Thanskgiving, and Giving Back to my Uterus

Our frozen transfer took place on November 28th. But first, Thanksgiving! It was wonderful having Thanksgiving the week before our FET because it gave me so little time to worry about it. Time flew by. We had a great Thanksgiving day at our house with family and a few friends.

My two sisters and I split the food making so that we each made 3 or 4 dishes, so it wasn't stressful at all to host. I even had time to make placecards...

...and "thankful cards." We each wrote down what we were thankful for, then we had to try and guess who had written each card.

The kids had fun at their table too, making Native American headbands and coloring pictures of turkeys. I think they even ate some food.

Once Thanksgiving was done, we had the weekend to relax and clean the house. I had Christmas card envelopes ready to address during my period of bedrest and Felicity DVDs cued up. Best of all, I felt great physically. It's amazing how much easier the FET process is on the body! No ovaries working overtime, no regimen of several shots a day. Just one a night. (Some nights it's two, but I figured out I could draw them up into the same syringe. Yay.)

My transfer time was 2:00 on Monday the 28th. Sawyer gets off the bus at 3:00, so Eric took the day off so he could be there to meet the bus. Which unfortunately meant that he wouldn't be able to be there with me, but since the whole process is getting pretty routine for me, I was OK with that. SG wanted me to arrive by 1:30 so I left around 12:00 so I'd have time to stop on the way for a quick lunch (I was already tired of turkey leftovers at home) and to get my mandatory beverage. For transfer you need to have a moderately full bladder, which means drinking about 20 oz of liquid an hour before. I got there right on time, which might be a first, and only had to wait a few minutes before they took me back to the transfer room. They had me take off my shoes and put on booties, and undress from the waist down and wait for Dr. S to come in. He went over the consent forms with me (no pushback about transferring two this time - the silver lining to two miscarriages in a row.) The transfer itself went very smoothly, and even though I apparently didn't have enough to drink they were still able to visualize well enough. Both embryos came out together this time. Afterward they had me lie still for 5 minutes, then I got up, got dressed, used the bathroom, and checked out with a nurse who reminded me to rest on a couch or bed for 24 hours, keep taking my meds, and not to freak out during the two week wait. I am a compliant patient but I made no guarantees about that last one. And that was it. I was pulling out of the parking lot by 2:25.

Bedrest was great. Nothing like lazing around reading and watching TV while all your meals are brought to you. We did have one minor incident in which Eric decided to play a video game in the basement and he couldn't hear us yelling for him, which caused me a sudden blood pressure spike and near aneurysm, but I survived it (and more amazingly, Eric did too.) By the next morning I was ready to be done, but I managed to hold out until 12:00 when Eric convinced me to come get lunch with him and drive around looking at houses. So I made it 22 hours. Don't tell my nurse and get me in trouble.

So now, we wait. For some reason SG makes us wait a full two weeks after transfer to have a blood test which feels eternal. I haven't been as busy the past few days so that makes it harder too. Maybe I need a new hobby.

As far as testing at home, I'm going to do it, but I'm not going to write about it on here. Once we get a firm answer one way or the other though, I promise you'll get the full story. I just can't put it out there yet, for my own sanity.

Here We Go...Again

There's something really different about this cycle. It's a different protocol than I've done before, but the biggest change is that I'm not excited at all. Last time was "Here we go!" and now it's more "Ugh, here we go again." I heave a sigh before every shot.

With two losses in the past 5 months, it almost seems impossible to me that this will work. And yes, I know IVF veterans are probably laughing at me at this point - 3 cycles in a year really isn't that much. But it's a lot for me. I'm not sure how many more times I can handle doing this.

On the bright side, this FET stuff is pretty easy compared to a fresh cycle, at least physically. Only two ultrasound and bloodwork appointments before the actual transfer (as opposed to about 10 for fresh.) And the meds are much easier too. Here's the schedule, trips to the doctor in bold.

Nov 12 - Baseline appointment, Delestrogen shot (0.2 ml)
Nov 15 - Delestrogen shot (0.2 ml)
Nov 18 - Delestrogen shot (0.2 ml)
Nov 21 - Delestrogen shot (0.2 ml)
Nov 23 - Ultrasound to check lining, bloodwork to check P4 and E2 levels; if all looks good begin progesterone (PIO) shots
Nov 24 - Delestrogen shot (0.2 ml), PIO shot (1 ml)
Nov 25 - PIO
Nov 26 - PIO
Nov 27 - Delestrogen & PIO
Nov 28 - Transfer, PIO
Nov 29 - PIO
Nov 30 - Delestrogen, PIO
continue both meds until....
Dec 12 - beta

I'm also taking all the same pills I've been taking since the spring: Metformin, FABB, Vitamin D, levothyroxine, bromocriptine.

So at this point I've had the baseline appointment and two Delestrogen shots. So far so good. Although the doctor who performed the ultrasound was kind of weird. I had to go to a far away office since it was a Saturday, so I didn't see my normal doctor. Actually, I'm not even positive she was a doctor, because she didn't introduce herself to me before shoving the wand in, and then she told me absolutely nothing about what she saw, except to ask me "Are you sure you haven't had anything removed?" Um...yeah, pretty sure. Apparently she found everything she was looking for though because she was done and gone before I could ask a question. Bizarre. They must have been running really behind schedule that day. Or she was just weird.

So that's the latest. Taking my big-A shots (they are both intramuscular) and waiting for the next appointment. Here we go. Ugh.

60 Days

In exactly 60 days we will be climbing aboard this:

We'll be on it for 6 nights in the western Caribbean, doing this:

and this:

and this:

and this:

and this:

We've booked our first ever Disney cruise. Actually, our first ever cruise. And actually (this is kind of embarrassing) our first ever family vacation with just our family. Since Sawyer was born we've always gone with extended family or friends. I am beyond excited to spend some time doing amazingly fun things in warmer weather with just the three of us. Well, just the three of us and a couple thousand new friends.

And yep, if you looked at your calendar you're right - in 60 days it's Christmas Eve. This will be an unconventional Christmas for sure but I'm very much looking forward to not having to cook or clean or wrap a bunch of gifts this year. After everything we've gone through in the past several months, we all need a break. And we desperately need something to look forward to other than shots and procedures. My beta test following this next FET is December 12, and the thought of spending Christmas at home a couple weeks after another negative or chemical pregnancy is too depressing for words. This way even if the results are bad, we'll be busy getting ready to travel and will have lots of pampering and excitement in the future. And if the results are good, even better. The countdown is on!

FET #2

It looks like we're ready to go...for what I sincerely hope is the last time. My period arrived on Sunday (and I'm using the term "period" very loosely, since I've learned that what happens after a chemical pregnancy bears almost no resemblance to my usual AF visit.) I had to go back to the RE this morning for one final beta test to make sure that my HCG level is down to the negative range. It is (yay?) so that means I'm cleared to start birth control pills again tonight. Here's the upcoming schedule:


October 12 - start BCPs and Lovenox (the shot-free days were nice while they lasted!)
November 7 - take last BCP
November 12 - baseline ultrasound, to make sure lining is thin and I don't have any cysts or anything. Turn in consent forms. Begin meds - Delestrogen, 4 mg every 3 days (unfortunately another big IM needle - but at least it's not every day.)
November 23 - ultrasound to check lining, bloodwork to check progesterone and estradiol. Begin progesterone-in-oil shots somewhere around this time.
November 28 - TRANSFER! The Monday after Thanksgiving.
December 12 - beta test


I'm still feeling very sad about this past cycle. Not knowing why it didn't work when everything looked perfect is really, really hard. At least with our failed FET we knew that the embryos we transferred weren't good quality and there wasn't much of a chance that it would work.  This time everything went so smoothly and all the pieces fell into place. I am definitely glad that we decided to go against our doctor's wishes and transfer two, because if we had only done one I'd be wondering right now if it might have worked had we done two. At least we know we did everything we possibly could. And there is a lot to be grateful for:

1) that we have TEN excellent embryos waiting. That gives me so much hope.
2) that despite having a record-setting 68 eggs retrieved, I only had mild OHSS. No fluid had to be drained. Seriously, that's a miracle.
3) that we have the means to continue treatment. This is not the end of the line.

Chemical ... Again

I hate that I have to do this update - but I do.

This cycle is officially a bust. At 8dp5dt (8 days past a 5 day transfer, or 13 days past ovulation) I got a faint positive on a First Response test. I was excited but worried because I knew it was fairly late to be getting a positive test and that usually means low HCG levels, which usually means chemical pregnancy (early miscarriage.) The tests kept getting darker over the next several days, but then when I had my blood test on Tuesday it came back at only 22. We tested again today to see if by some miracle the number would double, but today it was down to 7. Another chemical pregnancy. Here's the HPT progression - as gross as it is to post pictures of pee sticks, I find it really interesting. Especially keeping in mind that my HCG today was at 7, and I still got a clear second line. That is a sensitive test!

Obviously we are very sad and disappointed. Everything went so perfectly this cycle that we really had our hopes up. But we do have a lot to be grateful for. I'm relieved that it didn't take us weeks this time to find out that this pregnancy is not viable. And we have 10 awesome looking blastocysts that are frozen and waiting to be transferred.

We plan to move ahead right away with doing a frozen embryo transfer. Our insurance coverage is maxed out (amazing how quickly we reached that $15,000 lifetime maximum!) so from this point on we'll be paying for everything completely out of pocket. Needless to say, we very much hope that the next cycle will be the one that works.

Frozen

We got the call yesterday afternoon about our embryo cryopreservation - and 10 of them made it to freeze! That may not seem like a lot considering that we started out with 48, but since we had so many we were able to let them grow in the lab for 5 days. By watching them for that extra time, the embryologists are better able to determine which ones are likely to be viable after freezing and thawing. The ones that are defective stop growing and the ones that aren't keep on dividing. The culture medium they use only allows this to work for around 5-6 days and after that it can't support their growth anymore - otherwise they might go for a lot longer to get even better information. It's rare to have this many still growing, so we're thrilled...thrilled, and a little bit undecided about what we're going to do with all of them. But we're taking it one step (baby!) at a time, and if we get to the point where it's clear that we're not going to use some of them, we'll make that decision when the time comes.


Since yesterday I feel like the OHSS is coming back, which is weird but it might just be in my head (or maybe bloating from the PIO shots?) I also feel like I'm coming down with a cold (Eric already has a bad one so it's like a ticking time bomb for me and Sawyer) BUT I'm very excited about my sister Erin's wedding this weekend! My Utah family is here and it will be so fun to spend time with all of them while we watch Erin and Josh wed. The perfect joyful distraction!

Transfer

I can't believe this cycle is almost over. It's gone so smoothly and has been so much easier than I remember it being the first time. During Sawyer's cycle I remember thinking that if it didn't work, I wasn't sure I could do it again. This time I feel like I could - although obviously we hope we don't need to.

Wednesday was transfer day, 1:15 pm. We didn't get put on the schedule until Tuesday afternoon, so this caused some scrambling as Eric dealt with his work schedule and I tried to find someone to get Sawyer off of the bus (again.) After not having any luck and considering me just going by myself, it dawned on us that since I could drive (no anesthesia this time) we could drive there separately and Eric could leave early if he needed to. Wednesday we spent a nice quiet morning all at home together, then put Sawyer on the bus and headed to Rockville for hopefully the last time in a long time. I stopped to grab some lunch on the way and to get something to drink since I forgot the bottle of Gatorade I had planned to bring. For embryo transfer they use an abdominal ultrasound, so you need to have a moderately full bladder when you arrive. Chick-fil-A and a big lemonade to the rescue!

We arrived at the Rockville center right on time (which I'm pretty sure is a first) and checked in. After just a few minutes in the waiting room a nurse called us back and showed up to the transfer room where we waited for the doctor. And waited. And waited. I don't know why the take you out of the waiting room if you still have a lot of waiting to do, but it was OK. After about half an hour we finally met Dr. Widra. After shaking our hands he told me "You've caused quite a stir around here!" because of my awesome ovaries. Not the number one thing I'd choose to be famous for, but I'll take it. Next we went over our consents for transfer. I had already spoken to Dr. K on the phone that morning and let him know that we had decided to transfer two embryos, even though he was recommending an e-SET.  Dr. W didn't give us too much pushback (and actually neither did Dr. K) which I appreciated. We signed the forms and checked the box for cryopreservation of any embryos we have left over, which hopefully will be several. An embryologist also came in and had us sign some stuff and checked once again that my ID bracelet matched the embryos. After everything was signed and checked they left us alone once again so I could undress and get set up on the procedure bed.

After another wait, Dr W came back with a nurse and we got started. The procedure is pretty simple and not painful at all, although I would say it's somewhat uncomfortable because of the needing-to-pee factor. First the doctor put in a speculum, just like for a pap smear. He cleaned the cervical area, and then the nurse used the ultrasound to visualize the uterus while he inserted a small catheter through the cervix (the nurse commented on how great my ovaries looked - they are already back to almost normal size, which is crazy considering how many eggs I had retrieved just a few days before. Yay, my ovaries! And yay Lupron trigger!) Dr. W told the embryologist we were ready for the embryos, which were in a lab right next door to the procedure room. While she went to get them a live picture of them appeared on a flat-screen TV on the wall, so that we could verify that the name and social security number on their petri dish were correct. Here's the picture. I think they're cute.

A few minutes later she came back in with our embryos loaded into another soft catheter. She said "two for Watts" and the Dr. repeated "two for Watts" - to confirm once again that they were the correct embryos and that we knew how many were going in. The Dr. threaded the catheter holding the embryos through the one that was already in me, and when it was at the top of the uterus he told the embryologist to empty the catheter. After she did, they waited a minute before removing the soft catheter (the nurse timed it exactly) and kept everything else in while she went back to the lab to look at the catheter under a microscope to make sure that both embryos had been transferred. Which is a step I fully support, because it turned out that one of them hadn't been! It was still inside the catheter. So we got to do the transfer all over again, this time with the instructions "one for Watts." Dr. W answered "one for Watts, which is almost certainly female." He assured us that this happens a lot, and that it doesn't hurt our chances of success at all. A minute later, the embryologist took the catheter back and confirmed that this time nothing was left inside. Transfer was done!

At this point Eric had to leave in order to get home in time for Sawyer, so it worked out perfectly. They had me stay lying down on the bed for 5 minutes, but that turned into 15 because the discharge nurse was running behind. It was fine because unlike with our FET, I didn't have to go to the bathroom that badly. When the nurse came in she went over my instructions for the next few days: 24 hours of bed rest, getting up only to go to the bathroom or get a snack, followed by 3 days of "light activity" which they define as no strenuous exercise, no lifting heavy things, no sex, and just generally taking it easy as much as possible. She asked me how many eggs I had retrieved and when I said "65" she stared at me blankly and I could tell she was thinking "This girl has no idea what she's talking about." I said "I know, it's a lot" and she said "Wait a minute, I heard about you! I can't believe you're not in severe pain!" I told her I felt better this time than I did when we retrieved 20 eggs, which is totally crazy but true (I chalk it up to the HCG trigger I had the first time.) She warned me that if I do get pregnant it's likely that the OHSS will return, which I hope doesn't happen (it didn't with Sawyer.) We went over my medications and realized I wasn't supposed to be taking both endometrin and PIO (one of the other nurses post=ER had told me I was) so she put in a call to Dr. K to make sure, and sure enough I'm only supposed to be on PIO.

Finally I was able to get dressed, go use the bathroom and check out. I crashed on the couch as soon as I got home because I hadn't slept much the night before out of nervousness. It feels so good to be done! And I have to admit I enjoyed the bed rest - although 24 hours was plenty, I was getting kind of bored at the end. We should hear back soon about our remaining embryos and how many get vitrified. My beta test is October 4. And now all we can do is wait!

Fertilization Report

Out of 68 eggs, 54 were mature and fertilized via ICSI.

On day 1, 48 embryos were dividing!!!

Of course we are thrilled about having such astronomically high numbers because it basically means this should be our last fresh cycle ever, and we might end up being able to have a larger family than we had anticipated. The nurse who called me said "You have definitely set an all-time record."

The ONLY down side is that with such a high number of eggs, I'm at a very high risk of developing severe OHSS. I already have a mild case, but if it doesn't get worse we should be able to proceed with a day 5 transfer. The nurse who called gave me some instructions for alleviating OHSS (chugging Gatorade all day long and eating plenty of protein) and symptoms to watch out for (trouble breathing, not urinating, severe abdominal pain, vomiting.) Because I didn't have an HCG trigger or an HCG booster, they're hoping I can avoid the severe version.

I'm not feeling so hot today, seriously bloated, still taking Vicodin and spending lots of time on the couch. Hopefully over the next few days I'll get progressively better.

Retrieval

Retrieval is DONE! The hardest part (for me) of an IVF cycle...well, except for waiting for those first beta results.

We arrived at the Rockville center at 11:00 on Friday. Actually around 11:10 since the GPS took us on an unexpected detour and I was so nervous I wasn't paying attention to where Eric was going. I was really glad I had been to the center before because it could have been much worse! Also the place is really intimidating, it's a huge office complex and the whole thing belongs to our practice. The whole 4th floor is the surgery center. When we arrived they checked me in and sent us to a waiting room where 3 other couples were already waiting. After a few minutes they called us back, only to find out that the bed they thought was open was not ready yet, so we waited in another waiting room for a few more minutes. Finally they took me to my bed, which was in a large open-plan hospital-like room divided by curtains. Which I know is very practical, but unfortunately does not provide very much privacy and the patient next to me was just coming out of the anesthesia and not having a very good time. She was moaning, crying, and threw up a couple of times. I felt so bad for her, and also on a self-centered note it was not the most fun thing to listen to as I was waiting for my surgery to start. I did see her as she left a while later and she seemed better at that point.

I changed into the hospital gown, booties and hat, and the nurse who would be taking care of me came in and asked me all the pre-op questions: Are you on any medications? (It would be quicker to ask me what medications I'm NOT on) Did you remember not to eat or drink? Any allergies? Did you take your antibiotic last night? And then someone came in to take Eric to another room for collection. I didn't see him again, which was kind of distressing to me since I thought I'd get another chance to kiss him goodbye before surgery, but it all worked out OK. Soon the anesthesiologist came in and asked me all the same questions the nurse had asked, and started my IV line. That can be kind of a stressful process with my tiny veins, but he did a great job and gave me some numbing medicine first so I barely even felt it.

I waited for what felt like forever on my own, getting progressively colder and colder from the saline drip they were giving me with only a thin blanket. I didn't know what time it was because unfortunately Eric had taken my purse with him and I didn't have my phone or the book I had brought to pass the time. I tried to do some deep breathing and meditate but it didn't work so well.

Finally Dr. Wolff, the doctor who would be performing my procedure came in and introduced herself and told me it wouldn't be too much longer. They had me get up and walk my IV pole to the bathroom to empty my bladder, and then the anesthesiologist came to walk me into the OR. They had me get up onto the table and put my legs into the stirrup thingies and the anesthesiologist gave me something in my IV that immediately made me feel drowsy and warm. I remember seeing the wall of medical supplies and one container in particular that was labeled "Hysteroscopy: Big Boy" and thinking I'm glad they didn't use the Big Boy on me during my hysteroscopy! (Bad fertility treatment humor, always helps in stressful times.) I don't remember lying down, although I must have at some point because the next thing I knew I was waking up back in the curtained room where I had started.

The retrieval itself is a quick process that takes about 20 minutes. The doctor uses a transvaginal ultrasound transducer just like the ones I get at all my monitoring appointments, but this one has a long needle attached to the top. They visualize the ovary on ultrasound and guide the needle through the vaginal wall, through the abdominal cavity, and into the follicles on each ovary. The fluid from the follicles is aspirated into a test tube, and that's where all the eggs are. After aspiration they look under a microscope to see how many eggs they got. For the non-squeamish, here's a drawing to help you visualize: http://amarkedman.com/2011/08/31/day-314-part-1/egg-retrieval/ For obvious reasons, I was very very happy to be asleep through the whole procedure.

They called Eric back as I was waking up and asked me how I was feeling and the answer was - ouch. Very much ouch. The nurse gave me some fentanyl through my IV and a heating pad for my belly and almost immediately I felt better, although I still had some pain. A few minutes later she came back and said that I looked much better already. Soon our egg report was ready and they told us how many they got. I'm glad I was already sitting (lying) down, because the answer was....68 eggs. 68!!!! The nurse said she thinks it's a record. We were totally shocked, because at last count I thought I had around 40 follicles, and not every follicle has an egg, so we were hoping for somewhere around 30. Plus, with our first IVF I felt much worse physically than I did this time, and only had 20 eggs. I never in a million years expected to get this many!

After the shock had worn off a bit, about 20 minutes later they had me get up and see if I could walk with support, and I could, so it was time to change and go home. Eric took me out to the car while he picked up my prescriptions in the pharmacy (in the same building, the place is a fertility mecca) for Vicodin (hallelujah) and my progesterone in oil shots (not nearly as fun.) At this point it was 2:45 and I hadn't eaten all day, and Eric hadn't had lunch, so we made a quick stop to pick up some food and then went home. My amazing friend Ti had gotten Sawyer off the bus and was watching him, and then another friend came by to bring us dinner for that evening and a bouquet of roses. There was some drama with one of the neighbors when Sawyer got off the bus (long story) but I was pretty out of it so I couldn't care that much. I crashed on the couch for the rest of the evening watching season 7 of The Office on Blu-ray and trying not to laugh too hard because it hurt way too much.

Retrieval=DONE and a huge success! Better than we ever imagined. Thank you so much for all of your prayers and well wishes. Next step: recovery, fertilization report, and transfer!

Ready for Retrieval

There it is - the big needle that gave me 0.4 of Lupron, and that thankfully I didn't have to jab into myself. I was supposed to trigger at 12:30 a.m., and Eric walked in the door from Dallas at 12:28! Just in the nick of time. The shot itself wasn't bad. And this morning my bloodwork confirmed that the trigger worked and my LH is nice and high.

LH-96.9 (they want it over 15)
P4-8.07, I'll be starting PIO tomorrow to get that number up before embryo transfer.

Tomorrow my surgery is at 12:30. We have to be at the main center at 11:00 with photo IDs and no perfume. Tonight I'll take Azithromycin and NO Lovenox. They didn't tell me about the Lovenox at first, but I randomly thought "Hmm, maybe I should ask about that" at my appointment today and the nurse told me not to take it tonight or tomorrow or we wouldn't be able to do the retrieval. Good thing I asked!

So that means...no needles today. All day. (Well, other than the blood draw this morning.) I almost forgot what it's like not to have all those shots. Turns out it's pretty nice.

Triggering

Apparently my ovaries didn't get the message that I always do the least amount of work possible, because they are being little overachievers again. You know something's happening when the nurse looks at the ultrasound screen and says "Holy crap!" Dr. K was quick to reassure me that this is a good thing, much better than the alternative of not being responsive enough. At this morning's appointment we were still on track for triggering Thursday and retrieving Saturday. But then my E2 level came back at 5347 - a big jump from yesterday. So I'm triggering tonight with a nice big Lupron shot, and retrieval will be Friday at 12:30. We're scrambling a bit with our schedules (mostly figuring out how to get Sawyer on and off the bus) but it will all work out.

The one down side - because of the high risk of OHSS I can't have the shot of HCG they usually do after retrieval for luteal support, so instead of progesterone suppositories I have to do progesterone-in-oil shots. Nooooooooo!!! I was really hoping to avoid those this time, but the nurse said if I get a positive pregnancy test we will probably be able to switch to the suppositories at that point, so I'll hold on to that hope.

I'm supposed to trigger at 12:30 a.m., which is WAY past my bedtime these days so I'm going to have to set an alarm to make sure I don't sleep through it. Eric is coming home from a business trip tonight but it's likely that he won't be back in time to do the shot for me, so I'm probably going to have to do it myself. I'm good with the little sub-q needles, but the intramuscular ones are a whole different story. Wish me steady hands and nerves of steel.

Monitoring

Notes on today's monitoring appointment:

-I still have lots of follicles, so many that Dr. K didn't count (but he did exclaim "Wow, that's amazing!") and the largest ones are in the 15-16 mm range, which is good. When they get to 18 mm it's time to trigger, so we're right on track for Thursday or possibly Friday.

-E2 - 2896. Another too-big rise, so we're reducing my Follistim to 37.5.

-The nurse had to poke me twice drawing my blood today, and on Sunday at Rockville they had to do it three times. She commented that I must feel like a pincushion. Which made me want to count how many needle sticks I've had all together. Are you ready? Since starting this cycle, I have been poked by a needle 55 times. And I have at least 24 more to go.

Diagnosis

Along with all our infertility drama this summer, we also have been in the process of trying to get a diagnosis for Sawyer. He's been under the Developmental Delay label, but now that he's 6 that label is no longer appropriate according to school system. We've been taking him to a developmental pediatrician but those visits haven't led to any useful information, which has been frustrating given that we have to wait 4-5 months for each appointment. A parent of a child in Sawyer's ECSE class last year mentioned to me that their son had been diagnosed by a local psychologist, Dr. W, so we made an appointment with her. The assessment took place over two days, with a total of 9 hours of testing. I couldn't imagine Sawyer sitting through 9 hours of anything, but Dr. W and her assistant did an amazing job of keeping it fun and light and after the first day he was excited to go back! After the testing it took her a few weeks to write up her reports and recommendations. Soon after this we learned that Sawyer needed to be reevaluated by the special ed team at his new school, so we scheduled all of those assessments too. (The testing with the school psychologist was especially memorable, because the earthquake happened right in the middle of it and we had to evacuate the school! Sawyer was unfazed.) Finally about a month later the results were all in.

The diagnosis: developmental mixed receptive-expressive language disorder and phonological disorder. Basically, this means his brain does not process language in a normal way, so he has a hard time both understanding and producing language. He does not have autism or ADHD, and he is not intellectually disabled - although he scored in the ID range on some of the testing measures, the team believes it's because his learning disabilities are so pervasive. According to Dr. W he has a lot of potential for improvement and growth.

So that's where we are. Even though it's a formidable diagnosis, I feel relieved that we finally have some answers. A name for his difficulties. And there's a lot that we can do to help him understand more and say more, especially in the next few years. At the eligibility meeting all of his teachers expressed what a good kid he is and how hard he tries. One of them pointed out that for Sawyer, daily life is like living in a foreign country where no one speaks your language. It's such a struggle for him, and he still manages to be happy and sweet 99% of the time, which is pretty amazing to me.

The next step is coming up with a new IEP (individualized education program) for him and the school will decide which services he qualifies for. We're hoping at a minimum to get speech, occupational therapy, and possibly extra time in a special ed class at least a few times a week.

Progress

Because of my high estradiol levels and large follicle count I've been going in every morning for monitoring. Our local office isn't open on weekends, so I have to go to one of three that are, and the closest ones happen to be about 45 minutes away. Getting up before 7 a.m. on both Saturday and Sunday to drive 45 minutes = not my happiest time. But things are progressing very nicely. As of this morning I had 40+ follicles, the largest one being 13.5 mm. They are growing steadily and pretty uniformly, which is good. The idea is to have as many eggs as possible mature at the same rate, so that on egg retrieval day they'll be ready to be fertilized. In theory, 40 follicles means 40 eggs, but normally some of them will be immature, and sometimes the doctor can't successfully extract all of the ones that are there.

I was worried about things moving too quickly because E has to go out of town this week from Tuesday night to Wednesday night. Unlike a frozen embryo transfer, it's crucial that he be around for the egg retrieval because 1) I need someone to drive me there and back since I'll be under IV sedation, and 2) we actually need his genetic material this time. So I was relieved when Dr. K said he doesn't think we'll need to change the schedule. Even though my estradiol is high, the rate of increase has slowed down and my follicle growth is right on track. Yay, my follicles!

Saturday: E2 was 898
Sunday: E2 1500+ (started Ganirelix in the pm)
Today: E2 2092

Meds dosage: Follistim 75, Menopur 75, Ganirelix 250, Lovenox 40 (4 injections a day - this is the real deal now!)

Documenting

I'm going to make an effort this time to document all the details of this IVF cycle, since I didn't do that last time and now I wish I had. Turns out that after seven years, I can't remember what my E2 levels were after 3 days of stims! Shocking, I know. And did you know that doctors don't have to keep your records for longer than 7 years? They can just throw them away - our last fertility clinic did just that. So I apologize in advance for the minutiae ahead...but hey, maybe someone else going through the same thing will find it helpful.

Today is day 4 of stims, and I had my first monitoring appointment this morning (7 a.m., ugh, but at least it was only 10 minutes away!) At monitoring appointments they do an ultrasound and bloodwork. The u/s looked good - my lining was at 8.6, and I had 12 follicles on my right ovary and more than 10 on my left, all under 10mm.

I got the call this afternoon (while I was at the movies seeing "The Help" - I figure since I might get pregnant soon my days of having time to myself might be numbered, so I better live it up now - thinking positive!) and found out that my E2 (estrogen in the blood) is way too high for this early in the cycle, 737. This means that I'm in danger of OHSS, and possibly cancelling the cycle if things don't slow down. So we're reducing the Follistim to 75 tonight and I have to go back in tomorrow morning instead of waiting until Sunday for more monitoring.

Kitchen Pharmacy

Drum roll please! Here it is - my big box of meds. You're seeing:

-3 cc syringes and 33g needles
-Follistim pen with cartridge inside
-Extra Follistim cartridges
-Menopur
-Enoxoparin (AKA Lovenox)
-Ganerelix
-In the pill bottles:
    -Lupron, which will be my trigger before egg retrieval
    -Azithromycin, antibiotic to take before ER
    -Estradiol, for after embryo transfer
    -Bromocriptine, Metformin and FABB, all of which I've been taking since April for my PCOS and MTHFR

(and I just realized I forgot to include my Levothyroxine and Endometrin. So imagine those are there too.)

I started stims (Follistim 150 and Menopur 75) on Tuesday, which makes today day 3. So far so good, although I have to admit the preparation of all the shots is pretty intimidating. The first time I did it I sat on the couch with my laptop in front of me and watched the demonstration videos from Village while I did the mixing and prepping and dialing and finally injecting. I think I have it down now. Kind of.

Next step: monitoring appointment early tomorrow morning so we can see if anything's actually happening in there!

Labcorp Lady

To the receptionist at Labcorp:

It is never OK to ask someone if she's pregnant. Even if the lab order calls for tests that are normally done on pregnant women. They're done on infertiles too. It's also not OK to ask if I have any existing kids, and then to exclaim about how far apart my kids will be if I have another one. I am aware of my reproductive timeline.

Thank you,

No, Really, Not Pregnant Me

Meant to Be

Embryo transfer, with 24 hours of bedrest after: September 22. 
Season premieres of The Office, Parks and Rec, and Community: September 22. 

Coincidence???

Here We Go...

(And yep, unfortunately I now have this in my head. What can I say, I came of age in the nineties.)




Yesterday we checked off a lot of boxes to get ready for this cycle:

-mock embryo transfer (me)  ✓
-saline sonogram (me)  ✓
-infectious disease panel bloodwork (Eric)  ✓
-CBC, blood type, etc (me, because our old fertility center threw my records away)  ✓
-consent forms signed  ✓
-genetic testing waiver signed  ✓
-meds delivered  ✓

The mock ET went well, and everything looked good on the sonogram. I take my last BCP tomorrow (thank goodness, I have been so nauseous on them!) and on Saturday I have my baseline sonogram and bloodwork. If everything looks ready at that point (ovaries "quiet") I'm scheduled to start stims on Tuesday the 6th.

The meds I'm on are different than last time - different protocol, different brand names, but also I don't think I'll be able to mix them down into one injection. I'm using the Follistim pen (can't mix anything else into that), prefilled Ganerelix syringes (ditto, I think), and Menopur. Add to that the Lovenox I'm already taking (also prefilled syringes) and I'm going to be doing 4 injections a day for a while. And having blood drawn every other day/every day. I'm going to run out of spots pretty quickly. IVF friends, any suggestions??

First Day of Kindergarten

Ch-Ch-Ch-Ch-Changes

It's been a crazy summer. The FET, YW Camp (SO FUN), the miscarriage (really really not so fun), Sawyer's pre-kindergarten evaluations, and now we're gearing up for IVF #3.


After a lot of thought and discussion we decided to switch doctors. Our previous fertility clinic did a lot of great things for us, but increasingly we were running into problems there. For one thing it's about an hour away from where we live - it used to be the closest option, but we have moved three times since we started going there in 2003. In recent years they have downsized, and the office is severely understaffed. It was normal to sit in the waiting room for an hour before an appointment. There is only one coordinating nurse, and many times I called with a question only to find out she had already left for the day around 2:00 pm. I found this extremely stressful. And heaven knows IVF is stressful enough without stuff like that.

Before we could switch to a new clinic, we needed to get a copy of our records to bring to our new doctor. Sounds simple enough right? Wrong. It took an entire month of making phone calls to make this happen. The receptionist kept brushing me off and telling me she would get to it the next day (or week). She was actually quite rude about it and lied several times (she told me more than once that some of the records were stored off site and I later learned that this was not at all true.) Meanwhile, we were starting to get stressed because without the records we'd have to delay for an entire month. We did some research and found out that they are legally required to provide copies of our records within 15 days of requesting them. So we threatened legal action (I had Eric call, he's much better at being a jerk than I am) and guess what? The next day those copies were in my hands. We were still a bit on the fence about switching before this happened, and this made the decision MUCH easier.


We had a consultation with the new doctor the last week in July and were very impressed with him and the office. Besides the fact that they have an office ten minutes from our house (hallelujah!) it's the largest fertility center in our area, their success rates are some of the best in the country, and they have an extremely efficient system in place. This morning was my first real appointment (day 3 ultrasound and bloodwork) and not only did I not have to wait at all once I got there, I was in and out of the office in 20 minutes. It did feel a bit impersonal, like going through a factory, but I think it's a good tradeoff.


The best part about the new center so far is probably my nurse, C. She is about my age, and so nice - totally the kind of person I would want to be friends with. Every time I've left her a voicemail or sent an email she has responded within 1 hour. We haven't spent a lot of time with the new doctor, but he comes highly recommended (we know three couples who have gone to him in the past). He doesn't seem to be as personable as Dr. A, but he definitely knows what he's doing - and I hate to say it, but based on previous experience I'll take medical expertise and a well-run office over bedside manner any day.


Today's appointment went well, hormone levels are where they're supposed to be and uterus looks good. I picked up my prescription for OCPs (birth control pills) and I start taking them tonight. After some tweaking of the schedule to accommodate Erin's wedding (yay!) the rest of the cycle looks like this:

Lupron Trigger Protocol (High Responder Antagonist Protocol)  

August 19 - September 2 
-Take OCPs. 
-Day 3 bloodwork and ultrasound (done.) 
-Bloodwork for Eric and me (infectious disease panel for Eric, blood type, varicella and rubella titers for me.) 
-Mock embryo transfer. 
-Get clearance from hematologist to begin OCPs and Lovenox (done.)
September 3 - Pre-IVF bloodwork and ultrasound; sign all consent forms
September 6 - Start stims (Follistim 150 IU and Menopur 75 IU - these drugs stimulate the ovaries to produce multiple follicles/eggs)
September 11 - Start Ganirelix (this prevents eggs from being released before retrieval)
September 15 - Trigger injection (Lupron - helps mature eggs release so they can be retreived)
September 16 - Bloodwork - LH and P4 testing 
September 17 - Egg retrieval (I'll be under IV sedation, which will be awesome)
September 20 or 22 - Embryo transfer. (The exact date will depend on how well the embryos are growing in the lab - the 22nd would be optimal.)


Starting around Sept 11 the dates are a bit more approximate since everything depends on how well I'm responding to the drugs. I might need to be on them for longer or shorter than planned. We'll hope for shorter. I have become pretty tough about needles, I still don't want to be pricked any more than I have to.

Here we go... again!

Chemical

The results are (finally) all in:

7/1: hCG 30
7/5: 59
7/7: 64
7/11: 9

It's officially a chemical pregnancy. We are very sad, especially after being so surprised to get a positive in the first place. I keep telling people I was prepared to find out the FET didn't work at all, but I wasn't prepared to find out it did work, then maybe, then maybe not, then definitely not. It's been a very long ten days being in limbo, not knowing what will happen. In a way it's a relief not to have to wonder anymore, even though the news isn't good.

Thanks to all of you for your supportive words and prayers - we have needed them all and they have helped! We plan to move on to a fresh cycle soon.

Positive.....?

Yesterday was the big day - my quantitative hCG blood test. It was also the final day of Young Women camp, where I spent the past week as a level leader. (SO much fun, and so exhausting!) While at camp I tested with HPTs daily and on Wednesday, 7 days past our 5 day transfer (7dp5dt for those in the online infertile world) I got the faintest second line I've ever seen. In fact, I didn't quite believe that it was actually there, it was that light. The lighting in the camp bathrooms - and I'm using the word "bathrooms" here very loosely - was so dim that I had to take the tests outside into the sunlight to read them, which was somewhat comical since I didn't want anyone to know what I was doing, so I had to try to hide them behind my hand while also letting enough sunlight in to read the result. I texted E about that second line but didn't tell anyone else because it was so light I didn't really believe it yet. Thursday (8dp5dt) I tested again, and the line was still faint, but definitely there. I told my camp partner and sent out a few text messages.

Friday morning I had planned to go straight to LabCorp after packing up at camp, hoping I would get there early enough to get my results the same day. My sweet level leader partner Lezlie convinced me to leave early to make sure I wouldn't have to wait all weekend. Because of the 4th of July I would have had to wait until Tuesday, which was unfathomably long. I made it out by 7:40 and didn't get to LabCorp until 8:30 because my GPS kept telling me to turn onto streets that didn't exist (iPhone navigation finally came to the rescue.) I still thought that would be plenty of time. Once I got home, I took a shower, changed my clothes and waited by the phone. And waited. And waited. Finally at 4:30 I called the clinic, where I was very surprised to hear that they had not received my results, that they don't usually put STAT on the hCG lab orders (WHAT?!) and it was normal for them not to get results from LabCorp until 8 or 9 pm, long after the center closes. I just about lost it at this point, after having gone to so much trouble to get to LabCorp early enough in the day, only to have to wait over a 3 day weekend to get results. The receptionist I was talking to has never been exactly compassionate when I've had problems before (just her personality I think) but she seemed to feel sorry for me and promised to leave a note for Lan to call me first thing in the morning, since she was coming in for a transfer. I know I'm hormonal, and exhausted from camp, and a hundred other things, but REALLY? Is it that unreasonable to get hCG results the same day? I have NEVER heard of another center making patients wait overnight or longer to get results. This alone is enough to make me consider going with another clinic if we do this again.

Anyway...the call finally came this morning, and it was worth the wait - I got to hear the words "You're pregnant!" So wonderful to hear. The next bit was not as wonderful. My hCG is only 30. Within the normal range for 9dp5dt, but on the low side. The next test on Tuesday will give us a much better idea of whether this pregnancy is viable. And now you know why I'm postdating this entry. I'm not ready to put the news out there until we know things are developing normally.

Three Little Embryos

"Three little embryos"... kind of sounds like the start of a very modern fairy tale or nursery rhyme (have you ever noticed that in fairy tales things come in threes? Three bears, three little pigs, three brothers.)

We had our embryo transfer today and I now have three little embryos in my belly. They were thawed early in the morning and all three survived. Dr. A said they were "fair" in quality, a bit more tactful than "not so pretty." E and I dropped Sawyer off at his cousins' house, I took my valium (which made me completely loopy and weird) and drank my water, and we arrived to our appointment right on time. We had to wait for about half an hour because there was another transfer right before ours.

In the waiting room I quickly discovered that I had consumed way too much water beforehand. The instruction sheet said to drink 8 oz one hour before my appointment, because a full bladder helps them visualize the uterus with an abdominal ultrasound. I drank 40 oz, because during my mock transfer I drank 8 and it wasn't nearly enough. Nurse L had to keep bringing me water, and the final amount was 32 oz. So I figured 40 would be plenty. And wow, it definitely was. I was in so much pain I had to pee in small amounts FOUR times beforehand to relieve some pressure. Because water was constantly filtering in, I was still in a lot of pain during the transfer, with the speculum in and the transducer pushing on my belly. OW. Afterwards they want you to lie flat with the stretcher tilted so your feet are higher than your head for 30 minutes. After 10 I knew I wasn't going to make it. Nurse A asked if I wanted a bedpan and I gratefully said yes. Normally I would have been so embarrassed but it was so painful at that point I didn't care (the valium probably helped too.)

The transfer itself was very smooth. First they got me set up on the table and had us verify our names and birth dates with the embryologist to make sure we were matched up to the right straw. Then Dr. A put the speculum in me and cleansed the cervical area to make sure nothing harmful would be introduced with the catheter. At the same time Nurse A worked the ultrasound to get a good view of where everything was going to go. When it was time for the embryos they dimmed the lights (bright light can be harmful to them) and the embryologist brought in the straw (kind of like a catheter) that held our embryos. Dr A very slowly threaded the catheter through my cervix and up to the top of my uterus. The embryos are suspended in a liquid solution with a tiny air bubble next to them so that on the ultrasound the doctor can see where they land - the embryos themselves are too small at this point to be seen with the naked eye. They went right where they were supposed to. I wasn't able to fully appreciate the moment because of other urgent needs but it is an amazing process. We got a picture of the little guys/gals, which I'll post once I get a chance to scan it.

And now, we wait. I'm on two days of bedrest (only getting up to use the bathroom, although I admit I haven't been that strict about it). My parents and baby sister are in town so my mom and Tanne are coming over tomorrow to entertain me, which I'm very excited about. We have a busy weekend spending time with my family, and on Monday I leave for Young Women camp for five days. I think this two week wait is going to fly by.

Not So Pretty

Yesterday I had an appointment to make sure the birth control pills are suppressing my ovaries. Lan (the coordinating nurse) was out of town so they were running late and we had to sit there waiting for over an hour. I didn't think I was going to make it back home in time to get Sawyer off the bus. This is where living an hour away from the center can be problematic. Finally Dr. A was ready to see us, and everything looked good. I'm suppressed (in more ways than one now, haha) and the cyst is shrinking. The hormones are doing their job, beyond just making me really really cranky! I got the go ahead to start Lupron, 20 units a day.

Eric came with me to the appointment because we also had to sign our consent forms. The forms give basic medical information about the various procedures and their risks, as well as the risks of pregnancy. You sign off on those, I guess so you can't later sue the center if things go wrong. Then you have to decide what will happen to any leftover embryos. Since we only have 3 it's not likely that we'll have any left, but we're thinking ahead to fresh cycles in the future where that is a possibility. They take you through every possible scenario - for instance, if your husband dies, what do you want to do with the embryos? If you die but your husband's still alive? What if you both die? Or what if you get divorced? Yeah, all really fun to think about. For each scenario there are several options - donate to another couple, donate to research, store indefinitely, or discard. So we made all those decisions and signed off on them with the notary, Carol at the front desk - who by the way is hilarious. (Our decisions: If I die, discard; if Eric dies, discard; if we both die, donate to another couple; divorce, discard. I would rather donate to research, but Eric is not comfortable with that.)

Then we discussed our embryos and how many we should transfer. This part was pretty discouraging, because after reviewing the images taken 7 years ago, Dr. A said "They are...not so pretty...no offense." (To which I wanted to respond, "Hey buddy, tell YOUR embryos to look in a mirror sometime!") Last time we did IVF we used the best 2 embryos to transfer, which was obviously a good choice because it got us Sawyer. Unfortunately the ones we left behind are much lower quality, and will likely be even worse after thawing (the thawing process can sometimes damage embryos; interestingly, the amount of time they have been frozen is irrelevant.) Two are blastocycts, but not expanded, and one is a morula, which is not great at all.

We are doing assisted hatching, which could help, and the fact that we've had a positive result in the past works in our favor. But still, Dr. A gives us about a 20% chance with these embryos and told us to be prepared for a negative result. Which is kind of funny, because that's already the way I've been feeling about this cycle. I'm prepared for it not to work. But we are still going to give it our all, because we both feel strongly about giving these embryos a chance. As far as how many, we decided to go ahead and transfer all three - since they are lower quality the chances of all three implanting are "zero to minuscule...it would be an absolute miracle." So I feel good about that.

I also asked how likely it is that things will go according to schedule and he said "Extremely likely...98% chance." REs are really good at speaking in percentages.  So I need to reschedule Sawyer's opthamologist appointment that's the same day as embryo transfer.

Next step: I stop birth control pills on Tuesday, go in for another ultrasound on Friday and start Estrace that day if everything looks good.

I'm Only In It For The Drugs

I'm on a lot of medications right now. Like, a LOT. Here's the list (full disclosure: I have to look at my list on my iPhone to remember them all.)

-levothyroxine (for hypothyroid)
-metformin (for PCOS)
-bromocriptine (for elevated prolactin, probably also related to PCOS)
-birth control pills (part of FET cycle)
-prenatal vitamins (doesn't hurt to be prepared)
-vitamin D (because I am always pasty white)
-baby aspirin (increase blood flow to uterus)
-Lovenox (to prevent blood clots, since I am "blessed" with Factor V Leiden and MTHFR.)

The last one is what is causing all the trouble, and not just because it stings like a mofo. My insurance doesn't seem to want to cover it. At first they would let my pharmacy fill it, but only 6 syringes at a time. With a $10 copay, that's actually pretty reasonable compared to the out of pocket price (at least ten times that amount, even for the generic, which explains their reluctance to pay for it.) It was just kind of a bother to make such frequent trips to Target. Then last time when I tried to fill it I got rejected - they now will only give me 6 syringes every 23 days. Which is pretty useless since I need to take it daily or I could, you know, die from a pulmonary embolism. (Also, 23 days? Why not 20? Or 30? Or 42? Who came up with 23?) I've talked to several customer service reps who have been about as useless as their current Lovenox policy. It's supposed to be a straightforward process: have my doctor call them and tell them I need to take it every day, but that's happened twice already and for some reason that hasn't been enough to change it. Thankfully my hematologist had some samples in the office and she let me have enough to cover me for the next few days while we battle things out.

Watch out Cigna. I'm willing to fight for a long time to earn the privilege of not dying of a blood clot.

Scheduled

Big news today - well, not Osama Bin Laden-big, but infertility saga big. I'm scheduled! All the preliminary testing is done and we are officially cycling, gearing up for the big FET.

Here's the rundown, for anyone interested in such things (and for my future reference - I can't even count the number of times I've gone back to posts about our first IVF to remind myself of what happened.)

5/9 - Baseline sonogram & bloodwork. Begin birth control pills and Lovenox injections*. (Done.) The sonogram didn't go quite as expected since we found that I have a large ovarian cyst, but the bcps should shrink it down. We hope.

5/27 - Sonogram. Begin taking Lupron, 20 units a day (sub-q injections.)

5/30 - last birth control pill

6/3 - Sonogram & bloodwork. Begin Estrace (not sure yet if it will be in pill or suppository form,  but the important thing is it's NOT an injection!) Reduce Lupron to 10 units a day.

6/7 - Start doxycycline (antibiotic) 100 mg, 2x day for 15 days. Eric takes it for 10 days.

6/10 - Sonogram & bloodwork. 

6/16 - Sonogram & bloodwork.

6/17 - Begin progesterone. Suppositories, not PIO injections. Hallelujah! With Sawyer I did PIO shots for something like 16 weeks, and I had nerve pain in my butt for a good two years after. I hear the suppositories are messy, but hey, I'm a mom, I can deal with messy.

6/22 - Embryo transfer.

7/1 - Beta test.

The last half of the schedule is extremely tentative and there's almost no chance everything will actually occur on those days, since it all depends on my body's reaction to the drugs. And if there's anything we know by now, it's that my body is unpredictable these days.

I've been on the phone all day scheduling appointments and ordering medications - from two different mail-order pharmacies, since apparently Village is out of Lupron. It was pretty funny talking to the lady at Freedom Drug, which we used for our last IVF in 2004. When she verified my address the one she had was 3 moves ago. It's funny how many things change if you just wait 7 years.



*I've been doing the Lovenox injections for 5 days and I'm already running out of non-bruised skin on my belly. And it really hurts, every time. How did I do this for nine months?

Stats

Invasive fertility tests: 6 (HSG, SHG, hysteroscopy, endometrial biopsy, mock embryo transfer, pituitary MRI)

New things we've found wrong with me from said tests: 5 (high prolactin, high TSH, blocked fallopian tube, endometritis, PCOS)

Blood draws done in the past 2 weeks: 6

Blood draws where they had to stick me more than once: 3 (on one occasion it took 4 pokes. Nice going, LabCorp.)

Medications I'm taking daily: 7 (surely this is excessive, especially since I haven't even started cycling yet.)

Voicemails left for my coordinating nurse: haven't even tried to count.

My ability to focus on anything other than this FET cycle: negligible.

One Down

HSG=DONE.

Thank goodness. I was so nervous going into it because last time I had one (almost 7 years ago) it was very painful. Hollering obscenities painful. The main purpose of an HSG is to find out if the fallopian tubes are open and basically in working condition. They inject dye into the uterus and through the tubes while they watch on an x-ray machine. If a tube is not open it can be pretty painful as the dye tries to get through, and that's what happened to me last time. I ended up having a diagnostic laparoscopy to investigate the non-cooperating tube and they found that the tube was fine, but I had stage 1 endometriosis.

I was sweating the whole drive to the clinic yesterday. I decided not to have Eric come with me because I realized he wouldn't even be allowed in the room during the procedure anyway (since they use x-rays they limit who can be in there), and it was getting complicated figuring out how to get Sawyer off the bus and not interrupt his schedule too much. So E stayed home to get Sawyer, which simplified things and turned out to be just fine. I told Dr. A how nervous I was and he promised me he would go very slowly to minimize the cramping. I also took 800 mg of Advil an hour before the best and popped 1/2 a hydrocodone tablet, which really helped with the anxiety and probably the pain too.

The test went great. It did hurt, but it was totally manageable and I didn't swear at the nurse. The results were the same as before, one tube didn't open, but Dr. A feels that we're OK to proceed with the FET since there doesn't seem to be any swelling or fluid buildup. (If you're like me and you wonder why the tubes matter for IVF/FET - which bypasses the egg traveling from the ovaries - here's a good explanation.)

I also had a brief consult with Dr. A to talk about my recent bloodwork. My TSH (thyroid) levels are higher than they like to see - below 2.7, and mine is at a 3.02. Not a level where most doctors will treat you, but too high for fertility cycling. My prolactin levels have also been consistently high, which is concerning, so I have to schedule an MRI to make sure I don't have a tumor on my pituitary gland. From what I've been reading online, hypothyroid and elevated prolactin can sometimes be related, so that would make sense. It also explains why my periods have been completely wacky the past few months. I've been on levothyroxine for the thyroid for about a week and I'll probably start on meds for the prolactin soon once we rule out a tumor.

All of this is throwing me for a loop since last time we did IVF my tests were all completely normal (aside from the mild endo.) Now it seems like we keep finding things. I'm trying to take it all one step at a time. On to the next test.

Waiting

There are lots of things about infertility that are hard. Invasive testing, surgeries, needles, mood swings, being on a constantly moving emotional roller coaster, the list goes on. Someone asked me the other day what the hardest part is. I answered without hesitation: WAITING.

Every step along the way of an IVF cycle involves waiting, which can literally add up to months, even years. You wait for your initial appointment. You wait for your period to start. You wait for test results, then wait to schedule yet another test. You wait for your estrogen to go up, or your lining to thicken, or your estrogen to go down. You wait, yet again, for the nurse to call you back (this is what I'm waiting for today.) And the biggest wait of all, where after all the testing and procedures you wait on pins and needles to find out if it all worked or if you get to start the waiting process all over again. 

This cycle has had even more waiting than normal because for the first time EVER since hitting puberty, my period was late. Ten days late. They put me on provera to get things going, which worked much more quickly than it was supposed to, which means it's anyone's guess how long it will last and if I can go through the testing I've scheduled (period has to end before the tests.) Speaking of which, here are the dates for those tests. Very tentative at this point because of my screwed-up cycle.

3/31 - HSG (SO nervous about this one, and I really wish Eric could come with me. Still trying to work that out.)

4/5 - mock embryo transfer

4/6 - SHG

4/7 - hysteroscopy and endometrial biopsy

If all goes well we're looking at a transfer date somewhere from mid-May to early June. 

If I can wait that long.

Obligatory Catch-Up Post

In 2010...

Sawyer turned 5 years old, and is attending the special education preschool program again with his beloved teacher Ms. Brenda. We're trying to get him as ready as possible for kindergarten in the fall, and at this point it's looking like he'll do well in a mainstreamed class. It's amazing how much he has improved. Still no diagnosis but we're working on it along with his teachers and developmental pediatrician.

I planted more tulips. I will not rest until every inch of flower bed is full of tulips!

We finally replaced the dirty white carpet in our family room with hardwood - so much easier to keep clean!

We had lots of playdates with cousins Caroline and Mary Grace, always Sawyer's most favorite friends.

I went to Girls Camp as a stake level leader, and it was the highlight of my summer. I'm now working with the young women at church, and I get to be a level leader again this summer - yay!

The other highlight of my summer was spending two whole weeks at the Outer Banks with my family. Relaxing, refreshing, rejuvenating...take your pick. Eric even came for about 5 days.

Penny picked up a bad case of scabies at the boarding kennel while we were gone. It took us 3 vet visits to finally figure out why she was so itchy all the time. Poor doggie in the Cone of Shame.

In September we adopted another rescue dog, Duncan. He's a 1 year old Golden Retriever and loves every human being in the world like crazy. We love him too, even though my vacuuming has tripled since we brought his furry butt home.

Sawyer had a blast being Buzz Lightyear for Halloween. He was a big hit at the town parade - even though he wasn't actually in it. Kids from the floats kept yelling "Hey! I see Buzz Lightyear!"

We attended the Rally to Restore Sanity on October 30. Sawyer loved it, especially when we had to force our way onto a packed Metro car to get there. He kept telling everyone we saw "I'm going to a rally!"

I completed the Couch to 5k program in preparation to run my first 5k (the "Freeze Your Gizzard" in Leesburg) but unfortunately got injured the week before the race (not from running - from Duncan running into my shin! No break, just a bone bruise but the doctor was scared about blood clots.) I'll do another one someday. 

Maybe.

In December Sawyer lost his first tooth. He didn't even tell us it was loose, I just went to put him in the bath and noticed that it was missing. We found it on the kitchen floor.

We stayed in Virginia for the holidays this year. For Thanksgiving we had dinner with Robbie, Michael, Erin, and her friend Avery, and a fun brunch at Megan and Ryan's the next day. We spent Christmas Eve attending church with Megan, Ryan and their kids and had dinner at their home (where Sawyer lost his second tooth - Santa and the Tooth Fairy came the same night!)

We took Sawyer to his first Kennedy Center performance - The Nutcracker. He loved it and, to our great surprise, sat still through the whole thing.

After Christmas we flew to Utah to see my little sister Tori get married to Billy Strong during one of the biggest snowstorms of the year. It was wonderful to be there for their special day as well as to spend time with my mom. Another shining moment was spending New Year's Eve in a sports bar called Wing Nutz trying desperately not to laugh as a group of very white Provo rappers "performed" a few feet away from us.

Concerts! I got a few good ones in this year - Ray Lamontagne and David Gray at Merriweather Post Pavilion in August, The Weepies at State Theater in November, Joshua Radin at the 9:30 Club February 15, and David Gray again just last week at the Music Center at Strathmore in Bethesda. The last one was quite possibly the pinnacle of my entire concert-going career - front row, dead center, acoustic tour. Perfection.