Embryo Transfer for Baby #2!

Here we go!

July 22 was our first Frozen Embryo Transfer (FET).  We took our daughter to a friend's house, who was such a blessing to watch her for us.  Then we got to the Dr.'s at 10:30.  A little early.  The whole way there and before, I had to drink 32oz. of water.  That's a lot, in case you were wondering.  I didn't have to wonder, because I knew.  I knew when I felt the urge to do the "pee-pee" dance.  I can do a pretty mean "pee-pee" dance.  Well, the reason for the obscene amount of water is that it provides a straight path to where they need to go.  

About 30 minutes before the procedure, I took a Valium.  Doctor's orders.  Not gonna argue with that.  With all the poking and prodding that this whole process takes, I see it as a little bonus.  It made me very relaxed.  But the real reason for the Valium, aside from being a reward for being a human pincushion for a few months, is that when you have that much water, it makes the bladder contract, and the Valium prevents that. 

We watched some "House Hunters" in the waiting room, and I felt giddy.  I looked in my periphery at the other people in the room, and like I always do, I wondered about their stories.  Infertility is a tough journey, and has many origins and many different endings.  I hope their journeys through this fire-swamp end soon, and end happily.

Soon, they called us in to our room.  A room we were familiar with.  It is where I have had many ultrasounds, as well as my egg retrieval.  I like to think of it as the luxury room, as it is at least twice as big as the other rooms.  Boo-ya.  But I still had to sit on an uncomfortable table with a paper drape on my legs.  Not so Kardashian after all.

They brought in a picture of our baby.  I think this one looks a lot like me.  Ok, so it's only 5 days old--at the blastocyst stage.  But maybe this one will have some of my traits?

First picture.  Hopefully the first of many!  Technically, this is the 2nd picture of this baby.

We were stoked that the first embryo that they thawed survived, as sometimes this is not the case.  I think it is somewhere around 75%-90% survival rate.

They kept asking me if I had to pee a little bit.  They'll let you go a little bit, but I didn't really want to mess with it.  It was tolerable.  But they kept asking.  That made me think about peeing.  It was a little irritating!

After all of the talk of Niagara Falls, we had to verify our names and dates of birth and say how many embryos we were implanting and which one.  That way, we didn't end up with someone else's kid or 8 embryos or something like that.  I stand behind that protocol.

Embaby selfie!

So then they used an ultrasound and a catheter to transfer the embryo to my uterus.  The doc said it was "straight as an arrow", so good thing I held it.  When it was all done, he said it went as well as it could!  Now, that statement could be interpreted one of two ways:  If you are a "glass half-full" type of person, it means it was the best ever.  If you are a "glass half-empty" type of person, it means that's as good as it's going to get.  Haha I'm hoping for the glass half-full version!

The white dot in the middle is where the embryo is. 

I had to hang out on the table another 30 minutes or so after the procedure.  Then--and this is the best part--I was free to use the facilities.  It was glorious.

(Singing to the baby, working of the rest of the Valium, and trying to distract myself from nature's call.)

Doug and I grabbed a bite to eat afterward, and then picked up our little one.  We headed home where I had to be on bed rest (I know; poor me) for 2 days.  Nora was very cuddly and sweet during this time.  Maybe she knows something we don't?

Do I look pregnant yet? 

We have to wait a week or so for our first pregnancy test.  We will keep all 4 of you readers updated! ;)

Tomorrow, Tomorrow!

Tomorrow is a big day!  Tomorrow we transfer our embryo.  In other words...I'm getting "knocked up" tomorrow (hopefully). 

I'm so excited, as is Doug, of course!  I'm not as worried as I would expect to be.  Eager to get it over with.  Anxious for the waiting to be over.  Like a kid waiting for Christmas, I can't seem to think about much else.  It was nice when we went on our vacation to Alaska, because I was nice and distracted.  But now I'm just hanging out at home with Nora, and I think about it a lot! 

I've been on Progesterone for 4 days now.  It's a little rougher than I remember.  Maybe the estrogen patches are making me more sensitive?  The first one we definitely didn't do in the right spot.  My butt was SORE for a while.  It still is a bit.  It felt like someone punched me hard right in the ol' gluteus maximus.  We figured out the placement for the subsequent injections, which have been much more bearable.  Doug really does a great job with these injections.  I could see him in the medical field if he ever wanted.

Well, I'll let you know how it goes!  Prayers appreciated.  :)

1 week to go!

Tuesday was a busy day.  We traveled back from Alaska on the red-eye.  We arrived home around noon.  We went home to get some rest, and then had an ultrasound at 4:00.

The ultrasound went well.  My lining in my uterus is nice and thick, which is what they are looking for.  A nice thick lining makes a cozy bed for an embryo.  Then they checked to see that the ovaries are suppressed.  They had trouble finding the ovaries (again), which is a good thing, because they are smaller when they are suppressed.  They finally found them and verified that they were suppressed.  That is a good thing because if I were to release an egg, that would mess up the whole cycle.

During the ultrasound they also found a small endometrioma (sp?) on one of my ovaries.  That is a cyst caused by endometriosis, and I have had many of those in the past.  They said because it is so small, it should not be a problem.  But it does piss me off because I've been on all these hormones to keep my endo from flaring up, and here it goes anyway.

After the ultrasound, I had some blood work done.  Then I went for acupuncture.  I've been doing acupuncture treatments just about every day.  Last time I did IVF, the acupuncture appointments were more spaced out, but due to our spontaneous vacation, we've had to squeeze the appointments in to fit the entire protocol.  I enjoy the treatments, but the office is on the other side of town and I get tired of driving over there.  Just wish I would have started sooner so that I could space the appointments out more!

Yesterday, I got the results of my blood work back.  My estrogen levels were a little low, so in addition to the 4 patches of Estradiol each day, I have to take 1 Estrace pill per day.  Yesterday was also my last day of Lupron--yay!  Today is my first day of Progesterone--meh.

So, hopefully everything will look good by Tuesday, July 22.  That is my transfer day!  We are still set to transfer just 1 embryo.  Please pray for us.  :)

Baseline Ultrasound

Yesterday I had my baseline ultrasound.  They wanted to make sure everything was suppressed.  They had trouble finding my ovaries.  Probably because my ovaries are jerks and are in the wrong place because of my endometriosis.  And they didn't have any eggs in them, which is a good thing.  If I ovulate, it could disrupt the whole process.  They don't have to worry about my left side producing anything, cause it's a major jerk, but they had to check.  So it was a pretty uncomfortable ultrasound.  I was sore for the rest of the day.  But nothing terrible.

I have had acupuncture every day this week.  Normally, I enjoy acupuncture.  But now it is difficult to schedule because I have to make sure I have someone to watch Nora.  And having it days in a row is not as enjoyable as having it spaced out more.  Still, it is supposed to help, and everything went smoothly with our first IVF, so I just want to keep it pretty much the same. 

I hope this post was not as boring to read as it was to write.

The Dark Side...

All of this fertility treatment, while a miracle, enabling us to build our family, also has a dark side.  Also known as side effects.  The first time I had to take Lupron Depot for my endometriosis, I distinctly remember the doctor turning to Doug and saying something along the lines of, "Get ready for a roller coaster ride."  I think he said it much more respectfully, not to poke fun at me, but to really let Doug know that it was going to be a rough few months.  And it was.  It was menopause at breakneck speed, complete with hot flashes and mood swings.  I hated it. 

Fast forward a couple of years to mid-May 2014.  I unexpectedly had to have a one month dose of Lupron Depot to calm things down with my endometriosis again.  Only this time, it wouldn't be so bad because I knew what to expect.

Aside from the hot flashes, it wasn't a big deal this time.  Maybe because it was only for a month, instead of 3.  I will say that I don't think that it helped my pain from the endo, but it at least stopped my period, so that could help with some of the damage.

So I thought I was scot(?)-free.  Then I started the Leuprolide Acetate (Lupron, but not Lupron Depot).  This is a daily injection that is part of the IVF process.  It shuts down the reproductive system to allow it to be manipulated with other hormones (crazy, right?).

On day 2 of the Lupron, however, the evil Side Effect arrived.  No, not the hot flashes.  I wouldn't even call it mood swings.  Just pure evil.  Ever seen Dr. Jeckyl and Mr. Hyde?  Yeah, like that.

It happened 2 weekends ago.  My sister (also my bestie) was visiting, and we were cleaning up the kitchen from breakfast.  I went to put the griddle away, and she playfully snapped my brastrap.

I.
Freaked.
Out.

I'm not even sure of what I said (I know swearing was involved.  Probably the BIG ONE.).  Did I black out?  I don't know.  She said later that she could see it in my eyes.  Like it wasn't even me.  It was like everything that had ever made me mad in the history of ever was there in that moment.  I did it right in front of everyone, even my little niece.  Then, to make matters worse, I went and had some words with Doug for not helping clean the kitchen (so not an issue.  He was busy anyway, and cleans the kitchen more often than I do!). 

I had to go in my room to have a good cry.  I was embarrassed.  Angry at myself.  Angry at the Lupron.  Angry at my ovaries for getting me into this mess in the first place.  I think Doug came in to try to console me, but I was just so upset that I couldn't take it back.

I finally calmed down and came out and apologized to everyone.  I felt horrible.  Everyone was walking on eggshells after that, and I can't blame them.  It made me feel even worse.  My sister was kind and understanding (as always), but they did end up leaving earlier than they planned.  Not that I blame them.  I wish I could get away from myself sometimes.  I feel like the Incredible Hulk, or a werewolf who needs to be locked away.  Now I am afraid of the next time the Lupron Snake (as my sister refers to it) will strike again.  I have until mid-July and then I will be done with it.  For now. 

My First Shot

So on June 6, we saw the doctor for some final tests before we began IVF.  Long story short, the tests results were good, so we were sent to the IVF coordinator, who gave us a calendar which laid out each day of IVF.  I had no idea the amount of shots, tests, and appointments that we would have! 

The doctor put me on an extended regimen of Lupron, which basically shuts off communication from my brain to my reproductive system so the doctor can "drive".  He wanted me to start right away, so he had the medication overnighted.  We were going to my sister's for the weekend, so we had to have it sent there.  Furthermore, Doug was going on a camping trip, so it was up to me to do the first shot myself.

When the package came in, I had a nervous breakdown.  The box was fairly large, and was full of all the injectables that I would have to take.  I just had this overwhelming sense that I was in way over my head.  Doug is usually the voice of reason, but he was out of cell phone range.  I just sat on my sister's living room floor, crying, with all the medication spread out before me.  And this was ugly-crying.  I knew that I was out of control when I heard my 4-year-old niece telling my sister, "Uh, mom, she's crying."  I started to pull myself together, so as to stop freaking my niece out. 

The dreaded meds!  Dun dun dunnnnn!

My sister came downstairs to my rescue.  She helped me sort through the medication, determining what was what, and what should be refrigerated.  She helped me decipher the code of instructions and watched the instructional video with me (that's right.  To teach me how to inject myself with needles, they had me watch a video on my own.  Seems like an effective teaching strategy.  Not.) 

Then, the clock struck, and it was time to get this show on the road.  My sister and I were both nervous, and looked like a couple of dummies with needles.  No one should have allowed us to perform this task.  First, I iced the injection site on my leg.  I couldn't ice it for long, because my hand started getting frostbite.  I sanitized the top of the vial, put the needle into the vial, and injected air into it.  Then I loaded the needle with 20 units of Lupron.  Next, Michele was to give me the alcohol swab to swab my leg (see, she helped), but we were in such a frenzy that she threw it in the trash.  We both laughed at how ridiculous we were being.  At least she had been enthusiastic about throwing it away!

Finally, it was time to do the deed.  I counted, "One...two...three..........four..." I'm not sure what I got to.  But I was probably supposed to stop at 3.  Oh well.  When I got up enough courage (probably at 25 or so), I injected it into my leg.  Not gonna lie; it stung.  But I did it!  When I was done, my sister and I jumped up and down like a couple of doofuses (doofusi?).  We were so proud of ourselves.  Dorks.

Today I will give myself my 23rd shot of Lupron.  I have to say, it has gotten much easier, and it's not as bad as I thought it would be.  One trick is to hold the ice with a towel so your hand doesn't freeze off.  That's helped.  Also, just stabbing it in quickly helps.  I have had a couple of days where I just can't seem to stab it in my leg the way I am supposed to, so I gingerly prick my leg about 3 or 4 times.  I know it's stupid, but it's just some mental block that I can't seem to get past.  The other thing I've learned is to inject the medicine quickly and steadily.  I feel like a pro now.  Tomorrow I go down to only 5 units of Lupron a day, which will be a cake walk.  

The Timeline

The Timeline (Bah-bah-baaaah!)
Here is the timeline of our trying to conceive.  I know it's a little wordy, so feel free to skip.  But it's here for our own reference and for those that might want to know our story, and to encourage those who may also be having difficulty.  I put a lot of hyperlinks to explain medical jargon that has become commonplace to us, but not-so-commonplace for those who have never dealt with this issue.  If anything is still confusing and you are curious, feel free to ask!  We're pretty open about all this.

April 2010 This is where it all started.  We began "trying".  And as everyone says when they first start "trying", we weren't "trying", but we were going to "see what happens".  Whatever that means.  We didn't tell anyone because we wanted it to be a surprise. 

October 2010 6 months later, Amanda told her sister.  It was no fun to keep it secret anymore, and it was way too hard to keep a secret from her sister!

November 2010 Amanda's periods became so painful she couldn't eat or work.

December 2010 We stayed home for Christmas because Amanda's pain (both physical and emotional) had gotten worse.

January 2011 Amanda went to the GYN (gynecologist) for painful periods and to discuss concern over not being pregnant.  Doctor prescribed Progesterone cream for the pain and told her to come back after it had been a year.  Amanda went to urgent care for pain in her back that wouldn't go away.  Doctor told her to take ibuprofen.  (P.S. she HAD been taking the maximum dosage of ibuprofen for months already.  Thanks a lot, urgent care doc!)

May 2011 Amanda went to the GYN for an exam (it ended up being a different Nurse Practitioner, because apparently Amanda's doctor moved), during which something was found.  The doctor ordered an ultrasound to explore what she had found during the exam.  Doctor prescribed narcotics for pain with periods. Amanda also told the doctor about her back pain, which the doctor said should be treated by a chiropractor. (P.S. Amanda had already been doing that.  Thanks a lot, GYN!)

June 2011 First ultrasound found a 5cm cyst in left ovary (Amanda looked it up on Google; the size of a kiwi!  Amanda and her sister fondly referred to it as her "kiwi" from there on out".  Waited 6 weeks for next ultrasound.  Went to see GP (general practitioner) about digestive problems and back pain, which the GYN had said were not related to the cyst.  Doctor performed tests for parasites and kidney stones, both negative.

July 2011 Second ultrasound found that the cyst had not resolved itself (had to call the doctor for that info, since she didn't contact us).  Back pain was unbearable at this point.  Amanda had been unable to sleep for months because of it.  Boo.

August 2011 The GYN referred Amanda to a surgeon, who suspected she had endometriosis and would need surgery.  3 days later she had laparascopic surgery to remove the cyst.  The 45-minute surgery turned into 3 1/2 hours.  The doctor determined that she had Stage 4 endometriosis, and that the cyst was larger than originally thought.  She had a lot of adhesions on her organs and intestines.  He was not able to fully remove all of the endometrial lesions and adhesions. 

September 2011 Amanda was put on a 3-month long treatment of Lupron Depot to treat the rest of her endometriosis.  Due to the damage to her reproductive system, the surgeon highly recommended seeking treatment with a fertility specialist. He also emphasized that while there is no cure for endometriosis, pregnancy has been found to put it into remission in many cases.  We had our first visit with the fertility doctor to discuss options and make a plan.  Doug was tested; results came back fairly normal.

December--January 2012 Birth control to ensure that the Lupron was out of Amanda's system.

January 2012 HSG (hysterosalpingogram) that was fun.
 
February--March 2012 Used OPK (Ovulation Predictor Kit) to try naturally one more time.

April 19, 2012 First IUI (Intra-Uterine Insemination), failed

May 15, 2012 Second IUI, failed

June 6, 2012 Had a hysteroscopy and in-office HSG.  Met with doctor about IVF (In-vitro Fertilization).  Set up a schedule.

June 9, 2012 IVF medication arrived.  Amanda started her first injection of Lupron, which she will continue daily until around the end of July.

We will continue the IVF process through July.  Hopefully we can keep you updated as we go.  :)

Invisible Struggle

February 2012
Last month, I went to the dentist to get my teeth cleaned.  I settled into the reclining chair as the hygienist clipped a bib around my neck.  We made small talk as she examined my teeth and prepared them for cleaning.  Then the conversation turned where it inevitably always ends up.

"Do you have kids?"
"No, not yet." I replied.
"Do you WANT kids?'

Do I want kids?

Does she have any idea what she is asking?
Does she know how long we have been trying?
Does she know I recently underwent surgery to treat the cause of my infertility?
Does she know how many nights I cry myself to sleep, how many times my husband has held me as I cry uncontrollably, how many emotional breakdowns I have had, that come out of nowhere?
Does she know that I have underwent hormone therapy to treat my condition?
Does she know that my husband and I have a two percent chance of conceiving naturally?
Does she know that I WANT kids?  That I ache for a child with my entire being?

The pain for me is so real, both physically and emotionally, that I am taken aback to discover that outsiders have no idea what is going on with me.  From my perspective, it seems that my disease is visible to the outside world, that it can be identified by strangers.  But it can't be seen.

Someday, I hope to be able to pull out a wallet with a long accordion-fold of pictures to show every person who asks, "Do you have kids?".  Until then, I'll remember that that painful question is not intended to harm or poke fun.  It's just small talk.

The Backstory

December 2011

Hi my name is Amanda.  I’m 26 years old, and I’m medically infertile.

My husband Doug and I were high school sweethearts, and I’m pretty sure at least a couple of people thought we must have been pregnant when we got married because we were so young.  We both went to college and got degrees, all the while choosing to put off a family in order to be financially ready.

When we both had graduated and started our careers, we began trying to have a baby.  We had been married for 6 years at this point, and had endured as many years of that question, “When are you going to start a family?” 

We tried to time it perfectly so we would have a baby sometime in May, because I am a teacher and wanted the whole summer to bond with my baby.  I had heard that it can take up to 6 months for birth control to get out of your system, so we even planned for that.  I look back and think how silly it was that we were trying to orchestrate every detail of family planning.

Every month was disappointing, and the negative emotions increased with every negative pregnancy test.  In addition, my periods became more and more painful, until I had to take time off of work and even avoid family gatherings around the holidays due to the pain from my cycle.  I saw my doctor, who put me on a Progesterone cream in hopes that it would help with the pain.  It didn’t.  I started having excruciating back pain on a daily basis.  I thought perhaps I had a kidney infection and went to Urgent Care, only to be told to take ibuprofen. 

I followed his advice for 9 months, and finally got fed up with it.  I was taking 2400 mg of ibuprofen a day for 9 months, and doctors didn’t seem all that concerned.  I finally got an ultrasound, where they found a cyst on my ovary.  My doctor told me to wait it out.  All the while, I couldn’t sleep, eat, or function, and fell into a depression.  She was convinced that my back pain was unrelated to the cyst, so I went to my family practitioner to endure tests for kidney problems, parasites, pulled muscles, etc.  She gave me muscle relaxers and narcotic pain killers.  Nothing provided an answer or relief. 

In August, I was finally referred to another gynecologist who immediately diagnosed me with endometriosis and scheduled laparoscopic surgery three days later.  I couldn’t wait for the surgery; the pain I was feeling was so intense.

When I woke up from my surgery, I was in a fog.  I knew right away that my pain was gone.  Then my doctor started telling me about what he found.  I had Stage 4 Endometriosis, the most severe kind.  My organs were so scarred up and moved around from the endometriosis that he couldn’t even get rid of it all.  He said I will most likely need surgery on my large and small intestines because of the scarring, and I will need a hysterectomy in the future.  It was, and still is, a very emotional time.

Our doctor has not said that we can’t have children, but he says our chances of conceiving naturally are very low.  I am currently on hormones to treat my condition, and will have to always be on treatment, unless we are “aggressively” pursuing pregnancy, meaning with the help of an infertility specialist.  Furthermore, he has advised us to try to get pregnant in any way possible, because it can potentially treat or eradicate my condition, for which there is no cure.  So we are faced with the fact that we are having great difficulty conceiving, but it also may be the only way for me to find relief for my condition. 

In the meantime, it is a daily journey.  Some days I feel fine and other days I will begin weeping at the slightest mention of a baby.  I’m learning to deal with the insensitive comments from others.  I’m learning to “rejoice with those who rejoice” when yet another friend makes a baby announcement.  I’m learning to lean on God who is my strength.  And most importantly, I’m learning to be thankful for the many things I have been blessed with, in particular my husband, Doug.  He has been with me at every appointment, with me through every sleepless night, and always comforts me. While this has been hands-down the most difficult trial we have faced, our marriage is ultimately stronger because of it.   And we are convinced that God loves and cares for us, and we know that whatever the outcome, God’s plan is the best plan.