The Plan for Now

Well guess who showed up this weekend? Yep, good ole flow. I'm actually thankful that she came so quickly as I was worried I'd be the one who had to go on Provera because the drugs screwed me up. I have to say that this one is awful. I expected it, what with a great 12.75 lining this cycle. But in a general sense of things I'm feel good about getting this next cycle started. If it were up to me I'd be picking up my refill of BCP today but the clinic's protocol is to wait a cycle and then start.

We have our "what the heck happened" appointment next Tuesday. And (I am such a nerd) I've been looking up research articles on poor IVF response. What I've learned is that they define poor response based up on:

1. The number of eggs retrieved (poor = <4)
2. The amount of stims given per day (poor = greater than or = to 300 IU/d)
3. The total amount of stims given in the cycle (poor = greater than or = to 3000 IU/cycle)
4. And a cancelled cycle

We had:

1. 7 eggs retrieved of which 6 were mature
2. I took 225 IU of stims each day
3. In total I took 2250 IU/cycle
4. And we were not cancelled

So basically I think I just squeaked by a 'poor' response cycle and I think there is a good chance that my 'poor response' was that I was not on the right meds. That or I was totally over suppressed by the Lupron. I mean, hello, I started off with an E2 of LESS THAN 7!!! Does anyone else find that ridiculously low when they are just looking for anything below 80?

I also looked up poor response to IVF stims due to ovarian edometriosis. This is when endometriosis is found on an ovary. The effects are usually a smaller amount of follicles, typically on the side of the endometrioma, and a poor response in general with fewer follicles and fewer mature eggs retrieved. But in reading up on this I don't think I totally fit that picture either. What they found during my lap was:

1. one spot of endometriosis on my right ovary (which was causing all my pain), and
2. one spot on the back of my uterus

My GYN who did the surgery said I didn't even meet the qualifications for Mild endometriosis and that if there was a 'very mild' she'd 'think' about putting me in that category. Basically, she didn't think it was causing our infertility but is glad that my right side pain went away with the removal of the ovarian endometroma. And let's all keep in mind that if my right ovary is supposed to be 'effected' by my endometriosis it's always:

1. Had the largest follicles (except this last cycle)
2. The highest number of follicles
3. And this round of the cycle had the most mature eggs retrieved

So righty defies all logic of an ovary effected by endometriosis. (Way to go righty!) Now lefty has always been a quandary because it does not always participate and then some times it surprises us, like this last cycle, and decides to pop out the best looking follicles of the bunch. But it still failed to produced large amounts of follicles. That is why I'm wondering if I was either sensitive to the Lupron or Bravelle was just not the drug for me.

I'm excited to try a new set of drugs to see how I do. And I don't know about you but I think 6 mature eggs when I only had 4 mature sized follicles is pretty darn awesome! Plus we made it to transfer once before which means we have a really good chance of doing it again. That and we just got word that Hammer will be getting a bonus in the amount that will cover our drugs! This part was a total shock to us but it could not have come at a better time when we were just trying to plan out fiscally what we were going to pull from to do the next cycle. Hammer is actually in corporate finance so we are well managed $-wise to do another cycle but it takes off some pressure and every penny saved means more in our savings and the longer I can stay home with our future baby(ies).

My favorite part about all this is that it looks like we'll start cycling again at the end of August. Which means that we will be doing BCP and Lupron (?) in September with a retrieval/transfer some time in October. And October is when our Florida vaca was cancelled because my work is not letting anyone travel in October. So now with a looming Oct IVF on the horizon we wouldn't be heading south anyway. Originally, I choose to let Hammer be mad for the both of us about our cancelled vacation because I didn't want to add more stress on our first IVF which was a good idea in more ways than one. I didn't hold a grudge and now I actually have to thank the head of my department because we can jump right into another try.

So I'm armed and ready with my list of questions for Dr. F and feeling good about Operation Hammer Babies Take Two!

It's Official

My results today were confirmed negative. But has anyone else been given this directive? They told me to stay on the PIO until my next test to make sure that it wasn't a testing error. But I think this is ridiculous because I have 5 early HPT that confirm this as well. Aren't we just dragging this out? That and I would have to open up a new bottle of PIO and stick my already sore and bruised tushy for another 5 days just to reconfirm what we already know.

I think I'm just going to stop the PIO and get this thing over with. But first, any opinions out there if I would be doing the right thing?

I thought I'd put our IVF#1 summary of events in this as a closing on this chapter and make a fresh start.

• May 26-June 1 - Take antibiotic (Doxycycline)
• May 26-June 15 - Take Birth Control Pills
• June 2 - Injection class, meds scheduled to arrive
• June 8-June 26 - Lupron injections 10 units
• June 19 - IVF counseling session
• June 24 - Baseline Estrogen blood draw = 7 pg/mL day 0 , ultrasound and vaginal sounding
• June 27-July 7 - Decrease Lupron to 5 units, start Bravelle injections (1 vial am + 2 vials pm)
• July 2 - Estrogen blood draw = 107 pg/mL day 5 of stims, u/s = 6 follies 1x13mm, 5x less than 10mm, no change in Bravelle dosage
• July 6 - Estrogen blood draw = 888 pg/mL day 10 of stims, u/s = 6 follies 1 @ 20mm, 1 @ 19mm, 2 @ 14mm, 1 @ 15mm, and 1 @ 13 mm.
• July 7 - final blood draw = 1,176 pg/mL and u/s = 4 mature follies 1 @ 23mm, 1 @ 20 mm, 1 @ 19 mm, and 1 @ 18 mm. (2 immature that were 15 mm and 13 mm)
• July 9 - Official Egg retrival - 7 eggs retrieved
• July 9 - 6 mature eggs!!!! 3 fertilized normally
• July 12 (Sunday) - Transfered two beautiful embies (day 3) freezing one
• July 16 - Progesterone b/w results = 118
• July 23 - Beta #1 = negative

Knocked Down, But Not Destroyed

This week, as you know, has been a difficult one. On Monday when I was still nursing my wounds from the negative HPT I learned that another IRL friend is now expecting. It was not what I needed to hear that day. I went to bed early, crying and praying before going to sleep that God would help me get through this. Yesterday I started thinking about how Hoping for our own Peanut is still experiencing pain from the scars left by infertility even while she is expecting. I thought about how, when all this is over and God’s plan has been worked out, those scars from this trial would always be there. That I would never be the same person I was before infertility. And just how much this process has changed both Hammer and I. It’s amazing to think about the scars that we will inflict upon ourselves through infertility all for the love of some one who hasn’t even been born yet. And then I thought about someone else who bears scars. And I thought about the love that it took to take on the sins of the world and know that He would forever bear the scars from that choice. But that He did it for the love of those that came before Him, for those that stood at His feet mocking Him and wishing Him dead, and for those of us now who had yet to be born. He took a risk to bear these scars knowing that it would not be guaranteed success that those He loved would choose life with Him. But He did it anyway, because all the scars were worth the life that would come through it.

I used to think that God ‘understood’ my pain but not fully understood it. How could He? I’m a woman and while He was on earth He was a man. He didn’t truly know the pain of an empty womb; of mourning every month that went by without the hope of a child. But now I know that we are not so different, He and I. And If I can, in love, bear the burden and take on the scars of infertility for our child who has yet to be born; how much greater is the love of our Father who look on the scars for the whole world. He does understand our pain better than I even realized.

One day I will be a mother. But I will always bear my scars; I will always be infertile even if I give birth some day because we could never achieve our family without help. I will be a mother, a mother of infertility.

So I am knocked down, but not destroyed. This cycle was difficult mainly because we never even thought we would make it to transfer. To go from almost having our cycle cancelled or converted to an IUI, then retrieving the exact number of eggs we wanted to fertilize, then having three very good looking embryos to transfer seemed like a miracle. And it was. But I think it gave me hope that it was destined to work. And knowing that there were two little lives inside of me makes it all the more difficult. With IUI’s, if they don’t work you can assume that maybe nothing fertilized. But I KNEW life was in me and now it’s not and this makes the grieving process even greater. But I do have blessings from this cycle:

I have a normal FSH = 4.5
I have a normal antral follicle count
Lefty actually made the best follicles this cycle (go figure)
We can fertilize naturally
We can make pretty embryos (we just need one to stick)

Maybe I will respond better on another combination of drugs. I responded just fine on clomid with only 50 mg and always produced 2-3 large follicles.

So here is our plan for Operation Hammer Babies Take Two:

* Do acupuncture – I didn’t this time because I was doing chiropractics (don’t waste your time) and I think having done both needles are the way to go
* Ask that regardless of the count they should take them to day 5 – that way if they need to do emergency assisted hatching they can.
* Try a different cocktail of drugs
* Don’t let The Woman RE anywhere near me – just for my own personal sanity

And in the meantime Hammer and I are finally going to make it out to a RESOLVE meeting. They are having a speaker come talk about adoption next week. We have always kept adoption at the top of our list. Hammer, having had two older adopted siblings, and I have never stopped thinking about it. Originally we had talked about putting in paperwork for it at the same time as starting IVF but when we were praying over our next steps with our journey God told us to close that door for now. We have to admit that we were surprised but obeyed. But we would still love to learn more about the process and all the different options out there. We have begun to discuss a new “adoption option” but would like more time to pray about it together and go through at least one more IVF cycle beforehand.

I know that it sounds crazy to be talking like this when I haven’t even had my first beta yet but I just feel that I needed to let go of this cycle already and see what our future may hold.

P.S. - Oh and I didn’t test this morning; I ‘m just going to wait for the beta results from tomorrows blood work. I think it will be better for my mental health.

P.P.S - I just checked my email and was overwhelmed to tears will all the comments of support you have sent my way. Thank you ladies. No one else but you all can truly understand the pain of another BFN and your support means so much right now.

Nope

9dp3dt test = (-)

And we learned that our third little one didn't not make it to freeze :(

Odd Man Out

If hope were sitting in front of me right now I’d put my arm around her, look in the eyes, and tell her, “I told you so.” But it would fail to bring little comfort in being right. I don’t know why I felt compelled to test at 7dp3dt and again at 8dp3dt (11dpo) but I did. I think it might have been all the BFP happening around the blogosphere lately. That and I realized that my beta results that I will have done on Thursday would not be known until next week. Since I have to go to another lab now that we are post transfer due to insurance reasons there is a three day lag time in getting results and my RE’s RN is less than stellar in calling with blood work results. So I thought that it would be better to just find out on our own. That and I started to hope a little. Hammer came home from work on Friday with stories about his coworkers who did 3dt and now have kids. He filled my head with hope that just because I didn't feel anything did not mean that it didn't work. I even started talking about "when this works" at dinner on Saturday. I actually took a cheap CVS test Sunday morning and swore I saw a faint line, even took pictures and thought maybe this is the start of a BFP? I decided not to tell Hammer quite yet. Instead, I ran out and bought two packs of FR early tests yesterday afternoon so I would be well prepared. So this early this morning I couldn’t sleep and at 4:30 I woke up and had to pee so I thought, let's just get this over with. But three minutes later the loneliest bright pink line sat sadly on our bathroom counter. Not even a hint of a second line could be made out on the stark white back ground. I had been victim to an evaporation line on Sunday. I was wide awake at this point so I went downstairs on the treadmill for 30 minutes as running is usually the best place for me to sort out my emotions and I haven’t been doing any activity for the last two months. Shortly after 5 am I woke Hammer up and told him that I cheated and tested but that it had told me what I had already known, we were not pregnant, again. So far I have only shed one tear. I keep welling up but nothing falls. Someone commented that my negative feelings about this cycle could be a defense mechanism to protect myself. To a certain degree this was true but I also believe I knew on some level that life no longer existed in my womb.

So here I am again, the odd man out. Even my infertile blog friends are moving forward in their journeys. I am happy for you all, I truly am but it’s just hard to be left behind.

I still don’t know the outcome of our snow baby and will call today to find out but the likelihood that he met the same fate of his siblings is quite high. If a perfect 8 cell grade 1 and 6 cell grade 2 can’t make it in the comfort of my uterus what hope does a 6 cell grade 3 have in a petri dish?

I know that I still may be testing too early and that people have had BFN at 8/9 even 10dp3dt who then go on to have their BFP at 11/12/13dp3dt. I have three more FRER tests left that will get me to Thursday.

Story Time, Again

Well we're still waiting for our beta to get our results so I thought I'd tell another story of 'us' to pass the time. One of my favorite stories is how we got our furbaby Moses. In July of 2006, a good friend of ours had decided to adopt a dog from from a local shelter. I went on to the local shelter website to see a photo of her dog and ended up looking around. I found THE CUTEST photo of a little white fluff they called Moses. I was completely smitten. I immediately called Hammer and directed him to the website to see the dog. I begged him to go and see the dog but he was hesitant. Plus we were going out of town on Saturday and it would be 'foolish' to adopt a dog and then leave the next day. He said that if Moses was still available on Sunday that we MAY go by and see him. Well Sunday rolled around and I checked again on the website - it appeared that he was still available. I tried and tried to call but could not get through so I begged Hammer to just go there and see. I had the paperwork filled out and check book in hand when we arrived there but...Hammer said, "You realize we aren't getting a dog today." Whatever, we were so getting a dog. When we met Moses he was so pathetic behind the cage bars and he licked our hands and wanted to get out to play with us. We went back to the front desk to ask to 'meet' him but the lady said that he was on hold for another family. I was crushed. I literally cried the whole way home and for several hours after. The next day (Monday) I was supposed to go out of state for a business trip but I checked one more time on the website. He was still listed as pending. Why hadn't he been adopted yet? I asked Hammer to check to see if he was actually available just one more time since I would be on the road all day. It wasn't till about 4 pm that day when I heard back from him and he told me that Moses had been adopted. That was it. He failed to tell me, however, that it was HE who adopted him. I went the next four days thinking we had lost the dog to another family. I had been so sure he would be ours that I had even printed off the photo of the dog and showed it to my coworkers while we were gone. On Thursday my coworker dropped me off back home and as I headed into the house Hammer called me upstairs to the loft. Sitting on the floor was Hammer with MOSES! I started screaming with happiness and even ran back down stairs to stop my coworkers to celebrate with us. I have the best husband (and puppy too!)

Why 3dt's Stink

1. You essentially have a whole 2ww less 3 days. But it's still a 2ww. And it's long. And you have too much time on your hands to over analyze everything before getting confirmation. At least with a 5dt you only have 9 days to wait to learn if it worked or less even with all the early tests out there. And your little embies are already ready to implant the day after transfer. I have 11 days. 11 days! (What's that you are saying? Mrs. Hammer it's just two days less than everyone else? I know that but it's two digits instead of one and that makes it harder.)*

2. Embies at three days still have a long way to go before implantation. And my embies had to keep going for two more days before even reaching blastocyst stage which is where they are at for a 5dt. So much can go wrong. And you can read on the internet all about that. I know. I have. It's not good for me. Did you know that the majority of fertilized eggs stop dividing at morula stage on day 4. I do now and it's not helping.

3. People IRL who know you did IVF keep asking if I "feel pregnant" only two days after transfer. Well let's see, we can do the math: at 2 days post 3 day transfer it would only be a day 5 blastocyt and not even implanting yet - so no, I don't know yet. Would you ask your other friends who baby danced 5 days ago if they "feel pregnant?" No. It's the same thing. People who have no clue about IVF assume that once they stick the embryo in there *BAM* you're pregnant. They don't understand that once the doctors transfer those embies they have NO CONTROL over what happens next. And a LOT has to happen for it to work. That's why success rates are only 50%.

4. You do not know what is going on in there during critical stages so therefore if you have to do another round of IVF there is no way of knowing if you need assisted hatching next time or other embryonic procedures.

5. It means that you probably did not have enough embryos to freeze for a FET. Which means you have to go through the whole IVF process again if this cycle does not work. I was actually prepared for this one though because I was really worried none of the eggs would even fertilize. It still doesn't make it any easier.

6. Because you wait about the same amount of time it feels freakishly similar to every other non IVF cycle therefore making you remember all the past failed cycles. And after 3 years there are a LOT of failed cycles to recall.

*As you can see I have WAY to much time to think, rethink, analyze, and over analyze things, evidence, this post!

I'm now at 5dp3dt and I have had some cramping on days 3-5 (today) but some of my other symptoms have gone away i.e. sore bbs and indigestion. I've started to get fatigue but that can all be PIO as well or just the fact that it's been a long week. I hate to say it but I have a bad feeling they are gone. I don't think I'm going to POAS but instead wait for the beta. That way I just get a phone call rather than stare at one lonely little line, again. I don't mean to be Debb.ie Do.wner but it's just this 'feeling' inside that I'm 'empty.' I have not heard back about our last embie yet and maybe it will hold some answers for us if it ended up arresting. I did have my progesterone blood draw yesterday but it will take 24-72 hours before I get the results.

Story Time

I'm killing time waiting to see if our embies have made their home so I thought I'd pass the time with some stories. I did promise one way back so it's time to tell up: How Hammer got his nick name.

Hammer is not a name that I came up with for our blog. It's a name that was dubbed upon him back in freshman year of college on move in day. He was busy unpacking a box of items to put in his dorm room. It was a building made up of upper classman and freshman so there was the ever popular hazing of the freshmeat. Hammer was their prime target. One of the upper classman, wearing nothing but a towel, walked up to Hammer while he was on his knees unpacking. "Hey buddy, got a hammer?," he asked. Then, from behind, a guy runs up and yanks off the towel from around his waist. Hammer was standing face to um...yeah...Mr. winky. And the guy just says, "So how about that Hammer?" All he could do is yell at the guy to get out of his room. But the name Hammer stuck to this day.

1dp3dt

Well yesterday was a wonderful day. We transferred two little embies at about 9am and will let the third one continue to divide until Tuesday (day 5) when they will attempt to freeze our remaining embie. In the end we had:

1 @ 8 cells grade 1
1 @ 6 cells grade 2
1 @ 6 cells grade 3 - which is hopefully our snowbaby

It was quick and simple. I didn't have to do any prep and we laid there for only 15 minutes. We had Dr. W who was, again, awesome. And Hammer and I prayed together during our 15 minute wait time. After that we were back home. I've been pampered ever since. The guy freaks out when I get up to pee (but I'm allowed to pee!) I hope one or both decide to make their home. Dr. W said we have a high chance for twins but there is no way to know until it's over! I'm still not sure if I'm going to test before our beta #1 on the 23rd or not. I guess it will just depend on if I'm 'feeling' it. (And we are praying that I do). I go back to work on Tuesday when our embies will be at day 5 and hopefully ready to snuggle in. Oh this will be a long week!

Current Meds: 1/2 mL progesterone in oil (sesame) pm shot
Side Effects: fatigue, sore bbs, indigestion
Days Post Transfer: 1
# Eggs Transferred: 2
# Eggs Frozen: ?

"Beautiful" Day

It rained all day here. I could care less. Why? Because we got our call from the embryologist. All three are still thriving and in his own words look "beautiful." They should have at least 2 to 4 cells right now. Their rating scale is 1 to 5 with 1 being the best. Our embies...

4 cell grade 1
2 cell grade 1
2 cell grade 2

I could not believe it. Still can't. We are scheduled for transfer Sunday July 12 at 8:50 am.

We Broke the Yolk!

I'm still in shock but here is the report:

7 eggs retrieved

6 mature!!!!!!!!!!!!!!!!!

3 fertilized normally

Egg transfer is set for Sunday pending that we still have eggs by then (and I really pray we do!)

This was the part that I was most worried about. With Hammer's family history of super crappy sperm and questionable lab results we had no idea what we would be up against. I am just so thankful that any of them fertilized that I am shaking with happiness. This was the part I was afraid would go wrong (never did I expect that I wouldn't have enough follicles). But it has made me even more thankful for each step forward that we are taking in this process. I don't know how I'm ever going to focus on work now (yes I'm back to work today), or get through the next few days up until transfer.

Grow babies grow!!!!

Retrieval Update

First, thank you ladies for all your prayers and well wishes for today. I know that it made a difference because I was so calm and at peace all morning long.

Wednesday was such a long day because I was so anxious to just get to the retrieval. I felt bloated and from time to time would feel sharp pangs in my abdomen. I would have these fears that my follicles would ovulate early and I'd loose them. But then I realized that even if they did what could I do about it? Nothing. So I stopped worrying and just trusted God that it would be ok. Then all I had to focus on was the fact that my pants felt really tight and that I would catch some of my coworkers sneaking peeks at my stomach. Oh well.

Last night we went to my parents house as we would be staying over night to ensure that we would make it to the clinic on time. Because of construction going on it's nearly impossible to get across town in less than 45 minutes anymore. What a blessing that my parents live one exit away from our RE's clinic. It was so great to hang out with them and let them be a part of this process. My little brother even stayed the night because he wanted to do 'something' to support us. And on a side note: I slept great! Seriously. No nerves, nothing. Just slept like a baby and woke up refreshed.

At 8:45 am I downed the Xanax they had prescribed as an anti-anxiety med. I didn't think I needed it but because I didn't really know what lay ahead I took it anyway.

We arrived at the clinic at 9:30 am (right on time) to drop off Hammer's sample at the lab and then headed next door to the RE's office. According to the RN our room wasn't ready yet so she took us back in her office and administered the dilau.ded. Now I've noticed from reading several other IVF blogs that many women go under general anthesia or take an amnesiac drug so that they do not remember the retrieval. Our clinic does not do that but I have to say that it's really not that bad. I was awake for the whole procedure but was in a sort of pain free buzzing state. I spoke slower and a bit garbled only because dilau.ded makes your mouth so darn dry. I didn't even realize that Dr. S had administered two shots of anesthetic around my cervix. I got to watch the whole procedure on the u/s machine. I noticed that when he drained the larger follicles it felt less uncomfortable than when he drained the smaller ones. The most I felt was pressure and cramping but Hammer was there holding my hand the whole time. I'd never worked with Dr. S before but he seemed very nice and considerate. Afterward they had me lay there for about 30 minutes and then got me dressed and that was it. The RN came back in one more time to tell me that in total they had retrieved 7 eggs. I was a bit surprised by that number but apparently they got all four large follicles, the fifth smaller one had caught up to mature size by the time of the retrieval and there were two smaller ones. They drain all visible follicles just to be sure there isn't a good egg left behind but typically those do not contain mature eggs. There was a little bit of bleeding which I was warned will happen but that it was normal and should subside by the evening. I left still feeling dizzy and buzzing on my xanax/dilau.ded concoction when Hammer walked me out to the car at around 11:30 am.

I spent the rest of the afternoon in a recliner sipping on water and sprite. Now that the pain meds have worn off I just feel a bit crampy but nothing more. I'm relieved to have this part of the process over. They will call me tomorrow with the report of how many of the seven were mature and if any fertilized. This is the point where I expect to have issues. Like I've mentioned before I never thought we'd have trouble getting to retrieval so I was more prepared for fertilization issues. It still remains to be seen what God's plan is for this cycle.

I had my first progesterone shot tonight as well. They've prescribed 1/2mL IM. The recommendation to heat the injection site for 20 minutes pre shot and post shot worked wonders! Thank you cady and osuraj! Oh and Hammer did do an excellent job injecting it. I think I built that shot up so much in my head that I have to say it wasn't as bad as what I thought it would be. Of course, if this works I'm not so sure I'll be saying the same thing after 8 weeks of it. Then again it would also mean we were pregnant...

For now I'm just going to enjoy reaching this point. Hammer has picked up dinner from my favorite Mexican place, time to go eat!

Pre-Retrieval Day Ritual

5:30 am - wake up

5:35 am - take HPT to see if HCG is in my system, result: positive

6:30 am – call RN with results

8:00 am – take minocycline (to prevent infection from the retrieval)

12:00 am – take minocycline

4:00 am – take minocycline

8:00 am – take minocycline

12:00am – no more food or drink

*I can't believe we've made it this far...

And Then There Were...

Well you didn't think I just stick the dramatic conclusion right at the beginning did you? I’m going to milk this a bit.

Yesterday was difficult. I barely made it through the day and could hardly focus on work at all. My manager was so compassionate though and it was great to have her support and prayers. I got home just before Hammer did and spent some time in prayer outside as the weather was beautiful. When Hammer arrived home, the first thing he said was, “When is your appointment because I’m going to be there with you.” It was just what I needed to hear. I had been going to these last two appointment by myself because they were supposed to be standard here-are-all-your-follies-looks-great-now-let’s-trigger-type of appointments, which they weren’t. Then he made me dinner and told me just to relax. He is so awesome. Dr. W still wanted us to (in his own words), “be together” just in case I ovulated one or both of the larger follies last night. Not a problem. I really like my RE and his partner Dr. W and could not have been more thankful that I didn’t have to have The Woman again.

Today I didn’t feel ‘full’ or that same pressure in my abdomen that I’d been feeling the past few days. I knew that I had ovulated and that it was all over. I had so many questions. Would I still make a corpus lutem since I was on all these crazy meds? Or would I still have to take progesterone shots? What if I ovulated one follie but had others that were now mature, would I still trigger? Would I even stand a chance with IUI or natural this month considering our years of trying but never once being successful?

I left before Hammer so that I could be sure to make it to the lab on time. I had the radio on in the car and the Sanctus Real song “Whatever You’re Doing” came on that spoke so much to where I was at. Especially the last two choruses:

Whatever you're doing inside of me
It feels like chaos but I believe
You're up to something bigger than me
Larger than life something heavenly

Whatever you're doing inside of me
It feels like chaos but now I can see
This something bigger than me
Larger than life something heavenly
Something heavenly

I just started crying and telling God that I trusted Him no matter what the outcome and that someday we would see and His plan would be made clear to us. This song spoke so much to me while my dad was in the hospital and I reminded myself that my God is a God of miracles. That He saved my dad’s life and He has a plan for our family as well. I have a God of miracles.

When I went in for my lab draw I had the same two ladies from the day before. They remembered me and said how I must be close because I’m back two days in a row. I told that no, in fact I was back because things were not going well. The lady doing the blood draw grabbed a fertility god statue that was sitting on their windowsill and plopped it down on the arm of the blood draw chair. Then they started to rattle on about how they told this one couple that they should just get drunk and that we should do the same. They kept going on that Hammer should pick me up on the side of the road, go to a bar, get royally drunk and then screw. Then the older lady who was taking my insurance information told us to go on vacation, I replied that we tried that method and now we are here at the RE’s office. She then pushed and said, “Well go on a cruise then.” Guess what, we tried that too! And I told her that as well. As I was walking out the blood draw lady was rambling on about how she wished she had a magic wand to turn us all into pregnant women. I could not believe it. They do blood draws all morning long for my RE’s office and they are as insensitive about infertility as they come. I met up with Hammer and told him that we’ve been going about things all wrong and that apparently he needs to get drunk and treat me like a hooker while we’re on vacation. He laughed and then opened the door for me to the RE’s office. I guess I’m not getting picked up anytime soon.

At the RE’s we were led into our exam room. Dr. W came in again. He requested to follow up with us again today. I was so glad to see him. He examined the right ovary and we discovered that two of them grew yesterday to 19mm and 18mm. The other two grew to only 16mm and 14mm. Things were looking good so far. Then he scanned over to the left ovary. I could not believe it. There on the screen was the largest follicle I had ever seen – 23mm. It has stayed put. Not only did the large one remain but the other one had grown to 20mm. I had four follicles.

4 follicles!!!!

I still could not believe it. I had been so sure I had lost at least one of the follicles. My lining went from 9mm to 11.5mm which is the thickest it has ever been. We were told that was an excellent sign because that meant my E2 levels had gone up. If they were to come back less than the 888pg/mL that we had yesterday that would mean I was about to ovulate the larger follicles and we would still have to cancel even with reaching 4 mature follies. Plus my lining still looked grey on the u/s and apparently it turns white when ovulation occurs. Dr W. was all smiles and even gave us high fives (seriously, I love this doc). I started crying but this time it was tears of happiness. Hammer and I just hugged and cried alone in the exam room for a while, in shock that we were actually going to make it to the next step. Our retrieval is set for Thursday July 9.

I’m still a bit in shock even while I write this post but I am so thankful to even just have the chance to see if this cycle will work. Thank you God, for giving us the chance.

Whatever You're Doing - Sanctus Real

It's time for healing time to move on
It's time to fix what's been broken too long
Time make right what has been wrong
It's time to find my way to where I belong
There's a wave that's crashing over me
All I can do is surrender

Whatever you're doing inside of me
It feels like chaos somehow there's peace
It's hard to surrender to what I can't see
but I'm giving in to something heavenly

Time for a milestone
Time to begin again
Reevaluate who I really am
Am I doing everything to follow your will
or just climbing aimlessly over these hills
So show me what it is you want from me
I give everything I surrender...

To whatever you're doing inside of me
It feels like chaos somehow there's peace
It's hard to surrender to what I can't see
but I'm giving in to something heavenly

Time to face up
Clean this old house
Time to breathe in and let everything out
That I've wanted to say for so many years
Time to release all my held back tears

Whatever you're doing inside of me
It feels like chaos but I believe
You're up to something bigger than me
Larger than life something heavenly

Whatever you're doing inside of me
It feels like chaos but now I can see
This something bigger than me
Larger than life something heavenly
Something heavenly

It's time to face up
Clean this old house
Time breathe in and let everything out

Prayer Needed

We got bad news this morning at our u/s. I only have two follices that are above 18mm and they need three before they will do a retrieval.

L - 2
20 mm
18 mm

R - 4
14 mm x2
15 mm
13 mm

They may let me stim one more day to see if I can get another one to catch up but the risk is that one or both of the larger one's may 'take off' on it's own. Otherwise they will convert this into an IUI. We're heart broken. After five unsucessful IUI's it's hard to feel hopeful about a sixth. Either way we need much prayer and a miracle.

Update: 1:38 pm

I just got the call from the IVF RNs and they are going to let me go one more day. My E2 was 888pg/mL so they are hoping that a few more doses of Bravelle will get those last few follicles to reach the mature size. I go in tomorrow at 8am for my final blood draw and u/s. I will find out then if we are triggering for an IUI or IVF retrieval. Please pray for those smaller follicles to grow in time and for the two bigger ones to stay put for a bit longer.

Unsteady Ground

So to begin, I headed into the clinic this morning at 7:10 am to give myself more than 30 minutes to make it in to the lab for my appointment a 7:45 am. I found a better route from our area and it took only 20 minutes to get there. I was so excited that this could be an alternative to our freeway issue. Except that there was a big construction sign stating that on Monday July 6th the main road would be closed for construction. Drat! So plan A will remain in effect for egg retrieval where we will stay at my parents who live closer to the clinic.

The blood draw went well and then I walked over to the IF clinic for my ultrasound. I had a bad feeling that I would end up with "The Woman" RE today. And I did. She has no bedside manner. Seriously. She didn't even ask me to scoot down to the end of the table. Instead she put a condom on the u/s wand, lubed it up and stood there just waiting. Her technique is...painful and she didn't speak a single word to me as she checked out my girls. I had to ask, "Soooo do I have at least one follicle?" and her reply, "Yes, there's at least one." Ordinarily I would think it would be followed by an explanation from the RE about exactly how many she had found on each ovary, but not "The Woman." To catch you up on "The Woman" RE, when she did one of our IUI's her technique was so bad I nearly jumped off the table and then ended up bleeding for the next 5 days. Even if we had gotten pregnant that month I wouldn't have had a lining left for the embie to implant! My biggest fear is that she will be one of the RE's who does our retrieval or transfer and we have been praying against that from happening.

Back to the u/s, "The Woman" finished, grabbed my chart and was running out the door mumbling something about the ART nurses calling me. UNBELIEVABLE, she was just going to leave without telling me ANYTHING about my u/s??? It was like a bad one night stand* - wham-bam and running for the door without saying a word. I at least deserved something after our intimate encounter as she did just put a wand up my whoo-ha. So I stopped her by just firing away my questions at her and, let me tell you, it was like pulling teeth. Here is the summary after 5 days of stims:

6 follies total
4 follies on the right
2 follies on the left

Follie sizes
1-13mm
5- less than 10mm

Lining
6.5 mm (6-14 is ideal for implantation)

Six. I only have six. Don’t’ get me wrong, I’m glad its more than one but only six? I was surprised at this. I thought I would totally rock the stims and have an egg farm brewing in my belly. Right now, if I was an egg farmer I would have to file for chapter 11 bankruptcy. I walked out of there feeling deflated, disappointed and basically…blah.

I then had to go to work and spent the whole day with questions rolling around in my mind. What if this is because I messed up on my meds? What if I single handedly ruined our IVF cycle? What if I don’t’ make anymore follies? Will we have enough for a fresh cycle let alone a frozen? What if we don’t have any mature follies? What if our cycle gets cancelled? Could I just be over suppressed?

This last question is something that I’ve been thinking about since my first u/s on 6/24. I went back and listened to the message from the ART nurse again and confirmed that my E2 was below 7. They wanted me to be at least below 80 but I was below 7. Doesn't that sound extremely low? Aren’t I supposed to have SOME estrogen? Could I just be taking a while because I was basically starting from zero?

I didn’t have time to research this at work. I had to endure talking about pregnant ladies, babies, breastfeeding and hot flashes. Yes, hot flashes. I was in a meeting while three 45+ year old women that I work with were going on about how I just don’t understand what hot flashes are like but that someday I’d know. I said nothing but inside my head ran the following scenario where I just went off on them shouting,

“NEWS FLASH, I do know. I intentionally am giving myself hot flashes in a desperate attempt to try and get pregnant. And because of this I have to run off to appointments all the time which make you all speculate that I actually am pregnant and therefore you drop hints to me all the time to see if I’ll crack and break the “exciting news.” Well I’m cracking but not like you’d think because I’m infertile and all these appointments are so that we can do IVF, so there!”

*sigh* It was a long meeting and as you can probably tell it did nothing to help with my current mental state.

To make matters worse my cell phone battery died and I missed the call from the ART nurse regarding my blood work results and protocol changes. By the time I got to my car to plug in my phone it was past office hours. I did have a message from them regarding my E2 levels:

6/24 E2 = 7 pg/mL
7/2 E2 = 107 pg/mL

107???? Isn’t this too low for 5 days of stims? I instantly went into a spiral of sobbing. I thought I would be higher. I called Hammer who immediately left work to come home because I was inconsolable on the phone going on and on about how I was too old, my eggs were old, we were too late etc. It was pretty ugly. While I waited for him to arrive I called my mom who is a walking medical dictionary and knows just what to do to make things ‘all better.’ She was able to talk some sense into me. First that I was on too many drugs now to be rational and I needed to listen to Hammer and her, she was sooo right about that! And that I was jumping to conclusions since I couldn’t get in contact with my RE until tomorrow. I told her that they weren’t changing my protocol which I didn’t understand. Her, being the rational one, (I, not so much) thought was that it was likely because everything WAS fine and I was making assumptions.

I was basing my freak out on the following chart from the Advanced Fertility Clinic in Chicago, IL** (below) which shows that at day 5 I should be around 400-500 pg/mL.

“How is the monitoring of the IVF stimulation done?

We try to stimulate the woman to get at least 4 follicles with sizes of 14-20mm diameter. Ideally, there would be at least 8 follicles between 13-20 mm for IVF. The goal is to get a good number (about 8-15) of quality eggs. Blood hormone levels and developing follicle sizes are monitored. Ultrasound is used to measure the follicles. Estrogen hormone blood levels are important. Estrogen (actually estradiol) levels are usually under 60 pg/ml at cycle baseline and rise significantly as multiple follicles develop. Peak estradiol levels in IVF at the time of HCG are usually between 1000 and 4000 pg/ml. The stimulating process usually takes about 8-10 days.

Usually, it is not difficult to get enough follicles to develop. However, sometimes the response of the ovaries is poor and a low number of growing follicles are seen… The minimum number of follicles needed to proceed with IVF treatment depends on several factors, including follicle sizes, age of the woman, results of previous IVF stimulations and the willingness of the couple (and the doctor) to proceed with egg retrieval when there will be a low number of eggs obtained. In our experience, IVF success rates are very low with less than 3 mature follicles (18mm). Some IVF doctors will say that you should have at least 5 follicles of 14mm or greater while others might do the egg retrieval with only one follicle. Most IVF programs in the US want a minimum of about 3-4 mature (or close to mature) follicles. Women that are more likely to be low responders to ovarian stimulation would be those that have low antral follicle counts, those women who are older than about 37, women with elevated FSH levels, and women with other signs of reduced ovarian reserve.”

And this is why I became irrational. I was convinced I have reduced ovarian reserve and tail-spinned into a sob-fest. And while all these things I’ve worried about throughout day may come into being it is as my dad, who was listening on speaker phone, said, “None of this is in our control, it never was and it never will be. You just have to trust that God IS in control.” Aren’t dad’s great?

Now that I’ve calmed down a bit, eaten some chocolate and pizza (stress food), and spent some time praying I feel better. That and I’ve found some better information about where I should be at:

E2 Day 3 25-75 pg/mL
- my day 0 was less than 7 so I was probably still way below this at day 3

E2 Day 5 100 pg/mL or 2x day 3 levels
- so that means I’m actually right on track, I freaked out*** for nothing

E2 Surge day 200-600 pg/mL per 18mm (mature) follicle

My RE is giving the follies five more days to cook. So that means on the day I take my HCG trigger, if all my six eggs mature I should be at least 1,200 pg/mL. That’s a lot of ground to make up. But if your E2 levels are supposed to double every day after the day 5 check then I would be around 1,000 (107x2 = 214 x5 days = 1070 pg/ML so it’s possible.

And Hammer made a very good point that maybe we have only a small number of eggs because God was protecting us from having to make difficult decisions. We don’t want to be in the position where we have an ethical dilemma. When we talked and prayed about IVF we did feel that God had led us to go down this road. We also talked a lot about how many eggs we would fertilize. Since the first cycle has so many unknowns we agreed that we would not fertilize anymore eggs than we were willing to have children. We both felt extremely at peace with our decision to only fertilize seven eggs and freeze the rest. There was a lot of discussion about the probability game and that only doing seven could mean that we have few or no eggs in the end. But since the first cycle is a game of probability we would rather play it conservative until we know what we are dealing with as far as my egg making abilities and what his boys can do in the dish. We’ve had three years to save up for our baby and that has allowed us to have the means to do two full IVF cycles, drugs and all. We would rather pay more in the end than be in the position of having to decide which embryos we would use or not use. And since we both felt we couldn’t ‘get rid of’ or donate our embryos that could mean the purchase of a school bus in the future and my uterus just trembles at the thought of all those potential babies.

So our schedule will change a bit. Instead of Monday being our estimated egg retrieval day it will be another blood draw and ultrasound. So that means five more days of stims with the hope that we will trigger that night or the next day for a new estimated egg retrieval of Wednesday or Thursday.

Now all there is to do is pray and trust that God is still in control, always has been, and always will be.

_________________________________________________

*I've never had a one night stand but I watch movies and therefore assume this is similar to a one night stand, 'cause movies are like real life, right?

**This is not my IF clinic but a great resource I've used in the past on IVF cycles

***For those of you who thought I was ridiculously calm, you now have proof that I can freak out with the best of them.

Current Meds: Lupron 5 units, Bravelle 1 vial AM + 2 vials PM
Side Effects: burning and redness at injection site (Lupron only), moderate agitation, hot flashes, FATIGUE, headache
Follie Report: Day 5 = 6 follies (4R, 3L), 1x13mm and 5x less than 10mm
Days Post Transfer: 0
# Eggs Transferred: 0
# Eggs Frozen: 0

Um...Ow!

Today feels like it's dragging. In fact the whole week feels like it's dragging. I'm about to jump out of my skin with anticipation over what is going on in my tummy. Right now, it's pretty sore. That means something right? I feel like my ovaries are 'pulsing' and ready to jump out of my stomach. And the best part is it's only going to get worse. And now it leaves me with questions. Once my ovaries are full of eggs do they shrink back down to normal size or will they be big and saggy from here on out? Kind of like boo.bs after breastfeeding. And then if it works my poor uterus is in for it. Which I'm ok with but maybe I should have forewarned them about this. Seriously, they must be in there going, "hey, what the heck is happening to us?!?!" Ironically, I'd like to know the same thing.

Maybe I should bake them something to make up for it...

Aaaahhh, Cake Wrecks, they always seem to have the best cakes for the right occasion.

Current Meds: Lupron 5 units, Bravelle 1 vial AM + 2 vials PM
Side Effects: burning and redness at injection site (Lupron only), moderate agitation, hot flashes, FATIGUE, headache
Days Post Transfer: 0
# Eggs Transferred: 0
# Eggs Frozen: 0