Wednesday, November 30, 2011

Done With the Look-Back Posts

Thank you for putting up with my long first few posts. They will not all be that lengthy I promise! Just had to get all of that out. Can't keep it bottled inside anymore. Infertility is crazy like that... getting so caught up in it and wanting to shout from the rooftops what is going on/what you are dealing with... but on the flip side... it's this big secret because for most, infertility is difficult to understand.

Feels good to get my voice back through these words. My stories.

This blog is intended to be part of my healing and support for the future. Somewhere to remember where I have been and what I was like while going through it.

IVF #2

IVF #2 begin in Sept 2011. Leading up to that I had a endometrial biopsy in August that turned out normal and had also started acupuncture/herbal tea. After the stress and anxiety of cycle #1... I felt all of these would get me into the right frame of mind for our next attempt. I was right!! Cycle 2 was way better than cycle 1. I highly recommend acupuncture for anyone undergoing IVF. I went once a week for a month prior to my cycle beginning then twice a week through beta.... then back to once a week. 
Cycle 2 protocol was a way different protocol altogether... For cycle 1 I was on a Microdose Lupron protocol and Cycle 2 I was placed on an antagonist (Centrotide) cycle. Dr. C was basically worried that maybe my previous cycle medications had affected my egg quality so we changed it up! 

Cycle #2 Medications! Double the Boxes!

Here is the antagonist protocol I was on: 
  • Start Estrace 21 days into cycle (2mg tablet am & pm) 
  • Stop Estrace 9/4 
  • Begin Stims 9/5 - 450iu Gonal F and 1 Menopur Powder Daily
  • Start daily Centrotide injections once follicles reach 12-13mm
  • Egg Retrieval 9/16
  • Embryo Transfer 9/21
  • Beta 9/30
As I said already... this cycle was awesome. I felt better then I had during cycle 1. Not as heavy or sore. Not sure if it was because I was just used to it now or what? I even had way more follicles this time so I figured I should be hurting even more! Maybe the key was keeping busy. I tried to schedule daily activities/appointments for things to keep my mind off of it as much as possible. Needless to say... ER was here before we knew it! 

Matching War Wounds!

ER 9/16 - Egg retrieval went well. Got to see my favorite operating room recovery nurse (I had fell in love with her during the previous cycle ER). She gave me more apple juice and crackers... yummmm after not eating since the night before. After such a great 11 days of stimming I was so excited to hear they had retrieved 20 eggs! So exciting!! 20 WHOLE EGGS!! Such a great number to hear after getting 11 the cycle before.The next day Dr. C called with the fert report... 20 eggs were all matured and icsi’d, 17 actually fertilized and were looking good. We decided to move forward with a day 3 biopsy to PGD them again. See IVF #1 post for PGD Information. 
ET 9/21 - Adel and I went into embryo transfer day ready for anything. After hearing such disappointing news on this very day of cycle #1 we didn’t want to be unprepared again. We were hoping the different protocol would have done the trick and we would have improved egg quality this time. Dr. C came into the room and went over the report with us... We had 3 chomosomally normal embryos. Better then cycle #1 where we were only left with 1 but still... so crazy to see the other 14 with such serious genetic defects. What was wrong with my eggs? I am 33 years old, relatively healthy, etc, etc. Why are my eggs producing so many unviable embryos? Anyway... those were fleeting thoughts cause we had 3 embryos to work with! 1 was a beautiful hatching blast BB, one was a expanded blast CB and one was still a morula. The expanded blast and morula were really not great quality... at all (even though we knew they had all their chromosomes). Dr. C didn’t really think they would be successful so we opted to throw all three embyos in and see what happened! I was ecstatic. Not so much because of the potential for multiples but because we had basically braced ourselves for such bad news... that 3 was good for us. That still left us with none to freeze but these things happen. Because of the PGD we even knew the genders... two boys and a girl. I loved the idea of putting both sexes in and letting god decide which one made it. Gender selection was never our focus and we looked forward to being surprised at an ultrasound gender reveal. ET was beautiful, happy, optimistic and just felt right.
2WW - Bed rest (strict 72 hours) and the 2 week wait went fine. I have such a hard time laying around for days on end but I was really focused on relaxing and not thinking too much! Lol. I started POAS 6DP5DT (6 days past 5 day transfer) and it was a faint positive!! YAY!! Tested daily till beta day and they all looked good!

POAS Obsession? 

Our 4 year wedding anniversary was the day before our beta and I was really thinking this baby was the best present ever!! 

Betas/HCG - First beta was on 9/30 (9DP5DT) and it came in at 54. I was concerned that was pretty low. I was involved in a IVF cycle forum and everyone that was posting their initial betas were in the 100’s but Dr. C convinced me that pregnant was pregnant. Beta #2 was done three days later at 12DP5DT and was 420. OMG. Talk about an increase!!! My numbers were now right in line with all the other ladies on my forum! My last beta was 15DP5DT and my HCG was 1966. I was official/officially pregnant. And so excited. Next stop... ultrasound! 

Pregnancy was awesome! Even if only a few weeks in. I definitely felt it. My boobs were gigantic and sore (mostly from the progesterone). I was tired. Peeing all the time. Dreaming crazy dreams. The whole nine yards. 
10/11 - Sat down to use the restroom, looked into at underwear and saw they were bright red. Wiped... lots of blood. Red blood. I immediately thought it was over. Frantically called Dr. C who advised me to come in the next day for an ultrasound (one day earlier than my already scheduled u/s). He told me to take it easy/bed rest for the night and we would see what was happing the next day. I also called my dad... who is a doctor and always my go to during any medical situation. Actually, I go to him for everything medical or not.   :)  He had also advised me straight to bed rest and to update him with the next days ultrasound results. 
10/12 - Dr. C, Adel and I all piled into the exam room for our ultrasound. I was feeling nervous but decent since I hadn’t been cramping at all... and the blood had basically stopped overnight. Dr. C showed us a few things... the first was an abnormal looking mass that was a twin at one point... Second was a large hematoma in the uterus and third was a beautiful gestational sac, fetal pole, etc. It was still a bit early to see any heartbeat etc but there it was, right on the screen, our baby!!!! Dr. C seemed pretty grim... he said the hematoma was right next to/pushing on the healthy looking baby and the baby looked to be about 50% separated from the uterus. He said it could go either way at this point. He recommended I “take it easy” and try to stay off my feet as much as possible over the next week. He stated I might see more blood since we saw some in the uterus. I am also an rh negative blood type (O-) so I needed a rhogam shot for the miscarriage of the twin. This ensures my blood doesn’t build up any antibodies towards the healthy baby or future babies which would in turn attack them. 
Taking it easy was tough... that coming weekend was my brother’s wedding... which I was in. I made sure I rested frequently, laid around their couch, missed things like the bachelorette party, spa day, etc. Definitely took it easy till the day of the wedding which I needed to be standing for some of. I was actually feeling really good... I hadn’t had any more bleeding, no cramping, etc. I honestly felt as though we were going to get good news that coming week. 
10/18 - Ultrasound with Dr. C to see what we could see. I don’t know if I was just naive or what. But I actually thought the baby was fine. I climbed up on the ultrasound table and even had my phone next to me so I could take a video of the heartbeat for Adel (who was at work). *facepalm*  Dr. C was looking around in there for a bit longer then normal. Then slowly says “this is not good”. Eeeeep! He showed me the ultrasound screen which no longer showed a baby on my uterus. He saw a very large hematoma still in there but the baby was no longer attached. I was devastated. At that point I was a lil over 6 weeks pregnant (well not any longer) and really thought this was the one. I tried not to fall apart in the exam room while getting dressed and they shuffled me into Dr. C’s office for a quick meeting. I was advised to stop all meds (progesterone, estradiol valerate and baby aspirin). Dr. C said to expect a heavier than normal period and to let him know when I started bleeding. We also called Adel from his office. I wanted Adel to be able to ask the doctor any question he might have. Everyone in the office lined up at the door to give me a hug on the way out and I lost it. Very sad. 
It took 6 days to actually start bleeding again. During that time my mind was playing tricks with me. I actually started thinking maybe Dr. C had missed something and maybe the baby was still there. I had been ready all sorts of stories about missed miscarriages (the internet is evil) and was getting my hopes back up. But alas, early 10/24... I started bleeding, severely cramping for hours and eventually the tissue passed. Much bigger then I expected... was about the size of a lime. 

That for me marked the end of cycle #2.  

Tuesday, November 29, 2011

IVF #1

We begin IVF #1 in Vegas! One of Adel and I’s favorite places and it being 4th of July weekend just makes it even more fun! We thought it was a perfect beginning to our baby story! I had gone in before we left to do my baseline U/S and E2 (Estrogen) check and got the call that evening that everything was in line to begin our first of many stim shots the next evening. I had already been taking two microdose lupron shots a day (am & pm) for a little over a week and would add 1 powder of menopur and 150iu of Gonal f into the mix nightly. That is 4 shots a day for those of you that didnt count... Lots of shots. Lol. 
July 2nd - Started stims (again... 4 shots a day!). I remember being overwhelmed by all the drugs in the box. So many syringes, needles, colored boxes. I remember feeling how important it all was to making our baby. But most of all... I remember feeling so empowered. As if we had been floundering at making a baby for the last 4 years but FINALLY I was taking control back and going to make it happen. All I needed to do was be the best shot giver, egg developer, embryo incubator. I/we were so full of hope. 

My IVF Cycle #1 Drugs
Stims and monitoring went well for the most part... had some nervousness day 6 or so when the follicles weren’t as big and there weren’t as many as I hoped there would be. Dr. C was all over it and increased my Gonal F from 150iu a night to 250iu. I ended up stimming for an additional day to ensure sure they were mature enough. The last few days before retrieval was crazy. I was so bloated, sore and had this “heavy” feeling. All I wanted was to get those eggies out of me!! 
July 14th - Egg Retrieval is finally here!!!! One step closer to bringing my baby home! ER went well! I didn’t feel a thing which is exactly what one could hope for. I woke up... had a couple crackers and an apple juice and awaited our egg numbers! 11 eggs total. I thought that was ok. Of course... you hear stories of people getting like 20 but as everyone always mentions “all it takes is one”. 
Very sore in the next couple days after retrieval. Fertilization report came in on the 15th and we had from our 11 eggs, 9 were mature and ICSI’d, 7 of those actually fertilized. Ok... so down to 7. Still decent in my mind. 
PGD - Day 3 came and we decided to move forward with PGD (Preimplantation Genetic Diagnosis). This procedure involves a biopsy of each embryo and sending it out for genetic screening. It test whether the embryo contains all the required chromosomes 23 from the mom and 23 from the dad with no deletions or duplications. It also will give you gender information although that was not our reasoning for doing the screening. Our doctor had originally suggested it as a tool to weed out abnormal/unviable embryos. His explanation was this... “So on transfer day, lets say you have 12 embryos... and 4 of the embryos are really poor quality, 4 look ok and 4 look great... Looking at the great ones... they seem healthy and dividing properly... but we don’t really know what is going on with them for sure... I would be deciding between these 4 embryos just based on how they looked.” So we were sold. Again... this might have been another attempt at control. I wanted to control putting the right embryos back in! Lol. It was quite expensive ($4500) added to our already out of pocket IVF cycle but I felt it was worth it. To know for sure we were putting in a chromosomally normal (viable) embryo. 
Day 5 (July 19th) - Transfer Day!!!! We got into the office and were so excited about the transfer. Dr. C came in and informed us that out of our 7 embryos... we only had 1 chromosomally normal one. What? What do you mean 1? What happened to the other 6, what is wrong with them? How did we go through all of this for 1 embryo? SO may questions were running through my head. I was so disappointed. Dr. C went over the PGD paperwork with us, which showed severe chromosomal abnormalities. Severe. Chromosome deletions, duplications, etc... from both set of genes (maternal and paternal). Weird. But we moved forward with our 1 perfect hatching blast (graded BB). It was a boy. The transfer was emotional but beautiful. I couldn’t help getting caught up in the fact that we only had 1... none to freeze. Adel had to give me a stern talking to about embracing the moment and enjoying what just happened. I was officially PUPO!!! 

Our Beautiful Hatching Blast
The next 72 hours were strict best rest and I adhered to the extreme. I even ate laying down “just in case”. I watched movies, read, yapped on the phone... it was definitely hard to lay down for so long but I was willing to do so. 
2WW - The two week wait was tough. The progesterone so messes with your mind. Gives you all the normal pregnancy symptoms. I took an HPT 6DP5DT, 7DP5DT and 8DP5DT... and all were negative. I was still holding out hope however!! 
9DP5DT (July 28th) - Beta Day - BFN. Even though I knew... it was a negative. It doesn’t make it any easier. I felt like a failure. Such a waste. A waste of putting my body through what I did. A waste of money. A waste of hope. Was a sad couple weeks following.
Appointment with Dr. C - The aftermath appointment (often referred to as the WTF appointment) went decent. We talked about possible changes to my protocol to hopefully improve egg quality and overall numbers which I was definitely interested in. We scheduled an Endometrial Biopsy to ensure nothing interfered with implantation (even though we had just done a hysteroscopy the month before) and we set a date for IVF #2! 

Our Journey

Well... It’s high time I started writing about our journey on the road of infertility. Not sure why I decided to start now vs. earlier. Perhaps I thought we were always almost at the end of our infertility nightmare. But... that road certainly has a mind of its own and it is still rolling along. Such a lonely road. Full of the lowest lows, highs, hope, fear, uncertainty, joy, depression, confusion and many other emotions. This is why I need to start writing this story now... to get it out. I am bursting with these emotions, whirling around in my head as I (we) continue brave this lonely road alone. So here goes... 
My husband (Adel) and I were married 9/2007... Knowing we were ready to have a child right away (I was 29 and he was 38) we decided to have me stop taking my birth controls pills around June (a few months before the wedding) to get my system adjusted for a few months before trying to conceive. So funny looking back... I remember being terrified I would get pregnant immediately and be pregnant for things like my bachelorette party and wedding. In hindsight I would give anything for that to be the case. Seriously hilarious to think we anticipated being able to get pregnant immediately! Needless to say.. we didn’t get pregnant before the wedding. 
February 2008 Two weeks late!! Faint positive HPT!! YAY!!! Made an appoint for two weeks later to see my OB/GYN, One week later... Adel and I both lost our jobs, victims of the mortgage meltdown (we worked at the same company, which is how we had met). One week later... started bleeding heavily. Went in for my OB/GYN appointment and he confirmed miscarriage. Sadness. A weird part of me actually believed it was a sign... that maybe it was for the best we lost the baby so we could get our financial footing back in order before getting pregnant again. Maybe that was my way of coping? Who knows. 
The rest of 2008, 2009 and first half 2010 aren’t very exciting. We both got new jobs and dove ourselves into work and being successful. I travelled a lot for work (about 50%) and we would try to conceive as my work travel schedule allowed with my ovulating days. In 2008 we would still actively use OPK and attempt timed intercourse, etc but eventually after months of trying and not getting pregnant I think I may have gone into self preservation mode. I went into the “it will happen when it happens” mode. Stopped trying to time things, think about it, etc. Even actually started questioning my interest in having kids anyway. This for me... I believe was the ultimate self preservation barrier. Adel and I were enjoying our careers, financial flexibility, friends, traveling and just being with each other. 
July of 2010 my job was relocated to Utah. Loving where were currently live and Adel not wanting to leave his job... we decided to pass on the offer to move for my job... and decided to once again start trying. I would take some time off from working, be a stay at home wife, get healthy and de-stress. I had been traveling 100% of the time for about 8 months before the job ended... leaving every Sunday night and flying home every Friday night. So a nice break was needed to get our lives and home back on track. During this time at home... we tried... and tried and tried to make a baby. Finally April 2011 we decided we needed help. June 2011 we met with our RE (Reproductive Endocrinologist) who we will call Dr. C and we were diagnosed with severe male factor infertility. He stated we would not be able to conceive naturally and that due to the sperm counts and motility IUI was out as well. IVF and ICSI were our only hope. The news was hard to hear for sure... but I almost felt empowered.. like we finally had a reason for why it hadn’t been working and a plan to fix it. Easy enough right? 
So began the next leg of our journey... into the crazy world of IVF.