0

Two for the Price of One

Whenever you start to see a light at the end of the tunnel, you think to yourself “are we finally there… or is it another train?” On July 3rd, we had our second beta test, and it looked great!

No automatic alt text available.

HCG is supposed to double every 48 hours, and mine was well above that! **Note: 10dp5dt means 10 days past 5 day blastocyst transfer**
They scheduled our first ultrasound for yesterday, July 10th. Now with my high beta numbers I knew there was a higher chance that it was twins, but we wouldn’t know for sure until the ultrasound. It seems like every wait gets worse! The days drug by until the ultrasound.

And…. it’s twins!

Image may contain: ultrasound

This ultrasound is from 5w5d into the pregnancy. Even this early we got to see both heartbeats! One was at 108 and the other was too close to my iliac to get a good reading over my heart rate, but it looked visually to be about the same. In the ultrasound the top picture is the actually babies and the bottom picture is the yolk sacs. We have another ultrasound next Monday to see how they grew from their whopping 2mm each.

We are of course overjoyed, but I am still so scared. I am afraid that we will lose one or both or that something else will go wrong. I thought this would get easier, and maybe it will. Right now I’m still on edge.

Sending baby dust to all of my friends still struggling!

Advertisements
1

The Results are in

To say this was the longest TWW (two week wait, the time period in a natural cycle between the fertile period and waiting to know if you’re pregnant) is an understatement. Every hour felt like a day, and the days felt like lifetimes. The ten days was plagued with second guessing myself and the dreaded “what-if”s. What if it doesn’t work? What if it works but it’s a chemical pregnancy? What if the zombie apocalypse comes and Baton Rouge General gets overrun and I can’t get my beta test? Well, that last one is a stretch, but you can see how it has been a long wait.

Bed rest was enjoyable for the first day, even for the beginning of the second. But by the third day.. I hate to admit it but I was ready to get back to work. Bed rest gave ample more opportunity to overthink absolutely everything.

I thought it was in my head, but at 2dp5dt (2 days past 5 day blastocyst transfer) I started having small cramps. Not bad cramps, but it just felt like my period was coming. Little twinges that didn’t stop. On 3dp5dt, if I moved too quickly or unexpectedly I would get a sharp pain on one side of my abdomen or the other. On 4dp5dt, I felt like I had to pee ALL the time, and that didn’t stop.

I had been trying to wait until 7dp, but on Sunday morning, 5dp, I gave in a decided to take a test and this is what I got….

19424057_10158852026080285_1731530654949254360_n

That…. that is a LINE. It might be faint but a line is a line! Taylor is drug administrator at 0530 in the morning… so I decided to surprise him.

I tested throughout the week and as it was supposed to the line got darker.

19601415_10158897901905285_4615386791555410946_n

My first beta test was Friday. When I saw that phone number come across the screen I felt like my stomach was going to fall out of my butt. I answered, and everything came back positive! My first beta came back at 551, which the nurse said was fantastic for a day 10 beta!

I’m very anxious to see what my second beta comes back with tomorrow!

 

4

PUPO… Pregnant Until Proven Otherwise

We made it. On Tuesday we transferred two perfect looking embryos. I’ve been on bed rest since then and I’ve been reflecting on the last month.

The last I checked in I had my endometrial scratch and baseline. The day afterwards, I stopped birth control and got to start my favorite medication again… Lupron.  Lupron is a subcutaneous injection which suppresses the pituitary gland to decrease the chance of ovulation.

Image result for lupron

The medication I previously thought was the worst

 

Like last time, I somehow ended up with all kinds of bizarre side effects. Exhaustion, headaches, nausea, weight, hot flashes, night sweats, insomnia, and nightmares. I started on 10 units and was able to decrease it to 5 units near the end of the cycle. After I got my period (hopefully the last one for ten months!) I started the process to build a nice fluffy home for my embryos.

 

During IVF, the focus is the ovaries, and getting as many healthy eggs as possible without over stimulation. Success rates are slightly higher for a frozen transfer (FET) than a fresh transfer (transferring the same cycle as an egg retrieval before eggs are frozen) because for an FET the focus is 100% on the uterus and thickening the uterine lining.

Image result for frozen embryo transfer

Every month, the uterus builds up a lining. If pregnancy is not achieved, the body sheds that lining during the menstrual period of a cycle to build a new one. Menstruation is triggered by a drop in the hormone progesterone that is produced by the corpus luteum, where the egg is released in the ovary. Either progesterone production is picked up by the growing embryo after implantation, or a period is triggered.

Once my next cycle started, I began a few medications to help build up that lining. The first was estrogen patches.

Image result for estrogen patches

These are applied and left on for several days. They bothered me at first and I was worried that they would come off, but I don’t even notice them anymore. I wear four patches, and each patch is designed to release 0.1 mg of estrogen per day. The next is estradiol valerate – my first intramuscular injection.

Image result for estradiol valerate injection

This entire process has become overwhelming, so I’m at the point where I don’t take medications out of the box until I need them. It was the night before starting this one, so I pulled it out of the box. And I saw the needles for drawing up the medication, which is fine, I’ve used those for menopur. But then the other needle was just as long… wait… this was an intramuscular injection?!?

Image result for fainting gif

Well, I can’t give those myself, and I had been dreading them. I thought I had a few weeks to prepare myself for it. But it was starting tomorrow. Luckily I have an amazing neighbor who is more family than neighbor, and she happens to give amazing shots (tequila or medication, depends on the day). I called her when she got off of her shift at the hospital and she talked me off the ledge and gave me my first IM shot. It wasn’t as bad as I was expecting.

Image result for intramuscular injection

It’s a big freaking needle….

Like the other medication, this was estrogen to help build up my uterine lining. Fun fact time… did you know that very few species menstruate? It seems the list of animals that menstruate is quite short: humans, apes, monkeys, bats and elephant shrews. What do these seemingly disparate animals have in common?

It all comes down to how much control the mother animal has over her own womb. In a paper published in 2011, it was pointed out by Deena Emera and her colleagues of Yale University that in menstruating animals, the transformation of the womb wall is entirely controlled by the mother, using the hormone progesterone. Embryos can only implant in the womb wall if it is thick and has specialized large cells, so this means the female is effectively controlling whether or not she can get pregnant. This ability is called “spontaneous decidualization”.

In most other mammals, these changes to the womb are triggered by signals from the embryo. In effect, the womb lining thickens in response to pregnancy.

If only we had effective control over getting pregnant. I’m going to try and will it to see if it sticks. Anyways, back to the FET.

Image result for moving on gif

The week prior to the transfer (8 days before and 6 days before) I had ultrasounds and bloodwork to check my hormone levels and my uterine lining thickness. The office looks for a thickness 6 days before of 7cm, and I was at 10cm! That meant we were on schedule to move forward. I could hardly believe that we had actually gotten to this point.

Five days before transfer I started the progesterone injections. This was to signal to my body that I had “ovulated” and that it should be on the lookout for an embryo to implant. The progesterone oil injections are the devil. It’s 2 mL of liquid, and thick as all hell. The shot itself isn’t actually horrible. It’s afterwards. I’ve just accepted that I’m going to have pain for the next (hopefully) 12 weeks.

My tips for the injection:

  • Warm up the site prior to injection, I heat up a rice bag and put heat on whichever side I’m doing that day while I prep the injection
  • Heat the oil first, I wrap it with the rice bag while I prep the injection site
  • Completely lift leg off the floor and twist so that the muscle is expanded
  • Vigorously rub injection site for 3 minutes.. it hurts at the time but it’s worth it
  • Heat for 15 minutes afterwards

Apparently I am one of those lucky people who happens to have more pain with them… just another check in the box of side effects for me. It will be worth it if we end up pregnant! I will continue this injection every day until the pregnancy test or through the first trimester.

Image result for ouch gif

For transfer day I had no dietary restrictions and was to arrive at noon. Of course I showed up in my transfer leggings and socks!

19275024_10158826814975285_5988090974205670252_n19260808_10158826813740285_4863911909846728665_n

We both went back and got changed. I had to remove my bottoms (able to leave on my shirt) and put on a gown. Taylor got a full set of scrubs and hat. The nurse came in and took my vitals and doc came and talked to us. He even brought us a picture of one of our embryos!

19396953_10158826862935285_5764501143452309452_n

First family picture!

19399473_10158826862930285_7544411816060299305_n

This is a photo of one of the embryos, but we transferred two. In the picture you can see that the walls are starting to break down and there’s a lot of activity. This is how the internal organs begin to form. Before transfer, the embryos were thawed and given a bath (their first bath!). They’re bathed in a “sticky” solution to help with implantation. Prior to transfer, the embryologist uses a laser to begin to remove the embryo wall to assist with “hatching” and increase our chances of implantation.

I was given my feel good pill – AKA Valium – and I’m absolutely convinced that valium should be given for all fertility appointments because it really helped with my anxiety. When they were ready for us we both walked back. The procedure itself was very quick and easy… we were able to watch on the screen as our embryos were transferred into my uterus! They wheeled me back to the room and let me empty my bladder… thank goodness. You have to have a full bladder for the procedure and once again somehow I had underestimated how much it would take to fill my bladder.

We had to wait about a half hour but then we were out of there! Just in time to get Chick-fil-a and get home before Tropical Storm Cindy hit.

And now we wait. We have a 60-70% of a pregnancy, and a 30% chance overall that we will have twins. Fingers crossed…. until then I am PUPO – pregnant until proven otherwise!

Image result for waiting gif

4

Drowning in the Sea of Infertility

Everyone has good days and bad days. Everyone has ups and downs. It’s obvious when a friend or someone you’re close to is in a down, right? A successful, upbeat woman couldn’t possibly be depressed, could she? I wish it were that simple. I wish things were easy. I wish that when someone asked if I were okay, or what’s wrong, that I had an answer. Any answer, other than “I’m fine”.

Infertility feels like being in the ocean. It feels like you’re floating, being rocked by forces far beyond your control, praying that you have the will to keep treading water for just a little bit longer. There are periods in the journey where the sea is calm. It doesn’t go away, it is just a bit more at bay. You have time to stop, look at the sky, enjoy the breeze. But there is no way to truly prepare for the waves and storms that will do their best to drown you with vigor.

It’s much easier to recognize when you’re in a peak or trough.

The trough – the water is shallow. You can keep standing. Yes… you know there are waves on either side of you. But it’s okay. You can handle this. You go on with your life with an annoyance, that damn water keeps lapping at your ankles. But it’s manageable.. until it isn’t anymore. It’s like the frog in boiling water. If you take a frog and put it in a pot of water and slowly increase the temperature, the frog will keep increasing it’s body temperature and will not recognize that it is being boiled alive. When you’re in a trough you don’t realize that the water is rising until all of a sudden you’re treading water.

The other extreme is the peak of the wave. These are the bad days. These are the days that the waves knock you off of your feet and there is no other description other than you feel as if you’re drowning. You would give anything to just be able to breathe for more than a second at a time. It’s simply exhausting, treading water, but for how long? That depends. It depends on where you are in your journey. For me, most of the peaks are for a day at a time… today, I’m at a peak. But for some people these can last days, weeks, or even months at a time. And sometimes the waves just keep crashing.

The most dangerous times are the between times. In the between times everyone thinks you’re okay. Often in the between times even you think you’re okay. You go to work and are able to perform well. You go to functions with friends and family and are able to have fun and laugh like everything is okay. But when you get home and the world stops running at top speed everything just stops. Your mind stops, your body stops, and you just feel… empty. You get home and you can’t do anything. You want to, but you just can’t. You stop sleeping. You feel anxious about things that you typically wouldn’t feel anxious about. You feel insecure, especially with the people closest to you. But to everyone else… you’re okay.

Depression is as common in cases of infertility as it is in patients with cancer, HIV, and AIDs. High functioning depression, the “between times” slowly drown you, like the boiling frog.

So how do you not be the frog?

Talk to your friends and family. Tell them when you have bad days. As hard as it is, don’t try to cover it up. And if you aren’t completely open with your journey, find a group that you can relate to. I am very fortunate to have a group of online ladies that I can vent to. I would be lost without them. You may need to seek the help of a therapist or a doctor for help with depression. There is absolutely nothing wrong with seeking help.

Find something to blow off steam. For me, this is going to the gym. Even today I was able to go and work off frustrations. What makes you feel more like you? Go for a walk, go to the park, paint, read, take a bath, do what you need to do to make you feel like YOU again.

Be honest with yourself. This is something that I personally struggle with. Am I okay? Of course I am. I’m tough. I don’t need anyone. But.. I do. And I am truly blessed to have people that care about me. I have an incredible support system. It’s completely acceptable to admit when you aren’t okay. It is okay to not be okay, and sometimes the hardest part it admitting it. And that’s okay, okay?

Whatever you do, don’t lose the spark that makes you… you. It is easier to lose it than you think. Be open to that voice outside your head reminding you to stay positive when the one within feels lost.

A smooth sea never made a skilled sailor, and you must have hope we will make it to that island.

3ee0da97187a93c9b8c2b3113f2b26cb--the-ocean-ocean-life

 

3

On the Road to Embryo Transfer

Has it really been a month since my last post? I could be cliche and say time flies when you’re having fun, but honestly the past month has been dragging by. I just haven’t been able to bring myself to write lately, but since we are officially on the schedule for our frozen embryo transfer it is time.

I was disappointed when our fresh transfer was canceled, but I know it was for the best. My estrogen levels were too high and I was too high risk for OHSS (ovarian hyper stimulation syndrome). That doesn’t make it easier, as I’m not a fan of change… to say the least. Dr. Dunaway did reassure me that their statistics are very good for FETs (frozen embryo transfers). 37 of the past 42 have been successful.

tumblr_inline_mjblub252p1qz4rgp

So what have we been up to on the fertility journey this last month? To start, I’ve been on birth control for five weeks, today was my last pill. I’ve explained why many IVF/FET protocols include birth control in the beginning in previous posts, but it basically allows your hormones to start at a baseline and gives the team as much control as possible.

I have the opportunity to experience LUPRON again… my favorite.

tenor

Lupron stops estrogen production. Makes it tank. Out of no where… BOOM.. I’m a 26 year old experiencing menopause symptoms. I can’t sleep, I have hot flashes, headaches, and I’m all around miserable. To be fair, I already eat dinner 430pm and go to bed by 9. They should just go ahead and give me that senior discount.  I will say that as hard as it is to get out of bed at 430am, I do feel immensely better after going to the gym. I had stopped going for my entire retrieval cycle but I’m going to try and keep it up this time.

On Tuesday I had my baseline ultrasound aka a morning date with the dildo cam, along with bloodwork. On the ultrasound they were able to confirm that I had no cysts, but still have some hemorrhaging leftover from the retrieval, but since my ovaries have done their jobs, that won’t hold us back for the FET. Blood work also checked out, so that means we’ve checked the next box.

tenor1

The following day I went back to the Fertility Institute for my 21st appointment – the endometrial scratch. Fertility clinics only started offering endometrial scratching recently. Research is still ongoing. But it’s already one of the more accepted add-on treatments. Compared to the evidence on fashionable extras like embryo glue and intralipids, endometrial scratching has more kudos.

Best described as being similar to a smear test, an endometrial scratch involves a quick scrape of your womb lining at a certain point in your cycle by inserting a catheter into the uterus through the cervix. The promising research suggests it could improve embryo implantation, especially if you’ve had failed IVF attempts before.

How does it work? Well, endometrial scratching seems to provoke a reaction within the inner lining of the womb. Hormones and chemicals are released to help the lining repair itself. A genetic trigger response to an endometrial scratch may give the implantation ‘green light’. In essence, the temporary injury seems to make the endometrium more receptive to an embryo. That means a better chance of a pregnancy and a live birth.

Early studies into endometrial scratching have brought intriguing results, gaining the attention of infertility experts. A 2012 study found that having an endometrial scratch was 70% more likely to result in pregnancy in women with unexplained recurrent implantation failure. And researchers in 2015 concluded that endometrial scratching was more likely to improve the birth rate for women with two or more previous IVF failures. It is in the standard FET protocol for Dr. Dunaway.

Basically, he goes all Freddy Krueger up in that joint.

tumblr_lwvt4ui7lf1qbheumo1_500

It’s lovely. And by lovely of course I meaning I NEVER WANT TO DO IT AGAIN. The scratch itself wasn’t that bad. You’re instructed to go in with a full bladder. Well, I underestimated the amount of time it would take for my bladder to fill, so by the time I got there it was really full.

tumblr_inline_nf7u31g5i01t1hfzk

After getting undressed from the waist down, again, the procedure was conducted via ultrasound. But not the way I was used to. Nope, she threw that jelly on my abdomen and I had the pleasure of staring at my empty uterus. I had imagined the first time I had that ultrasound that we would be looking at our baby. Thanks for that.

Anyways, he prepped the cervix with iodine, which felt like a regular pap smear. Then came the catheter. Which would have been fine, except my uterus had two bends in it (maybe partially because I was about to pee myself… and on doc I suppose). He had to twist the catheter multiple times while it was inserted, took it out to bend it, and tried again. This happened not once, twice, but THREE times before he got to where he needed to be. I was seeing stars it hurt so badly. Thank goodness for the 1000mg of tylenol and 1000mg of ibuprofen I had popped.. after that the scratch felt like nothing.

So now… we wait. I’ll wait for hopefully my last period to come (hopefully I can tell, I’m still bleeding from the scratch and spotting from the lupron) and then I start estrogen patches and a new injection.

It is impossible to give an exact date, but I think our FET will be around June 20th. We will be transferring two embryos, with a 60-70% chance of pregnancy and 30% chance of that pregnancy being twins. If this cycle is successful, the due date would be March 7th.

Sending you all love and baby dust!

Fertility Treatment Running Cost:
Ovulation Kits for a year: $80
Pregnancy Tests for a year: $100
Vitamins: $300
GYN Apt: $50
Semen Analysis: $175
Semen Analysis w/Urinanalysis: $250
Fertility Institute Consultation: $166 ($250 without insurance)
Clomid: $9.60 ($100 without insurance)
IUI Payment #1: $880
hCG trigger: $125
IUI Payment #2: $485
IVF Consult: $100
IVF Workup #1: $350
IVF Workup #2: $205
Infectious Disease Testing: $92
IVF Payment #1: $7,600
IVF Medications: $1,344
IVF Workup Balance: $196
IVF Payment #2: $7,600 (IVF payments covered by Sarah’s Laughter giveaway)
Anesthesia: $550
FET Medications: $1,500
Endometrial Scratch: $110

TOTAL: $22,464

 

 

1

You Are Not Alone

People make allowances for all sorts of grief. Compassion is often our first and most natural response when it comes to bereavement and loss, especially loss we can give a name to. Something discernible that from the outside is easy to understand. Easy to put into words.

Infertility is a loss of staggering proportions.

To those of us who experience it, it can be incomprehensible. Bewildering. Mind-numbing. Yet it is not an easy loss to define. Nobody died. There is no funeral to attend. No one sends flowers or sympathy cards.

Even to the ones who suffer this loss, it can be a struggle to find the proper words to describe it. What have we really lost? What words can we use to do justice to this thing that knocks the air from our lungs?

It isn’t loss that has a name or memories or a number of years attached to it. We are mourning something intangible — what never was and what we are afraid may never be. Because of this, it can also be difficult for others to grasp.

While most people would agree it is sad to not be able to have children, the idea of feeling desperation and wild crippling grief could seem dramatic, excessive and even weak.

I have come to think that the most common response to infertility is: “At least it isn’t… “

From well-meaning souls I heard that at least we don’t have cancer. At least we hadn’t had a miscarriage or three. At least we hadn’t lost a sibling or a parent or even my job. At least I wasn’t dying.

To be fair, these “at leasts” aren’t meant to be hurtful, but they did breathe distance into some of our relationships. A part of me understands that these phrases are meant to reassure me, that these people genuinely want to help me to put what I felt in perspective, but at this early point in our journey we are still reeling from the pain and shock of it.

It wasn’t perspective I have sought, (that will come later, probably), it was understanding.

I needed someone to sit down and hold my hand and say, “I’m so sorry, this must hurt so much. I’m here for you.” There were some who did exactly this, who it was safe to grieve with. They spoke with love and compassion and the very fact that they allowed my grief to exist and they heard me was healing. Unfortunately, more often, the unintentional message I heard was that of my sadness being undermined, made less by the words “at least.”

How could my personal pain possibly measure up against all the greater tragedies in the world?

So I would sit there, my eyes cast down. Twisting my fingers together. Nodding my head apologetically because how could I disagree with such logic?

Yes, at least I wasn’t dying.

Except I was.

And sometimes I still am.

I have caught myself feeling as though I should apologize for all my sadness and anger, for daring to be so bold as to let my heart shatter and my world fall apart over this. Apologize for all this hurt my heart couldn’t contain.

I would bite back all the words I wanted to say. The hurt and desperation I thought I might be able to share with someone. I have felt complete dismay that others couldn’t see how this loss to me felt like grieving an actual death. We haven’t had a child we were mourning, but in my heart it has felt as if I am morning every child.

I have cried rivers over the little boys and little girls who I thought would never have my smile or my husband’s eyes. I began to have dreams of stumbling down a difficult forest path leading to a pitch black lake where a child was floating face down in the water (this is not something I have shared with anyone). The grief I experienced in this dream echoed my grief in real life—indescribable and haunting.

I hurt endlessly, and on top of all this, I felt like the worst sort of failure because I wasn’t able to just slap a smile on my face and convince myself that at least it wasn’t worse.

For myself,  and others in the process of going through this, it is the worst. It just is.

There is nothing trivial about grief over infertility. A person can grieve the loss of their dream of a biological family as honestly and deeply as someone else can grieve the loss of a child or parent or partner or their health.

There is no “at least” when it comes to the breaking of the human heart, there is no need to try to measure one person’s pain against another to see who is worthy of feeling grief and who isn’t.

If you are in a similar situation, you probably know already that no grief ever fully disappears, but I want to tell you that one day these wounds that now feel so raw and open will heal. They will still pulse with pain every so often but you will be restored to yourself and left with the truth of who you are.

The truth is things will change and you will change. It won’t always hurt the way it does now. I promise you that you will find your way.

I’m going to leave you with one “at least” that I hope makes a difference.

That in this pain that feels so solitary, at least you’re not alone.

you-are-not-alone.jpg

1

D-Day and the Ice Age

Happy Easter, y’all! D-Day (Egg Retrieval Day) has come and gone, and tomorrow is the Big Freeze. I am fortunate enough to be writing this from the beautiful Gulf Shores in Alabama.

Photo Apr 16, 6 49 27 AM

Sunrise on the beach this morning

The past week has honestly been a blur, and it is bittersweet to be on vacation, but truth be told I probably needed it. I’m even taking a few days off of work (what!?!) to stay until Tuesday. Well, I pulled the trigger (to “trigger” ovulation) at 2100 on Monday.

Screen Shot 2017-04-16 at 10.02.51 AM

Ovidrel was one of the easiest shots that I’ve taken

The egg retrieval was the most fun I never want to have again. The day before the retrieval was miserable. At that point my ovaries and follicles measured several inches across, and I could feel it. I could feel the heaviness and discomfort with every step, and every time I changed positions. And on top of that, I was showing “pregnancy symptoms” from the Ovidrel, which contained hCG.

Egg retrieval takes place 36-37 hours after the trigger. We got to the clinic and I got to change into my incredibly stylish gown, hair cover, and booties.

Screen Shot 2017-04-16 at 10.08.51 AM

Oh hey good lookin’

Come time for the procedure the anesthesiologist came and put in my IV (in the wrist, and yes, it hurt) and it felt like after that things started coming all too quickly. They had me walk to the back and lay on the table, and started strapping me in. It was maybe five seconds after that when the room started spinning. I’m fairly certain that I said something inappropriate and then I was out.

Photo Apr 12, 10 45 44 AM

I basically remember nothing else except vaguely driving home and waking up on the couch. Apparently I was quite entertaining on anesthesia. For some reason, I kept calling the eggs and potential babies “gerbils”. Lucky for y’all, my wonderful husband recorded everything.

For the most part I have felt okay. My heating pad was my best friend for the first two days. The only time I really had pain was when I would get up and push myself (I have a hard time just sitting still). In the future I’ll write another post with some tips on surviving the retrieval, but it went a lot more smoothly than I imagined.

So here’s the big news… the count!! Drumroll please….

14 Eggs Retrieved
12 Eggs Fertilized
8 High Grade Embryos, 2 Medium Grade, and 1 on watch

Y’all we have eight embryos for sure!!!

We are over the moon excited that we can move forward to the next step… tomorrow is the Big Freeze, and the start of the Ice Age for our little embies.

So now what? We wait. giphy

And wait… and wait…

16865037_10212327649088395_2663550399585455414_n
We will have a better timeline when my next cycle starts. Doc said it could be two weeks, it could be a month. We will see what my body does. Until then … we get to “relax”. Cheers to brewing up a baby!