Friday, August 29, 2008

Encouragement During this Long Wait....

Trust in the Lord, and do good; Dwell in the land, and feed on His faithfulness. Delight yourself also in the Lord, and He shall give you the desires of your heart.

Psalm 37:3-4

Tuesday, August 26, 2008

Our Beautiful Embryos!

These are our two perfect embryos we transferred today! This is the actual picture Dr. A gave us which Roger then took a picture of the picture to post on the blog for everyone to see. Dr. A said they both look exactly like a healthy 5-day blastocyst is supposed to look, could have been a picture right out of a textbook. We actually had three blastocysts that could have been transferred today, but Dr. A is so confident in the quality of these two embryos that he said there's no reason to put back three and risk having triplets and all the potential pregnancy complications that can come along with that. I tried to talk him into it, but to no avail. It makes me sad to think of that one little embryo frozen all by itself, but I'll get over it. At least we have one frozen embryo for future use. The procedure only lasted about 10 minutes start to finish -- really easy. No pain or bleeding at all. Unlike my two IUIs last summer. Then I laid perfectly still for 30 minutes and was released to go to our hotel where I'm now vegging out horizontally until about noon tomorrow. A lot of reading, sleeping, eating, and movie-watching.
I'm down to one injection a day now (Lovenox -- a blood thinner) along with our progesterone injection Roger gives me every three days. I also take a prenatal vitamin, a baby aspirin, Dexamethasone, and now will be adding vaginal suppositories (to help keep my uterine lining thick) twice a day. Yuck, I know.
I will find out next Thursday, Sept. 4, if we are pregnant. I will do a blood pregnancy test on Sept. 2 and then again on Sept. 4 and if the number has at least doubled between the 2nd and the 4th that will be our confirmation that we have succeeded! Until then we wait and pray.

Sunday, August 24, 2008

The Art of Growing Embryos

We got a call from the Sher Institute this morning around 10:00 a.m. to let us know we still have teeny tiny babies growing in petri dishes! Out of the 6 embryos 2 look great, 2 look good, and 2 look not so good. So right now we are expecting four viable embryos to do a 5-day transfer on Tuesday! Once again, great news! We aren't writing the other 2 off yet as they may still catch up/improve by Tuesday, but we were told to expect 4. If, in fact, it is 4 embryos on Tuesday, our plan is to transfer the 2 best and freeze the other 2. IF somehow one or both of the lesser quality embryos catches up and we have more than 4 to work with, I would like to put 3 back. So that's it for now. We won't get any more phone calls between now and Tuesday unless something unfortunate happens. Our transfer is scheduled for around noon on Tuesday and we will come home early evening on Wednesday. Hopefully we'll have Internet service in the hotel room and I'll be able to post Tuesday night sometime. In the meantime I'm going to be eating two whole/fresh pineapples! The girl I talked to during my immune treatment last Monday who was pregnant with her sister's twins told me pineapples have some certain enzyme in them that's good for implantation. Anything to help the cause!

Friday, August 22, 2008

We Have Fertilization!

My nurse called at 3:00 this afternoon to let us know that 7 of the 13 eggs retrieved yesterday were mature and therefore appropriate to be fertilized. And of the 7.......6 fertilized! We are soooo excited to get this news! Roger has awesome swimmers who really know how to do their job! Now we wait until Sunday morning for our next phone call to let us know if we will do a 3-day transfer (on Sunday afternoon) or a 5-day transfer (on Tuesday). There's some varying opinions in the medical community about which day is better to transfer embryos back to the uterus, but my doctor believes a 5-day transfer is best case scenario because it allows the embryos time to develop a little bit more and reach blastocyst stage before transferring them back to me. I think it's just a case-by-case situation of watching each particular couple's embryos to see how well they're tolerating the petri dish and whether the embryologist thinks it would be beneficial to get them into the womb sooner. Either way, we won't know our transfer day until Sunday morning. And, of course, we still don't know how many we'll transfer back because we don't know how many out of the 6 will make it that far. I hope and pray all of them grow like they're supposed to so we can freeze some of them for a future cycle (the alternative is destroying them which I can't fathom doing), but we'll just have to wait and see. Once we go back to STL for the transfer we'll stay overnight since I have to be on bed rest for 24 hours afterwards to give the embryos the most hospitable conditions possible.

After being doubled over in pain last night due to my egg retrieval, I woke up this morning feeling almost 100%. I felt so much better, in fact, that I thought it would be perfectly fine to vacuum my bedroom and hardwoods. Big mistake. I had to cut my shower short and lay soaking wet on the bed for 30 minutes because I thought I was either going to pass out or throw up from the cramps I was experiencing. I guess when they said I would need a couple days to recover they meant it! But I am feeling much better now (thanks to two Advil and a couple hours with the heating pad....again) and realize I need to take it easy for the next week. I think my body is really starting to wonder, "What the *** is going on here?"

Thursday, August 21, 2008

Egg Retrieval Accomplished

The egg retrieval went great today. IV drugs are amazing -- that's all I've got to say. In fact, I wish they were still streaming into my veins as I'm writing this to hide the intense abdominal cramps I'm experiencing right this minute. It's normal to have abdominal discomfort because they seriously jabbed a needle through my uterus and directly into both ovaries to aspirate the follicles. Ouch! But anyway, we were in and out of the office within an hour and a half, so no complications at all. They retrieved 13 eggs -- one more than I was expecting! The nurse reassured me that's a good number (because I'm paranoid and ask a million questions all the time). After it was all over I thought he only got 8, but I guess I was somewhat coherent during the procedure and heard Dr. A say something about 8 eggs, but he wasn't done retrieving yet, hence the confusion. Drugs do strange things to your mind. We will get a phone call sometime tomorrow (Friday) letting us know how many eggs fertilized. I can't believe Roger and I are potentially creating embryos right this minute. It's really quite amazing. I just hope my body will be nice to them when they're put back in.

Roger did my first IM (intramuscular shot) in my rear this evening. He did such a fantastic job! I'm so proud of him. I felt so bad for him when I handed him the 2-inch needle and saw the look of terror cross his face. It certainly is large and just a might bit intimidating! But we iced my butt cheek up really good and he took his time, and it went off without a hitch. The injection is progesterone in oil and we only have to do it every three days, so it's not too bad. I told him the hardest one was over, by far!

Tuesday, August 19, 2008

880 miles...

Roger's take:
2 days + 2 trips from Springfield to STL = 880 miles. We can tell you where each "clean" gas station restroom is along I-44....and the ones to avoid. A couple of things I've learned over the past 2 days....Abby and I will NEVER live in a city with more traffic than Springfield (read previous post)....When your wife is hooked up to an IV getting meds it's best to do exactly what she says. Exactly. (Lesson #1 for pregnancy.) But this is the craziest thing I've learned the past 48 hours. Next time you have $45.00 burning a hole in your pocket don't take your wife out to a good dinner or any other type of date. Get in the car and drive to the nearest gas station. Put $35.00 in the tank, spend $10.00 on water, snacks, red bull and candy, and drive on the highway for 3+ hours with nothing but music on the radio. It really sucked that we had to come back yesterday and drive to STL today, but driving on the interstate is an awesome way to spend quality time with your wife. No TV. No computer. Nothing but each other, snacks, and an endless road. (However, if your wife is on meds and hates traffic, it's best to avoid rush hour in St.Louis)

In case you are like me and would rather watch a video instead of reading, here's a decent video I found about IVF.

Thursday It Is!

Our egg retrieval is scheduled for noon this Thursday. After looking at the follicles again today, Dr. A decided sooner rather than later will work the best for us. He counted 12 follicles (how appropriate - a dozen eggs!) ranging in size from 14 all the way up to 24 which seems kind of strange to me, but he said that's normal and out of our control and we should expect a good number of good quality eggs. I sure hope so! I will do my trigger shot tonight at 11 p.m., which is exactly 37 hours before the retrieval, and then I am done with shots for a while, like a few days maybe. That's okay. I'll take whatever break I can get!

Monday, August 18, 2008

A Looong Day...

So it's 8:52 p.m. and we're finally home from St. Louis....only to turn around tomorrow morning and drive right back for another ultrasound. Gotta love it. Nothing is wrong. In fact, everything is going as planned. Dr. A upped my Follistim dose from 225 mg to 300 mg for tonight's injection to get some of the follicles to grow a little bit more before the egg retrieval. They're ranging in size between 12 to 16 with two of them in the right ovary measuring 21. He wants the majority of them to be between 16 and 20(?) on the day of the egg retrieval, so the two 21s are most likely already out of the running. It's very normal to have your medication tweaked to get the perfect-sized eggs at the perfect time, hence all the ultrasounds so he can monitor them very, very carefully. We were warned we could have appointments back to back, but I think we kind of forgot and were a little surprised when we were told to come back tomorrow. Why didn't we just spend the night in STL tonight, you ask? Well, we didn't have any clean clothes with us for tomorrow, it's cheaper to sleep at our house rather than a hotel, and I didn't bring all my drugs and vitamins with me to get me through another day/night. Driving at this point is not that big of a deal. It gives us time together to regroup and digest everything that is happening.

As we were driving in horrendous rush hour St. Louis traffic this morning to get to my 8:00 a.m. appointment, I had a bit of an anxiety attack (thanks to my PTSD from my '03 car accident) and walked into the clinic with a red tear-stained face (thanks to my uncontrollable mood swings), so that started off the day with a bang. Then the first thing the receptionist does before she even greets us is informs us we have a $53.27 balance we owe, which just kind of rubs you the wrong way after we've already paid the amount of money we have to them. As if we're not good for it! Thank goodness we love our doctor as much as we do because the support staff leaves something to be desired once in a while. Oh, well. I think that can happen no matter where you receive your health care. BUT, anyway, my uterine lining is measuring 10.5 mm which is very good and right where it should be. I didn't ask exactly how many follicles I have, but the nurse who was in the room with us during the ultrasound told me "Good job!" after Dr. A got done counting and measuring, so I guess that means I'm doing something right.

I had my first (of hopefully many) immune treatments today which is called IVig. It was at a different office a couple miles from the Sher Institute. The transfusion consists of human blood product (like plasma) and is supposed to suppress my crazy overactive NK cells so my body won't kill off the embryos after the embryo transfer. Don't ask me how, but that's the theory behind it. My next IVIg treatment will be a few days after my positive pregnancy test and then once a month for the first six months of pregnancy. During the treatment all I have to do is sit in a recliner and receive an IV drip and drink lots of water. I was told it would take three to four hours and it took six and a half! Again, par for the course for the way today went. As of right now I have no side effects, so that is very, very good news. Some of the side effects I was warned about were headaches, nausea, body aches. Basically flu-like symptoms. I was instructed to drink lots and lots of water before, during, and after the treatment, which I've done, so that's probably why I'm symptom-free.

The very wonderful thing that happened today (besides the good report from Dr. A) was there was another girl sitting next to me receiving the same treatment as me, and she is eight months pregnant with her sister's twin boys! They're dealing with a problem called alpha matching rather than NK cells, but the same IVIg treatment can be effective for that problem as well. Anyway, we spent six and a half hours talking about our experiences and IVF in general (along with speculating amongst ourselves whether our nurse knew what the heck she was doing) and it was really, really awesome to talk so personally to someone else. Of course, it's a little different because she's a surrogate for her sister, but I learned so much information and got so much reassurance from her and her sister that Roger and I will be able to overcome our infertility with IVF. I just kept looking at her big belly thinking this will all be worth it if I can just look like that someday. After my treatment was finally over and we were ready to walk out the door we were instructed we needed to hand over $500 to pay for the treatment. A little warning would have been nice! It makes sense, of course, that there would be a charge, but no one bothered to tell us beforehand how much it would be or when it would be due, etc. Oh, well. At this point Roger and I have just learned to laugh at the insanity of it all rather than getting upset. It's a whole lot more fun.

So that basically wraps it up, I think. Dr. A is planning to do our egg retrieval this Friday but maybe Thursday. He'll tell us for sure tomorrow. Stay tuned for further details.

Tuesday, August 12, 2008

Grow, Eggs, Grow!!

Did my first injection of Follistim last night. This will help all 15 (or thereabout) follicles develop into mature eggs that will hopefully be capable of being fertilized next week. So now we're up to two injections a day, one in the morning (Lupron) and one at night (Follistim). It's going well, though, so I can't complain. In addition to the injections I'm taking the Dexamethasone every day with a prenatal vitamin AND a multitude of other vitamins: 1,000 mg Calcium+, 1,000 mg Vitamin C, and 1,500 mg DHA. I said something to my nurse last Friday about my daily headaches, and she said it was probably from the Dexamethasone and that it would be okay to take it only every other day. I verified this with Dr. A and he concurred it would be all right too, but I'd rather just play it safe and deal with headaches than have this cycle fail and wonder if it was because I didn't take the Dexamethasone every day. It wouldn't be prescribed for every day unless there was a very good reason; right?

Monday, August 11, 2008

T-minus 2 weeks?

Right now it feels like the calm before the storm. Like when you know you have to give a speech/presentation in two weeks. All you want to do is hurry up and give the speech -- but first you have to think about it and wonder about it for two weeks. It's all you can think about. And the more you try to think about something else, the more you focus on what's coming up...

Everyone keeps ask how everything is going. Well, so far it's just been a lot of driving and quick doctor appointments. (You gotta love when the doctor APOLOGIZES for making you wait -- and the wait was five minutes.) Dr. A is amazing. Here's just another example of his attitude and confidence:
Abby: We are thinking about putting three fertilized eggs back, when it's time.
Dr. A: Three would be the worst case scenario. I was thinking more along the line of two. And when I say three would be the worst case scenario, I was meaning triplets.
Abby & Roger: Oh, right. Two will be fine.

I couldn't ask for two better people to be going through this with.
Dr. A has the attitude and confidence that just puts you at ease and makes you optimistic.
Abby is rocking with the shots, side-effects, and all the other stuff that I have no idea about. She's an absolute stud! (Sorry, couldn't think of a better word).

Friday, August 8, 2008

So Far So Good

Our appointment went well today. It was super-fast. No better way to spend a Friday than driving six hours for a 15-minute appointment! Oh, well. As long as it's good news I'm fine with it. Dr. A says I have around 15 follicles. He also said my left ovary was more prolific than my right. Maybe it's because I'm left-handed! At any rate, that number is exactly where it should be for someone my age. He was also checking for ovarian cysts of which I have none. Also very good news. I had blood drawn to measure my E2 levels, but haven't heard back on that yet. I will assume it's normal for now until I hear otherwise. It was nice to meet our doctor again, though, as this is only the second time we've seen him face to face. Roger really likes him and is impressed with him so far. So am I, of course, but I'm so thrilled that Roger is happy with him.

I did have my first blunder this morning. In the midst of trying to leave for St. Louis on time (6:30 a.m.), I accidentally left my Lupron sitting on the bathroom counter after I did my injection rather than putting it back in the refrigerator like I'm supposed to. I called my nurse, Peggy, when we got home and she assured me that it is fine and will still be effective and I don't need to get a new vial FedEx'd overnight like I thought I would. Duh. Won't do that again.

P.S. I would like to give my husband HUGE props for being the absolute best husband a girl could ever ask for. I tell him this frequently, but I'm not sure he believes me sometimes. His support and patience has been absolutely limitless, and I don't know what I would do without his humor. He is going to make an incredible dad someday, but, of course, I knew that before I even married him. I am one very lucky girl.

Wednesday, August 6, 2008

The Dreaded Dex

After a week of being on Lupron and Dexamethasone, I can officially say I am experiencing side effects. I was hoping to be one of the lucky few who wouldn't, but, alas, that is not the case.

Side effect No. 1: Extreme hunger -- the kind where you think you might throw up if you don't eat immediately. This is becoming increasingly difficult to ignore. I'm just powering through with glass after glass of water trying to trick my brain into thinking I'm full.

Side effect No. 2: Hangover-like headaches every afternoon. I'm actually not sure if this is from (1) the Dexamethasone; (2) the fact that I quit taking BCP (birth control pill) Sunday night and therefore my body is adjusting to new hormone levels; or (3) from taking a depo every day for the past two weeks to try to compensate for our medical expenses. Whatever the cause is, it's annoying.

Side effect No. 3: Mood swings. Last Thursday I had myself a really good cry in the car for no apparent reason at all listening to "You Raise Me Up" by Josh Groban. Seriously.

Side effect No.4: Obsessive/compulsive disorder. I don't even want to know how many times I walk over to the refrigerator every day to check and recheck my drug calendar to make sure I've done the right injection in the right dose at the right time, didn't forget to start a new medication, etc., etc., etc.

Other than that, everything is going great!

Monday, August 4, 2008

Upcoming doctor appointment

This Friday I will go to St. Louis to have my first ultrasound done and also have blood drawn to measure my hormone (E2) levels. The purpose of this ultrasound is to look at how many follicles my ovaries are likely to produce this month so my doctor can get an idea of how many eggs to expect when he does the egg retrieval sometime the week of August 18th. Yes, I did say "follicles" as in plural. All healthy women of reproductive age produce multiple follicles naturally (as many as 10 to 20) each month. Of those follicles only one of them matures into one egg that is released each month (or, in the case of fraternal twins, two). Because we are doing IVF, I will take a follicle-stimulating hormone called Follistim to help ALL of my follicles mature and develop into eggs. Yes, ladies and gentlemen, we hope to have lots of eggs retrieved for fertilization! This does not mean we will have 10 to 20 embryos when all is said and done. Some of the eggs retrieved will not be fully mature, even though that is the goal, and unable to be fertilized, and then, of course, some eggs once they are fertilized will not develop at all or start to develop and then arrest. So this is really a case of survival of the fittest. Our hopes are to grow at least two really great embryos to put back that will result in a healthy pregnancy and healthy baby/babies! I will post another blog after my doctor's appointment so we all know how healthy and productive my ovaries are.

Roger and I have had this question asked many times: "What if you have four or five babies?" I can assure you this will not be the case. By doing IVF you will only have as many babies as embryos put back into your uterus. It is a very controlled situation. For example, if we decide to put back three embryos, the maximum babies born would be three, but more than likely two, one, or none. There is that very, very unlikely chance we could get one more than expected IF one embryo divided after it was put back and resulted in identical twins, but neither Roger nor I have identical twins in our family, so that is the least of our worries at this point. As of right now we have no idea how many embryos will be used in our embryo transfer. We have to wait and see (right up to the day of transfer, even) to find out the quality and quantity of embryos Roger and I make together and what the appropriate number to put back will be.

If you've ever watched "Jon & Kate Plus 8" on TLC or have heard of the McCaughey septuplets from Carlisle, Iowa, those children were born through a fertility treatment called IUI (intrauterine insemination), NOT through IVF. Doing an IUI is a lot less expensive than IVF but also less controlled. Basically the mother takes a fertility medication (Clomid) to stimulate her ovaries to produce multiple eggs and then her doctor will inject sperm directly into her uterus at the opportune time of the month in the hopes that at least one egg will get fertilized and then implant successfully. The chance of having high-order multiples (four or more) as a result of an IUI is incredibly slim, but it does happen. And when it does we all hear about it which makes everyone paranoid about fertility treatments. It's a little misleading. But what isn't misleading when the media is involved?