Winning

This post is a long time coming, but with the flu, colds, Christmas and travel, I have been so busy and worn out that I'm only getting a chance to write now.

Thank you all so, so much for your support during the SIRM IVF contest. We did not make the finals, which was a shock to us and many who voted for us. I honestly thought we would at least make the top ten and go to the final round, and I have to admit that I was more crushed then I expected to not even make it that far. However, reflecting on the experience, I think we did win in a way. The love, support, and words of kindness from family, friends and strangers showed us how loved we are. It was incredible to look at my Facebook feed and follow the shares of our video to see how far our story went. People we don't know on the other side of the planet wished us the best and voted for our video. So amazing.

As I mentioned, not making it to the finals did hit me harder then I expected. We also 'tried' this month, and of course, it didn't work. I couldn't help but get my hopes up though. That, combined with getting AF on Christmas Eve and suffering from horrible, horrible cramps this month made me an emotional mess. I was depressed and struggled to enjoy the day. I did come around after a couple of days, but I have to admit that I'm in a bit of a sad place right now with the whole TTC thing. We need to take a bit of a break from it all and regroup - focus on us for a little bit. Because really, that's the most important thing for us...each other.

When words are inadequate

The Sher Institute of Reproductive Medicine (SIRM) occasionally runs contests for eligible couples to win a cycle of IVF. This time, Derek and I decided to enter. The contestants submit a four-ish minute video about their story and, starting this past Tuesday, December 11th, the videos went up for public vote. Once the voting ends, the top five to 10 videos are reviewed by a judging panel consisting of previous winners. The winner of the free cycle is announced on December 20.

Since we've posted our video, and since I've shared the contest link with friends and family, the response has been overwhelming. Actually, overwhelming doesn't even begin to describe how we feel. We feel honoured, inspired, lucky and thankful for all the wonderful, amazing, empathetic people out there, of all nationalities, sexes, backgrounds and what have you. My friends and family, and the amazing ladies in my Facebook and Fertility Friend buddy groups have been promoting us since the contest site went live. I look at my Facebook feed and see person after person posting the most amazing things about us and how we deserve this, and asking people who don't know us to support us by voting. And they do. And then they share with their friends. It's just...there are simply no words.

I feel like, even if we don't win, we'll still be ok. Why? Because of all of you. Your support, love, compassion and tears have worked to heal a piece of our hearts. Infertility is one of the toughest things a couple will go through, but just knowing there are so many people out there who genuinely care makes us feel less alone. So thank you.

To vote for us, follow this link and click on 'Jobson Family': I Believe

A direct link to our video is here (this is my Youtube page, not the Sher Institute page): We Believe - Derek and Emily Jobson

Thoughts

Just mussing on paper....

Today, during my lunch break, I went to the pharmacy and bought OPK's ($60!) and Instead Cups. Why do I do this to myself? What makes me want to try again and again, with no positive results? Is that not the perfect definition of insanity? I know I'm setting myself up for a stressful month, but I can't help it. I mean really, if we do everything exactly right, why shouldn't this work?

I read a study earlier today that said that a couple with 'unexplained' infertility has a 30% - 60% chance of conceiving within three years. Seems pretty high, right? But three years is a loooooong time, and that's just the chance of conceiving, not live births (hey, that's me!). It's things like that, though, that keep me on the fence about everything. On one hand, I just want to call the clinic today and say 'sign me up for an IVF next month, let's try this again and bring out the big guns!', but then on the other hand, it's just.so.hard. It's a lot of work (and money) for minimal rates of success. And really, we have a good reason to wait to do anything right now (see my last post), but I don't wanna wait. Why can't life just work out the way you want it to?

I've been reflecting on two things related to infertility lately. The first is that the last (almost) six years of infertility, TTC, treatments, losses, etc., have taught me patience. Sounds crazy considering I just wrote about how I don't wanna wait right now, but it's true. All we do is wait when it comes to this stuff. Wait to ovulate, wait to take a pregnancy test, wait to do blood tests, wait to do surgeries, wait for the next beta, wait to get the call for our IVF cycle, and on and on. It's been difficult, but I think patience is something that is valuable, and I'm glad my capacity for patience has grown.

The second thing is that I feel like such a horrible person for sometimes hoping that other women/couples get to experience a small touch of what we've gone through. I don't know why, but I feel like people might be able to empathize a teeny bit more if they go through a small slice of this. I'm such a jerk, I know. Can't help it though, and I'm not really sure what to add to this statement. I guess I have some more self-reflection to do here, but my gut reaction is that this feeling comes from a place of jealousy on my part.

Anyway, we had a wonderful weekend with S. I met her mom for the first time and saw what type of home she lives in. I think of S all the time - I find myself thinking of life milestones she will go through and how we can help her and give her advice. I think of the things I might say to make sure she remains a strong, self-confident girl, I look at clothes in her size and imagine the types of clothes I might buy for her if she was with us. I think of the bike we want to get for her and how we'd decorate her room. And then I try to make myself stop thinking about it because I can't let myself go too far down that path in case it doesn't work out.

Sometimes I wish I could turn my brain off.

The Stuff of Life

It's been ages since I posted an update, but I have a good excuse - I've been in Victoria, B.C. for my second year residency (graduate studies). While being away from home for 3 weeks was stressful, and the residency this year was academically and emotionally draining, it was nice to be away from the TTC game with no time to dwell on things.

I arrived home this past Sunday and took Monday off, which was much needed. I slept for a blissful 13 hours Sunday night! Monday afternoon we went for a visit with S's part time foster mom to get an update on the little one, who has been back with her mom five days a week since the end of August. It sounds like things aren't going that well, unfortunately. It's a struggle for both Derek and I to not get a little bit excited about this - S is struggling right now, as is her mom, yet this means we might actually get her in to our home permanently. I feel like such a bad person for being hopeful that things go wrong. Horrible.

So, in light of these possible changes, we have decided to postpone our FET for now. We were planning a November/December transfer, but because of the way things are going with S, we'd like to focus on her for now. It was a tough decision, but it's for the best in the long run. I just have to stay positive, which is especially hard when it seems to be a season of new pregnancies in my life at the moment. I don't begrudge anyone, I don't cry over it, but it's still difficult.

In other news, I went to an allergist yesterday because I've always wondered if I'm allergic to bees or wasps. I've never been stung, and since Derek and I spend a lot of time outdoors, I worried that I might be allergic, get stung in the middle of nowhere and have a reaction with no epi pen. The good news is I am not allergic to any local insect venoms. The bad news is I apparently have chronic environmental allergies and allergic rhinitis. The doc said I've likely had this since I was a child and it's caused my eczema (hands, feet and face), sporadic hives, and the keratosis pilaris I had as a teenager. It likely started with exposure to smoke and animals as a baby and child and my body became so used to it over the years ("chronic") that I no longer have the runny nose and itchy eyes. My nasal passages are inflamed, however, and my body is working in overdrive and has been for years. So my immune system is overloaded. Back to the immune system...huh. It's interesting how so many things come back to that; I'm almost 100% convinced it's linked to our fertility issues.

The game plan for now is to continue on my supplements (3,000 - 4,500 IU Omega-3, NAC, high folic prenatals, 5,000 - 10,000 IU liquid Vitamin D3 daily) and add daily sinus flushing with a Neti Pot and a pet free bedroom with a HEPA air filter and TTC naturally. I seem to get pregnant naturally once a year, so we have a while before anything happens, probably. Sometimes I feel so overwhelmed by all of this crap I have to do, but I at least have to give it a try, I suppose. Life, ack.

The Immune System and Miscarriages

A fairly well known but often unexplored avenue for recurrent pregnancy loss is immune system and inflammation issues. There are thousands of articles and stacks of research on the connection, but few clinics, especially clinics in Canada, explore these issues. Rather, they run the standard RPL panel, which focuses more on issues that cause second trimester losses (such as clotting issues).

According to Reproductive Immunology Associates (http://www.rialab.com/miscarriages_prevented.php), up to 50% of repeat early losses are caused by immune factors, either autoimmune (female's body fighting itself) or alloimmune (immune response to the father's cells in the embryo). Unfortunately, many of the tests recommended for detecting these issues are not performed regularly in Canada, so we pay out of pocket to send it to the U.S.

In a cost saving effort, I went to my GP and asked her to order as many tests as possible locally. Luckily, she is very understanding and accommodating, and ordered exactly what I asked for, plus a few other factors such as Vitamin D (summary of it's use in miscarriage here) and iron, as well as a full thrombophilia panel (clotting issues). Everything came back within normal parameters, though my Vitamin D was low for TTC. Odd how I'm disappointed that everything is normal - I suppose I was hoping for an answer.

Next on the list of important tests is an NK Cell Assay. Dr. Beer describes Natural Killer cells: "The bulk of the cells detected that express CD56 on their surface have a particular function that accounts for their name, natural killer cell. This function is, of course, the ability to identify and then kill foreign or abnormal cells. Identification of the number and activity of these cells gives us an idea of the strength of this killing capacity." Basically, these cells kill foreign materials. If the body sees a pregnancy as 'foreign' and 'abnormal', it will attack the embryo and cause a miscarriage. Assessing the levels of these NK cells in the body can give a better indication of the likelihood that an overactive immune system is the cause of early pregnancy loss.

I'm checking with both Reprosource and Millenova for costs, but word is that we're looking at between $250 and $400 for this test, not including shipping in to the U.S. I would love to do this before I leave for University in (eek!) a week and a half but it's unlikely. We'll aim for the end of October and hope for a short turn around in time for our FET in November/December. Fingers crossed for a sticky pregnancy by year end!

Another Loss

Apologies for not updating, but it's been a rough few days and we've been pretty busy at the same time.

I went in on Monday for another beta with hopes that I'd see something around 1000+, considering my decently rising betas from the previous draws. The lab tech butchered me (seriously, you should see my arms, I look like a junky because he couldn't get a vein) and in my possibly sticky pregnant lady obsession, I decided to go to the walk in clinic immediately after and ask for an ultrasound.

I went to the same clinic I went to on Saturday but saw a different doctor. Again, everyone was awesome (if you're looking for a good walk in in NW Calgary, I know a place!). He ordered an ultrasound and had the nurse phone around until she found me an appointment that day at 1 pm.

The spotting had stopped again for about 24 hours, and I had zero cramping, so I was still positive. But, when the ultrasound tech was doing the transvaginal and obviously wasn't focusing on one area (I couldn't see the screen), was asking me questions like "Have you actually had blood work to confirm?", and said to clean myself up and wait for the radiologist to come in and talk to me, I knew it was bad news.

He came in with my most recent lab work - my beta dropped to 120. He said there was nothing in the uterus, and as far as they could see, nothing in the tube. I am thankful it's not an ectopic, but of course, loss number six is hard to take. Those damn beta numbers made me way too hopeful when it's obvious something is wrong in there and I just can't hold on to a pregnancy.

I think, for my mental health (as well as Derek's), we are just going to prevent for a few months. As in, birth control and/or condoms. Every month we hope, every month we grieve, and then about once a year the hope/grieve cycle is about 1000 times worse and drags out for a few weeks. It's just too much.

In the meantime, we have started our adoption training seminars. Last night's topic was loss and grief. We did an exercise where we talked about our most recent loss (in general, not just related to infertility). Luckily, I was in a group with two other women so my tears were met with sympathy and hugs. It felt sort of nice to have that kind of support from total strangers, and to know I'm not alone in my sadness and sense of loss.

Having the adoption training to focus on and look forward to keeps us, especially me, going. It'll happen one day, we both know it, it'll just take perseverance and time.

Beta Number Four

I had what I would call light flow yesterday, and that combined with some mild right sided pain made me head to the walk in clinic yesterday evening. Normally, with a walk in clinic, you see a grumpy, overworked doctor who doesn't give you any answers. I was pleased to get the exact opposite!

The wait was a short 20 minutes and this grizzled white haired man in his 60's walks in to the room and asks what the problem is. I say 'I'm about five and a half weeks pregnant and bleeding....' Before I can go any further, he interrupts me with 'Bleeding is very common in pregnancy, blah, blah, the way we tell if a pregnancy is progressing normally is to draw blood tests for beta hcg every two days...'. I interrupted him this time and told him I had had multiple beta's done, including one on Monday and one on Friday, though I didn't have the results from Friday yet. He hops up and says 'Well, we can do something about that...follow me!' and led me to his office.

He pulled up my electronic chart and my beta on Friday was 449, with a doubling time of about 62 hours! He said that although I'm bleeding - which is very normal - the numbers look perfect and since I'm not having severe cramping, I should try to relax. He noted that we are not out of the woods yet, of course, but so far, so good. His exact words were 'If you were my daughter, I wouldn't be sleeping soundly until you passed 14 weeks'.

Just to recap, my beta's are:

August 13 - 8
August 18 - 41
August 20 - 158
August 24 - 449

Now I'm stuck trying to decide if I want to go in for another beta tomorrow, or just go in to see my GP on Tuesday and wait for an ultrasound later this week. These betas drive me crazy, but the next number will give me a better indication of viability. Or, we can continue on in happy bliss for another week until it either looks good on the ultrasound or it all comes crashing down. I'm also at risk for ectopic, so it might be worthwhile to keep an eye on my beta's ongoing just in case. Ugh, waiting and decisions, waiting and decisions....

20 DPO Beta

I went in for my 20 DPO beta and it came back at....158! So in two days, my beta jumped from 41 to 158, which is a doubling time of around 24 hours. 'They' look for a doubling time of 48 to 72 hours, so this made me a bit more optimistic. However, the number is still low for how far along I should be and we are doing a repeat today. Unfortunately, we won't get the results until Monday.

I did a CBE Digital with Conception Indicator yesterday evening after I got home from my work trip (I was out on a drilling rig all week) and it popped up as 2-3 weeks past conception (so 4 to 5 weeks pregnant) after a 2.5 hour hold, so my beta is still rising. My FRER this morning has the test line darker than the control. All good signs!

But, I'm spotting. I have been for seven days now. It comes and goes, and is enough that I need to wear a panty liner. It started as brown/tan, but about three days ago turned pink/red. I also have mild cramps, which I know are 100% normal as long as they don't get really bad. I am praying for a bleeding cyst or irritated cervix or something and that all is well.

When I call on Monday for my beta numbers I will line up an appointment with the doctor on Tuesday. I'm assuming she'll confirm pregnancy and then give me a requisition for an ultrasound.

Please, everyone, keep us in your thoughts and prayers. I know we have a lot of people doing that already, so all we ask as that you keep doing what you're doing!

Update

My beta came back at 41 (at 18 DPO), which is really, really low. Too low to really think positive, if I'm completely honest with myself. We would have been looking for something between 200 and 300, but 41? No way.

I'll head in for another beta today and will try to post the results tomorrow some time. I'm heading out of town for work first thing tomorrow morning, returning on Thursday night. I'll go in for another beta on Friday and make sure the numbers start going down instead of up. Fingers crossed for a natural resolution to all this - I really don't want to have to take methotrexate or get a D&C!

Thank you everyone for all the support - my real life friends and family as well as my online friends. Derek and I are so, so lucky that we have such a wonderful support system in our lives. You are the reason we get through this!

The universe has to be testing me for some reason.

I mean, if it wasn't, why would I get this FRER at 13 DPO?

Yup, that's a positive pregnancy test. For the sixth time. It's actually pretty decent for 13 DPO, the day before I am supposed to get my period. Excited, I called my doctor and asked for a beta. It was eight. EIGHT! Very low for 13 DPO and likely a chemical pregnancy. In fact, I assumed my beta was on it's way down, which was confirmed the next day when my pregnancy test was lighter. 

Anticipating that the lines would disappear quickly, I continued to test to make sure things were moving in the right direction. Well, they aren't. They're getting darker again, though no where near as dark as they should be. 

Here's my IC progression. From top to bottom (14 DPO - you can only see half of it, 14 DPO pm, 15 DPO pm, 17 DPO pm, 18 DPO am, 18 DPO pm, and today, 19 DPO am):

And my FRER this morning at 19 DPO:

I went in to the ER yesterday and they ran another beta, though there was no use trying an ultrasound as it's way too early. I'm hoping for the beta numbers today, but am obviously planning for the worst. I'm spotting and cramping and am sure the end is near.

The way I see it, the universe MUST be preparing us for something by testing our resilience to horrible circumstances like this. If we can continue to get through these disappointments, one day we'll be rewarded with a child of our own, whether biological or not. That's how I keep looking forward and staying positive. One day it'll be our turn.

Adoption

One aspect of our journey that I haven't mentioned previously is that we are currently looking at adopting a nine year old, should she become available. In the interests of privacy, I'll keep the details minimal for the time being, but S has been in the foster system for a number of years. Her mom will regain custody in August but will essentially be on probation for the time being with close monitoring by the case worker.

Derek and I started thinking about adopting S last December. We've spent a lot of time with her and see her potential (every kid has a lot of potential, in our opinion) and have decided that should things not work out with her mom - this is mom's last chance - we would like to adopt her. To do this, we need to be approved to adopt by the Province of Alberta. This process consists of an initial application, criminal records checks, references, training, interviews and a written report. So far, we have submitted the application, completed our records checks, and our reference paperwork has gone out for completion. We have also lined up our training, which will take place over an evening session, three Saturday sessions, and a Sunday session in August and September, after which our interviews with the case worker start. The original timeline given to us to go through the approval process was six months, and it seems we might finish slightly faster.

We have indicated that should this adoption fall through (which is, obviously, the best case scenario for S, who should be with her mom, if mom can parent successfully) that we may be interested in adopting another child or children. We are unlikely to be able to adopt an infant, which I think we're ok with, and all kids in the public system have some sort of special circumstance, from Fetal Alcohol Syndrome to emotional issues, though we can chose the issues we are willing to work with or not. We would be provided with a lot of support from the public system to help us succeed, which is important to us. This option, however, is still in the distance for us, though it's nice to get this process started now.

That said, we will still be doing our FET in November-ish. Lately I've been a bit depressed about the whole infertility thing, but at the same time, I feel as though I don't want to do any additional IVF's. I'm on the fence, as usual. I'm glad to have the adoption stuff to look forward to!

Failed IVF WTF Appointment and November FET

Being busy has it's benefits, one of which is that I have little time to wallow in my sorrow. I'm less than a week past the end of my last course for my first year of my MA, so have more free time (less homework, yay!) for a few weeks. However, my schedule for July through September is crazy, with trips to the Yukon and Houston for work, Stampede here in Calgary, and one of my favourite activities - camping! Before I know it, it'll be the end of September and I'll be preparing to head to Victoria, B.C. for my three week University residency.

That puts us in November for our FET. We finally had our WTF appointment for our failed IVF in March/April. Dr. Foong went over the embryologist report with me and we discussed why I had so many poor quality eggs. Looking at the report, the majority of my eggs were rated at a 3 (1 is good, 2 is moderate, 3 is poor quality), a few were 2's, and only two were 2+. No 1's. I asked about the protocol and it's contribution to the poor egg quality and she explained that while the protocol would have recruited more poor eggs, they were poor in the first place. The protocol can't cause poor eggs. I'm not 100% convinced and need to do a bit of research on this before we look at another IVF.

We found out that our two frozen blastocysts are rated 4BC and 5BB. The first number relates to the quality of the overall structure of the embryo and is a 1 - 5 scale, with 1 being the poorest quality and 5 the best. The first letter relates to the quality of the 'embryoblast', the part that turns in to the baby, with C being poor and A being good. The final letter relates to the quality of the 'trophoblast', which is the bit that turns in to the placenta, and again, C is poor, A is good. Overall, these two would be called 'medium quality' blasts. Dr. F is recommending we thaw both, hope they survive the thaw, and transfer whatever we get.

Derek and I have decided that while we are both ready to pursue another IVF, we're going to hold out hope for this FET and focus on that for now. I'll still do some research on our options (we still haven't done our testing for Dr. Sher yet), but at this point it's a bit overwhelming, so it's best to take a small step back for now.

In other news, we've submitted our preliminary paperwork to the Province of Alberta to start our home study for possible future adoption of a foster child. We have one child in mind right now (that's another story in itself!), but if that falls through, it'll be good to have already completed this process once we're ready to move on, if it comes to that.

Phone consultation with Dr. Sher at the Sher Institute for Reproductive Medicine (SIRM) in Vegas, baby!

I have long suspected that something other then 'unexplained' infertility was preventing us from getting pregnant and carrying to term. Luckily, I know a number of wonderful, knowledgeable women at Fertility Friend who have similar issues and who have undergone immunological testing and immune infertility specific treatments with success. These women helped to educate me on the possible immune issues we might have and led me to ask more questions. There are a few clinics in the United States that study immune system problems in infertility, but few, if any, in Canada. For that reason, Derek and I decided to schedule a phone consultation with Dr. Sher at SIRM in Las Vegas, which happened this afternoon.

This is a summary of what Dr. Sher had to say:

1) My IVF protocol through the Regional Fertility Clinic was incorrect. They started me on a low dose of Gonal-F and quickly increased it (because I wasn't responding well enough), which can cause poor egg quality. Considering we harvested 17 eggs, but only four made it past day three, there was likely something wrong with the eggs. Considering my youth (that was nice to hear!) and all my normal bloodwork, the poor egg quality was due to environmental factors, which Sher thinks relate to the protocol.

2) He is recommending immunological testing for Natural Killer cells as well as antithyroglobulin and antimicrosomal (both relate to anti-thyroid antibodies) for me and DQ Alpha and HLA genetic matching tests for Derek and I to check for genetic matching issues (which essentially means we share too much similar genetic material). These tests are not available in Canada, so we have to go through a lab in Calirfornia. Once I know what this entails, I'll update.

3) He does not recommend genetic testing of the embryos prior to transfer at this time (a relief, this is very expensive).

4) We qualify for the two IVF shared risk program. I will get the cost details from 'Sharon' tomorrow afternoon, but the jist of it is that the first IVF costs about 20% to 30% more then a typical IVF package. Should that IVF fail (or we miscarry), transfer of any frozen embryos for that cycle is free. Should that fail (or we miscarry), another IVF and FET is also free (likely not including med's, but still a huge savings).

I agree with everything he had to say and am glad our thoughts are in line. I have to say, he is a talker, and I couldn't get a half a sentence in edgewise, but all in all, I'm happy with the consultation. He also kindly assured me that this consultation, as well as the follow up after we do the immunological testing, is free of charge. We do not pay anything until we start a cycle with his clinic.

Hopefully the prices aren't too outrageous and this is something that might work for us! I will update when I know more.

Taking a Break (Cycle 50!)

Here I am, Cycle Day 1 of cycle 50 - I can't believe we've been actively trying for 50 cycles! This was my first full cycle post failed IVF and my period was about five days late, which is typical. Of course I tested. Stark white BFN's, as expected, and AF is on in full, painful force this morning.

Derek and I have been doing well since the IVF, and feel like we still have options. We're planning to do the FET (Frozen Embryo Transfer) in the fall, either in September, before I leave for University, or in November, after I return. We've talked about what we might do after that, should the FET fail, and we are of differing opinions. I was set to move on to adoption, but Derek is pretty sure he wants to do at least one more IVF, if not more. We're looking at switching clinics - either the Victoria Fertility Clinic or the Sher Institute in Las Vegas - if we decide to move forward with more cycles. We have time to decide, and a summer full of trying to focus on ourselves again.

We arrived home from a much needed vacation in Hawaii last week (we went with my parents, and my middle sister, Lara, was there for part of the trip too) and head to Penticton, B.C. for a ten day cycling camp on May 11. Vacations are fantastic at cheering a person up! Not to mention a loaded assignment schedule for University and our ongoing house renovations (which WILL happen this year!). I appreciate my busy life more at times like these - it's not as if I'm avoiding thinking about the failure, it's more like I'm able to process it in bits in pieces while looking forward to other things. I'm not letting infertility rule my life.

It might be premature, but I'm actually starting to think about the option of living child free, as is Derek. It is an option for me now, though it wasn't less then a year ago. It will be painful to make that sort of decision, and I hope it never comes to that, but at least I know in my heart that things will be ok, however they turn out.

IVF #1 - It worked...and then it didn't.

Previous to starting this whole IVF process, Derek and I discussed how and when we were going to do a pregnancy test following the transfer. I am a self admitted POAS addict, so had originally planned to test out my trigger and then (hopefully) watch the line get darker again to indicate a pregnancy. However, Derek pointed out, and rightfully so, that this whole process should involve the both of us, and we both needed to be involved in the testing. In an effort to take the pressure off, and to keep this as close to a shared process as possible, we agreed to test together on a day where we would be sure the trigger was gone, and any second line would mean a pregnancy.

There was some disagreement about the test date, but I recall that we decided to test 14 days post trigger (or 9DP3DT / 12DPO) while Derek remembers 14 days past the retrieval (11DP3DT / 14 DPO). Either way, we ended up testing on 10DP3DT / 13 DPO, this past Saturday. And we got this:

It's light, but it's a line, a line even Derek could see. It's a line that is reasonable for ten days past a three day transfer. It worked, and I cried. Derek asked why I was crying and I said I was just so happy!

But alas, it was not to be. I tested again the next day and the line didn't get any darker. Looking to calm my fears, I went in for a beta and tried my hardest to remain positive. I didn't get the results until the next day, Monday, and I knew what was coming. My beta was only 4, which is technically 'not pregnant' (below 5 is classified as not pregnant). My test that morning had been almost negative (damn those FRER's are sensitive!). By this time, I was 12DP3DT, or 15DPO.

Today is my official test day with the fertility clinic - yes, they make you wait until 18 days past retrieval - and I'm not even going to bother going in. I'll give them a call and let them know I've tested negative and schedule our WTF appointment. This is our third uterine loss (I also had an ectopic last summer) and I'm convinced there is something going on with implantation. Our plan going forward is to review the results of my repeat pregnancy loss panel and request additional immunology blood work for potential problems including increased NK cell activity and lupus.

We also need to take a few months off. Though I was happy, positive and emotionally stable through the whole IVF, I feel mentally drained at this point. In retrospect, this took a much bigger toll on us then we thought. In less then two weeks we will be in Hawaii with my parents and sister Lara for a couple of weeks, and then we head to Penticton, B.C. for ten days in mid-May, and we need it. We'll start the immunology testing in June and expect the results to take a few months. That puts us at August or September for our frozen embryo transfer (FET).

At this point in time, I don't feel like I could handle another IVF cycle. Adoption seems like a reasonable option for us at this point, and comes with a much better guarantee at close to the same price. That said, we'll see what the next year brings.

IVF #1 - 4dp3dt and we have Totsicles!

4dp3dt = four days past three day transfer, otherwise known as 7 DPO.

I'm not going crazy yet, but I can feel the crazy right around the corner. Time is slowly moving forward and I'm thankful for a very busy week at work (including travel from Wednesday to Friday) and a final assignment for University due next Sunday. My few symptoms, sore boobs and light cramping, can be attributed to the 600mg of progesterone and 4mg of estrogen I'm on each day, but that doesn't keep me from analyzing every little twinge and pushing on my boobs every once in a while to make sure they still hurt (they probably hurt because I keep pushing on them).

We got some amazing news yesterday! Left with little to no hope for frozen embryos after the transfer last Wednesday, we got a call from Chris the embryologist early yesterday afternoon to let us know that they had successfully frozen two day six hatching blasts yesterday morning! Last we heard, we had a few embryos that were a day or so behind that they were going to leave in culture to 'see what happens'. We didn't have a lot of hope, but figured there was no harm in letting them sit, right? Well, two of them caught up, and we have two more 'average' blasts on ice for when we need them.

Not only does this let me breathe a bit easier, but it will really help me to relax for the rest of this cycle, because we have a couple of totsicles in the fridge for a second go if we need it. Hopefully we use them for sibling(s), but it is a relief to know that we have a plan B.

IVF #1 - Embryo Transfer

One day post transfer and I'm already starting to obsess. Logically I know nothing has implanted yet, but every twinge and cramp draws my attention immediately to my abdomen and my thoughts to those two little embabies in there. How am I going to get through the next two weeks?

The transfer was right on schedule yesterday afternoon. Derek arrived shortly before the appointment and we were ushered into the same room the egg retrieval was performed in. I had a full to bursting bladder for the ultrasound guidance - too full, even, and they asked me to empty about half. Once I was up in the stirrups, the embryologist came into the room to talk to us about our embryos. We had two 'average' day three embryos, one a six cell and one an eight cell, which are exactly where they should be for how old they were. There are a few slow four and five cell embryos still in culture that they'll continued to monitor until day five (tomorrow) to see if we have any that catch up for freezing, but it didn't sound hopeful.

Dr. Scott and the nurse started to work on inserting the external catheter, which was painless - a nice change from the usual pain I experience because of my bent cervix. Apparently the pressure of my full bladder straightened it out. I was seriously shocked when she said she was in, my hand in Derek's ready to squeeze the living hell out of it! I think Derek was somewhat relieved that it went so well.

On the same monitor where I watched them harvest my eggs only a few days prior, they brought up a magnified image of our two little embryos. We watched on the monitor as he sucked them in to the needle, verify they were in there, and then come into the room with the catheter and hand it to the doctor. We were also able to watch on the ultrasound as she injected them - we could see exactly where they were injected. Of course, you can't see the embryos themselves, but there is an air bubble in the catheter between the two embabies that shows up as a white dot on the screen. In less then ten minutes, it was done.

She pulled all of her tools out and covered me up. I lay still for about 10 minutes while Derek and I reflected on the fact that we had two of our own inside me at that very moment. I was moved to a recliner and told to relax for 30 minutes before getting dressed to leave. We sat beside a couple who had gone in before us and wished each other luck as they left.

I spent last night lazing on the couch under direct orders from my husband, who cleaned, cooked and wouldn't let me get up unless it was just to go to the bathroom. We are both in a very positive place and feel like this is going to work for us. We're trying not to talk too much about what will happen if it doesn't, and I sincerely hope we never have to.

One of the best parts of the whole thing was when they handed us a picture of our embryos, which is now hanging up on our fridge with the other family pictures. Here's to hoping that this will be the first page in our baby book:




Six cell on the left, eight cell on the right.

 

IVF #1 - Fertilization Reports and Transfer Day

After a hugely successful retrieval, we were pumped to get a call from the embryologist on Monday morning telling us that 14 of the 17 eggs had fertilized naturally over night. This was much, much better then we expected, and I got to shock Derek in to silence when I called him to say he's a father of 14!

Unfortunately, we got some bad news on Tuesday (yesterday). Apparently most of the embryos had fragmented over night, and we only had between two and four that were of decent quality. Because of this, they recommended a three day transfer, which happens in about two and a half hours.

The website Advanced Fertility (a clinic in Chicago) has a pretty good explanation of what they look for in an embryo, including proper and timely division, and degree of fragmentation. You can read about it here. Fragmentation is when little bits of the cells break off from the main cells. There isn't a definitive explanation as to why this happens, it just does. Some theorize that it's due to poor egg quality, or possibly sperm issues, or even the type of protocol that's used for the IVF. That said, some fragmentation is ok, and even expected (up to 10% is normal). When we go in this afternoon, I expect them to tell me how fragmented the embryos were as well as at what stage they started to fragment.

Because of the fragmentation issues, they clinic recommended assisted hatching. After an egg is fertilized with the sperm, it develops a tough zona pellucida, in part to prevent other sperms from getting in a ruining the embryo (that does happen sometimes, and you can end up with too many chromosomes, or other issues). Assisted hatching uses a laser or needle to pierce the zona pellucida and allow the embryo to hatch. A summary of how and why it's done can be found here. Because our embryos have undergone assisted hatching, I started taking a steroid yesterday, and will continue for another five days, to prevent exposure of the embryo to inflammatory cells in my uterus.

What we are hoping for this afternoon is two good quality embryos to transfer over. We would be very happy if we had some to freeze, but that seems unlikely at this point.

So, with fingers and toes crossed, Derek and I head to the clinic for our 3:30 appointment to be PUPO. Pregnant Until Proven Otherwise!

IVF #1 - Egg Retrieval

Today was the big day! I was a bit stressed out because I stupidly spilled some of my HCG trigger shot on Friday night. I was supposed to be injecting 2 mL split between two syringes, but in the end, I had 1 mL in one, and just over 0.7 mL in the other. However, when I talked to the doctor doing my retrieval this morning, he said that the 10,000 units I was supposed to take (a total of 2 mL) was more of a safeguard, and half of the dose works just as well for most women.

We arrived at the clinic at 9:30 am and were ushered in to the back where the nurse sat me in a chair and put a heating pad over the arm that was going to get the IV. She explained the process to both of us and went over the post-ER instructions, including my doses for estrogen and progesterone to be started tomorrow morning. After about 20 minutes, the doctor came by and did my IV (he said I have nice veins - but really, it's just that he was great at inserting it). They walked me in to a darkened room with stars painted on the walls and roof and a TV screen on the far wall. He immediately gave me Fentanyl for the pain and Versed to relax me. I was awake and responsive for the whole procedure.

He inserted an ultrasound probe and I was able to watch what he was doing on the ultrasound screen. He gave me a heads up before he inserted the needle through the vaginal wall and in to my ovary. I felt a lot of pressure and some pain, so the nurse gave me some more pain meds. Afterwards, I felt very little until the very end of the procedure when he had to dig a bit to get at the last two follies on the left. It wasn't any worse then period cramps though, so tolerable.

I could see the needle go in to each follicle on the ultrasound, which looks like a dark, almost circular spot on the screen. I could actually see him sucking the fluid and egg out on the screen - pretty cool to watch! Every few minutes, the embryologist would come in to the room and pick up a bit of the fluid and take it in to the lab on the other side of the wall. I was able to see what he saw in his microscope on the TV screen at the end of the bed. Every few minutes he'd tell us how many eggs we were up to.

"...five eggs..."

"Up to seven now..."

"...eleven!"

I was out of the room and in recovery before he had counted them all, but he came by within about 15 minutes.

17 eggs!


If you recall, at my last ultrasound I have 11 follies on the right and five on the left (with only two looking promising), so we ended up with more follicles and eggs then we thought.

Now it's more of a waiting game. The clinic hasn't called today, which means they had enough sperm to attempt natural fertilization. The embryologist will call tomorrow morning with our fertilization report. According to the clinic's typical rates, we're looking at around 70% mature, so of those 17, around 12 will be mature. Of those 12, 70% will fertilize properly. We should end up with eight or nine embryos.

By Tuesday morning we should know if we're doing a three day transfer of two embryos, or a five day transfer of one blastocyst. It's really up to the embryologist to decide what will be best for us.

Either way, I'm very, very pleased with the retrieval and can't wait to get that call tomorrow. It's amazing to me that at this very moment, Derek and I have a bunch of our potential babies in a dish at the lab. Crazy.

IVF #1 - Final Monitoring Appointment

Last night sucked. Around 8:30, Derek called me from the union meeting he was attending to tell me he had very serious stomach cramps and was throwing up, so was on his way home. He arrived home and went right to the bathroom, where he continued to suffer out of both ends (poor guy). He crawled on to our bedroom floor and laid there in pain while I called Health Link (our nurse hot line) to ask for advice. Of course, the advice was to head to the hospital, as it could be his appendix or gall bladder.

At this point, the pain was so severe that Derek couldn't sit up long enough to ride in the truck to the hospital, so we called an ambulance. The paramedics gave him morphine and gravol and transported him to Foothills. Once there, a barely conscious Derek sat in a wheelchair while we waited to be admitted. Around midnight, we finally got on the wait list to see a doctor, and actually saw him around 1:30 am. After some blood work and diagnostics, the doc said it was a severe stomach flu and not something requiring surgery, thank goodness. I was seriously starting to question our karma as there seems to be issue after issue happening during this IVF that keeps threatening to cancel. Luckily, it appears that Derek's flu will not affect anything, and we're still good to go.

They gave Derek Buscopan, which relieves stomach cramping, and sent us home around 3 am. Derek seemed to feel a bit better and settled in to the couch while I went to bed for about three hours of sleep before I had to get up for my monitoring appointment this morning. Thankfully, while he still feels pretty horrible, he has no stomach cramps today and the vomiting is gone.

I spent what felt like forever at the clinic this morning, but got only good news. Seems that my right ovary is picking up even more, as they found eleven follies today compared to eight just two days ago. The left still has five, three of which look pretty good. We have a leader at 19mm on the right, and a 16mm lead on the left. My lining is at 9.5, so pretty much perfect. My estrogen has continued to climb and is at 6665 (Canadian units) / ~1800 (US units), which I am happy with. The rule of thumb is about 1000 (Canadian) units of estrogen per mature egg (which is what we need - keep in mind we'll get more total eggs, but about 70% of those will be mature and ready to fertilize). At this point, I'm looking at about six or seven mature, but likely another one or two on top of that by retrieval, as my estrogen will continue to climb.

We had expected to trigger tonight, but the doc has me doing one more night of stims with trigger tomorrow night. That puts egg retrieval on Sunday, which works perfectly for us. I had my HCG mixed today and got instructions on how to inject. Just about there - only one more night of injects and we're done, not to mention no more Suprefact nasal spray. To be honest, it will be somewhat strange to not have my life ruled by such a strict schedule, not to mention being able to actually sleep in on the weekend instead of waking at 6 am to do my spray and being unable to fall back asleep.

Almost there!

IVF # 1 - How to Mix and Inject Luveris (and a monitoring appoitnment update)

*Update - the clinic just called with my E2 and we're up to 3879 (1057 in US units). Holy huge jump! I'm very pleased with this!

*Monitoring update at the end!

Today we are going to learn how to mix and inject Luveris, one of my daily injections. Luveris is synthetic lutinizing hormone, aka LH, and is used in conjunction with Gonal-F (which is a follicle stimulating hormone, or FSH) to stimulate oocyte growth. I'm now on day ten of injections, so I've kind of got this one down, but the first couple of times I was really nervous that I was going to miss a step and screw something up.

First thing first, you need to get all your supplies in front of you on the table. You need a box of Luveris, a syringe, needle, Q-cap, and two alcohol wipes.

Now go wash your dirty hands. I dry them off using paper towel just to avoid lint and possibly dirty dish towels. First step is to take out the two vials (one saline and one the powdered Luveris) and pop off the tops.

Using one of the alcohol wipes, wipe down the tops of both vials really well.

Set 'em down and open up the Q-cap and syringe. Make sure you don't touch either end of the Q-cap, especially the pointy end (that goes in to the vial).

The Q-cap screws in to the end of the syringe. Screw it in so it's tight (not too tight), and the pull back on the syringe plunger and fill it with 1 ml of air. You do this so you can displace the volume of fluid in the vial as you're drawing it out. Makes things easier, apparently.

Now that you have air in the vial, you can flip it over and push the Q-cap down in to the bottle of saline. It takes a teeny bit of force, but shouldn't be difficult to snap it in. Push the air in to the vial. Then, holding the plunger down (the air will try to push back out), turn the syringe/vial upside down and slowly draw in the saline.

Once you have it all in there, flip it back over and pull off the vial. Don't worry, it won't spill. Next, take your vial of powdered Luveris and pop it on with the syringe right side up. Slowly push the saline in to the vial. Now, swirl it around. Don't shake it, or you'll create bubbles, which are bad. It'll only take about 30 seconds for everything to dissolve.

Now that it's all mixed, flip it back upside down and slowly draw the mixture back in to the syringe. I usually draw back so I have a bit of air in the top, then push it back up so the liquid is right at the very top of the syringe. Next, screw off the Q-cap and open the needle package. The needle screws in similarly to the Q-cap.

Holding it needle point up, take a look for bubbles and flick the syringe to get them up to the top. It's ok if there are a few small bubbles, it's not like it's going in to a vein. Once you get the bubbles to the top, remove the cap and slowly, slowly push on the plunger until a few drops of liquid come out of the needle. Now you're set to inject!

Now is where the second alcohol wipe comes in. I inject in my stomach, but you can also inject on the outer thigh. I tend to move around a few inches each time too, just to avoid too much bruising. Take your wipe and wipe down about 2 or 3 square inches on your injection spot. Let it air dry for a few seconds and then take a good pinch of fat.

Keeping it in a pinch, insert the needle. It really doesn't hurt, just try not to hesitate too much. The anticipation is the worst part, trust me! Once it's in, slowly inject the liquid. It does seem to sting a bit if I go too fast, so I take about 10 - 15 seconds to inject it all. Once it's all in, hold the needle in for another few seconds to make sure it's all in there. Let go of the pinch, and pull the needle out.

Cap the needle, take it apart, and put it in your sharps container. Easy peasy, right?

Honestly, in the beginning of this all, I was thinking there was NO WAY I could give myself injections. But, I will do anything to have a baby, and it is not bad at all once you get comfortable with it. Good luck!

Monitoring update: my ultrasound this morning went well! I now have eight follicles on the left, with the leaders at 16mm, 13mm and 13mm, and five on the right, with the leaders at 13mm and 11mm. My lining is triple stripe at 8.3mm (this is good). They have me on the same dose of Gonal-F and Luveris for two more nights, and then my final monitoring appointment on Thursday morning. I should be triggering Thursday night if it all looks good, which puts the retrieval on Saturday.

Just wanted to post this cute note my husband left for me on our whiteboard the other day:

Yup, I'll get right on that!

IVF #1 - Day Six Ultrasound and Bloodwork and How to Inject at a Party

Bright and early yesterday morning (I never get to sleep in anymore) I headed to the fertility clinic for my day six ultrasound and blood work. Surprisingly, the clinic was pretty busy, so I had to wait about an hour and a half. One of the other clinic doctors did my ultrasound and he kindly showed me everything on the screen. He started on the left ovary and counted seven follicles. He measured five of them and they were all around 10mm or 11mm. The ideal size for trigger is about 18mm to 20mm, so we are just over half way there. The right ovary was not responding as well and only had four follicles, of which only two of them were around the 10mm mark. Not too bad, but I guess I was hoping for more.

I got the call with my E2 results a couple of hours later: 501. This is still pretty low, so they've significantly bumped up my Gonal-F to 375 UI. Hopefully this gets things going a bit faster! Either way, the nurse thinks we'll be triggering on Wednesday with egg retrieval on Friday. I can't believe how fast this is going!

So last night Derek and I travelled an hour and a half north of the city for his cousin Jon's 1920's dress up Murder Mystery birthday party (We had a ton of fun! Derek is still sleeping off the fun he had!). We arrive just a few minutes before six, which is when I do my injections, sos soon as I was in the door, I beeline it for the bathroom. Normally, it takes me about 10 or 15 minutes to do both injections, what with mixing the Luveris and making sure I'm doing everything properly. Considering there were a bunch of loud people outside the bathroom door, and a knock or two, I was trying to hurry up and get it done. I was nervous I was going to mess something up and tried not to drop plastic caps and needles off the small bathroom counter. I was unable to use ice on the injection sites, but surprisingly it didn't hurt at all - guess I don't really need it! I was so shaky and rushed that I had to take a few deep breaths before each inject to make sure I got it in straight. I think I was in and out in about seven minutes.

I've heard stories of women who've had to do injects in an airplane bathroom or in a vehicle - I don't envy them! Doing it in a strange bathroom was bad enough. Anyway, I got it done, and the side effects are certainly kicking in. I'm bloated and crampy, have a constant headache and am tired all the time. Hopefully my body is just preparing for the next ten months!

Next appointment is Tuesday for another ultrasound and blood work. Fingers crossed for good news!

Hobbling to my First IVF Appointment

First thing this morning Derek and I headed to the fertility clinic for my first round of blood work. They are looking at my estrogen levels, which are indicative of how my follicles are developing. Ideally, at this point, they like to see between 250 and 500.

While there, we spoke with the nurse and I had her explain to me what it was the doctor used during my ultrasound on Sunday to straighten out my cervix. Apparently they use what are basically forceps and pull on the cervix to straighten it out and get the catheter in. No wonder it hurt so much! I also learned, as the nurse was describing this process, that the non-pregnant uterus is about the size of putting your pointer finger against your thumb and making a tear drop shape. Way smaller then I thought. Must refresh self on anatomy, apparently! Derek is also having bad side effects from the antibiotics he has to take - lots of nausea. She said that if he's still having issues after tonight's dose to call and they may let him forgo the last day.

Following this appointment, we went to my physical therapy appointment for my knee to determine if I will need surgery or not. If I did need surgery, we would postpone the embryo transfer, freeze everything, and do the knee surgery first. Our primary concern was that my knee would not be able to support the pregnancy weight, and I wouldn't be able to get around during or after. Of course, I thought this was fine ("I'll figure it out!" says I, in tears), but Derek pointed out that this would put a lot of unfair pressure on him and the baby, which is not what we want. 

Anyway...I don't need surgery! Well, I might some day, but the therapist was confident that I will be able to rehabilitate and strengthen up enough to support pregnancy weight and even go back to cycling and running. He did say I will have to avoid the harder skiing, but could probably get away with skiing resort runs (not this year, of course). He did an assessment, said he felt some laxity in the forward/backward movement and thinks I may have partially torn my ACL and MCL. I am planning to pay for a private MRI in the next week or so and will see him weekly. We did a bit of acupuncture and ultrasound on my knee to help with swelling and he gave me two exercises to help increase the range of movement in my knee.

As I'm laying on the table with needles in my leg, the clinic calls. My estrogen today was 130, so not even close to where they want it. All this means at this point is that I increase my dose of Gonal-F to 225 UI, and continue with 75 UI of Luveris. Not a big deal, but this does mean our drug costs increase. We do get it back from insurance eventually, but it's still hard to pay thousands of dollars up front.

So, next step is to go in for an ultrasound and more blood work to check estrogen levels on Saturday morning. Fingers crossed everything looks good! If I progress as expected, it's only ten more days to egg retrieval!

IVF Number One - Day One

Bright and early this morning, I hobbled in to the fertility clinic (I hurt my knee pretty bad on Friday - more on that later) and had my baseline ultrasound and blood work. I remember when I used to be scared of needles and would almost cry any time I had to get blood taken. Ah, those were the days. Dr. S came in to do the ultrasound, check my lining, and check the depth of my uterus. She said my ovaries look nice and quiet (the right looks really good, apparently, whatever that means) and my lining is nice and thin. She had to insert a catheter to measure the depth of my uterus to determine how deep they insert the catheter during the embryo transfer in a couple of weeks. The last time I had catheters inserted was during our IUI's last winter and it hurt a lot back then. It still hurts now. She tried two sizes and still couldn't get through, so she ended up using this painful tool to straighten my cervix out and finally got in. I had some pretty good cramps for a few minutes, but nothing I've never felt before.

I came home and waited for the clinic to call with my blood results and the final go ahead. I got the call at 11:15 - my blood work showed my estrogen was 'below 72', which means I have no cysts or rouge follicles growing. So, I start injections tonight - 150 UI of Gonal-F and 75 UI of Luveris. I continue to take the Suprefact, which I've been on since February 2, but drop from five sprays a day to three.

Now, when you do IVF, there is a lot of information and...medical stuff to deal with. The afternoon I pulled the Luveris and one of my Gonal-F pens out and set everything up on our kitchen table.

It's a bit overwhelming

The Gonal-F is a pen, so all I need to do is insert the needle, twist the dial to '150', and inject in to my stomach or thighs.

Easy-peasy!

The Luveris is a bit more involved. It comes in two vials - one of saline, and one of the medication in powder form. Using a syringe (no needle on it yet) and something called a Q-cap, I pull the saline out of the first vial and inject it in to the powder. I swirl it around until it dissolves (no shaking - it creates bubbles) and pull it back in to the syringe. Add the needle and inject in to my stomach or thighs. I've read that this one might sting, so I'm planning on icing for a bit first.

Let's hope the instructions are clear enough.

I go in on Wednesday to get more blood tests to check on my progress. My estrogen should be rising indicating that my ovaries are being stimulated and creating those precious eggs. As long as my numbers are not too high, I don't go in again until Saturday, when I get more blood work and an ultrasound to count follicles. I'm just so glad we've passed this first hurdle and can get going!

Now, the knee injury. On Friday, Derek and I went skiing and I fell pretty hard on our first run. My ski got caught up and I twisted as I fell. When I fell, I felt and heard a loud pop in my left knee and had significant pain. After about 10 minutes, the pain started to subside and I tried to stand on it...no go - it felt like it completely dislocated and collapsed inwards. I was taken out by ski patrol and we went to the hospital. The preliminary diagnosis was a dislocated knee, but after some of my own research, I think it's more likely I tore my Medial Collateral Ligament (MCL). I am in a brace and on crutches, but the knee still feels pretty unstable. The bad news is that if it's a complete tear, I'll need surgery, and I'll need it before I attempt to support pregnancy weight on my knee. That means we might have to postpone.

I spoke to the nurse and she suggested we continue on with the injects until I can see the physical therapist on Tuesday. If it's something that is going to require surgery, we do have to option of freezing everything, or there is the possibility of doing the surgery with an epidural instead of general should I become pregnant (general anaesthetic isn't really recommended in pregnancy). If it does not require surgery, I'll be undergoing intense physical therapy to rehabilitate my knee as quickly as possible.

So, fingers crossed for lots of eggies and no surgery! Here we go!

Lucky Cycle Number 48!

When I went in to pick up my medications and review the instructions with the nurse the other week, she specifically told me I may or may not get my period while taking Suprefact. Regardless, my period was late, so I started to panic a bit. My first thought was that I must be pregnant, so tested. BFN, of course. And then I started worrying that this might delay things, and was ready to call the clinic this morning, when AF was six days late, to ask their opinion.

What happens when AF is six days late and your lining gets to build up an extra little bit before it lets go? You have a massive period, that's what. I was violently awoken at about three this morning in a sweaty mess with horrible cramps. I laid in bed, afraid to move, trying to breath through the pain. It's a tough spot to be in - thankful it's finally here, but pissed off that it sucks so much. I finally got out of bed and started searching for pain relief. I normally take Naproxen/Aleve, but it's off the table during IVF, so my only option was aspirin, which never works well for me. Because it never works well, I don't really keep it in the house. All I had was the low dose aspirin I take daily as part of my protocol. I check the bottle and see that one to four pills at a time are recommended. I take five, which is almost equal to one extra strength aspirin. I crawl back in to bed and waited for it to kick in, finally falling asleep around 4:30 or so for an hour.

So, yay, Valentines period! I'll take that as a good sign, er, somehow. We're at t-five days and counting until the baseline appointment this Sunday. The last four or five days have gone by surprisingly fast, and my week's plans are starting to fill up, so Sunday will be here in no time. I am a bit nervous about starting the injections, and hopeful I can do them in the evening rather then the 1:00 pm to 5:00 pm window they give on the information sheet. Bringing the needles and sharps container to work is not ideal.

Fingers crossed for a good baseline appointment and for finally getting going on this! We're now officially in lucky cycle number 48 - yup, about four years of TTC now. Crazy how time can fly but seem to drag on at the same time.

IVF #1 begins with Suprefact!

A couple of weeks ago I excitedly went and picked up the first two thirds of my IVF medication. I was excited until I saw the price, anyway. Oh, the costs of having a baby the science-y way.



Oh, the fun!


Along with low dose aspirin and prescription prenatals (with 5 mg of folic acid), I started my down regulation last Thursday (February 2) with Suprefact. Suprefact is synthetic LHRH analogue and the purpose of it is to put my ovaries to 'rest'. It stops me from ovulating on my own by supressing hormone production in my pituary gland. Suprefact is a nasal spray that I spray once in each nostril, every four hours, five times a day. As soon as I wake up in the morning, I grab it from my nightstand and squirt, squirt the stuff up my nose. Right before I go to sleep, I take my last dose. It's not horrible, but it does run down the back of my throat most of the time and it's not that tasty. Fortunately, the only side effects I've noticed so far are occassional hot flashes, and they aren't that unbearable.

I'm on Suprefact until my baseline bloodwork and ultrasound on February 19th. If my estogen levels and ovaries look good, I start injects of Gonal-F and Luveris to stimulate the production of follicles. More on that when the time comes.

While all this is going on, I'm also holding out hope that this last month of TTC worked. I know it likely didn't, but I am still analyzing every pinch and cramp. I'm 12 days past ovulation and should be getting my period on Wednesday or Thursday, but I'm holding out on testing (again!) until then. However, I do feel much more positive about the fact that if this cycle doesn't work out, we have a fantastic next step lined up! While I'm scared the IVF won't work, I'm hopeful that it might be our turn this time.

By the way, next cycle is cycle 48, so about four years of TTC now. Time flies, but not when you're TTC!

IVF #1

The clinic called this morning and we are good to go right away!

I will be doing the Long Lupron protocol for this cycle. We start Suprefact on cycle day 21 of this cycle (which is February 2) and I'll have my baseline ultrasound on February 19th.

If all goes well, I start my injections on the 19th as well, followed by more bloodwork and ultrasounds every second day to adjust doses as needed. My tentative egg retrieval date is March 3, and we will do a three or five day transfer depending on how the embryos look.

I'm waiting for the pharmacy to call with my final list of medication and the cost. Oh my goodness, the cost. The IVF must be paid for by next Thursday and we are looking at almost $7000. That doesn't include the medication, which will be anywhere from $3000 to $5000. We are hoping our health care will cover some of the cost, but it's tricky, because while they do cover the medications, the don't 'if it's part of fertility treatments'. Stupid.

I am nervous and scared, and when I called Derek this morning to tell him the clinic has us booked in for right away, he sounded the same. We know there are no guarantees, and there are so many emotions going on in my head right now. Excitement, fear, impatience, sadness for Lara, worry that something will go wrong.

Fingers crossed for success with number one, and pray that time flies for the next five and a half weeks (how am I going to deal with an IVF two week wait? Gah!).

Here we go

This afternoon I had my appointment with Dr. Scott to discuss our revised plans to do a frozen cycle for Lara and Roland, followed by a fresh cycle for us. After an hour wait (ugh, I hate end of the day appointments), I met with the doctor and her resident.

Holy dramatic change of plans!

Dr. S recommended that we do not do a frozen cycle for Lara and Roland. She showed me the statistics, and a fresh transfer for 31 year old eggs shows a 70% pregnancy rate. A frozen transfer shows only a 35% success rate. So, if we freeze all of Lara and Roland's embryos, we effectively cut their chances of a pregnancy in half.

The other glitch is that if for some reason Lara never responds well and can not build up her lining enough, she'll need to use a surrogate. We have always thought that I'd be the surrogate. However, this is illegal in Canada. Surprising, right? The reason is that it's my egg, so it is effectively an 'adoption', and illegal in this scenario, where I am the donor and surrogate.

So what does this mean? This means that Derek and I are doing our own IVF first, and that will happen soon. As in, possibly starting at the end of this month or mid-February. We will do a fresh transfer, and if it takes, we will do a cycle for Lara and Roland after I finish breastfeeding. If it doesn't take, and if Lara is responding well by then, we can do a fresh cycle for them.

Now we just do what we do best - wait! If they call this week, we will go ahead with it this month. Otherwise, I call the first day of my next period (in just over two weeks) and schedule in.

Calling my sister with this news and new plan was very hard. I understand how upsetting it is to wait for what seems like a million lifetimes to become a mom, and now her wait is extended even more. I know she understands why this is the recommendation and new plan, but I also know she's hurting. It is frustrating when we can't just do it on our own, and more so when you are dependant on another person to help you build your family. Lara, I love you, and I just want you to know that I know you're hurting and upset right now. And that's ok. It will happen for you, trust me. Like you said, 'this is fate', this is how it's supposed to happen.

Change of Plans

Should have updated this at least a week and a half ago, but I've been busy with work, life and University!

Lara went for her ultrasound on January 3 to check her response to the increased dose of estrogen and viagra. Unfortunately, her lining was only 5.5 - 6 mm, which is not enough. She spoke to our nurse, who conveyed that the doctor wanted Lara to take a couple of months off, then try mock cycles again, putting us well in to the summer for IVF.

The infertility journey seems to have very explicit ups and downs. You have the rise and fall of emotions during treatments - Clomid cycles, IUI, trying naturally, using something new. I had the rollercoaster of pregnancy loss three times, where I had days of joy and excitement followed by days of sadness and pain. Even then, getting a good beta after a bad one can renew hope, which is just crushed when you get the next call. Some months I'm perfectly patient, knowing our time will come, and some months I am practically biting my nails with impatience. The last six months I have been patient. I am now impatient. I can't wait any more.

So, this is what we're doing: I am going to do a cycle for only Lara and Roland right away. All eggs will go to them, they will fertilize, and freeze it for when Lara is ready. I will take the requisite month off, then we'll procede with our own IVF. I have an appointment with the doctor on January 23rd to discuss this and hopefully get moving. I will be mid-cycle at the appointment, so I hope, hope, hope we can get started right away and do the first egg retreival in February. If so, after a month off, that puts us in to April. We are planning a trip to Hawaii with my parents and Lara for the first half of the month, so hopefully it doesn't interfere, but if so, we'll bump ourselves to the next month.

So, fingers crossed for moving quickly! I'll update after the appointment on the 23rd!

(P.S. Lara may do a fresh transfer even if her lining is less then ideal. The nurse did say that they have had successful IVF's where the lining is not as thick as they want it...)