Sunday, February 26, 2012

IVF leads to Bun in the Oven!

Friday was the last day of my two week wait so I went in for blood work at 7:00am to see if I was pregnant. At 12:19 I got the call and I felt like I breathed for the first time since November.

It was positive!
Thank god!

Now I know this is just the first hurdle in a series of hurdles and I still have to keep mum for the most part until May, but what I relief! Of course I called my mom right away and then Gina, one of the few friends who has been in the loop and absolutely fabulous throughout this entire debacle. Others in-the-know got texts and sent congratulatory responses, but it is still a small group for obvious reasons.

After all of this I realized I didn't ask any of the appropriate questions one should ask after receiving such news, so I had to call Jen back and get the rest of the important information. Apparently this happens all the time so she was ready for my call back.

I go back tomorrow morning for blood work and continue the progesterone shots (woot! woot!) until further notice. According to the calendar we were given in Medication Class, shots last 25 days from the retrieval date. This said, March 6th could be my last day of shots. Fingers crossed.

I still wear St. Jerome for good measure and, even though I got the okay to go to the gym, I am keeping things light because I'm paranoid. It's not too much of a challenge though since I am, or at least I feel, super out of shape so after 35 minutes on the stationary bike I am embarrassingly tired.

Either way, YAY!!!!!!!!!!

Thursday, February 23, 2012

DIE in Diet

For the first time in my life I actually have to watch what I eat and I hate it. I love the gym. I'm not psycho about it, I'm not a fanatic, a junkie, or a gym rat but I love the feeling I get when I'm done. I love sweating. I love endorphins. But more than that, I love knowing that if I want seconds or to sneak a dessert, I can because I earned it.

For the past month or so, I have either been too bloated, too uncomfortable, or too nervous to do any of that. Before the retrieval, my belly was crazy bloated it felt like I was already pregnant or had a 10 pound weight strapped around my mid-section. After the retrieval and several days after the transfer, I had that same feeling, plus soreness, cramping, and the inability to fit into anything I owned. Now I feel really good (hopefully not too good) and want to get back into my old routine. Today was a BEAUTIFUL day so I took the opportunity to walk all over my town and not only did I feel very "green" but I felt good about it. It was kind of a tease because I saw all the runners out there and had the urge to pick up my pace, but restrained for the good of cell development.

If all goes well tomorrow, I got the "ok" to resume certain activities - yoga, stationary bike, walking, etc. I have to avoid "pounding activities" such as running or jump rope, so I got a kettlebell DVD, 4 sessions with a personal trainer via Groupon, and DJ and I got a heavy bag for boxing :) . As long as I am protecting my abdomen, life is good. All of the above activities have also been Googled to assure they are good for pregnant women - assuming I become one of them :)

But for now I just start longingly as my husband snacks on anything available after dinner, turn down that extra helping, and drink water so I can fake myself into being full - until I pee - then the jig is up.

Monday, February 20, 2012

2 Week Wait

I am 4 days away from my pregnancy test. It will be the final day in the longest two weeks of my life.

My bloating FINALLY went down on Friday. My stomach wasn't 100% back to normal, but I was actually comfortable going out in public to meet friends for dinner. I was smart to have saved some of the pants I had prior to my pre-wedding weight loss because they came in handy this weekend. I was actually getting tired of wearing sweat pants and, for those who know me, that is actually quite shocking. Either way, it was nice to have a reason to get dressed, blow dry my hair, and put on make up.

Friday I also got a call from the nurse confirming everything was okay with that morning's blood work and to continue with the nightly progesterone shots. She also told me 4 embryos were frozen. This is great news but also amazing that I dropped from 20 retrieved eggs, to 18 fertilized, to 8 on Day 3 transfer, to 4 for freezing. I feel very fortunate because I know there are a lot of women who can only produce 7 or so eggs for retrieval. You can do the math from there.
Other good news is I don't have the "bad symptoms" which include shortness of breath, vomiting, and nausea.

I also realized that I haven't worked out in almost a month. A MONTH! As you can imagine this has also been a challenge since I love it. I miss sweating, and getting my heart beating, and pushing through that last mile. When I see runners in this amazing February weather on the streets, I sigh and long to lace up my sneakers and join them. Once I get feedback on Friday, I will be able to start working it back into my life and I am so looking forward to it.

Today I still have a little pooch, but am back in my regular pants. I feel good though I am still preparing for the worst and hoping for the best. And I have been wearing my St. Jerome pin every day :)
When you are home-ridden, you make very long scarves

Tuesday, February 14, 2012

Where do Babies come From?

When a man and a woman love each other very, very much....
They go to the hospital and Mommy has eggs retrieved from her ovaries and three days later a fertilized embryo is placed back in her uterus. Hopefully this leads to a baby!

Yesterday was my transfer. I was so nervous!
This website has a cool video of what actually happens: http://www.advancedfertility.com/embryotransfer.htm
My favorite part is the narrator saying "that should do the trick" at the end.
Your bladder has to be full for the procedure, so I am sitting in the waiting room for over an hour about to burst! I had a "Day 3 Embryo Transfer" with means it is performed 72 hours after egg retrieval (Brilliant!). Sometimes if there is concern about the development of your eggs, you will wait for Day 5. This is called Blastocyst transfer. Some fertility specialists prefer doing blastocyst transfers because it is easier to choose a healthy embryo for transfer at this stage.
The best embryo candidates for transfer are between 6 and 8 cells and I was lucky enough to have a "beautiful" 8 cell embryo to transfer. They even give you a picture of the little guy to take home. I am still on the fence as to whether I like this idea or not. Even though it is just a small cluster of cells, it evokes a lot of emotion and you have to remain positive but cautious.

The procedure itself is very quick. It's only uncomfortable because I was still bloated from the retrieval and I had to pee, but once it gets started its amazingly quick! and you are surrounded by such wonderful and positive ladies, if it weren't for the stirrups, it could be described as enjoyable.

You also get an embryo report card.
Of the 20 cells that were retrieved, 18 were fertilized, and 8 lived until Day 3. We will get a call tomorrow to see how many of the remaining 7 live until Day 5. Those are the embryos that can be frozen for future pregnancies.
If, for some reason, none of those 7 are transferable and I need IVF for another baby - we would have to start the process all over again. But we aren't even going to think about that!
I'm not on bed rest but I am on "limited activity rest". Today grocery shopping was the highlight of my day since I got to walk around a little and get out of the house.
Its small, but that's an 8-cell embryo

This Friday I will go back for blood work and an ultrasound and then the following week I take a pregnancy test. Longest.Ten Days. Ever.

PS. Progesterone shots suck!

Monday, February 13, 2012

I'll Sleep when I'm Dead

As with anything - cold symptoms, melancholy, cramps - everything is usually worse at night. The same goes for the bloating that comes after a retrieval. I start off sleeping sitting, then like a corpse on my back, then I try my sides but that hurts, and then I have to get up to pee and start all over again.

My ultrasound yesterday indicated that my ovaries were hyperstimulated. This means my ovaries are still larger than normal, tender and fragile. There is also a high level of estrogen (E2) and progesterone in the bloodstream is upsetting my digestive system and fluid balance causing bloating. In a nutshell, I feel like a fat mess. Ironically I haven't eaten very much at all. This morning was the first time since Friday that my stomach growled.
The black spots are the follicles inside the ovaries - this picture appears
to show 13, but that's a guess.


This means my transfer will either be today (Monday) or Wednesday. I am supposed to be on call both days. Now, I am VERY fortunate to work from home as needed but this is getting a little out of control. Its hard for me to make commitments, keep meetings, and not be shady. What if I was a teacher or a nurse and didn't have such flexibility? Its currently 8:54 am and I am still waiting for my instructions for the date.

The old Elizabeth would get off her butt and go to the gym to be proactive about the fat mess, but the new IVF Elizabeth is stuck on the couch (doctor's orders) and is probably suffering the early stages of depression. There was a nervous breakdown in the bathroom yesterday when all my aches and pains came to a head. It was probably a pathetic scene but the frustration of not being able to move comfortably and happily is in describable. The worst is, unlike a flu, my head, chest, sinuses are fine so I don't have the sick lazy feeling. I'm just bored and antsy. And the weird thing is as much as I want to go out and do stuff, I am so gross and lethargic that getting the energy to do it is exhausting. Its gotten to a point that I forget to shower because I can't go anywhere. I know that's gross, but when you wake up every morning with no plan, just a balloon in your guy you lose motivation.

As I said way back in November, I was allowed one day of wallowing which I used already so I decided to get a craft. I started to make a scarf. My first attempts were pretty bad and what I have now isn't awesome, but at least I have a purpose.

Saturday, February 11, 2012

Update!

Just got a call from St. B's with my fertilization results. 20 eggs were retrieved (I blame the drugs for mishearing this nurse) and 18 fertilized!!! That's 90% success as opposed to the 50% average fertilization.

Below is a good article about retrieval and the "ideal" number of eggs one should have for a successful, live birth. If you look at the chart, I fall into the "highest success" group as a woman under 35 with good eggs for embryos (Yay!).
 http://health.usnews.com/health-news/family-health/womens-health/articles/2011/05/11/number-of-eggs-retrieved-helps-predict-ivf-success-study

IVF success rates by number of eggs and age


Egg quality for transfer is measured by your age, your ovarian reserve which is your overall egg quantity, your menstrual cycle (this includes length, spotting, and hormones), outcomes of previous IVF cycles, if applicable, and the results of the Preimplantation Genetic Screening (PGS) aka Preimplantation Genetic Diagnosis (PGD). Both refer to the procedures performed on embryos prior to implantation used to screen  for anatomical, physiological, and genetic conditions prior to transfer. In a nutshell, it ensures the strongest of the fertilized eggs is transferred during IVF. If you look it up, its really amazing all the things this process can discover about your future baby at such an early stage. It seems you can go a lot further in this process than determining the "health" of an embryo such as determining the baby's sex based on genetic diseases linked to sex and cancer predisposition,

The rest of the article is a little over my head, but in our case, DJ and I used just used PGS to screen for abnormalities that would influence the success of a live birth. Because of our age and current health, we were told this was all that was necessary since we didn't care if it was a boy or girl nor do we have a history of genetic diseases such as Huntington's or Tay-Sachs.


Currently my transfer is scheduled for Monday at 12:45, but I have to go in tomorrow to make sure all my plumbing is good and ready!

Pumped!

Gone Fishin'

Retrieval Day!! YaY!

Yesterday we headed to the Atkin-Kents Building across the street from St. Barnabas Hospital to get my follicles into their petri dishes for fertilization.
My appointment was at 11:00 and I had been fasting from midnight the night before. Surprisingly I wasn't very hungry by time I was called in by the doctor.
I changed into my gown, bathrobe, and put on my "hat" (it looked like a thin blue shower cap) so I looked like I was institutionalized.
Holy hotness!

I met with Dr. G prior to the retrieval and she was super nice. She talked me though the procedure and then I met with the anesthesiologist, Dr. Chung. I don't think we had the same bond as I had with Dr. G, but he make sure I didn't have any loose teeth that I would swallow while I was under.

In the surgical suite, I laid down with my feet in stirrups and my arms outstretched for the anesthesia. Somewhere between the nurses asking about my wedding and how I knew I needed IVF, I was out for the count. Here is a Youtube video of the retrievel process: http://www.youtube.com/watch?v=OfGWxGYFETo. They have videos for everything!
Meanwhile, while I was in the procedure, DJ went and donated his boys.

I guess it was an hour or so later I woke up in recovery and had the nicest nurse ever prop me up and make me comfortable. It was glorious. I think one of the first questions I asked was how many they got and she said "28". Now I was a little groggy at the time but I decided not too many numbers sound like 28, so I think I heard correctly. According to the nurse, Wanda, in our medication class, 50% of the follicles received make it to transfer so that's 14. All good numbers!

I was transferred from my bed to some kind of reclining chair and chowed down on graham crackers and cranberry juice. I was a little slow going, but felt okay for the most part. DJ met me, I changed out of my patient clothes, and we called it a day.

My parents met us at home with soup and sandwiches which was awesome and I spent the rest of the day in sweatpants following my instructions that included:
1. Don't drive
2. Don't operate heavy machinery
3. Don't make any important decisions, such as signing legal documents.
I thought the last one was funny.

Before dinner we took my first progesterone shot and it was not awesome. The needle is the longest of the bunch so far and needs to go right into the butt muscle. Also the progesterone is thick, like olive oil, so it doesn't come out of the needle easily as one would like.

This morning I hoped to wake up light as a feather, go to my yoga class, and start feeling back to my old self again but had no such luck. Instead I got up at 5:00am and watched The Confessions of Animal Hoarders where a woman had 60 dogs. She did make me feel better about myself but I was jealous that her ovaries (or Ovi Wankanovies - as DJ calls them) weren't sore.
Now, as I type this, I am watching my 3 episode of Law & Order.
I'm a loser.

I'm hoping the soreness goes away later in the deal so I can stop looking like the woman in the depression commercial:


Thursday, February 9, 2012

You down with HCG? Yea, you know me

Last night was my first official butt shot - HCG.
Once the follicles are big enough for retrieval, you take this shot to mature the follicles and get them ready for "extraction" (as Gina so eloquently put it).

My call from "Charlie" had a lot of details. So many that I listened to the voicemail three times, took notes, and then had DJ listen to it and check my notes.
The shot needs to be administered 36 hours prior to the retrieval so we had to give the shot at midnight. Because we had taken the medication class several weeks ago, we forgot the deal so we went to the IRMS website and watched the educational video. I kind of wish I didn't watch it with DJ because the way the nurse jabs the patient with the need during the "injection" clip is a little unsettling.

Because DJ and I are losers, we went to bed at 10pm and set our alarms for 11:50pm for the shot.
Jumping into medical action, DJ prepared everything while I paced and rubbed my butt muscle with an alcohol swab. I was nervous, but despite the awkwardness of the shot itself, it really wasn't that bad. It was quick and I guess it worked.

Today I went in for my 5th consecutive day of blood work and ultrasound. My veins are starting to look like that of a junkie. No wonder crackheads have to look to other parts of the anatomy for their highs.

Tomorrow, assuming my follicles matured properly, we have the retrieval. My appointment is at 11:00am but I have to get their an hour early for pre-op stuff. I don't know much else other than I can't eat tonight after midnight and have to fast prior to the procedure. Depending on how I feel, I for see chocolate chip pancakes as my post retrieval meal.

Tuesday, February 7, 2012

Hello Charlie

One of the more frustrating elements of the IVF process is the timeline.

Every other day, or in today's case two consecutive days, I go in for blood work and ultrasound. This is done to check my hormones, count and measure my follicles, and change dosages if needed. Since I am getting close to retrieval, its been tricky because I have to plan around work and, more annoying than that, work travel.
At the end of my visit this morning, I was told the HSG shot would be soon which would actually be ideal since next week is pretty sparse and I more or less planned to be free that week. HSG stimulates all my little eggies and gets their ready for retrieval. It is also the first shot I have to get in my bum.

Because each day I get a medical and calendar update, I feel like a less sexy version of a Charlie's Angel. The IRMS nurse, Jen M., being Charlie, calls me each afternoon and gives me an update on my plan. Sometimes its come back in for blood work, some times in changing a dosage, or some times its just letting me know to keep doing what I'm doing. Hopefully the next call will be "ok your retrieval is on day X and we can get all those swollen follicles out of your ovaries".

Which leads me to my next topic - ovaries. I mentioned in yesterday but I realized I had been spoiled. My ovaries started to really grow Friday afternoon allowing me to sit in sweat pants most of the night, into Saturday, and get away with dressing down Sunday for the Superbowl. I was able to sit on couches, use a heating pad, or sit in fetal position as needed.
Today I am in the office and I don't really know if busting out a yoga pose will fly.
When getting dressed, I stared blankly at my closet convinced my pants weren't going to fit me and certain this bloating in my belly would be a dead give away of my situation. Fortunately I lost weight before my wedding and kept it off (so far) so I was able to reach back and get a pair of "big" pants and an over sized sweater.
Walking is also an issue because its more comfortable for me to crouch forward a little or shrug my shoulders down. Of course DJ thinks it looks ridiculous but to hell with looks for the time being. Again, the Quasimodo walk may turn a few heads at work so I've been pretty conscious about my posture.

No other news to report at the moment. I've just been drinking a lot of water, becoming close personal friends with the stationary bike at the gym, and doing my best to stick to the weight lifting plan DJ created for me. Interestingly, although I  miss running terribly just thinking about it today made my ovaries hurt.

Monday, February 6, 2012

No Room at the Inn

My ovaries are getting crowded!
I wanted to open this post with the size of the average womens' egg during ovulation as compared to those that aren't ovulating that month, but my Googling wasn't working out as planned. I did learn when an egg is ready, it is usually between 16 and 22mm - the bigger the better. I am thinking there is usually one egg that is ready to go and that is the one that ovulates, while the others stay behind to grow.

In comparison (I think), I am preparing as many as possible for ovulation as opposed to normal person's one. For this reason, I feel like a bloated fat mess with cramps and a constant need to pee.
For example, yesterday I spent much of the afternoon in sweatpants with a heading pad on my stomach because that's what people do when they are crampy - they warm it up.
En route to a Super Bowl Party in a Delaware, there is a short piece of highway where there are rumble strips, speed bumps, or just stupid uneven road every 10 feet of so. This becomes a huge pain (literally) as every time the car bumped, it was like a punch to the gut. Once we got to the party, and I decided to eat my face off, my stomach ballooned out to such a degree I was mortified even though I was the only one who knew how immense it was.
This morning when I woke up, it had deflated but I still feel like I am weighing in at about 180lbs - but the incessant amount of bacon rolled tater tots from last night probably didn't help.
Anyway, I digress....

I went in this morning for my blood work and ultra sound and learned I have about 12 and 7 follicles "ripening" and waiting for retrieval. This is very exciting because I have seen other blogs, posts, and readings where women only have one or two. I don't know how many of these guys will be around retrieval day either but I am optimistic that everyone will stick around.

As I said, for retrieval, follicles should be between 18 and 20mm for best results. Today they ranged between 10 and 12mm. I think they grow one or two millimeters per day so its looking like next week will be go-time. This is also great news but I can only imagine the tight fit it will be as everyone gets bigger.
20mm follicles - so crowded
(I tried to find a 12mm for comparison but had no luck)