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...)

Dealing with family babies when you're dealing with infertility

I come from a family of three girls. I am the oldest, and the other two are in their early and mid-20's, both married. My middle sister, as you know, also has infertility issues which were caused by cancer treatments for Hodgkin's Disease when she was a teenager (she had it twice, but has thankfully been in remission for about ten years now). My youngest sister was diagnosed with endometriosis in December 2010 and her doctor recommended that she get pregnant. I know this is one of the 'solutions' for endo, but I was a little WTF? when I heard this.

Anyhow, she went off birth control and got pregnant her first month off the pill. I would never wish infertility on anyone, but at the same time, I was jealous and felt like it was unfair. I found out she was pregnant while I was going through my second of three failed IUI's. I was very emotional and didn't handle it well, though I know her intentions with the way she told me were good. It was just very hard for me, as I'm sure it is for many infertile couples who have friends and family around them having babies, often more than one, while they remain childless.

Leah was born on September 25, ten days after my birthday. I got regular updates during the birth from my parents and saw pictures within a few minutes (the miracle of technology!). Even after her birth, while I was happy for my sister and her husband, I was still somewhat thankful that we lived so far away from each other and I was able to avoid a face to face situation. However, Christmas arrived and Derek and I were heading home for an early Christmas with my family.

I am in a good place right now emotionally, so felt prepared. My other sister told me she had cried when she held Leah the first time, and my mom told me 'when you look at Leah, you will see what your children will look like.' This scared me. How will I react? Will this Christmas be a horrible emotional drain on me? Am I going to devastate my sister? Am I even going to be able to hold her?

When I held Leah for the first time, and every time after that, I was in love. I felt exactly what a happy aunt should feel: love, pride, hope, joy, happiness. She's my little niece, and she fell asleep while I rocked her and she slept on my chest. I look forward to watching her grow up, amaze me with how smart she is, how kind she is, how funny she is. I can't wait for her to drive her mom crazy and call me asking if she can come visit because I'm the fun, cool aunt that takes her skiing and hiking.

And I can't wait to give her a cousin.

They're putting my sister on Viagra

My sister's last ultrasound did not bring good news. Her lining had only thickened to 5 mm, far below what they like to see. So, we're on to the next protocol.

Interestingly enough, the standard prescription for men with erectile disfunction also works for women with issues related to thin uterine lining. Viagra works by improving blood flow - like it does to the penis - and therefore facilitates better transfer of estrogen to the uterus. This makes total sense for Lara's situation. She has not had a period in over ten years, and I know that the body, over time, will reduce blood flow to areas of the body it is no longer using. The veins and vessels will retract and shorten, and her uterus, which hasn't been in use for over a decade, minimizes the amount of blood flow. The body is amazingly efficient!

Going forward, Lara has started taking progesterone to bring on a period and shed what lining she built up. She will be going on a combined estrogen patch and pill protocol, along with the Viagra. If this works out, her first ultrasound to measure her lining is on January 3.

Another bump in the road, but at least we're making progress! I'd much rather we figure this stuff out now then later, when we're in to the big bucks.

In other news, Derek and I leave next Sunday (the 18th) to drive up north to see my family and meet my new niece for the first time. I can't wait to see my family!

Mock Mock Cycles

(Only my family will get that title!)

So we're still in a bit of a holding pattern at the moment. As I mentioned in September, my sister has to do two mock cycles to see how she responds to the protocol they have her on. Basically, they're forcing her uterus to go through a menstural cycle, but without the ovulation bit. So they give her estrogen to build up the lining, and then once it gets nice and thick, they give her progesterone so she gets her period.

Unfortunately, through a series of miscommunications, her first mock cycle in October was a complete bust. There was a mix up in dosing instructions somewhere between the clinic and the pharmacy, and Lara ended up taking progesterone during the first half of her cycle, which she isn't supposed to do. She did build up a nice lining eventually, but the test results weren't going to be representative, so we had to start all over again.

Her second first mock cycle started almost three weeks ago. She had her first ultrasound last week, and after two weeks on Estrace, her lining was only at 4.4 mm with a barely there triple stripe (trilaminar). They like to see 7 mm or more, and a clear triple stripe, for an embryo transfer. So, she's continued on 6 mg of Estrace for the last week and has another ultrasound today. Hopefully her lining is developing well and we can move on to the second mock cycle. If it's not doing so well, they're going to try a different protocol and we have to start all over AGAIN! So much waiting. Fingers crossed for a good ultrasound!

By the way, my baby fever has lately kicked in to overdrive. I am surrounded by pregnant women and babies right now, and my craving for one of my own is sometimes overpowering. It's doubly hard because Derek and I are preventing right now in preparation for the IVF and it feels so weird. I guess it gets rid of the stress of the TWW, which is nice, but it still makes me a bit sad that we are losing time.