Incompatible with life

I was going to wait to post this tomorrow, but I’m getting tired of reliving the past. I want to look forward, not back! So I’m going to post this tonight and finish up my story tomorrow. After that, I can AW about our latest donor cycle.

**WARNING**In this post I talk about the difficult subject of termination for medical purposes. Not everyone will be comfortable reading this, nor will everyone agree with our decision. You might also notice that I approach this post with humor and acceptance. Forgive me if I seem uncaring. This is a side-effect of my sunny outlook, my sense of humor, and the healing that’s taken place these past few months.***

Despite all the bad feelings I’d had about the cycle, I wasn’t surprised to get a BFP. At 7dp3dt I’d had really mild cramps all day long. I never get cramps before AF, and I’d never had cramps for any previous cycle, so I took the cramps as a good sign. I also received a batch of 50 cheapie pregnancy tests from Amazon that day, so I decided to test in the morning, or 8dp3dt.

Sure enough, the next morning I got a faint second line on an HPT. To rule out an evap line, I had Mr. GB get out of bed, pee in a cup, and watch while I tested his pee. He got a BFN. (For the record, I am a big advocate of POASing, and I would’ve done so sooner if I’d had HPTs in my possession.)

Fast forward past a few ultrasounds at the RE’s office. Despite my high betas, I admit I was disappointed to only have a singleton, because I knew we’d have to repeat the donor process (and expense) if we wanted siblings. At the same time I felt very lucky to have no morning sickness or fatigue. There were many times I’d forgotten I was pregnant. My mom was the same way with me, so I wasn’t worried. We even met my mom in Las Vegas for a short vacation and broke the news. She was thrilled, of course. We swore her to secrecy. Or so we thought.

Fast forward to my first OB appointment at 11 weeks. Yuck. Coming from a fancy-pants RE clinic to this OB’s office was like a culture shock. The waiting room furniture was uncomfortable, there were no magazines, and the décor was dated. The paperwork had no place for me to indicate that I’d used IVF, let alone an egg donor. The nurse kept asking me when my last menstrual period was, and I had to explain to her that my LMP was irrelevant and that she should use the donor’s LMP. She also asked me if I wanted genetic testing for cystic fibrosis. Clearly she was clueless both about IF and donor eggs. And don’t get me started on her gender predictions based on the Doppler heart rate. The doctor was equally uninspiring. I hated being treated like a pregnant fertile in an assembly line. I was ready to get out of there.

I vowed to find an infertile-friendly OB just as soon as I got my referral for an NT scan at 12 weeks. To me, the NT scan was a big milestone. Technically I didn’t need one because our donor was 28 and not AMA, but I wanted one anyway—I wanted to revel in the magic of high-tech ultrasound equipment and get my hands on the DVD they give you at the end.

Per my usual impatience, I booked the appointment on the early side of the NT scan window (11 weeks & some days) at a Maternal Fetal Medicine clinic at a local hospital. (MFMs see high-risk patients and have better-than-average ultrasound equipment.) The MFM’s office was also an upgrade over the trashy OB’s office in the same hospital complex. The MFM paperwork had questions about IVF treatments and a nice little “Donor Egg” checkbox. I was happy.

The exam room was also lovely, with twinkling lights on the ceiling. Didn’t see the doctor at first, just the technician and nurse. The ultrasound was my first experience abdominal ultrasounds--the RE is all about the vag-cam, which is a different experience altogether. It was weird keeping my pants on.

Long story short: at some point I was asked to go empty my bladder and return to the room for a vag-cam for a closer look (so I got to take my pants off after all). Ladies, I’m telling you, if this happens to you, it’s probably not good news. I’d seen the technician do the NT fold measurement and the number looked good to me, so I had no idea WTF was going on. So I pee, come back, meet the MFM’s vag-cam, and the technician resumes looking at the baby’s head. Finally she says she needs to go find the doctor. I ask her if everything is ok and she said she’s having trouble seeing the baby’s head.

At this point she stepped out of the room and left me and Mr. GB to hug and try to deal with this news. A few minutes later the doctor (a very nice woman) and a genetic counselor come to talk to us. They told us that the baby has a severe neural tube defect that was incompatible with life. Basically the baby had a brain but no skull. Our choices were to terminate or continue the pregnancy knowing that the baby would not survive.

As you can imagine, this news was terribly upsetting. But I knew there was no way I could continue the pregnancy, so we made arrangements for a D&E the following week.

Alrighty, that’s enough for today. I’ll try to wrap up my history in the next post.

Golden Bud

1st baby related ultrasound!

Yaaaay! Yesterday went awesome. I was so nervous walking into my RE's office, but Mr. Worry Bud assured me that everything would be alright...don't you love how men are always so confident? LOL. Anyways, the u/s yesterday went AMAZING!!! As soon as the tech stuck the probe (vag cam) in, we saw a big black sac and a little white mass looking thing towards the bottom of the sac (there is also the yolk sac right above the baby). That little white mass is our pride & joy - Baby Worry Bud!!


Yep, only one LO growing in there, but we are more than thrilled with that as long as our baby is happy & healthy. The u/s tech took some measurements, then zoomed in for "the fun stuff". And we saw our baby's sweet little heart flickering on the monitor (116 beats per min :o). It was one of the best moments of my life - and even Mr. WB almost cried. :) I finally felt like I could breathe at least a small sigh of relief. Afterwords, we sat down with my wonderful nurse & she gave us instructions for the next few weeks - I am to continue the Endometrin 2x a day until March 27th, then I can go down to once a day until April 4th; I also continue my Estradiol 2x a day until April 4th; stop the baby aspirin now. As soon as we left the office, Mr. WB called his mom on speaker & told her she was going to be a grandma - she cried. She always cries about EVERYTHING, so no surprise there but she was so happy.

Based on the talk with my nurse, I will get one more ultrasound at my RE's office when I'm just about 8 weeks & then will likely be released, so she advised that I call my OB/GYN to set up a prenatal appointment with them. I called yesterday afternoon & my first appointment is March 31st! It will be an "intake appointment" with a nurse & she will discuss the Dos & Don'ts, ask questions, etc. Then, the next appointment will be about two weeks later where they will listen for the baby's heartbeat with the Doppler. I plan on asking how many ultrasound's I get at my first appointment. I know for sure my OB/GYN doesn't do u/s in office, so I'd have to go somewhere else.

Today I am 6 weeks, 4 days pregnant & am due on November 6, 2010!! As always, I want to thank all of you for the continued thoughts & prayers - they have really helped us get thru this IVF cycle! I get to go back on March 26th for another look at Baby WB, woot!! Until then, I'll be counting down the days!

Starting from the finish line

When Dr Z says we're not starting slow, he means we're NOT starting slow.

I just got home from my suppression check where I had my first official cycle vagcam/follicle check and blood draw. I also got my medication instructions for the next 4 days.

Vagcam/Follicle Check: All is well at this point. Lining is 6mm, homozygous and I have 12 antral follicles. Thats up from 10-11 at my vagcam 2 weeks ago, so I'll take it. Also, the bleeding has S-L-O-W-E-D down... it's still red, but I'm barely spotting at this point, so that makes me happy. If today is my last spotting day, i'll be thrilled. That would make 34 days bleeding all together. I'll be happy to stow the tampax - finally.

Blood draw: shockingly, they're checking my beta level. I laughed when Dr S (the embryologist that drew my blood this AM) told me that they were checking that in addition to my E2 level. Can you imagine if I were pregnant? Ridiculous thinking. But, they have to make sure. I know.

Instructions for the next 4 days: HOLY MEDICATION BATMAN. Dr Z warned me we were starting strong. I'm at maximum doses... for now. That's 2 vials of menopur (which burns like a bitch) and 300 units of gonal-f every day. Tonight the gonal will be in all one dose. Starting tomorrow, the gonal will be in 2 injections daily. We'll see where things are on tuesday. When my follicles hit 14-15mm, they'll add in ganirelex, which will prevent my ovaries from ovulating on their own.

Anyway - there's my update for now. We're starting from the top.... but we're on our way.

IVF #2 starts now.

And we're off... AKA... Um, when did it turn March?

I've been waiting almost 3 months to start IVF #2. March used to be SO far away. And now? Now I didn't even realize March 5th was here.

It hit me about 1 hour ago. Oh, I have to go to Dr. Z in the morning and then start injections tomorrow night.

Wow.

I'm having a weirdly difficult time with this cycle. Not in emotionally preparing for it, but I think in my LACK of emotionally preparing for it. I'm not being negative, but I'm having a difficult time being really positive, also.

It's a weird feeling. I just kind of feel like, okay, let's get this done.

I remember WAY too clearly how I felt getting that IVF BFN, which (i'm sorry if this offends you in any way) is worse than any other BFN possible. And I'm so scared that I might ever feel that way again. One girl on a message board I frequent even said that an IVF BFN is worse than a m/c, (she had both). She said that at least with the miscarriage she got tons of support and love and with the BFN she got a lot of "well, you'll try again" or "better luck next time" and no one really understood how completely devastating it was.

I'm not saying that I agree with that statement... just that it's an interesting perspective. I don't know if I believe it - But i think pain is pain, it's all real, and it's not my place to judge it.

It's really a strange feeling that I have right now. Mr. DB really thinks that it is going to work, now that we know everything. My acupuncturist tells me I'm healthier than she's ever seen me. She thinks it's going to work I really HOPE it's going to work. But I'm scared to "think" either way.

Do you know what I mean?

Anyway - T-23 hours til vagcam.

Meetings, procedures & classes, oh my!

The last two days I have been staying pretty busy gearing up for our IVF cycle. Last night I attended the IVF Support Group meeting I talked about yesterday. When I got there, I saw a couple sitting outside in the hall & when I tried them, the doors to my fertility center (different location than my normal office - same place I went for my HSG) were locked. So I rang the doorbell & the group facilitator came out to let us in, the couple sitting outside followed me in, saying they didn't realize that there was a bell to ring! Then the facilitator, who is a licensed clinical psychologist, went back to her office to grab a few things. While we were waiting for the meeting to begin, the couple & I started chatting a bit. The other couple & other lady who was attending showed up about 10 min. later & we got started! It was really great to get to talk to people in similar situations & having similar feelings about their upcoming IVF cycles. One of the ladies attending even has an estimated ER three days before me! We all exchanged information & left saying we'd keep in touch. It was seriously awesome. I have absolutely no regrets about attending & I plan on doing it again next month if I am available - for sure! I highly recommend that anyone facing IF - whether you feel like you are really having a hard time or even if you feel like you are coping with your IF pretty well - attend a support group meeting either thru your RE's office or check out RESOLVE to see if there are any group meetings in your area. Talking to other women in a situation similar to you is really very powerful & takes away a lot of the feelings of being broken & isolation that you may be feeling. (Photo Credit for above photo).

Today I had a saline sonohysterogram (SHG) & mock embryo transfer (MET). I did not realize I was even getting an SHG until I got to the office & they gave me a paper to sign agreeing to undergo the procedure. I thought it would just be a MET, but I guess my RE likes to do both at the same time to ensure there are no problems uterine problems that had not been caught. Anyways, the whole thing went by pretty quickly. He inserted the cathetar & released a little of the solution in slowly. Mr. WB was right there with me & my RE showed us where the catheter was & the solution being released in side my uterus, and also showed us the shape of my uterus & ovaries - both of which he said looked perfect! No cysts or any other problems he could identify.

After that, we headed over to the injection training class. It was very informative & we got to meet a few other couples from our center. The nurse leading it was my nurse, who I LOVE! IMO, the scariest of the shots seems to be the HCG Trigger shot, but I think I will ask my sister (a nurse) to do that one for me. If she's unavailable at the time I need it (doing it exactly on time is VERY important as it must be done 36 hours prior to retrieval), then Mr. WB can do it. We start Lupron injections on Tuesday. I can't believe we are really getting this cycle started...hard to believe that our greatest wish could become a reality in just about a month! I am hoping that everything continues to go smoothly & my body responds well to the meds. As always, thanks so much for the all the T&P (sorry I always end like this ;o), but I really do want to express my gratitude to everyone thinking of us)! (Photo Credit for above photo).

Suppression Check, checked!!

I got to the RE at 7:30am for the monitoring cattle call, where it's first come first served from 7-8:15 for blood work and vagcams. Considering that I didn't get out of there until 9:45, i think next time, i'll be there right at 7. Maybe even a few minutes before. Might be rough, considering it's almost 40 minutes away, but I was almost late for work this time, and don't want to take that chance again.

Anyway - the update.

I took my first shot in my leg today, previously i've been doing them all in my arms. starting monday, i'll be taking 4 injections daily. I needed more options than my arms. And since it seems that my RE is more strict than some others, i can't take them in my abdomen. The leg shot hurt, but at least i'll be able to do them myself.

Bloodwork (bw)
I don't know if I'll even find out the results of the blood work this time, but I really don't care yet. I'll want to know my estrogen (E2) levels and progesterone (P4) levels as time goes on.

Ultrasound (us)
We're very happy about my vagcam results. My IVF Nurse (F) did it this time, rather than Dr. Z, so the eyes on the US were different. She also had a much lighter tough, and wasn't looking for things as aggressively as he does. 10 days ago, Dr Z saw 14 antral follicles. F saw 11. I'm okay with that. She said the most important thing is that there's obvious activity in both ovaries. The other great news is my endometrial lining. It measured 7mm. F said that is a great starting point. Apparently they like to see lining from 8mm-13mm for implantation, and I'm well on my way to that point. It's also homogeneous, which means it's one layer right now. Eventually, they'll want to see it at three layers for implantation to occur.

Stimulation Protocol
So, here we are... i'm ready to start cranking these follies out! Sunday morning, I'll reduce my Lupron dosage by half to 10 units (and hopefully lose these migraines in the process). Then, sunday night, I'll take 150 units of Gonal-F and 1 vial of Menopur.

Monday starts my new schedule:
In the morning:

• Gonal F 75 units
• Lupron 10 units
  

At night:

• Gonal F 75 units
• Menopur 1 vial
  

My next monitoring appointment will be thursday morning. My dosages may be adjusted based on the bloodwork results and the ultrasound that day.

Thanks for all of the continued good wishes and T&P. With your support, I might just get through this.

The meds giveth, the meds taketh away....

I was SO happy! FINALLY, after 5 weeks, these ridiculous boobs were starting to feel a little better. They're still larger than life but at least the pain is going away. I was starting to feel a LITTLE more like myself. Still overwhelmingly emotional, but not the lethargic slug that i've been. Just a little more tired than usual.

So happy that I was able to stop taking the BCPs on thanksgiving.

But now... hello Lupron side effects. It's your turn.

The migraine that I attributed to my first BCP period (i forgot that i was going to get one) is now CLEARLY not from my period or the BCPs. I've had migraines now every day for the past 3 days. I haven't had a migraine in almost 3 years. That combined with the dizziness and the crazy dreams I've been getting every time the headaches come tells me it's Lupron's turn.

I've taken some tylenol here and there. I've actually added the tiniest bit of caffeine back into my diet because caffeine can help with headaches. And it IS helping (i'm putting maybe 2-3 oz of caffeinated coffee in my decaf once a day).

Mr. DB keeps saying he hopes we have multiples so I don't have to go through this again. Too bad for him, i keep telling him that being pregnant once might not be enough for me.

I don't know why he keeps laughing.

Meanwhile - 2nd med teaching tomorrow afternoon. I'll post the rest of my protocol when I get home. Monitoring appointment with bloodwork and vagcam on Friday at 7am. Stims start sunday... with us luck and stay tuned...

Until then, follicle wishes and thick lining dreams.

Finally.... Game On

This past friday, my 13x13 box of medications arrived!


Wednesday afternoon, Mr. DB and I had a visit to the RE. I knew we were going to learn about our first medications... and possibly having an internal ultrasound as well. Dr. Z wanted to check my ovaries, make sure they were at rest (since I've just started week 5 of the devil BCPs). He told me that my ovaries are behind my uterus (of course it is, why wouldn't it be?), but that wouldn't be a problem. It just makes them a little bit harder to see. And then he looked at my antral follicle count. According to this link I found, I have pretty good numbers. He saw at least 7 antral follicles on each ovary. So, based on that link - i'm in pretty good shape.

So - the plan....

Yesterday, i started taking baby aspirin, which I will continue to take daily, through 12 weeks of pregnancy.

Tomorrow morning, at 7:30, I start Lupron injectibles in the backs of my arms (apparently I'm too fat to take them anywhere else, thanks). I will continue these injections through December 6th, when the dosage will be dropped by half.

photo credit

On thanksgiving, I get to take my last devil pill. No worries - the lupron should be giving me plenty of side effects by then!

On december 3rd, we get to go back to Dr. Z for another med teach, and the following morning, I get to go in for another vagcam date, to check how well the lupron has been suppressing my ovaries.




December 6th, I start my stims.







photo credit photo credit

Over the next 10 days, I will have 4 shots daily and will likely have 5-6 visits to Dr. Z's office at 7am for blood work monitoring and vagcam ultrasounds.

Sometime between december 16-18, I will have my egg retrieval. Looks pleasant, right? Can someone tell me how it's fair that I have to go through ALL of this, and Mr. DB gets to just "provide a sample"?

photo credit

Then depending on the numbers, how well they fertilize and divide and the quality of our embryos, 3-5 days following my retrieval, we'll have our transfer.

It seems crazy.... but we could potentially find out that we're having a baby on New Years Eve.


I can't believe after all that we've been through... this is finally here.