His will for us.  I pray that it will be so, but more importantly whatever the outcome, I pray that I will continue to trust in His good plan for my life.