August 13th. I worked from home just as a precaution but I felt fine. That morning the embryologist called and said that of the 7 eggs they'd retrieved the day before, 5 were mature (probably the Big 5) but of those 5, all of them fertilized! Hooray for ICSI! She said she'd call with one more update on them the next day, but that we were still all set for a Tuesday embryo transfer.
August 14th. The call from the embryologist on this day said that all 5 embryos were still dividing as they were supposed to, and she'd see us on Tuesday. We wouldn't be getting any more updates between then and Tuesday. Alrighty then.
August 15th and 16th. Nothing of note on these days (crazy!).
August 17th. Transfer day! I had set up an acupuncture appointment for before and after the transfer. There's a study that says that this specific acupuncture can increase our chances so I went for it. I showed up an hour before the transfer time (so 10am) at the clinic and met the acupuncturist and she led me back to the room I'd recovered in the prior Thursday. She set up the stretcher/bed with comfy cushions and pillows and then I stretched out on it and got comfortable. She stuck a needle in the very top of my head, two in each ear, one somewhere on each foot, I think one in each of my legs, and one in each arm, and maybe one or two in my belly. And then I was just supposed to relax for about a half an hour. So I did.
The husband showed up around 10:45 and the acupuncturist led him into the room, she removed all the needles, and then the embryologist came in to give us our pre-transfer update. She showed us a picture from the microscope of all 5, and showed us how two of them were the farthest along, two had stopped developing since Saturday, and one more was still developing, but not at the same pace as the strongest two. She said that the strongest two were a little behind where they expected them to be, but that they were still growing and that we should transfer them both. So we did!
I'd had to drink about 20 oz of water before the acupuncture so that my bladder would be full and pushing on my uterus making my uterus easier to see on the ultrasound during the transfer procedure. So at this point I felt that I had to go! But instead, off to the OR we went where The Husband had to put on scrubs and a hairnet and a mask and booties on his shoes. Then the doc came in and got everything ready to go, and then the embryologist came in with a tube full of fluid and the two "early blastocyst" embryos. We watched on the ultrasound while the tube was inserted, threaded through my cervix, into my uterus, and then we saw the fluid with the embryos in it emptied into my uterus and then we were done! They had me lie there for another 10 minutes and then I could get up and rush to the bathroom, yay! After the transfer we did about another 30 minutes of acupuncture and then I was free to go. The Husband had gone back to work already, but I wasn't allowed to. I'd been ordered to 2-3 days of bed/couch rest so I went to a drive-thru for lunch and then headed home where I spent the rest of the day relaxing and napping. I didn't have any cramping from the transfer at all, so it felt strange to be doing all the things I do when I'm sick, while not being sick.
August 18th. My friend Amy brought me lunch this day and came to keep me company for a little while. My friend Laurie brought dinner over (The Husband had to be gone this night to study for a football officiating test he had to take) and we played a couple board games and watched a movie. Laurie's first baby is due in less than a month so it was some nice girl-time that we probably won't have for awhile again. It was great to have some company during the day that day because I was SO BORED sitting around and napping at home. I felt fine!!
August 19th. I worked from home on this day. I sat with my feet up most of the day and work didn't really stress me out that week so I figured it was ok. The embryologist called that morning and told us that the last embryo we had arrested overnight and stopped developing so we weren't going to have any to freeze. He did, however, say that the two we transferred "should get the job done." I sure hope so!
August 20th. We had this day off work and since my bedrest was over we decided to go out for lunch and run a couple of errands. It was so great to get out of the house! We were out for only about 3 hours but I was exhausted when we got home and spent the rest of the afternoon on the couch. We had dinner at home that night, even. On a weekend!
August 21st. The Husband had a race to run at Copper Mountain on this day so we headed up to the high country early, stopping for breakfast on the way there. I had a camping chair with me but it turns out some friends who were also doing the race had scored some great comfortable Adirondack chairs at the base of the mountain and so I sat there most of the morning. I got up and did a bit of walking after an hour or so to watch a bit of the race and then back to my seat - I didn't want to overdo it. We headed home around 1:30 or so and stopped with friends for lunch on the way home. During lunch I felt some cramping and I did some quick Googling on my phone and found that cramping a few days after embryo transfer is usually a good thing - it could be the end of implantation! The cramps weren't that painful and only lasted a few minutes so I decided not to let myself be concerned by them.
August 22nd. That's today! Today I had my blood drawn at the clinic. I'll go again on Wednesday and Saturday and Saturday's the day that they'll call and tell me whether this whole process worked or not. Fingers crossed!
Sunday, August 22, 2010
Wednesday, August 18, 2010
Chips on the side!
Where was I? Oh yes, trigger shot day.
August 10th. At exactly 7:30pm I needed to take my "trigger" to make me ovulate about 38 hours later. This medication had been in the fridge since the Big Box O' Meds had arrived a few weeks prior. It was two pre-filled syringes of a drug called Ovidrel. Unlike the trigger shots I had to take for the IUIs this didn't need to be reconstituted and I was told to inject it subcutaneously in my abdomen so I wouldn't need any help. Yay! Also, we had plans this night to go play poker with friends so I packed the Ovidrel into my insulated lunch tote cooler thing and off we went. Right at 7:30 I excused myself to the bathroom, did my thing and then we played some poker!
August 11th. I'd stopped all my stims the day before, but on this day I had to start taking a profilactic round of antiobiotics, Doxycycline, twice a day. And before bedtime, they wanted me to drink about 14 oz of juice, either grape, apple, or cranberry. I found a bottle of cran-apple-raspberry at the store and had that. I wasn't allowed to eat or drink anything after the juice until after the retrieval the next morning.
August 12th. Egg retrieval day. This was going to be my first experience with anesthesia and I was a little nervous. Probably more nervous about that than the outcome of the actual egg retrieval procedure. We got to the clinic right at 7am and within 5 minutes they called us back. We were taken to a room with a few comfortable chairs and an adjustable hospital stretch in it. I was given a gown and told to take off everything but my bra, and have the gown open in the back. But before we were left alone in there, we were introduced to the nurse anesthetist who had to go over a few questions and answers with us first and also who we had to pay $400. At some point in the conversation with the anesthetist the subject of what kinds of food I'd be able to have later that day came up. He advised us that I should be able to eat a little bit once I was hungry, but that he wouldn't recommend a 2-lb burrito from Chipotle. No problem, there.
Once the anesthetist left the room, I changed into the gown and just kind of stood around until the nurses came to get me and take me to the operating room at the clinic. It was at this time that the husband was whisked away to his own room to make his donation. We waved goodbye to each other and wished each other good luck.
I lay down on the OR table and the anesthetist started an IV line and then the room started to get crowded. There were two nurses, and then the doctor came in, greeted me, said that he was excited about the Big 5 follicles and I expressed a bit of confusion/frustration at there being only five, but he insisted it only takes one!
I remember the nurses making some small talk with me as somebody put my legs into the proper position and had me scoot down a bit lower, and the anesthetist must have brought up Chipotle again because I recall saying that I prefer the gumbo at Qdoba to almost everything at Chipotle. And the next thing I remember is waking up in the OR and being asked if I thought I could stand up and go back to the room I'd been in earlier to lie down on the stretcher. The two nurses helped me walk down the hall and then I lay down on the stretcher for a bit. I think they let me sleep a little bit longer, and then the husband was there, and then I was propped up a bit, given an anti-nausea pill to dissolve under my tongue, and I started to ask about the procedure.
They told me that 7 eggs were retrieved and that the last thing I said before I went under was about the gumbo at Qdoba and how when you get it to go, you have to insist that they put the chips on the side so they don't get soggy. So we all had a good laugh and then they brought in the embryologist for us to talk to.
She reiterated that they had retrieved seven eggs, and that the doctor said we would most likely to doing a Day 5 embryo transfer on Tuesday. She told us that she'd call us the next morning and let us know how many of the eggs were mature and how many fertilized, and asked if we had any other questions. At that point, we did not.
The nurses came back a few minutes later to go over the post-retrieval meds protocol. I'd need to start taking baby asprin, oral estrogen, progesterone, and a steroid called Medrol. All of these drugs combined are supposed to help soften the uterine lining, promote implantation of the embryo, and sustain a pregnancy.
At about 9:45am they said that I looked ok, asked if I felt ok (I did), and then sent us home where I was to take it easy the rest of the day, and the day after.
To be continued...
August 10th. At exactly 7:30pm I needed to take my "trigger" to make me ovulate about 38 hours later. This medication had been in the fridge since the Big Box O' Meds had arrived a few weeks prior. It was two pre-filled syringes of a drug called Ovidrel. Unlike the trigger shots I had to take for the IUIs this didn't need to be reconstituted and I was told to inject it subcutaneously in my abdomen so I wouldn't need any help. Yay! Also, we had plans this night to go play poker with friends so I packed the Ovidrel into my insulated lunch tote cooler thing and off we went. Right at 7:30 I excused myself to the bathroom, did my thing and then we played some poker!
August 11th. I'd stopped all my stims the day before, but on this day I had to start taking a profilactic round of antiobiotics, Doxycycline, twice a day. And before bedtime, they wanted me to drink about 14 oz of juice, either grape, apple, or cranberry. I found a bottle of cran-apple-raspberry at the store and had that. I wasn't allowed to eat or drink anything after the juice until after the retrieval the next morning.
August 12th. Egg retrieval day. This was going to be my first experience with anesthesia and I was a little nervous. Probably more nervous about that than the outcome of the actual egg retrieval procedure. We got to the clinic right at 7am and within 5 minutes they called us back. We were taken to a room with a few comfortable chairs and an adjustable hospital stretch in it. I was given a gown and told to take off everything but my bra, and have the gown open in the back. But before we were left alone in there, we were introduced to the nurse anesthetist who had to go over a few questions and answers with us first and also who we had to pay $400. At some point in the conversation with the anesthetist the subject of what kinds of food I'd be able to have later that day came up. He advised us that I should be able to eat a little bit once I was hungry, but that he wouldn't recommend a 2-lb burrito from Chipotle. No problem, there.
Once the anesthetist left the room, I changed into the gown and just kind of stood around until the nurses came to get me and take me to the operating room at the clinic. It was at this time that the husband was whisked away to his own room to make his donation. We waved goodbye to each other and wished each other good luck.
I lay down on the OR table and the anesthetist started an IV line and then the room started to get crowded. There were two nurses, and then the doctor came in, greeted me, said that he was excited about the Big 5 follicles and I expressed a bit of confusion/frustration at there being only five, but he insisted it only takes one!
I remember the nurses making some small talk with me as somebody put my legs into the proper position and had me scoot down a bit lower, and the anesthetist must have brought up Chipotle again because I recall saying that I prefer the gumbo at Qdoba to almost everything at Chipotle. And the next thing I remember is waking up in the OR and being asked if I thought I could stand up and go back to the room I'd been in earlier to lie down on the stretcher. The two nurses helped me walk down the hall and then I lay down on the stretcher for a bit. I think they let me sleep a little bit longer, and then the husband was there, and then I was propped up a bit, given an anti-nausea pill to dissolve under my tongue, and I started to ask about the procedure.
They told me that 7 eggs were retrieved and that the last thing I said before I went under was about the gumbo at Qdoba and how when you get it to go, you have to insist that they put the chips on the side so they don't get soggy. So we all had a good laugh and then they brought in the embryologist for us to talk to.
She reiterated that they had retrieved seven eggs, and that the doctor said we would most likely to doing a Day 5 embryo transfer on Tuesday. She told us that she'd call us the next morning and let us know how many of the eggs were mature and how many fertilized, and asked if we had any other questions. At that point, we did not.
The nurses came back a few minutes later to go over the post-retrieval meds protocol. I'd need to start taking baby asprin, oral estrogen, progesterone, and a steroid called Medrol. All of these drugs combined are supposed to help soften the uterine lining, promote implantation of the embryo, and sustain a pregnancy.
At about 9:45am they said that I looked ok, asked if I felt ok (I did), and then sent us home where I was to take it easy the rest of the day, and the day after.
To be continued...
Monday, August 16, 2010
Taking the IVF Plunge
June 2010. In mid-June we met with the financial people at the clinic and one of the IVF nurses. We went over, in-detail, all of the costs associated with an IVF cycle, including optional genetic screening and genetic testing in case we may want to one day donate any unused embryos. We committed ourselves to one cycle since they told us the odds were so good that it would work. The clinic has a "shared risk" program where you can pay for two cycles up front, and get three for that price, and if you don't have a baby after the third cycle, you get something like 75% of your money back. We considered it, but chose to just sign up for one. We are so fortunate that we both have good jobs and have been saving since we began working and we were able to even explore this option. Our insurance covers exactly $0 of all of this.
Also in this meeting with the nurse we went over the exact schedule for a cycle and while we could have begun just a few days later in June, our July travel schedule was a little busy so we chose to delay for a month and start in July, meaning all of the big days in the cycle would occur in August. Additionally, the nurse gave us a private class in how to do all of the injections that I would be needing once the cycle began. I also came away from this meeting with a big bag of samples of prescription-strength prenatal vitamins and homework - to choose which one I liked best. I had some bloodwork done this day as well, and ended up testing positive for a mutation of a gene called MTHFR. A few days later I took another blood test, a fasting homocysteine level test, and they determined that the mutation I have hinders my absorption of folic acid, so I was prescribed a drug called Folgard to take twice a day to help me absorb folic acid.
July 2010. Ironically, the first medicine in my protocol was the birth control pill. For 21 days in July I took the pill in addition to the prenatals and Folgard, and about two weeks into taking the pill, the pharmacy that the clinic uses called and said that my meds had been called in and were ready to ship as soon as they had payment. Boy, was that a big payment! But on July 20th I received a huge box of medications that they said would get me through one whole IVF cycle.
The last 5 days I was on the pill I began taking an injection of Lupron once a day (July 25th was the first Lupron injection). Lupron is supposed to suppress your ovarian activity and prevent premature ovulation of eggs. The shot itself didn't hurt at all, but the skin near the injection site would itch for about 15 minutes or so after the injection.
August 2010
August 1st was what the clinic refers to as Cycle Day 1 in the IVF cycle. The only thing that changed on this day was I started taking Dexamethasone, an oral steroid. It's supposed to augment the response to the ovarian-stimulating drugs, reducing the likelihood of an IVF cycle being canceled.
August 2nd I went in for bloodwork and a baseline ultrasound of my antral follicles. This gives an indication of how many potential eggs I would be able to produce during the cycle. I had 10 follicles in one ovary, and 12 in the other and they called later that afternoon and told me that I was safe to start my "stims" or ovary-stimulating meds the next day.
August 3rd I added 2 more meds to my arsenal. Menopur and Bravelle. Menopur is used to stimulate the development of a mature follicle and egg. Bravelle is a follicle-stimulating hormone and is used to develop multiple follicles during the IVF cycle.
August 6th I went in for bloodwork an another ultrasound to check my follicles. The ultrasound showed about 3 large follicles on one side, 2 on the other, and a bunch of smaller ones. When they called that afternoon they said to come back on Sunday for more bloodwork and ultrasound.
August 8th I went in again and the ultrasound showed the same 5 follicles still way ahead of the rest of the pack. The nurse we spoke to after the ultrasound said that she needed to consult with the doctor regarding my meds and she wasn't sure if he would keep them the same dose or not. Also, I would need to start coming in daily until my trigger, which she now assumed would be about 2 or 3 days earlier than we'd originally planned for. When the nurse called that afternoon they upped both my dose of Menopur and Bravelle and we scheduled another appointment for Monday morning.
August 9th went just as I expected. The same 5 follicles were still growing strong and my meds stayed the same that day.
August 10th on the ultrasound it looked like maybe one of the smaller follicles was catching up to the Big 5 but was still straggling a little. When they called that afternoon to tell me about meds they said I was done with stims and Lupron and that at 7:30pm exactly that night I needed to take my trigger shot, and that on Thursday morning I was to check in at 7:00am at the clinic for egg retrieval. Well, ok then. Here we go!
To be continued...
Also in this meeting with the nurse we went over the exact schedule for a cycle and while we could have begun just a few days later in June, our July travel schedule was a little busy so we chose to delay for a month and start in July, meaning all of the big days in the cycle would occur in August. Additionally, the nurse gave us a private class in how to do all of the injections that I would be needing once the cycle began. I also came away from this meeting with a big bag of samples of prescription-strength prenatal vitamins and homework - to choose which one I liked best. I had some bloodwork done this day as well, and ended up testing positive for a mutation of a gene called MTHFR. A few days later I took another blood test, a fasting homocysteine level test, and they determined that the mutation I have hinders my absorption of folic acid, so I was prescribed a drug called Folgard to take twice a day to help me absorb folic acid.
July 2010. Ironically, the first medicine in my protocol was the birth control pill. For 21 days in July I took the pill in addition to the prenatals and Folgard, and about two weeks into taking the pill, the pharmacy that the clinic uses called and said that my meds had been called in and were ready to ship as soon as they had payment. Boy, was that a big payment! But on July 20th I received a huge box of medications that they said would get me through one whole IVF cycle.
The last 5 days I was on the pill I began taking an injection of Lupron once a day (July 25th was the first Lupron injection). Lupron is supposed to suppress your ovarian activity and prevent premature ovulation of eggs. The shot itself didn't hurt at all, but the skin near the injection site would itch for about 15 minutes or so after the injection.
August 2010
August 1st was what the clinic refers to as Cycle Day 1 in the IVF cycle. The only thing that changed on this day was I started taking Dexamethasone, an oral steroid. It's supposed to augment the response to the ovarian-stimulating drugs, reducing the likelihood of an IVF cycle being canceled.
August 2nd I went in for bloodwork and a baseline ultrasound of my antral follicles. This gives an indication of how many potential eggs I would be able to produce during the cycle. I had 10 follicles in one ovary, and 12 in the other and they called later that afternoon and told me that I was safe to start my "stims" or ovary-stimulating meds the next day.
August 3rd I added 2 more meds to my arsenal. Menopur and Bravelle. Menopur is used to stimulate the development of a mature follicle and egg. Bravelle is a follicle-stimulating hormone and is used to develop multiple follicles during the IVF cycle.
August 6th I went in for bloodwork an another ultrasound to check my follicles. The ultrasound showed about 3 large follicles on one side, 2 on the other, and a bunch of smaller ones. When they called that afternoon they said to come back on Sunday for more bloodwork and ultrasound.
August 8th I went in again and the ultrasound showed the same 5 follicles still way ahead of the rest of the pack. The nurse we spoke to after the ultrasound said that she needed to consult with the doctor regarding my meds and she wasn't sure if he would keep them the same dose or not. Also, I would need to start coming in daily until my trigger, which she now assumed would be about 2 or 3 days earlier than we'd originally planned for. When the nurse called that afternoon they upped both my dose of Menopur and Bravelle and we scheduled another appointment for Monday morning.
August 9th went just as I expected. The same 5 follicles were still growing strong and my meds stayed the same that day.
August 10th on the ultrasound it looked like maybe one of the smaller follicles was catching up to the Big 5 but was still straggling a little. When they called that afternoon to tell me about meds they said I was done with stims and Lupron and that at 7:30pm exactly that night I needed to take my trigger shot, and that on Thursday morning I was to check in at 7:00am at the clinic for egg retrieval. Well, ok then. Here we go!
To be continued...
Sunday, August 15, 2010
5 Embryos
Right now, in a lab about 15 minutes away from our house, there are five embryos with half of my DNA and half of my husband's DNA growing in a petri dish. Possibly more than one dish. I really have no idea.
Two years ago, we opened ourselves up to the possibility of having children when I had my IUD removed at my yearly physical. Our plan was to just let whatever happened happen. We figured that eventually I'd miss a period and we'd have a baby some time in 2009 or 2010. I actually figured it would happen pretty quickly. We were both healthy and we were two years younger back then, how hard could this baby-making thing be, right? Wrong.
So how did we come to this?
It's a long story. Ready?
August 2008. IUD is removed. Life goes on as it always had. Months go by and things are great. I'm not even that disappointed that I haven't gotten pregnant yet for awhile. All I am keeping track of at this point is how far apart my periods are occurring. Usually 26 or 27 days apart.
April 2009. I have a very short cycle. 21 days. I'm a little concerned, but don't do anything different the next month.
May 2009. Another short cycle. 24 days. Now I'm getting concerned that letting whatever happens happen may not eventually yield the results we want. I decided to start charting my cycles. This consisted of buying a basal thermometer and taking my temperature daily as soon as I woke up. I entered the temperatures into a website and it made graphs for me. Doing this charting would let me know whether I was ovulating, and when, and if there were enough days between ovulation and my period beginning to allow a pregnancy to develop.
Summer 2009. Charting, charting, charting. Graphs indicate that I ovulate normally, my cycle should be sufficient to develop a pregnancy, and our timing was usually pretty good. In July, I even had a few pregnancy symptoms as my period approached and I was just positive that I was pregnant. I wasn't. At some point that summer I ended up at the doctor's office for some ear issues (turned out I have TMJ, this is unrelated) and she asked me how the baby-making was going. I told her and she said if after 6 months of charting I wasn't pregnant, to call her.
November 2009. 6 months of charting, over a year of no birth control. I call my doctor and she refers me to our HMO's Reproductive Endocrinology office. I make an appointment with the RE, they say to bring the husband to the first appointment. Ok. The appointment goes pretty well, our doctor was really nice and assured us that we were young and healthy and they could help us get pregnant. They take full family medical histories, ask us all about our own medical histories and suggest a couple of tests to be taken. First - I should go get some bloodwork done downstairs and then we should schedule a hysterosalpingogram, or HSG, for me. Also, the husband needs to get a sperm analysis done. My bloodwork came back normal and we scheduled the HSG, which is an x-ray test of the uterus and fallopian tubes. They inject a dye up into the uterus and have you move around a bit on the x-ray table to make sure that your tubes are open and clear and that your uterus doesn't have any cysts or other abnormalities in or on it. My HSG came out clear, and was around ovulation day so they encouraged us to "try" that night and see if the test itself cleared things up to the point that we could conceive that month. Apparently this is pretty common. It didn't work.
December 2009. Once we knew for sure that we didn't conceive in November the husband scheduled his semen analysis. We received the results of it in mid-to-late December. Count normal. Motility normal. Morphology well below normal. Neither of us has any idea about this morphology term. So we did some Googling and found that it means the heads of the sperm aren't shaped correctly to penetrate an egg. We received this news right before we left for a 10-day trip to FL to visit family so we didn't really do much more in 2009.
January 2010. We meet with the RE again and he tells us that low morphology means it's pretty unlikely that we will conceive in any given month without help. He suggests that we try an intrauterine insemination (IUI) procedure the next cycle. He says that pairing this procedure with me taking a drug called Clomid will give us a little better chance. The Clomid will allow me to release more than one egg each month, giving the few properly-shaped sperm more targets to hit. I begin taking the Clomid on day 5 of my cycle and take it through day 9. On day 10 I go in for an ultrasound to see how many follicles I have growing in each ovary and I get bloodwork done to see if I'm nearing ovulation.
February 2010. I keep going in daily for bloodwork and ultrasound until the day that they think the follicles are almost mature. And then one day they tell me I need to take a "trigger shot" which will induce ovulation 36 hours later. This shot is basically pure human chorionic gonadotropin (hcg), the pregnancy hormone. It has to be administered intra-muscularly in my upper hip (butt) with a very long needle. By my husband. It hurt. But then just under 36 hours later we went to the doctor's office with a semen sample. They wash it and spin it and give it back to us and we take it upstairs where it's loaded into a big syringe with a skinny plastic tube instead of a needle, and that plastic tube is threaded up through my cervix and the semen is deposited. It barely has to do any swimming! We're sure this will work! It didn't. The husband gets another semen analysis done because apparently new batches are made every 7-8 weeks. This result is not any better than the first. Also this month we get a new car for me, and we choose the less expensive of the two we narrow it down to, in case we need extra money later in the year for all this baby-making.
March 2010. We do the same thing again - another IUI. It doesn't work. The husband is told by the RE to go see the urologist. The urologist examines the husband and says there's nothing apparently wrong with him, they do not know what causes this low morphology but there are some supplements that he can take that may increase the % of pointy ones after two months. The husband stops on his way home and picks up some of the supplements and begins taking them right away. The urologist also suggests that while IUIs are inexpensive, they're not that much more likely to get me pregnant than just trying on our own, so we should begin to consider In-Vitro Fertilization (IVF).
April 2010. We take the month off from any procedures. It's our anniversary this month and we have a vacation planned at the end of the month. We decide that if we don't conceive on our own this month we will try IUI one more time before considering other options. Also this month, we get a big refund back from the IRS and instead of spending it, we put it away in case we choose to do IVF. We did not conceive on our own in April.
May 2010. We go back to the RE and tell them we want to try one more IUI since the husband has been taking the supplements. This time we plan on doing a double IUI which means one procedure the day after the trigger (day before ovulation) and one procedure the day after that (ovulation day) to give ourselves a bit of a better shot. But ovulation ends up falling while we are out of town for Memorial Day weekend, so the nurse just tells us to try on our own since it's really the multiple eggs giving us the better chance, and not the actual procedure. So we do that. We did not conceive in May.
June 2010. We go talk to a new RE at a clinic where they specialize in IVF. Friends of ours conceived through this clinic in 2009 using donor eggs and are expecting twins. They rave about the clinic. We meet the doctor and he tells us there's a procedure called ICSI (intracytoplasmic sperm injection) where they use a tiny needle to inject each egg with one sperm to promote fertilization. This means that the shape of the sperm doesn't matter! We go over the costs (a lot) and the odds of the IVF procedure working (70-80%) and the risk of multiples (40-50% likelihood of twins) and decide that this is our best bet for baby-making. We schedule an appointment for a week later to get the ball rolling.
To be continued...
Two years ago, we opened ourselves up to the possibility of having children when I had my IUD removed at my yearly physical. Our plan was to just let whatever happened happen. We figured that eventually I'd miss a period and we'd have a baby some time in 2009 or 2010. I actually figured it would happen pretty quickly. We were both healthy and we were two years younger back then, how hard could this baby-making thing be, right? Wrong.
So how did we come to this?
It's a long story. Ready?
August 2008. IUD is removed. Life goes on as it always had. Months go by and things are great. I'm not even that disappointed that I haven't gotten pregnant yet for awhile. All I am keeping track of at this point is how far apart my periods are occurring. Usually 26 or 27 days apart.
April 2009. I have a very short cycle. 21 days. I'm a little concerned, but don't do anything different the next month.
May 2009. Another short cycle. 24 days. Now I'm getting concerned that letting whatever happens happen may not eventually yield the results we want. I decided to start charting my cycles. This consisted of buying a basal thermometer and taking my temperature daily as soon as I woke up. I entered the temperatures into a website and it made graphs for me. Doing this charting would let me know whether I was ovulating, and when, and if there were enough days between ovulation and my period beginning to allow a pregnancy to develop.
Summer 2009. Charting, charting, charting. Graphs indicate that I ovulate normally, my cycle should be sufficient to develop a pregnancy, and our timing was usually pretty good. In July, I even had a few pregnancy symptoms as my period approached and I was just positive that I was pregnant. I wasn't. At some point that summer I ended up at the doctor's office for some ear issues (turned out I have TMJ, this is unrelated) and she asked me how the baby-making was going. I told her and she said if after 6 months of charting I wasn't pregnant, to call her.
November 2009. 6 months of charting, over a year of no birth control. I call my doctor and she refers me to our HMO's Reproductive Endocrinology office. I make an appointment with the RE, they say to bring the husband to the first appointment. Ok. The appointment goes pretty well, our doctor was really nice and assured us that we were young and healthy and they could help us get pregnant. They take full family medical histories, ask us all about our own medical histories and suggest a couple of tests to be taken. First - I should go get some bloodwork done downstairs and then we should schedule a hysterosalpingogram, or HSG, for me. Also, the husband needs to get a sperm analysis done. My bloodwork came back normal and we scheduled the HSG, which is an x-ray test of the uterus and fallopian tubes. They inject a dye up into the uterus and have you move around a bit on the x-ray table to make sure that your tubes are open and clear and that your uterus doesn't have any cysts or other abnormalities in or on it. My HSG came out clear, and was around ovulation day so they encouraged us to "try" that night and see if the test itself cleared things up to the point that we could conceive that month. Apparently this is pretty common. It didn't work.
December 2009. Once we knew for sure that we didn't conceive in November the husband scheduled his semen analysis. We received the results of it in mid-to-late December. Count normal. Motility normal. Morphology well below normal. Neither of us has any idea about this morphology term. So we did some Googling and found that it means the heads of the sperm aren't shaped correctly to penetrate an egg. We received this news right before we left for a 10-day trip to FL to visit family so we didn't really do much more in 2009.
January 2010. We meet with the RE again and he tells us that low morphology means it's pretty unlikely that we will conceive in any given month without help. He suggests that we try an intrauterine insemination (IUI) procedure the next cycle. He says that pairing this procedure with me taking a drug called Clomid will give us a little better chance. The Clomid will allow me to release more than one egg each month, giving the few properly-shaped sperm more targets to hit. I begin taking the Clomid on day 5 of my cycle and take it through day 9. On day 10 I go in for an ultrasound to see how many follicles I have growing in each ovary and I get bloodwork done to see if I'm nearing ovulation.
February 2010. I keep going in daily for bloodwork and ultrasound until the day that they think the follicles are almost mature. And then one day they tell me I need to take a "trigger shot" which will induce ovulation 36 hours later. This shot is basically pure human chorionic gonadotropin (hcg), the pregnancy hormone. It has to be administered intra-muscularly in my upper hip (butt) with a very long needle. By my husband. It hurt. But then just under 36 hours later we went to the doctor's office with a semen sample. They wash it and spin it and give it back to us and we take it upstairs where it's loaded into a big syringe with a skinny plastic tube instead of a needle, and that plastic tube is threaded up through my cervix and the semen is deposited. It barely has to do any swimming! We're sure this will work! It didn't. The husband gets another semen analysis done because apparently new batches are made every 7-8 weeks. This result is not any better than the first. Also this month we get a new car for me, and we choose the less expensive of the two we narrow it down to, in case we need extra money later in the year for all this baby-making.
March 2010. We do the same thing again - another IUI. It doesn't work. The husband is told by the RE to go see the urologist. The urologist examines the husband and says there's nothing apparently wrong with him, they do not know what causes this low morphology but there are some supplements that he can take that may increase the % of pointy ones after two months. The husband stops on his way home and picks up some of the supplements and begins taking them right away. The urologist also suggests that while IUIs are inexpensive, they're not that much more likely to get me pregnant than just trying on our own, so we should begin to consider In-Vitro Fertilization (IVF).
April 2010. We take the month off from any procedures. It's our anniversary this month and we have a vacation planned at the end of the month. We decide that if we don't conceive on our own this month we will try IUI one more time before considering other options. Also this month, we get a big refund back from the IRS and instead of spending it, we put it away in case we choose to do IVF. We did not conceive on our own in April.
May 2010. We go back to the RE and tell them we want to try one more IUI since the husband has been taking the supplements. This time we plan on doing a double IUI which means one procedure the day after the trigger (day before ovulation) and one procedure the day after that (ovulation day) to give ourselves a bit of a better shot. But ovulation ends up falling while we are out of town for Memorial Day weekend, so the nurse just tells us to try on our own since it's really the multiple eggs giving us the better chance, and not the actual procedure. So we do that. We did not conceive in May.
June 2010. We go talk to a new RE at a clinic where they specialize in IVF. Friends of ours conceived through this clinic in 2009 using donor eggs and are expecting twins. They rave about the clinic. We meet the doctor and he tells us there's a procedure called ICSI (intracytoplasmic sperm injection) where they use a tiny needle to inject each egg with one sperm to promote fertilization. This means that the shape of the sperm doesn't matter! We go over the costs (a lot) and the odds of the IVF procedure working (70-80%) and the risk of multiples (40-50% likelihood of twins) and decide that this is our best bet for baby-making. We schedule an appointment for a week later to get the ball rolling.
To be continued...
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