Wednesday, October 31, 2007
As of this morning, Blobby was measuring 12.6mm and the heart rate was 158bpm, which is also right on target.
Just thinking about what could have happened if I had not thought to monitor my progesterone level makes me shudder. The good thing about infertility is that it makes you educate yourself on hormone levels and how your body is supposed to react at different stages of your cycle.
Now the tricky part is going to be keeping this pregnancy a secret, when all I want to do is shout it from the rooftops. We've already told our immediate family: my parents, DH's aunt, uncle, and cousins, and my SIL, given how supportive they all were while we were going through the IVF process. And of course, all of my fantastic online friends know, and my medical practitioners, including my acupuncturist, know. The problem is that DH and I promised each other that we wouldn't tell anyone else until we got to 12 weeks. This is going to be hard! No wonder so many women announce their pregnancies so early- it's nearly impossible not to tell.
Not to mention how bloated I am. I already look like I have a significant baby belly, thanks to all the meds. I don't even know what I am going to look like in a month. Hiding my belly is going to be quite tricky. Yes, this is going to be a challenge. It's a good thing that my hips are not proportional to my waist, so all of my pants have larger waists than I need. Trust me, I'll be needing them very soon.
Monday, October 29, 2007
So I went this morning to have more blood drawn. Good thing I advocated for myself on this one because my progesterone dropped down to 6 (from 25+ last week). I was so nervous about losing this pregnancy that I left work early so I could go home and start using the progesterone suppositories that (thank god) I had left over from my last IUI cycle. I am to use them twice a day, and I'm going back on Wednesday to have my level checked again, and to have another u/s for my peace of mind.
My dear friend Teri calmed me down a lot. She told me that the placenta doesn't start producing its own progesterone until 12 weeks so it's normal for the progesterone to drop after stopping the PIO shots. She was relieved for me that I caught this in time before any bleeding started. Hopefully she's right and the pregnancy is not in any danger.
I'm hoping for the best on Wednesday. Fingers crossed.
When the nurse called that afternoon with the results, I was shaking. She told me that my beta was 43. This was a very low number for 14 days past ovulation. A positive result, but a low number. The nurse suggested that it could be a chemical pregnancy. I was crushed. I wanted an answer. Even if the answer was negative, I wanted to be able to discontinue the PIO shots, move on, and prepare for the next step, whatever that may be.
So all that waiting, and I did not have a definitive answer.
When I would have a totally craptastic day, I could post about it and I knew that the IF girls would completely understand what I was going through. It has meant so much to me and I will always love these girls.
There's something about struggling with infertility that has brought so many different women together. These are women with very different backgrounds who live all over the globe, and who, other than sharing a history of IF, may have very little in common with me; and yet they have embraced me and shared with me their wisdom and empathy and friendship.
To all the IF-ers, I love you all dearly! ((hugs))
This was probably the longest two weeks of my life. When you're waiting to find out if you're pregnant, you don't know how you should act. Could I drink alcohol? Could I take medication? Could I eat sushi? What if that tiny blastocyst was implanting after all? It's such a state of limbo: pregnant but not really pregnant. It was seemingly, such a long wait.
Upon waking up, I was told that they had retrieved 24 eggs! That was an amazing number, considering my age and that some women don't respond this well to the medication during their first IVF cycle. In fact, a good friend of mine had told me that in most cases, the first IVF cycle is considered more of a learning cycle, and does not work because there are so many variables to get just right. I was so thrilled that I had gotten over the first hurdle- I had plenty of eggs to work with. The goal was to have at least half of them fertilize, then transfer the best three and freeze the rest.
So after the ER I went home and rested. I was crampy but feeling pretty good about the way things had turned out.
The day of the ER I had to start taking two more medications, Medrol and Doxycycline. The following day I had to begin my Progesterone in oil (PIO) injections. These were also intramuscular injections and I relied on my DH to administer them. I would be on the PIO shots for at least two weeks.
The day after the ER we got a call from the clinic. Out of 24 eggs, 18 fertilized! This was fantastic news. This means we would have many more embryos to choose from. Our Embryo Transfer (ET) would be in 5 days. I was on cloud 9. I couldn't remember ever being this happy during the two years I had been TTC.
Sunday, October 28, 2007
After a long discussion with DH, we decided that trying IVF was worth a shot. My doctor didn't think I had any egg issues, like poor quality or low reserve. My BBT charts and bloodwork had always suggested that I had plenty of eggs left, and there was no evidence that they were of poor quality. For women with decent eggs but nowhere for them to go, IVF is usually the next step.
So we scheduled an appointment to meet with my RE for an IVF consultation. This was certainly a direction we never thought we'd go. But yet here we were. We discussed the procedure, all the various medications I'd be on and the increased dosages, how I had to follow a very specific protocol, and how my chances for becoming pregnant would be about 50%. The goal was to retrieve about 12 eggs and get three good embryos to transfer; the rest could be frozen for later use. It all sounded so simple and very promising.
And more importantly, why were both cycles of injectable IUIs failures? I had the laparoscopy. My doctor had supposedly fixed me. Why couldn't I get pregnant, even with the aid of hormones, and doctors probing me, and nurses shoving sperm up my nether regions? Somethinig was still wrong but nobody could figure out what it was. I'm just so tired of all of this bullshit.
Or so I thought. Four months passed. Four cycles of charting, and four more BFNs, or 'big fat negatives' as we say in the online TTC forum world. But I was supposed to be fixed!
Saturday, October 27, 2007
So we decided that I would have a laparoscopy. It would be an outpatient procedure that would only require a few days for recovery. It would be worth it if she could find something that was causing my infertility and fix it.
I had the lap surgery in December of 2006. After the surgery, while I was in recovery, my RE came to talk to me. She told me that she had lased a lot of scar tissue. I didn't quite comprehend exactly how much scar tissue was removed, until I had my post-operative appointment. As she read her surgical notes to me, I was shocked to hear about how messed up my insides were. This was what she found:
- My left ovary was adhered to the back of my uterus (we knew that already).
- My right ovary was adhered to the right fallopian tube and to the pelvic sidewall.
- My uterus was adhered to my intestines.
- I had mild endometriosis.
Wow. All of these adhesions were a result of the myomectomy I had had a little over 2 years before. So my fibroids, although gone, still were having major after effects. No wonder that, even though my two IUIs appeared to be the solution to my problems, both were a huge failure. My poor little eggs were probably getting all caught up in all that scar tissue and had nowhere to go. But now it all was gone. I was fixed.
There's something about being the only married couple you know without children that is extremely isolating. It's like a club that you're not qualified to join. Infertility is a very lonely place. I felt like I was broken- damaged goods. Our friends were having babies left and right. It seemed like everyone else could have kids except us. What's worse was that no one understood the loneliness and isolation. People would make inappropriate comments such as, 'Be happy you don't have kids- they're so much work!' (right, because I didn't realize that before- thanks for the warning; now I'm so relieved that I'm infertile!). Once, a friend of mine, who was fully aware of the medical intervention I had been through, was complaining about how her toddler was starting to throw temper tantrums and asked, 'Are you sure you really want one of these?' There's nothing more hurtful than someone who can have kids speaking lightly of your situation. There was no one in my real life who would understand. Which is why I sunk lower and lower and stepped farther and farther away from my friends.
I was really nervous the first time I did my insemination. It involved stirrups and speculae, two things that I never enjoyed. This time it also involved a long catheter, through which my husbands sperm would be sent directly into my uterus. The procedure was very uncomfortable and caused a lot of cramping, but after 20 minutes of relaxing, I could leave.
Now there was nothing stopping his sperm and my egg(s) from meeting. Before IUI, you never knew if those little swimmers could get to where they needed to be. Now, there was nothing stopping them. So we thought.
After the IUI we hung out in the city for the remainder of the day. We went to see The U.S. vs. John Lennon and then walked through Strawberry Fields in Central Park. I thought that would bring me good vibes for conception. I was so hopeful that cycle. My first IUI with injectables just had to work.
This is why I was required to return to my clinic every few days for careful monitoring of my cycle. This would consist of blood draw to check my estradiol (e2) level, and a follicle scan so the doctor could measure the dominant follicles. It was very much up to the doctor on call that morning to determine if the follicles had reached mature level. That, and my e2 level would determine when I was to receive my HcG trigger shot. I would watch the the doctor click his or her cursor on the u/s monitor at various places on each follicle to measure it. A follicle of 18mm or greater is considered mature.
Each day that I visited the clinic, one of the nurses would call me that afternoon to give me instructions for that evening's medication dose. These instructions were based on the e2 level and the size of the dominant follicles.
Well, it really wasn't all that simple at all. First of all in order to increase our chances, we decided to start on an injectible medication. This would help me to produce more eggs each cycle, which would increase the number of targets for the sperm. It also increases the chances of multiples, but that was a chance we were willing to take. After all, if I could get pregnant with twins, we wouldn't have to worry about doing any of this ever again.
So I went to my injectibles class and learned how I was to inject the medication. It seemed so simple: the medication came in a pre-filled cartridge that you placed into a pen. You attach a micro-fine needle and inject it into your belly fat. Simple.
Before I could start the cycle, I had to go in to the clinic for a baseline blood draw and u/s. They needed to be sure that my body was ready to start stimming. This was the first of many early morning visits to the clinic. My clinic was open from 7-9am for monitoring. Which means that I had to drive into Manhattan, find parking, and get to the clinic with enough time to have a scan and my blood drawn, while still getting to work on time. Which means that I had to wake up at the crack of dawn, battle rush-hour traffic, all while experiencing the side effects of the medication: mood swings, hot flashes, headaches, ovary pain, and a sore & bruised belly which resembled a pin cushion. The medication was enough, but add to it the early wake-ups and rush-hour traffic, I was quickly losing my mind.
Fortunately, my health insurance would cover up to six Intrauterine Inseminations (IUI) and all the medication I would need. Fantastic. Except I was confident that I wouldn't need six. With my new RE and our new plan, this would surely work. I'd be pregnant soon.
It's a scary thing to have unprotected sex for the first time. If everything I believed from Junior High School was true, I'd be knocked up the moment my legs were spread. They really don't teach you a lot in school about making babies.
For 6-8 months we continued this naive behavior. I was already 35/36 so I figured it might take me a little longer. I consulted my OB-GYN who sent me for some tests. I had hormone levels checked, I was sent for a HSG to determine if my tubes were open. That was such a fun test! It was performed by a male radiologist with absolutely no bedside manner and was extremely painful, uncomfortable, and humiliating. All of my testing came back completely normal. DH was also sent for a semen analysis, which also was normal. So why wasn't I getting pregnant?
So I decided to start BBT charting. Charting is good because it helps to pinpoint your most fertile days. Charting is bad because you find yourself becoming obsessed with it. Did my temp go up or down? Did I ovulate yet? Why didn't I ovulate yet? Oh no! I only got 2 hours of sleep before I took my temperature! Should I record the 4:30am temperature or the 6:30am temperature? You completely lose touch with reality and can't even remember what day it is, unless you're talking about what day it is in your cycle or how many days past ovulation you are. I won't even go into how you're supposed to check your cervical fluid.
To say I was obsessed with my chart is an understatement. My poor DH had to put up with my behavior. I hear so many people make jokes about how fun it is to try to get pregnant. After all, it's about having as much sex as you can, right? Well those people have never had to TTC while charting. No way. If you're a long-time TTCer, you know what I mean. Sex on demand is not fun at all.
This is turning into much more than a brief history. It's almost at the end, I promise.
In September, 2006, we were almost at the one-year mark of TTC. They say that the average healthy couple can take up to a year to conceive. Once you hit that year point, you're considered 'infertile' by the medical community (and by TTC forum standards too). So we decided to seek help from a specialist. I had my consultation with a Reproductive Endocrinologist (RE). She ordered blood tests, looked at my BBT charts, and did an ultrasound (u/s). Upon performing the u/s, she discovered that one of my ovaries was stuck to the back of my uterus. She thought it was most likely due to residual scartissue from my myomectomy. She didn't think it would cause a huge problem with conceiving, but as we would learn later on, that was just the tip of the iceberg.