Sunday, June 28, 2015

Embryologist's Reports: Days 3 + 4

So as of our report on Day 2, we had 9 of our embryos doing well and one doing poorly.

Yesterday, Day 3, the embryologist reported that 7 are doing well, one was still doing poorly, and the two remaining ones were at the right stage of development, but low quality.

Today, Day 4, we still had 7 doing well. I asked for the grading on them this time. We have no grade 1 (excellent), four grade 2's (good), three grade 3's (average), and three grade 4's (below average).

We're excited that 7 are still doing fine. Now we wait til tomorrow to find out how many of them make the big leap from morula to blastocyst.

For the last couple days, the discomfort has continued. I've spent most of my time on the sofa with minimal physical activity except for short daily walks for circulation. I'm glad that I've been doing better since yesterday evening. Also pleased to be done with taking antibiotics.

Big news: our embryo transfer is scheduled for tomorrow at 11:00 am. That means one of our sweet little embryos is coming home to me! We could use lots of finger crossing and prayers, please and thank you!

Friday, June 26, 2015

Embryologist's Report

Now we're in the next stage of IVF which is really quite exciting - daily phone updates from the embryologist!

On Day 0, egg retrieval day, we were told that we had 19 eggs collected.

Yesterday, Day 1, we learned that 16 of our 19 eggs were mature. Out of those 16, ten of them fertilized. It was sooo cool to learn that we had ten itty bitty little embryos sitting in a petri dish that are half me, half hubby. And hopefully at least one of them will soon become our very own baby! 

Today, Day 2, the embryologist said that nine of our embryos are growing as they should, and one is doing poorly. So now we still have nine little embabies! Most of them are 4 cells now, but one is 6 cells, and one is 8 cells. Hoping they hang on til they either get put inside me or the freezer! 

Yesterday, I was uncomfortable, but not in a lot of pain. Today was a rough morning. I woke up early to do my daily progesterone suppository (which really hasn't been too awful so far) and then eat so I could have my antibiotics. Suddenly, I was having intense pain. Like the kind of pain where you're doubled over and wonder if you'll vomit or faint from the pain. Only Tylenol is allowed, as the stronger pain killers will thin out the endometrium which we're trying to thicken to prepare for implantation. I took two extra strength Tylenol, and for over an hour, I was still having intense cramping. 

I talked with a friend who has been through IVF, and then I realized that pain made sense. She pointed out that my ovaries had been poked 19 times with a needle to get those eggs out. And they're also stretched out from holding all those follicles, and now they're bloated with fluid. And then of course there were the two vaginal punctures. After poking needles in my stomach during stims, it got bruised and painful.. So of course my internal parts would be causing me pain, too. 

I'm glad the pain has faded, and I'll need to keep on top of the Tylenol so it doesn't get as intense as this morning. I've spent the majority of the last 48 hours on the sofa and in bed, but I go for a short walk each day. Gotta keep my eye on the prize - the pain is temporary, but there's a chance of a pretty sweet reward! 

So excited for tomorrow's update from the embryologist!

Thursday, June 25, 2015

Stims, Trigger, and Retrieval

Here's the update:

Sunday, June 21

Our clinic visit on Sunday was a nice surprise! It's always nice to have my hubby there with me when he's available on weekends. My estrogen increased as it should have, and the scan showed 20 follicles! This was up from the 15 we saw on Friday, so we were pretty excited. Some of them were tiny, 9ish mm in size, so they are new and likely won't mature by the time the rest do. It was also nice to see some familiar faces of the ladies cycling with me. Chatting with them is so much better than sitting in the waiting area thinking too much! I continued another night of stims. We purchased three more batches of medication this week.

Monday, June 22

I returned to PCRM for monitoring on Monday. I've been super tired, but I was in good spirits. My scan showed some follicle growth, and the doctor said I was ready to trigger! Trigger means to take an HcG (pregnancy hormone) injection which gets the follicles ready to release the eggs and also primes the uterus lining to thicken in preparation for implantation.

I got a brief injection training and then received my HcG supplies, antibiotics, and instructions for egg retrieval. And that's when I kinda freaked out. Turns out that my antibiotics were capsules which I couldn't swallow. After a fair bit of panic and some weeping in the staff room at work, I managed to get a tablet version of the same pills, and I was good to go. The HcG injection bled more than the other injections, but it wasn't too bad. Pain was expected as my stomach is more sore each day. It was a nice to relief to know that it was my last self-injection in my belly - #28!

Tuesday, June 23

I was trying not to be super nervous about egg retrieval. Work is an awesome distraction, but the procedure was on my mind a whole lot. I also had a really sore belly and needed to ice it repeatedly. I'm blessed to have caring and supportive colleagues while I go through all of this. It seemed like a long day with too much time to think. Finally, I went to bed early and was really quite pleased when I remembered that I didn't need to poke myself!

Wednesday, June 24

I actually managed to get some sleep! Hubby and I were up early for the clinic. I was on an empty stomach and getting quite thirsty and hungry. When we got to the clinic, it was nice to see a cycle buddy before retrieval.

When it was my turn, they checked my HcG absorption and blood pressure, gave me a warmed up blankie, then hooked me up to an IV and got me started on sedatives and pain killers. I was happy to have a familiar nurse and my main doctor involved in the process. And it was nice to meet the embryologist beforehand too.

Once I got into the operating room, the nurses hooked up blood pressure and heart rate monitors. They put these sticky things with metal buttons (no idea what they're called!) on my chest and stomach which were a bit of a pain (literally) to get off later. I had a bunch of wires all over the place! Next, they put an oxygen line on my nose and added more meds into my IV line. The meds were going to make me feel relaxed and dizzy. I don't really remember anything about the procedure after that. I was conscious, but I just remember them saying it was done and they were going to wheel me to the recovery room. I'm glad I have no memories of pain or discomfort! My hubby joined me in the recovery room, and they kept monitoring vitals for 45 minutes. I was pretty happy to get juice and cookies. The embryologist came by to tell us 19 eggs were retrieved!! We were very excited to hear that number! We needed to wait a day to find out how many were mature and how many mature ones fertilized.

I was relieved to not be in pain. It wasn't until I got up that I realized how woozy I was. Walking made me dizzy and nauseated. I was glad I had my hubby around to dress me and get me to the car. The nausea continued for a few hours. I came home and began with my high salt diet - it's intended to prevent and relieve OHSS - ovarian hyperstimulation syndrome. Basically, if you take in a lot of salt, it draws water out of your ovaries which are enlarged and fluid filled. So I was mostly just having chicken noodle soup and sugar free Gatorade. A 2-hour nap helped a lot with the nausea and dizziness. I spent almost the entire day in bed and on the sofa. Towards the evening, I could feel that the IV drugs were wearing off. I started getting crampy and a bit uncomfortable. Before things got worse, I went to sleep.

Now we have daily reports from the embryologist to look forward to!

Saturday, June 20, 2015

Day 9 of Stims

I've been stimming for 9 days during which I've made 23 injection holes in my belly. My belly is sore, and it's been getting worse over the last couple of days. I'm having to ice it longer. It feels all bruised though only a tiny bit of bruising shows on the skin. It's mostly all inside. I was pretty stressed yesterday when I opened my new Gonal-F and it was completely different.. no pen! Instead a syringe with two needles and a vial of powder. Thanks to YouTube we learned how to mix n inject it.

On a more positive note, I had another follicle scan yesterday. I was really hoping that all 14 of my follicles were healthy and none had deteriorated. I was pleasantly surprised to learn the this doctor found 15 follicles! So wasn't expecting my number of follicles to go up! Also, she said my lining looked healthy with the triple layer look that is wanted. The follicles also grew a bit bigger than the previous scan and stayed close together in size. All very good news!

Since yesterday, a new side effect is picking up. I'm glad the headaches are gone, but now I just feel exhausted despite plenty of rest. I was in bed about 12 hours last night and had a decent sleep. This afternoon I was lying in bed for another two hours. And now, less than three hours later, I could totally go for a nap. I do remember feeling this way when I took Gonal-F a few months ago. Fatigue is really not as bad of a side effect compared to some of the other possibilities.

I have bloodwork and another follicle scan tomorrow morning, so up at 5:00 am again! Monitoring is now supposed to be daily. I'm excited to see how my follicles are doing! :)

Thursday, June 18, 2015

Stims and Scans

A week has gone by since my baseline scan. On Friday, I began my injectable ovary stimulating drugs (stims). Here's the update!

Day 1 (Friday)

Began my stims with two injections each night, 50 units of Gonal-F and 75 units of Menopur. I've previously used Gonal-F, so that wasn't too scary. Menopur was totally new for me.

Gonal-F comes in a pre-filled pen. You clean the area, screw on the needle, dial your dosage, grab a bunch of stomach fat, inject and wait 10 seconds, remove, dispose of the sharp part. Really not too awful.

Menopur isn't not quite as straightforward. It doesn't come pre-mixed, so you get to pretend you're a chemist and prep your own medication in addition to doing most of what you do for Gonal-F. I was pretty stressed that first time on Friday night. I don't always get the exact amount of saline into the syringe (apparently this is not a big deal anyways), and I have a heck of a time getting the air bubbles out. Supposedly, tapping the side of the needle removes the bubbles. That's what the teaching video shows. But in reality, tapping lightly does nothing, and tapping harder makes more bubbles! The hardest thing about using menopur is removing the cap from the needle. Yes, I'm serious. The cap is sooo tight. And so I tried to screw it off. That doesn't work. So I tried to pull it off. And it didn't move. So I tried pulling it harder. And again. And eventually I pulled with all my strength, the cap flew off, my hand lost control of the needle, and I stabbed it into my middle finger. OWW! So then I was bleeding and shaky and I still needed to inject myself while a bruise was rapidly forming in my finger. Day 1 of stims did not go as smoothly as I'd hoped. Ice helped a bit!

Day 2 (Saturday)

Same meds, same doses. Very very shaky hands! I was super nervous after accidentally stabbing my finger the previous day. Lucky for me, I had a cycle buddy who gave me some tips and a picture to help me get the cap off of the Menopur syringe off in a better way. This time I didn't stab myself. But it was still a pain (pun intended). Icing is gonna be a daily thing.

Day 3 (Sunday)

Cap and bubbles still annoying. But everything worked out fine. Got holes and mini bruises in my belly from the three days of injections.

Day 4 (Monday)

Bloodwork at PCRM. Up at 5:00 am to get to the clinic, got poked for blood, and then back to work after 16 days off! My estrogen was supposed to be between 500 and 1000, and it was 558... within the normal range, but on the low end. My Gonal-F dose was increased to 75 IU. Menopur still at 75 IU. Injections were still a bit stressful, but not as scary. This is the day when the bad headaches started. Only way to get rid of them is to sleep them off. More holes and bruises.

Day 5 (Tuesday)

Continued with the same dose. Felt weepy in the morning, and had a headache again in the evening. Getting hard to find new places to inject cuz already so many holes n tiny bruises on my belly.

Day 6 (Wednesday)

Bloodwork and first IVF follicle scan at PCRM. I don't know what the estrogen level was this time. Hopefully it doubled (or more) as it was supposed to. The most exciting part was finding out how many follicles we have - 6 in one ovary and 8 in the other - a grand total of 14 wee little follicles! The good news is that they are all close in size. The number will be going down as we get closer to retrieval. The doc is hoping for maybe eight embryos. For now, though, they're about 8-10ish millimeters each.

After the clinic, I had a great day at work... it was our Recognition Day and Graduation. Reminded me again how much I love my job. :)

Menopur and Gonal-F stayed at 75 units each, and I began a new, third injection of Orgalutran. I was pretty scared of this one because the needle is thicker and less sharp. That means harder to get in and likely more painful. The hardest parts was (again) the cap! Removing it took a long time because I was trying so hard not to stab myself with it. The injection itself wasn't too bad. It's supposed to keep me from ovulating - don't wanna lose our eggs before retrieval!

Day 7 (Thursday)

All 3 injections again tonight. This time they left me with more pain that usual. Iced it for longer, too, but still got a little bruise.

Tomorrow morning is bloodwork and follicle scan at PCRM again. Hoping all of them grew and none of them fizzled out! Going to the clinic every 48 hours while back at work is pretty exhausting. Not much of a headache today though, so that's a bonus. I'll find out tomorrow if my doses are changing, too. I'm pretty excited to get the update on our follicles though!!

That's all for now, but I'll have more news to share soon.

Thursday, June 11, 2015

A small victory

If you read yesterday's post Baseline Scan, I'm pleased to report that my ultrasound this morning showed result #1 - no cysts! According to the doctor, my ovaries look happy, and my lining (endometrium) looks normal. I won't be hearing about the results from my blood draw unless there is something wrong. But since there aren't any cysts, my estrogen should be under 80. I was so worried that something could come up at the baseline that would prevent me from moving forward with IVF. How nice to make it past this hurdle!

After my scan, I picked up my first batch of fertility medications. Ovarian stimulation starts tomorrow evening. Wanna see what $1154 worth of IVF drugs look like?

This represents a whole lot of poking, and like they say on infomercials, "And that's not all! If you open up those boxes up right now, you'll get another dozen needles to poke yourself with!" Good thing I pick them up in person so I don't pay shipping and handing. :)  Would be pretty sweet if they came with the classic infomercial money back guarantee though!

Even though IVF isn't covered by health insurance (boo hoo!), I do get help when it comes to the drugs (yay!). I end today's post with a happy sigh. I'm relieved and excited to move forward.

Wednesday, June 10, 2015

Baseline Scan

Tomorrow is my baseline scan to make sure everything is okay before I go ahead and stimulate my ovaries! I'm expecting one of the following results in terms of the cyst that was previously found in my ovary:

  1. No more cyst  = buy my meds and begin stims on Friday - Yay!!
  2. Cyst present but not producing estrogen = the same as above - Also yay!!
  3. Cyst present and elevating my estrogen  = no stims and more waiting for cyst to go away - Definitely not yay!!

#1 is ideal, but I'd settle for #2 since it would still give me the go ahead to move forward. 

In addition to the cystuation I described above (hehe, I amuse myself!), I also need my uterus lining to look nice n healthy.

Wish me luck, readers! I'll keep you posted.

Friday, June 5, 2015

Infertility Before Treatments

In the fall of 2008, when my hubby and I were planning to get married, I was asked by someone if we were going to start a family soon after the wedding. I remember saying, "We're not even married yet - ask me in 10 years!" After the wedding, some more people asked. Indian families are big on procreating and love to ask people when they're gonna get moving on starting a family. After the wedding, my answer changed to, "We just got married - ask me in 5 years!" Half a year later, I remember thinking, 'I'm already 28! Maybe we should start trying next year.' My timeline for wanting babies was shrinking rapidly.

In June of 2010, a year a half into our marriage, I stopped taking the pill and waited to get pregnant. And I waited. And waited. They say that if you don't get pregnant within a year and you're under 35, you should seek help. That's also when you get the label of infertile. I noticed that I had put on weight, my acne had returned with a vengeance, and my cycles were way too long and irregular. After way too much googling, I was convinced that I had PCOS - polycystic ovarian syndrome, and that's why I wasn't getting pregnant. So in May 2011, after 11 months of unsuccessful trying, I went to the doctor.

The doctor said that some people just take a little longer to get pregnant. He checked my hormones, and he said I was perfectly healthy. I wasn't convinced. I told him that I'd noticed certain things about my body, and I wanted him to check my ovaries for cysts. He reluctantly agreed, but it turned out that my ovaries were clear. I was told there was nothing wrong and to keep trying, and that was the end of that.

Another year went by. Still no pregnancy. By then, I was so terrified that if I went back to the doctor, I'd be told that I could never have kids. So I didn't go. Eventually though, I knew I needed to get more testing to find out what was going on. In the fall of 2012, I tried another doctor. This time, I got the diagnosis. PCOS with a string of cysts lining each of my ovaries. Three months of Day 21 Progesterone bloodwork verified that I wasn't even ovulating.

I was referred to an OBGYN. It took me a few months for my first appointment, and then three more cycles to do further testing. He confirmed that I still wasn't ovulating. That summer, he had me start on Metformin pills for insulin resistance. The meds did their job - they balanced out my hormones and they got me ovulating. I even lost half the weight I'd gained. But I was sick all the time. Constantly running to the bathroom only works when you stay at home during the holidays. But going back to work meant that I had to stop taking the meds. I was sure that there was no way I'd even be able to get pregnant on those pills because I was so sick and dehydrated all the time I took them.

The following year was rough. Everybody around me seemed to have babies or be pregnant. It was hard to see. I felt jealous, and then I felt guilty about being jealous. I was sad for myself. I prayed, I pleaded. I was mostly happy on a day to day basis. But my longing for a baby was in the back of my head... so about once a month, I needed to break down and cry it out. And then I'd be okay. And go about my normal daily life in a healthy way. I exercised and ate healthy food. I spent way too much time googling ways to treat infertility without actually going for fertility treatments. I was scared to go that route. All the testing and money and physical and emotional pain of treatments was something I wanted to avoid. I kept hoping that I would miraculously get pregnant on my own. I didn't.

Finally, in the spring of 2014, my family doctor said I should go ahead with fertility treatments. He wanted to refer me to a fertility clinic, the Pacific Centre for Reproducive Medicine (PCRM). I agreed.

Monday, June 1, 2015

Moving along

Things are moving along in so many aspects!

First, my job situation with finding a position for next school year is solved. (Yippeeeeeee!) With the help of a dear colleague and my union president, I was lucky to get support from my principal and HR during a meeting on Wednesday. After holding my breath for a day and a half, on Thursday evening, I got the phone call. I was given a full time continuing position in the same school where I've been for 8 years. This exceeded what I'd even thought was possible. I get to stay in Adult Ed, and I get to stay at my own school. I was in disbelief for the first couple of days, but now I'm just plain happy. The last 8 weeks of uncertainty really took a toll on my my mind which ended up affecting me physically. Feeling normal is so underrated.

Second, I had my trip to PCRM on Thursday. Paying another $6500 was a little nerve wracking. And that's not even the entire cost yet. Paid $500 last week, and more payments to come over the next few weeks. I described it to to my friend like this: "It's like buying a car. But after you pay, you might or might not actually get one."

After payment, I had my sonohysterogram. I was happy to see my own main doctor would be doing the procedure. At the clinic, you never know who will be doing what for you - one doctor manages my case, but anyone of the docs can do the monitoring and procedures. Turns out that my uterus looks fine with no abnormal growths inside!! Speculums are always uncomfortable, but this time it wasn't painful. When he pumped the saline solution into my uterus, I felt cramping and discomfort, but again, not a lot of pain. Another good thing is that the catheter was easily able to get to where it needed to in my uterus, which means the shape of my uterus shouldn't be an issue when it comes time to transfer an embryo or two back in there.

Next, I had my medication appointment. It was a bit overwhelming. I'll be on Marvelon for 19 days instead of 21 (yay!). I'm relieved because I've had a few days of really bad headaches that started midday and wouldn't go away til I went to bed for the night. Not much nausea anymore is a relief.

 A few days later, I'll have baseline bloodwork and ultrasound and then start stimulating my ovaries. I'll be on an antagonistic protocol for my IVF to make sure my ovaries don't let those eggs go before they're ready for retrieval. During the following weeks, I'll be using Gonal-F and Marvelon to stimulate follicle growth, Orgalutran to prevent ovulation, Pregnyl to trigger ovulation at the right time and to prime the endometrium. Then I'll use Crinone suppositories for progesterone support. I'll write more about the meds once I move onto that step.

I'm excited to start stims and get closer to making our embryos, but also a bit apprehensive to be poking myself a ridiculous amount of times, also getting pokes from nurses during monitoring, and having a whole lot more of those internal ultrasounds. I've heard the suppositories are pretty gross. And then there's the side effects of all those meds. EEEEEEK!! I'm keeping my eye on the goal, though. :)

I'm off of work for two weeks now which is really nice! Also means more time for more posts! Catch ya soon!