Posts Tagged ‘IVF’

Petri Dish Pregnant-ish?

PetriDishI remember after I’d gotten married, how many of us who were over the hurdle of wedding planning would jump into ANY conversation we overheard from other people who were planning their own.  We’d found our way through battles of chicken or fish, and we’d managed to find a safe seating chart where our divorced aunts and uncles weren’t forced to sit within each other’s eyeline.  We were vets basically, and could solve whatever little issue the newly fianceed would possibly face. (whether they wanted our advice or not)

Infertility feels like it should fit in that vein, but it is not one of those situations for me.

I don’t believe, outside of just continuing to encourage people, that I’ll feel like much of an expert after this.  It has moved so fast and so…seamlessly, that it freaks me out a bit.  Like I’ve said before, I’m so used to this NOT moving smoothly, that the idea that it has, is uncomfortable for me to say the least.  Every phone call, I’ve expected or at least prepared myself for bad or disappointing news.  Every visit, I’ve been expecting my blood pressure to be high, or my uterus to have decided suddenly that she’s had enough and would like a divorce.  Every time, they say, “Nope, everything looks great!” or they give me instructions for the next step.

I’m constantly wondering why then, if this is all so simple now, was it so horribly NOT simple before.  The only answer I can surmise is that it’s simple now, because now is the time.

So Thursday was our egg retrieval.  To prepare for that procedure, you have to take what is called an HCG Trigger shot about 36 hours before.  So remember when I said I had to take Ganirelix, the medicine that tells your ovaries to tighten their grip on those eggs?  Well, the HCG shot is what tells them, “It’s cool now, I got it, go ahead and let em go.”

The problem with the trigger shot?  It has to be taken at PRECISELY the time they tell you. And of course, on the day I receive mine, I’m scheduled to work until closing.  Because of course.

In a sheer stroke of ingenuity and spinning plates, I found myself asking someone to man my desk at work for ten minutes while I ran out to my car, had my husband drive us around to a side-street off the path and give me a shot from the front seat of the car while I sat in the back.  I am absolutely CERTAIN that anyone who just happened to have the misfortune of laying eyes on our ridiculous ordeal believed wholeheartedly that their friendly, neighborhood librarian was on the side of the alley shooting heroine.  I’m convinced there are rumors.  I’m certain I don’t care.

giphy (2)

The next day, nothing really felt much different, and I was convinced that we’d done it wrong and the whole cycle would be cancelled.  Because that’s how my brain deals with things not being chaotic.  My husband rolled his eyes at me, and proceeded to plan for the retrieval as though I was speaking gibberish.  He’s smart like that.

Thursday morning, we flew down the highway to office, and things moved really fast from there.  A really nice anesthesiologist gave me some really nice happy juice through an IV, and a really nice nurse came in to talk me through everything that was about to happen.  My doctor sat with me for a sec just to explain why the timeline had moved when it did.  My body, as predicted, had gotten seriously excited about the meds and was very close to hyperstimulating.  For my safety, and to save the cycle, it was best to move now.

Egg Retrieval Day

The face of someone who could use a nap, and is waiting for the IV to provide one.

So what is involved in egg retrieval?

The procedure involves using a needle to extract the eggs directly from the follicles.  Yes, ANOTHER needle.  Hence, the need for light anesthesia.  You aren’t completely asleep, or at least I wasn’t, but you’re out of it enough to not freak out about that.  Overall, I think most of mine was spent yammering on about whatever came to my brain. Nervous tick.

On the way out of the room, and back to recovery, my doc stopped my chair and showed me the lab techs already at work cleaning and counting the eggs.  I told her, “You do realize the blogger in me wants to take a picture of this whole situation, right?”  She said, “I know,…but no.” LOL

Back in recovery, or just across the hall, I was finally allowed to have something to eat and drink.  The most delicious saltine crackers and apple juice I may ever have, to be exact.  And then, I was allowed to just chill for a bit and get my bearings while the nurse came in to talk to me about what was going to happen next. Basically, once those eggs are extracted from the follicles, the follicles tend to fill back up with liquid.  This is what causes much of the discomfort people feel after retrieval.

While I don’t really make much of a fuss about discomfort or even pain sometimes, I have to admit that it isn’t the most comfortable of feelings to basically have saddlebags inside of your hips filling with fluid. And that’s generally what’s going on in there, I’ve decided.  Also, I’d suggest getting your hair done sometime before this.  You feel really yucky and hideous, but if you can look in the mirror and say, “Oh, but no, my hair is laid.”, it helps. I promise.

Once the techs have counted and cleaned the eggs, they immediately collect the sperm as well so as to move forward with fertilization.  It still amazes me, that people get pregnant unexpectedly, when I look at all of this really intense biological precision.

Anywhoo, our final egg count at the end of the day….TWENTY.  The average?  Eight.

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Come on, overachieving ovaries!

Now, after retrieval, most people are highly uncomfortable.  You should really go home and lie down if possible.  So of course I instead went to the Goodwill for a few minutes, and then went to look at an apartment that we’re interested in.  Because I’m hardheaded.

Fast forward to the next morning.

Do you ever get annoyed at your phone ringing because it isn’t who you’re expecting to call? That was my Friday.  It just kept on ringing, and none of the numbers belonged to my doctor OR her office.  I told you, I tend to expect the worst, (I’m working on it), so I was curious about whether any had fertilized at all, let alone if anything had gone wrong overnight.

Finally, a little after 2, my phone rang with the right numbers.

Call #1, was the lab, to process payment on that embryo storage fee.  They’re serious about that. Thank you to EVERYONE who has bought a shirt from our shop, or attended our fun-raisers. You helped pay them!

But call #2, was finally my doctor, to let me know how things were looking.

In the follow-up call, we talked a bit about just what has been the problem all these years, and it was explained in what I have to say is the best way I’ve ever had it explained.  Looking at the full picture now, she was able to see CLEARLY what had been our issues.

Basically, my PCOS and Hypothyroid have been BFF’s for years.  Together, they decided that they ain’t have no time for no stupid ovulation.  Add to that a pair of blocked tubes and what you have is great eggs, that have been all dressed up with nowhere to go, for decades. Then, on my husband’s side, you have diabetes and a childhood hernia surgery that made breaking through all my barriers basically impossible.  IVF was and is the only route to getting around our unique and numerous hurdles.  Through ICSI (Intra-cytoplasmic sperm injection), the magicians of the lab were able to further get around the foolishness of our bodies by taking one individual sperm and implanting it directly into one individual egg.

So,  what’s the final count?

Of the 20 eggs collected, only about 13 of them were mature.  This is fine.  Again, remember the average is eight.  Of that 13, one presented with an extra set of DNA and was therefore abnormal.  Also fine and common.  Of those 12 left, NINE fertilized and were growing as of the next day.  She said, “everything looks PERFECT. IVF was the only way we were going to get around this stuff and it worked.”

So, those nine are being housed in what is called a MINC Incubator. Now, according to the manufacturer of the incubator’s website, (Yes, I looked it up, because I am a librarian and a thug), the MINC is described as such: “the MINC holds a constant temperature, provides rapid pH recovery and helps the embryo maintain homeostasis to reduce embryonic stress.” All of that to say, this thing is a pretty big deal and the BEST possible place for them to be.

In traditional IVF, this is where my doctor would let us know if she wanted to let them grow for 3 days or 5, and when the transfer would be.  However, a TON of research has suggested that a better route is to get to day 3 or 5 and then freeze the embryos.  Freezing them, allows for the woman’s body to take a little time to decompress from all those medications and stresses of the stim phase.  It will allow for my ovaries to calm down, and my body to get back to pre-meds status.  As my nurse described it, “it took two weeks to get up, now you take two weeks to get yourself back down”.  After that time has passed, then we’ll move to the transfer. (and then wait another painfully slow two weeks to see if any of this worked).

So we’re giving those little guys a five day, all expenses paid (by the sheer grace of God), vacation in the MINC.  On Tuesday, we’ll find out how many of the 9 have continued to grow and will be frozen.  Also on Tuesday, we’ll decide a transfer date.

And that, my friends, is how you work around a lazy Stork and get pregnant in 9 petri-dishes…kinda.

Next up…seeing if any of this works.

So Check This Out…

Check This Out

Music I’ve heard at the fertility center while preparing for ultrasounds so far:

So what’s going on?

I’m quiet.

I find that I’m walking (pardon the pun) on eggshells as I move through the stims phase of our IVF cycle.  Everything began to move so very fast, and my feelings are so very, very terse.  Although most of us know that our infertility and our treatment successes and/or failures have very little to do with anything we do or don’t do, it’s hard to not still feel like you need to talk softly so as not to make the cake fall.

My normally buoyant social media profile is languishing in the water.  My IM’s and emails are taking much longer to reply to, and even if you are literally sitting a foot from me, I may not reply to you immediately, as my mind is perpetually elsewhere.  I don’t mean any harm,…I’m just…quiet.

Basically, my nerves is bad.  (yes, IS bad.)

We are well into our stims at this point.  Today marking day 10 of Follistim and Day 3 of Ganirelix.  If this is your first intro to those two words, allow me to explain them, and also point out that you could be getting your information from a much better source than me, I’m positive.

Anywho, Follistim is basically what it says in its name, a Follicle Stimulating drug.  Follicles, are basically where eggs grow.  Eggs are far too tiny to be seen on ultrasound, so it’s by measuring and counting the follicles, that doctors can see how many eggs you might be able to retrieve.  For some people, Follistim is a quick shot in the tummy every night.  For me, it’s a quick shot, but instead of the tummy, it’s in the spot behind my hip and just above my bum with a really large needle that I try not to look at much.

I was really nervous about that shot when the meds arrived and I saw the needle length. Now, I’m glad to say that while it is unpleasant, it is not as unbearable and terrifying as it once was.  If you have to take intramuscular shots for your cycle, here’s my tips on that:

  1. I recommend you take a look at this video of the amazing Nurse Linda from Sher Fertility, as she explains how to find the sweet spot.
  2. Get a distraction and don’t look down.  These shots, I’ve decided, are not my business.  My job is to be as oblivious as possible, so as not to do a whole lot of jumping around as I know I would.  Look, a few years back, I asked my husband to check my sugar with his PAIN FREE glucose meter, and acted such a clown, for a tiny finger prick, that we eventually gave up.  When I was a kid, I acted so completely ridiculous at the dentist that the office PUT ME OUT and told my mother never to bring me back.  When I was like 4, I was known to walk into the doctor’s office and TELL the nurse or doctor from the jump, that they were NOT to administer any shots to me that day, and that if they had a problem they could jump in the lake. Basically, I know my limits as a patient where the possibility of pain is concerned. For that reason, every night as we prepare for this shot, I grab my Ipad, turn to something funny (First it was Parks & Rec, and now it’s Bob’s Burgers), and I zone out.  When he moves in with the alcohol swab, I hum really loudly, but that’s about as far as I go.  We don’t do any count downs, and he doesn’t ask me if I’m ready, because then I’ll just over-think about when the hammer is coming down.  We have a silent agreement that once the Netflix starts, I’m not conscious.
  3. Walk it off.  Follistim stings in the few seconds after it’s been administered.  A slow and steady afterburn that is kind of just to piss you off.  It also causes a bit of bloating as the follicles begin to grow, and I have to admit that it isn’t the most comfortable of feelings.  To combat this, we’ve begun going for a short walk every night.  Nothing dramatic or overly strenuous, but enough of a fresh air distraction, that I can focus on being outside and in the air, before I begin feeling annoyed or sad, or frustrated, or any other emotional side effect of the meds.  If you don’t feel like actually walking, find something that will make you feel better.  A nice bathtime, or a good book, or if you’re anything like me, a few rounds on the video game.

Ganirelix, is a gonadotropin-releasing hormone antagonist.  In human language, that means it tells my body not to drop those eggs until it’s told to.  It says, “hey, I see you’re holding a few dozen cartons there, can you do me a favor and not drop them until I’ve had a chance to finish preparing everything?”.

It happens to be a subcutaneous shot, the tummy one, and I do this one myself.  I know, I know, “how is it that you can do that one yourself, but you freak out about the other one?”. I wish I had an answer for that.  Basically, the truth of the matter is that it’s a huge difference in needle size.  Also, I believe that the thing most of us have about shots, is mental and visual.  Ganirelix comes already put together.  When you open the box, the medicine is already in the needle and you basically just open it and push it.  Not having to see a huge needle draw up a huge amount of medicine from a vial, and watch it all be put together elaborately, does wonders for not giving you enough time to freak out.

So, is it working or not?

Welp, on the first follow-up after starting the stims, there was only one measurable follicle. Nothing much seemed to be happening, and I could tell that my nurse was curious as to why that was.   With PCOS, there’s such a chance of hyperstimulation (too many follicles, too fast), that I think we were all expecting some massive turnover.  But she assured me that it was a good thing, and told us to come back in a couple days.

Two days later, on the next visit, this past Saturday, we had jumped to 10.  5 measurable follicles on the left, and 5 on the right.  She lowered my dosage because my body had apparently said, “Challenge, accepted”.

As of this morning…I don’t have a count.  Because there were that many.  Good Grief

So, guess who’s making another hour drive tomorrow morning before work?  And then again on Wednesday?  You guessed it, ME.

And guess who doesn’t care?

ME.  giphy (2)

I will drive those 60 minutes for a 15 minute appointment.  I will refill that gasoline tank.  I will call into work apologetically if I cut it too close.  I will do whatever I am asked to do. Because I worked too hard to get here.

 

 

Getting to Go Time.

My mom always says, “You have to have yourself in order, even if nothing is moving forward, because when God finally says “Go”, it’s gonna move SO fast, you have to be ready.”   She’s right, you know.

So following my initial appointment, where we found the dreaded polyp, I was scheduled for yet another polypectomy and hysteroscopy.  Big whoop.

Cue panic #1

When the nurse called to pre-register me for surgery, he let me know that the hospital where the surgery was scheduled, does not typically accept my insurance, and that I should check in with them again in two days to make sure that I didn’t have a bill.  I freaked out EXTENSIVELY (and internally) as I waited the couple days before I could call the office and ask.  When I finally got in touch, they assured me that all was covered. giphy (1)

Having had this surgery previously, I was expecting more of the same.  But my doctor came to my room to greet us.  She hung out with us for a few minutes, explained the procedure and talked with my mom for a good while.  She even apologized that I’d had to get up so early to make it to the hospital.  She stopped in to see me two more times that day, and walked alongside my bed to the OR, just chatting away.

Have I mentioned how much I love her? I think I have, but I’ll say it again: I LOVE HER.

So, last week, I went into the office for my follow-up. I was prepared for a repeat of the stalled out meeting I had following the last procedure with my previous clinic.  You know, the one where they lay out all the things that don’t work, and how much delay we can expect?  As hopeful as I’ve been trying to be, I’m also cautious, having been at the starting line more times than I can count, and STILL never taking off.

So imagine my surprise, when my nurse proceeded to move along to baseline testing and ultrasounds. giphyWhile drawing my blood she said, “So did you get your meds yet?”  I didn’t even try to hide my confusion.  “I sent in the order for your meds and you should have them by Friday because your protocol will start Saturday.”  Here’s some perspective,…this was Thursday morning.

I went into my ultrasound, still reeling from that little bit of info.  They were a little wary of my notoriously ridiculous uterine lining, but said it wasn’t a huge issue and that most importantly, I was polyp free!  From there, we sat in an injection walk-through and a layout of our drug protocol.

Let me remind you, when I came into the office, I was expecting to just hear about my polypectomy, and find out what was the next thing for us to wait on.  At this stage in the game previously, we were again at “hurry up and wait”. We were extremely unprepared for the amount of information that was being hurled at us.

We left the office, called the insurance regarding the meds, and were told to await a call from the pharmacy.

Cue panic #2

When the pharmacy called to confirm the meds order, they ended the phone call by saying, “We’ll call you back with your final bill.”  I freaked out.   Everything had been going so fast and so well, that here was where the hammer was going to come down.  They were going to call me back with an astronomical cost that my t-shirt sales and fundraising events weren’t going to be able to cover.

The pharmacist called back.  She said, “We just need a credit card to cover your final balance on your meds.  The total is $5.85.”

I asked her to repeat herself.  I thought I’d heard $585″.

She laughed and said, “$5.85.  Your insurance covered everything except for an antibiotic.” Remember how I was freaking out because my insurance had changed?  Turns out, it was for my good.  

giphy

In 24 hours,…this was in our front hallway:

IMAG5953 In 20 minutes, this was in our apartment, along with the giant cooler of follistim cartridges that was also packed in the huge box:Untitled

 

When I talked to my aunt, to fill her in on the meds being PAID FOR and DELIVERED,…she said, and I quote:

“They not playing around.  You are.”

She’s right too, you know?

When you get used to being slowed around and pushed back, it can be easy to fall into routine.  We have had so many stops and starts.  Job changes, insurance changes, new diagnoses, extra issues, dosage changes, and a few mind-calming breaks in between. Every, single, time that I have gotten really excited about this, or even when I put this aside completely, and stepped out on faith for adoption, things have consistently found a way to grind their way down to a standstill.

There have been times where I couldn’t even bear to visit my own site, because it seemed like a glaring reminder of failure and the most excruciatingly slow timeline. People have asked me if I was afraid of getting pregnant, or if I was choosing not to move forward, because they couldn’t comprehend just what was taking so long.  Most of these stalls and setbacks were so unbelievable that even explaining them sometimes, made people look at me like,

But as discouraging as it’s been, and as long as it’s taken, and whatever other dramatic culmination I could use right now…

TODAY, is stim day 3.

And we are officially in an IVF cycle.

And regardless of the 1 1/2 inch needle that delivers these meds intramuscularly.

And not getting focused on the money we still have to spend on embryo storage, etc.,

Whatever else happens on this journey, for just getting HERE, to this exact moment of this exact thing,

THANK YOU LORD.

1st Peter 5  10

Sh*t Just Got Real

Ladies, (and the ever-elusive gentlemen), we have a verdict.

The jury was out for a good, long while, but within 45 minutes, the final decision was finally made.

BOTH of my tubes are completely blocked.

There is a weight on that sentence that has been rolling around on my tongue for a while.  But before I get into that, let me break down how I got this long-awaited answer.   Things started with an HSG test.

My appointment was at 9am, and I was actually taken back sometime around 9:30.  After undressing from the waist down, I was led to the x-ray room by a very nice nurse named Tammy.   Prior to getting things started, Tammy had me sit down so that we could discuss each thing that was going to take place.

First, she asked if I’d taken any pain relievers prior to coming to the appointment, which I hadn’t.  She then double-checked to make sure that they had been recommended by my doctor.  They had. I have a pretty high pain threshold in my opinion, and couldn’t see how two tylenol an hour beforehand were going to make much difference, so I didn’t take any.  After those preliminaries, it was time to break down the procedure itself.

My doctor, Doctor C., would be called down to the room to insert a catheter, Tammy would remain at my head to keep me calm and explain what was happening, and a radiologist would be called in to perform the x-ray itself.   Through the catheter, my doctor would use a syringe to push dye directly into my uterus, while the radiologist simultaneously photographed the process with the x-ray machine.  Done correctly and without complication, we all would be able to see the dye travel through my uterus and tubes by way of the monitor placed beside the exam table.  She asked if I had any questions.  I didn’t.  Then it was time to sit on the table and wait for the doc.

My doctor came down, as explained, asked me if I was comfortable, and went over the details again.  Then it was time for the catheter.  Okay, now I have a pretty high pain threshold, like I said, but this was very uncomfortable for me.  It didn’t “hurt”, but it was extremely jolting.  There is a precise feeling of someone pushing or pulling on a tender part of your skin, but it feels somewhat worse because it’s internal.  I was pretty cool I think, but according to Tammy, I was definitely tensing up, so she sat beside me and talked me through a few calming breaths.  I stared up at the arm of the x-ray machine, where there was a sticker that read: “7/2”.  I focused on that sticker because it is actually my wedding anniversary.  I found this, combined with the “breathing exercises” to be maddeningly ironic, considering the situation, but I shook it off.

Once the catheter was fully in, I couldn’t feel any other discomfort.  I forgot it was there actually.  In about three minutes, the radiologist was there and turning on the machine.   Tammy moved the monitor closer so that I could see.  Lights, cameras, action!

Only, there was no action. LOL

I watched the screen, I felt Doctor C. push the syringe harder, and none of us saw a damn thing.  My lady bits basically flipped us all the bird.  I remember vividly that there was one moment when Doctor C. said, “I really can’t push any more.  I think they’re both blocked.”

And that’s when shit got real.

I don’t know.  The picture in my head was of the dye showing up brightly on that monitor, and of my leaving there with a new script for Clomid.  I fully intended on beating this thing with the most minimally invasive procedures as possible.

Instead, she walked to the head of the bed and told me flat-out that I would need to call the RE, and that the most viable option for me would have to be IVF.  She put a hand on my shoulder and said, “You did what you said that you wanted to do. You went as far as WE could.  This test, was that last thing that WE could do.  Now, you go further.  Call the doctor I told you about.  She’s a great person, who is very honest and personable.  This is fixable.”

And I don’t really remember much after that.  I mean, it isn’t that this wasn’t frustrating or painful before.  It was.  But somehow this felt more devastating.  There’s something very definitive about the moment you’re told that this thing you didn’t want to do, this path you were avoiding, is the ONLY way to your goal.

Bring me the slippers of the Wicked Witch of The West!

I do remember some things.

I remember getting dressed.

I remember telling my mom, who was in the waiting room.

I remember her taking me to breakfast, and asking gentle questions about what to do next, and sitting there for almost two hours.

I remember her taking me shopping.

I remember holding on to my facade for hours.

I remember watching every mother I encountered, even when I told myself not to.

Mostly, I remember feeling really confused and shitty.

I also remember feeling like I “had” to be positive.

I remember thinking to myself that I didn’t want anyone “worried”, “concerned”, “feeling sorry for”, or “uncomfortable about” me.

So I just shut it off.

I was about to think of the finances.  But I shut that off.

I was about to think of the frustration.  But I shut that off too.

I just, completed the day.

Fill in the bubbles completely on this standardized test.  If you don’t know the answer, after using your study and test-taking skills, make your very best educated guess.  

And that’s what I did.

And that’s what I’m still doing.

There’s a plan in here.  I always have one.  But at the moment, it’s tightly buried beneath my anger and frustration.  I’ll pull it out in a bit.  But at the moment, I’m frantically filling in these blank test bubbles.

Whatever