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!
Wednesday, February 22, 2012
Sunday, February 19, 2012
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.
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.
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.
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!
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 |
 |
| Easy-peasy! |
 |
| 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!
Tuesday, February 14, 2012
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.
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.
Monday, February 6, 2012
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.
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!
 |
| 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!
Tuesday, January 24, 2012
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!).
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!).
Monday, January 23, 2012
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.
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.
Thursday, January 12, 2012
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...)
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...)
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