The Journey Continues.....Part 2

By mid-July we were pretty well settled into our new home and ready to make a plan for continuing our IVF adventure.  The kind of odd part was that I wasn't wanting to move forward because I was mourning my recent loss and really wanted another chance for a different outcome (because I wasn't...I was still completely at peace about it all), it felt more like important unfinished business that needed to be addressed.  (Believe me -- I KNOW how detached and strange that sounds, but it was the truth just the same.) So I called the local clinic and made an appointment to get the ball rolling.  Because my fresh cycle was so recent, there wasn't much to do.  All the necessary testing and bloodwork, etc., was already done and my Utah clinic was very helpful in transferring up all those records.  So basically I had a preliminary ultrasound with the doctor, and then met with the FET coordinator to set up my schedule.  Due to some planned family vacations (took the girls to Disneyland -- SO FUN!) and other scheduling conflicts, we decided upon September 8th (today!) as a tentative transfer date.  I left the office with a pack of birth control pills and a plan.

Now that I had an actual date set for the transfer, I began a daily "exercise" of evaluating my feelings about everything.  And I have to say, I was all over the place.  I spent some time with my very-pregnant sister, and kept thinking, "Man! I am so glad that isn't me!!!" (But then again, I have already clearly decided that wanting to be pregnant and wanting a child are for me two very different things...)  But then at the end of July when that same sister moved to a new home close to me (YIPPEE!!!!) and I got to spend time with my newborn nephew, I would think, "Okay - he is so cute and snuggly and warm....I could do this again!"  And for a few days I found myself (for the first time, really) wanting a baby.  Especially when I watched the pure delight on my girl's faces as they held their tiny cousin.  And honestly - that wanting was not really welcome.  If I was wanting, then that meant I was open for massive heartbreak.  I preferred neutral.  Fortunately for me, after a few days of the "wanting," the feeling kind of subsided and I was back to my happy neutral -- either my upcoming FET would be successful and we would be very blessed with another child to love, or it wouldn't, and I would continue to be blessed by the two miracles I already have.  I have no idea why my heart and mind have been so truly neutral about this whole thing, but I consider it a tender mercy from God, since I was absolutely powerless to control the outcome...

On August 18th I went in for my baseline ultrasound.  My lining was a nice, thin 2.27mm and my ovaries were "quiet" - just like it was all supposed to be.  Then the next day I started my first injections of Estradiol Valerate -- basically straight estrogen, I think.  Though I was certainly not eager to start having my hubby stick a 1 1/2" needle in my bum again, the amount of medication was not a big deal, and so the resulting soreness wasn't a big deal either.  And I only had to do the injections on Tuesdays and Fridays, so I was good.  (The biggest problem was that the meds caused my boobs to get sooo sore! Not that any of you wanted to know that, but the whole point of this blog is to accurately record this whole experience, and believe me - this soreness was not to be ignored!)  On August 29th I went in for my second lining check.  The injections had done their job - my lining was a nice, thick 12mm!!  Everything was progressing nicely.

Then came Saturday, September 3rd--the day I had to begin the dreaded PIO (Progesterone-in-Oil) injections. (This clinic doesn't do the Crinone... :( ) When I drew up the full 2ml into the syringe, my dh looked at it and said, "Surely that can't be right...that is so much!"  Unfortunately I had not made a mistake.  Just to be clear, it is NOT the 1 1/2" needle being shoved into my muscles that is the problem, it is the fact that ALL THAT OIL has to go somewhere!  And I can feel it spreading out into the muscle as my dh does the injection.  The initial shot isn't too bad, but about three hours later the whole left side of my upper bum was so painful!  By the next morning, it seriously felt like I had been kicked by a mule and it hurt to move at all.  And what did I get to do?  Draw up another 2mm of oil to inject into the non-sore side.  Then comes Monday, and my left side is still so very sore, but I have to inject another 2mm of oil into it anyway!  And I am not exaggerating when I say that it starts to feel very much like torture.  I pretty much sat on a hotpad all day Monday and tried not to move.  The heat seemed to help and by Tuesday I wasn't feeling quite so miserable anymore.  And I sat in a long, hot bath Tuesday night which also helped ease the ache.  By Wednesday my body had kind of gotten used to the "torture" and the constant ache had settled down to a tolerable level. (Good thing, too, because IF I get pregnant I have to do daily PIO injections until 12 weeks gestation!!)  But believe me when I say that PIO shots really are awful and anyone who has to endure them deserves the right to whine about it as much as they like... (In addition to the PIO injections, Saturday I also started a course of Doxycycline and Medrol in preparation for my Thursday transfer day...)  

The Journey Continues.....Part 1

Yikes!  I can't believe the last time I wrote was clear back in April...   There is so much that I should have been writing, but I didn't.  So I will do my best now to get down the important stuff.  But it won't be in the "present tense" anymore...sorry!

Well, after my early miscarriage in April, we decided it was time to take a little break from the whole madness that is fertility treatments.  But first, I needed to get my little embies safely up to Boise.  Fortunately for me, my parents were planning on coming to Boise in May anyway to attend WICKED.  So I got on the phones and got everything arranged for RCC in Utah to pack up my three "frosties" in a specialized cryotank.  Then my parents were able to pick up the tank and strap it into the backseat of their car for the trip up to Boise.  (Normally that tank gets sent via UPS, where who knows how roughly it gets tossed around!  I much preferred the peace of mind of my parents making a road trip with their potential grandbabies!)  And my mom was cracking me up during the drive.  She kept sending me texts saying stuff like, "Things are going well, but #2 keeps complaining that #3 is touching him," and "We had to stop AGAIN for #4 to use the bathroom..."  The best quip I could come up with was, "Too bad my embies were too "cool" to enjoy a roadtrip with their grandparents!"  We were just being silly, but it was fun.  And when my parents arrived in Boise that evening, the clinic was already closed so we needed to keep the cryotank overnight.  It could have been placed anywhere that it wouldn't get knocked over, (it is about 3' tall and 18" wide, and sort of mushroom shaped) but I thought it was funny to set up my port-a-crib and put it in there.  So somewhere I have a picture (I will post it when I find it) of the first night my embies spent at home, safely tucked away in the port-a-crib in their cryotank. :)  The next morning we took the cryotank to the Idaho clinic where my embryos were safely transferred to their storage place.  (And luckily for us, they said as long as we were planning on doing a frozen transfer in the near future, they wouldn't charge us any storage fees! Hooray!)

Honestly, I did breathe a huge sigh of relief knowing that my embies were now safely waiting close to home.  It enabled me to mentally as well as physically take a real break from fertility stuff for a bit.  And that was a good thing, because when I returned home from Utah in early April, I noticed that my next-door neighbor was totally gone and that there were For Sale signs in front of her home.  I didn't know it, but the home had been foreclosed on while I was out of town, and was now bank-owned and up for sale.  I didn't think much about it, because that home had been for sale before in the past couple of years, but always at a price that was waaayyy more than we would have ever considered.  But then a dear friend of mine told me she was looking to buy a new home, and I teasingly suggested she buy the one next door!  So on May 15th I saw a realtor leave the home, and on behalf of my friend, I inquired what the asking price of the home was.  He told me that the bank had just lowered it and told me the new asking price.  I think I about fell over.  They were asking LESS than we had paid for our current home, and this one was 900+ square feet bigger with nicer upgrades.  I went home and told my husband the asking price, and we immediately called our realtor.  Jake came right over (because he is the best realtor ever!) and we all took a look at the home.  Besides the fact that it desperately needed new carpet, the home was in beautiful condition!  And it had all my favorite elements of my current home, just bigger and better with lots of new ones.  (Like a huge laundry room with a SINK, and extra bedrooms for a toy room, guest bedroom, etc., plus still giving Rich an office and me my photography studio!)  That night my hubby and I had a LONG discussion about things.  And even though we had not EVER mentioned buying a new home, we decided this opportunity was too good to pass up.  So the next day our realtor came over and we put in an offer on the home.  (And as it turns out, two other people had the same idea that day, so if we had waited even ONE MORE DAY thinking about it, we would have lost the home.  Instead we got into a mini bidding war, which we ultimately won. :) )  The next few weeks were a total crazy blur.  We very quickly worked out our financing, and managed to convince the bank to let us close on June 8th -- just 21 days after our offer was accepted!  And I spent those 21 days sneaking over to the house (I managed to procure a garage door opener...hee! hee!) dragging different carpet samples to pick out just what I wanted, and measuring different spots in the house to plan where our stuff would go.  So by the time the bank representative came to get the lockbox and signs on June 9th, I already had people in the home ripping out the old carpet, and someone else helping to install my new range, etc.  (The look on his face was pretty funny!)  So in less than one month, we went from NEVER discussing buying a new home to the strange but exciting task of moving all of our belongings next door.  (And I mean LITERALLY the house NEXT DOOR.)

And somewhere in the middle of all that crazy, exciting chaos I paused and thought, "Oh yeah, I just miscarried my pregnancy after an intense full IVF cycle!"  But it was strange...even though that had just occurred, it already seemed like so long ago.  From the moment I got the call telling me that the babies were gone to that point, I had been completely numb about it.  Not grief-stricken-can't-deal-with-this numb, but totally-at-peace-with-everything numb.  And then I just busied myself in the task of getting my new home all organized and put away.  (I should add that before we had even moved, some friends of ours who had moved away told us that they were moving back and wanted to rent our home.  So two days or so after we moved out, our friends moved in.  And they are not only fantastic tenants, but awesome neighbors as well. :) )  So life was just great and the new house was so amazingly fun and sometimes in the back of my mind I would remember that I had three little embies waiting for me to give them a chance at life...

this will have to do for now...

hello everyone.  I am so sorry...I know I am seriously the world's worst blogger.  And I don't have the time at the moment to write the whole story down (I will, just can't do it right now.)  But I am very sorry to everyone who has been waiting and wondering. So here is the very, very quick version:

I was starting to feel kind of pregnant and then on Saturday, April 9th, I started bleeding.  Very much like a period.  I raced home to bedrest and went in Monday morning for an early beta hcg (pregnancy blood test.)  It came back at 67! Hooray- I was pregnant!  But the bleeding was NOT a good sign.  (Although a 67 was a really high beta for that early of a testing day, so that was a strong indication for multiples.) But over the next three days, all of my pregnancy symptoms went away.  Then a repeat beta test on Thursday came back at 6.  I had an early miscarriage.

I am disappointed, but like I said at the beginning:  if it is supposed to work, it will.  If it's not, it won't.

But it's not game over yet.  We did freeze embryos #2,3,&4. So now I am in the process of figuring out how to transfer our embies up here to Boise.  We are going to attempt a FET (frozen embryo transfer) here with our local  fertility clinic.  That way is so much less disrupting for my family, and I can keep more quiet about it.  (I am not going to even tell my girls unless it works.  Don't want to have to tell them again that the "babies are gone."  More about that later when I really update this blog.)

So there is the update for now.  Again, I will "flesh out" this whole story soon, just not today.

The Superstar and The Underdog

Today was the big day....embryo transfer day!  Our appointment was scheduled for 9:00.  We headed out of the house on time, but as we were on the freeway, traffic all of a sudden came to a dead stop!  Apparently there had been a bad accident up ahead, and no one but ambulances and police cars were going anywhere.  As we sat there for a while it became obvious that we were going to miss our appointment.  So I called RCC to let them know.  Barbara answered and said, "Oh! That's too bad.  Thanks for letting us know.  But no worries, we are here and so are your embryos, so just get here safely when you can...Oh! And we got your PGD results in and they are awesome!  You have only one affected with CF, four that are carriers and four that are totally unaffected.  So we have some great embryos waiting for you -- see you when you get here!" And then she was gone.  I sort of just sat there for a moment and tried to process what she had said.  For one thing, I really didn't expect her to just sort of blurt out our PGD results.  But once my brain could wrap around those numbers, I got really excited!  That meant that we had eight embryos to pick from for transferring!  We have never had anywhere near that many to choose from before.

Eventually traffic got moving again and we arrived at RCC around 10:00.  We waiting in the waiting room for about 15 minutes before Barbara came to get us.  She took us to the consult room and told us that the doctor would be in when he could, but because the other scheduled patients had come when they were scheduled, we were going to have to wait a bit until they could "work us in."  But in the meantime, she gave us our PGD Report and our day 5 Embryo Report to look over.  So let's start with what the PGD Report said:

Embryo #1: Normal  (This one was the "superstar" from day 3...hooray!!)
Embryo #2: Normal
Embryo #3: Carrier (received gene from Mom)
Embryo #4: Normal
Embryo #5: Normal
Embryo #6: Carrier (received gene from Dad)
Embryo #7: CF AFFECTED (received gene from both)
Embryo #8: Carrier (received gene from Mom)
Embryo #9: Carrier (received gene from Dad)

Basically what this means is that we totally beat the odds again!  We have a 50% chance of contributing the mutated gene to our offspring, but we each only contributed it three times, and only one of those instances overlapped created an affected embryo, which is better than the odds! (And a lot better than our previous two cycles...)  So, so wonderful to be able to have eight choices, because it's not just CF status that matters, but also embryo quality.  So here is what the Embryo Report said Sunday morning:

(Embryos are rated according to stage of growth and quality.  By day 5 we need to see them advanced to Blastocyst stage.  Blastocyst 1 is okay, but they want to see Blastocyst 2 or 3 for the best chances of actually getting pregnant.  Then they rate the quality for Blastocyst 1 on the same Excellent-Good-Fair-Poor scale as day 3, but Blastocyst 2 also gets rated on outer cells and inner cell mass on a scale of A-B-C-D.)

Embryo #1: 2 BB Good  (Hooray! Again, this was the "superstar" from day 3, and not only was it not affected at all by CF, it also continued to grow really well and was a Blastocyst 2, rated BB and Good.  This is an excellent embryo!)
Embryo #2: B1 Fair  (not as good as hoped, but still this rating is a decent transfer candidate.)
Embryo #3: 2 CC Poor
Embryo #4: 3 BC Fair
Embryo #5: Stagnated (meaning stopped growing after day 3, was less than 30 cells when it should have been over 250, this type of embryo is essentially "dead.")
Embryo #6: B1 Fair
Embryo #7: B1 Fair (BUT CF affected, so not viable for transfer)
Embryo #8: Stagnated
Embryo #9: B1 Fair


So can you see how thrilled we were with our PGD results?  What if the only embryos without CF were number 8 and 5?  Or even 8, 5 and 3?  Our chances of getting pregnant with a 2 CC Poor would not be very good.  That is why starting with only four or five eggs is so awful.  But because we started with 10 mature eggs and had nine embryos and only one knocked out by CF, we had OPTIONS!! :)  And options, my friends, are a wonderful and amazing thing to an IVF/PGD patient.

We had already decided we would transfer the two best embryos on transfer day (if we were lucky enough to have two to transfer.)  So no matter what, we were transferring Embryo #1. (And I was very pleased about that, because I think that if genetic material is perfect enough to produce a "superstar" embryo, it stands to reason that the same genetic material is less likely to produce other congenital birth defects.  That's not coming from the doctor, that is coming from me and could be completely wrong.  But I like the thought just the same.)  But they weren't sure about what the second choice should be.  They told us that they were debating between Embryo #2 and Embryo #4.  They said that they would check them again right before our transfer to see which one looked best because they can change very quickly and even an hour can make a huge difference.  Then Barb left us alone in the consult room to wait for the doctor.

We waited probably 30 minutes more before the doctor was finally able to come consult with us.  He brought some consent forms (which we signed without even looking at them...so not like me!  I honestly have no idea what we signed, only that whatever it was they wouldn't go on without them so whatever.  But I am laughing at myself that I didn't even read anything on them.)  Then he gave me some valium to make my muscles relax.  This is because they don't want the uterus contracting when the catheter is inserted.  After only a few minutes of swallowing the pills I started feeling "fuzzy" in the head and heavy all over.  It was fascinating to me how quickly it took effect.  Then they led us (and my hubby was half-carrying me!) to a pre-op area to change our clothes.  Then it was time for the transfer!

The transfer room is a small "operating" room  joined by a secured door to the embryo lab.  And since our last time here they added something super cool -- a large flat-screen tv on the wall that is connected to cameras in the lab!  So they opened the door and Dr. Reggio (the supercool embryologist) was telling us what he was doing while we got to watch on the tv!  So we watched him take a circular "tray" that had little numbered indentations containing our embryos and he positioned the one labeled #1 under the microscope.  Then he scanned the medium for a small spot, zoomed in, and there was our embryo!  Then we got to watch him gently suck it up in a very, very small tube and transfer it to a holding indentation in the center of the tray.  (SO FASCINATING TO WATCH!!) Then we got some more amazing news.  Dr. Reggio explained to us that he had checked our other embryos right before we came in, and even though they had previously only been considering Embryo #2 or #4, in the past hour or so, Embryo #6 decided to have a "growth spurt" and was now upgraded from B1 Fair to 2 BB Good, the same as the "superstar"!! So even though that one was a CF carrier, it was now a really good looking embryo and our next best choice.  So we got to watch him find Embryo #6, gently suck it up and transfer it to the holding indentation with the other one.  Then we watched as he zoomed in the microscope, focused the camera and took the following picture for us:

My potential babies...aren't they cute? ;)

That, my friends, is what two great-looking embryos look like five days after conception.  And the "oozing" you see is them starting to hatch.  Yes, human embryos must hatch.  And once they do, the outer cells are what "burrow" into the endometrium and start forming a placenta.  And the inner mass of cells begins forming a fetus.  So even though this "oozing" is partially hatching and partially because there was a weakness in the shell from embryo biopsy, the result is the same: outer cells ready and waiting to burrow!

After taking the picture, Dr. Reggio very gently sucked them both into a catheter.  (All this time I was lying on the bed with my feet up in stirrups and the warm blankets over me...love those warm blankets! That plus the valium and I was feeling very heavy, and comfortable and kind of sleepy.) Then Dr. Reggio brought the catheter in to Dr. Heiner. While using ultrasound to guide him, he carefully and slowly inserted the catheter through my cervix and into my uterus. (You can't really feel much of anything, so it certainly is not uncomfortable or painful.) Then he pushes the contents of the catheter in and you see a little white "flash" on the ultrasound screen.  After that they all said "congratulations and good luck!" and left my hubby and I alone in the room.  They told me to lie still for about ten minutes and then slowly get up.  When it was time, my hubby had to help me up because I still felt like my limbs were filled with sand...strange feeling really!  Then we got dressed, and that was it!

So here is where it gets fun.  Unlike last time, this time I WILL KNOW which embryo (or both!) "took" (hopefully, hopefully!!) because #1 is unaffected and #6 is a carrier.  So when a baby (or babies?!) is born,   we will have them tested for CF to confirm the PGD results.  So if it is twins, I will know for sure if they are identical or fraternal (if same gender, otherwise it is pretty obvious!), because they will either have the same CF status (meaning an embryo split) or different, meaning both embryos implanted and grew.  Or if it is just a singleton, I will KNOW which embyro is his/her first baby picture!  Isn't that fun?!  And I can't help but smile when I think about Embryo #6.  Hopefully that one will "stick" and someday I will be able to tell my child that Heavenly Father knew he/she needed more time to grow so He had to delay my arrival to RCC! If I had been on time to my 9:00 appointment, Embryo #6 wouldn't have even been considered.  But because I was late, it was included!  I just think that could make a neat story to tell someday.

So now I just get to wait!  I have a pregnancy blood test scheduled for April 15th.  And right now, that day seems forever away!

"We Have a Problem..."

So yesterday I was waiting for my nurse to call me and give my Embryo Report (meaning how well the fertilized eggs had been growing into an embryo.)  She didn't call, didn't call, then finally I see her number pop up.  So I answer hello and my darling nurse says, "Olivia?  Hi, it's Katie.  I am calling because, um, we have a problem..."  Immediately I think, "Oh no! Not again! Did they all die?  Did someone drop the petri dishes and they got contaminated? What? What?"  Then Katie continues, "Well, I know I had you scheduled for 10:30 on Sunday, but some things have come up and I need you to come in at 9:00 instead....is that going to be okay?"  She sounded so nervous and worried I almost laughed when I realized it was just a scheduling conflict!  Seriously darling Katie -- don't call someone waiting to hear about their embryos and start a conversation that way!  After I confirmed that 9:00 would be just fine, she continued on to let me know that she didn't have my Embryo Report yet.

A few hours later, I was wondering why I hadn't heard back from her yet, so I called.  Katie answered and said, "Oh my gosh!  I totally forgot to call you back!  I am so sorry.  Let me get that report for you..."

So the deal with a day-3 Embryo Report is this:  by day 3 the fertilized egg should have grown into a 7 or 8 cell embryo, 8 cells being the optimal number.  But there is also a varying degree of quality, depending on things like how uniform the cells are in size, if there is any fragmentation (pieces of the cells broken off), etc.  They rate them as Excellent, Good, Fair, Poor.

This is what an "Excellent" day-3 embryo looks like.

This one is a "Fair." See the fragmentation?

 So here is our Embryo Report:  (from worst to best.)

1 10-cell Fair

1 8-cell Fair

1 8-cell Fair+

3 8-cell Good-

1 7-cell Good

1 8-cell Good

1 8-cell Excellent

Katie told me I should be excited about the "Excellent" one because they rarely see embryos that perfect.  And though I am, here's the "rub" for us:  no matter how perfect that embryo is, if we find out tomorrow that it is affected with CF, we will have to just throw it away anyway.  If we were doing regular IVF, we would be thrilled!  We would have an "Excellent" and a "Good" to transplant and seven others to freeze.  But we don't really know what we have yet. That said, we have six embryos that are looking pretty great, and three others that aren't too bad.  (We didn't have any Poors, or even Fair-, so that is quite good, actually.) So we are nonetheless quite pleased at this stage.  

Yesterday was also embryo-biopsy day, where they remove one of the cells from each embryo.  And although they do this as carefully as possible to avoid further damaging the embryo, sometimes they die because of it.  Here is a picture of a cell being removed from an embryo:

So now it all comes down to tomorrow.  We have an appointment with Dr. Heiner at 9:00.  We will get the PGD results from RGI then.  We will compare the PGD results with a new Embryo Report and see what we have to work with.  By day 5, an embryo should have around 256 cells, and either be an advanced morula or hopefully a blastocyst. (If you want to see a picture of both of those, go to my second blog post -- I have a picture of both from my last cycle...)  So either we will find out that we have something to transfer and we will continue on to that procedure, or we will find out that we have nothing CF-free left alive and we are left with nothing.  But with nine potentials, we are actually hoping that we will have two to transfer AND have something left over to freeze!  Even though we know embryos don't usually thaw well, (the failure rate is very high) it still would be nice to have the choice/chance of another child in the future without having to go through this whole process again (which is pretty much NOT going to happen...) 

For tonight, let me end with this:  everyone has been asking me how I feel about the whole baby thing now that I am this far into the process.  So I have really been thinking about it, and here is what I realized.  I honestly have no desire to be pregnant or have a baby!  In fact, I really dislike being pregnant!  (I am very, very grateful to have my own biological children and accept that pregnancy is a necessary part of that, I just don't have to like it!)  And babies are so hard!  I dread the lack of sleep, the constant pooping and feeding, etc., and am not the least bit eager for any of that.  HOWEVER (and this is a really big "however,") I DO WANT another child, in fact, very much.  I think another sibling would be fantastic for my girls, and so much fun as they get older.  If I could go to a store and pick out my very own 18-month-old, I would totally do it tomorrow!  (And no, I am not interested in adoption right now....I want to do it this way.) So I have finally come to the conclusion that I DO want to have this process be successful, just that I will have to endure the pregnancy and find the joy that I can in the newborn/needy phase.  Because after some time, I will have my wish, another darling toddler of my very own!

I Kick Out Quality, Baby!

I slept with my phone right by me last night in case RCC called earlier in the morning to give me my Fertilization Report.  But by 10:30 they still hadn't called and I started getting antsy.  Then around 11:30 I tried to call, but it went right to voicemail.  So then I got busy helping my mom with a project and tried not to think about it.  But then I started thinking, "What if all my eggs were bad and they just don't know how to tell me and that is why they haven't called?!"  (Which I know is ridiculous, but it could happen!)  Then finally at 1:44pm they called.  After chatting for a few minutes about how I was feeling, my cute nurse finally said, "So, are you ready for your Fertilization Report?"  And then she told me the craziest news ever!  Out of my ten eggs, all ten were mature!  I seriously don't even know how that is possible, since those last two follicles were new and not very big at all, and the doctor was actually surprised (as were we) that we collected ten eggs in the first place.  But for all of them to be mature?  That has got to be some new record for RCC.  Then she went on to tell me that nine out of the ten fertilized normally!!  That also is off-the-charts good.  So I now have nine potential embryos!  Who would have thought that possible?!?!  Now obviously there are still hurdles to cross before transfer day, but still -- starting with nine potential embryos is waaaay better than I expected.  It will be interesting to see what happens next.  All nine could grow well and be genetically okay which means we would transfer two and actually have some to freeze (another thing I never thought possible for us...)  But also, all nine could stagnate and/or be CF-affected.  Most likely something inbetween will happen.  We won't know until we get there.  So stay tuned!       

So Far, So Great!

I want to start this post with a note about the trigger shot.  I took it on Sunday night and the injection itself wasn't much worse than the routine ones.  However, the next morning there was a red mark about the size of a silver dollar around the injection site and my whole upper leg hurt so much!  I felt like I had been kicked by a mule!  The instructions said, "may cause redness and irritation around the injection site...."  You think?!?!  I was seriously limping around all day.  I was just really grateful I did the shot in my leg and not my stomach -- that pain would have been much worse to bear.

Monday morning I got the girls ready and headed to the airport to pick up Daddy (and Uncle Blaine who came with Daddy.) We collected them and headed to the mall for a bit.  Afterwards I realized that I was quickly running out of time to take the necessary pregnancy test in the timeframe I was instructed.  So we drove down the streets of Murray, Utah, searching for a grocery store or something.  And I tell you what, if I ever desire to open a grocery store, I will do it there!  Mile after mile we could find nothing!  Finally I saw a "Family Dollar" store and told my hubby to pull over.  I went in and searched a little, but couldn't find any pregnancy tests.  My plan was to grab one, sneak into the restroom and use it, then take the empty box up to the register to pay for it.  In desperation I finally asked an employee, and she told me that they keep them under the register and the check-out girl would be happy to get one for me.  So I had no choice but to ask the only check-out person for a pregnancy test.  And to make things even better, I had also noticed that you needed a key to unlock the restroom door.  So I had the pleasure of asking the girl for a pregnancy test, paying for it, then explaining to her that I had a real medical need to use the test right away and could she please open the restroom for me?  To her credit, she was very gracious about it, but for me that still was a very long two minutes in the bathroom waiting for the test results!  (It was positive, like it was supposed to be.)  We spent the rest of the evening as a family, going to dinner and watching a movie.  It was great to have Daddy with us.

Then this morning my hubby and I headed up to RCC for egg retrieval day!  It was actually very nice to have the whole drive alone just to talk.  Pretty soon after we got there they took my hubby back to The Room to collect his "deposit."  Then it was time for a consult with Dr. Heiner.  He basically just went over the things we already knew: that not every follicle will have an egg, that not every egg will be mature, etc., etc.,  Then he said that based on how things looked, we could expect to retrieve five or six eggs.  After the consult we were shown to a pre-op room where I changed into a hospital gown.  Then it was time for my procedure.  I was taken into the "procedure room" and covered with warm blankets.  I love that part!  There is something so relaxing about having a heavy, pre-heated blanket draped on you.  Then the anesthesiologist put a needle in my arm and I started feeling fuzzy all over.  The next thing I remember was my hubby saying something like, "Hello, Sleepyhead!" And then the best part of the day:  our nurse came in and told us that they retrieved (drumroll, please...) TEN EGGS!!!  Now we won't know until tomorrow how many were mature and how many fertilized properly (and I know not all them will), but still -- when we were hoping to start with six if we were lucky, ten seems just awesome! (And that is a new record for me as well.) Especially if you consider that up until my very last ultrasound, I only had nine total follicles showing.  So that means that even one of the smallest ones that popped up in the last couple of days had an egg.  So I am thinking that if my system was able to produce an egg from a little one, the chances of the medium-sized follicles producing a mature egg are that much greater. :)  Of course, I could be wrong and maybe only four were mature.  Who knows?  But I'll find out tomorrow!

As for the rest of today, yikes am I sore!  The pressure from all the follicles is gone because they drained them, but my ovaries are feeling very swollen and painful.  It is tolerable if I am sitting/lying down, but if I have to stand up it's like everything shifts and oh man! It is making me walk around doubled over like an old man. (If I must walk around.  I prefer to not move right now!) I am not trying to complain, merely documenting the truth for anyone who may read this and wants to know what this whole process is really like.  But this pain will go away (hopefully sooner than later!) and at least it comes with what feels like a great victory -- we got TEN EGGS! More hurdles to come, but we sailed over the first one and in spite of everything else, that feels great. :)

Triggering Tonight

I had another ultrasound/blood draw today and the results were as follows:  estradiol level of 1,032. (Dr. Heiner said that if it came back 1,300 I would trigger tonight for sure; if it was over 1,000 he would have to decide.  So I am not sure why he decided to not go one more day, but I must trust his judgement...)  The two follicles on the left were 16.12 and 15.04.  And today he found nine follicles on the right.  They measured as follows: 18.57, 18.2, 11.92, 13.44, 17.15, 11.69, 18.76, 10.25 and 7.66.  So if anything over 14 has a chance of containing an egg, I am looking at a possible of six eggs.  But sometimes the big ones don't have one, and sometimes they get surprise eggs out of small ones.  So...we'll have to wait and see!

So tonight I take the "trigger shot."  Each day as part of my meds I have been taking a small amount of low-dose HCG.  (This is the "growth hormone" that makes the eggs mature.  It also is the same hormone produced by a growing fetus, hence the mild "pregnancy symptoms" I have been experiencing.) But tonight I take a 10,000 IU dose of HCG.  This is the final push to help the eggs mature.  And I have to take it at exactly 10:00 pm, because a certain set hours after taking this shot my body will release all the eggs on its own.  So egg retrieval is very carefully scheduled to this trigger shot.  The funny part is that tomorrow morning I must take a pregnancy test.  It is supposed to come out positive, meaning that all the HCG has been properly absorbed.  If the test is negative, something went wrong.  It is just a funny experience to be able to get a bright pink line on a pregnancy test when I know it is not real!

So tonight at 8:00 I will inject my last drug cocktail, then at 10:00 inject the trigger shot and then I am ALL DONE with the needles!!  Tomorrow I don't have to do anything but pick up my hubby from the airport and enjoy being a whole family again.  Then Tuesday morning it's off to RCC for egg retrieval!

It's a Numbers Game

Well, I just got back from my ultrasound appointment and things are interesting.  Let's start with the positive:
The other day my uterine lining measured at 3.97, and today it measured at 7.94, which is great!  It must be above 7 to be "ready", and 8 is actually optimal.  So that aspect of things is perfect. :) (This means that an embryo would have the best chances possible to implant or "stick" and actually perpetuate a solid pregnancy, so that is very, very important!)  However, of the nine or so follicles he measured, he thinks we can expect only FIVE eggs.  He said anything over 14mm has a good chance of containing an egg, and he likes to trigger when one or two have reached 17mm. (Today the two on the left were 14.83 and 13.8.  The seven on the left were 17.02, 15.66, 11.04, 9.34, 16.4, 15.33 and 10.43.) Now, there are still a couple of days to follicles to grow, so I still have hope that I will again have some "late bloomers" pop up and give us an egg.  (After all, on Wednesday my estradiol level was 174, and today it was 686, so who knows what could happen in a couple more days!)  We won't really know until all is said and done at egg retrieval day.  I am going back in the morning.  He is going to decide whether I will take my trigger shot tomorrow or Monday.  Personally I am hoping for Monday just to give my potential eggs that much more time to mature.

So why does number of eggs really matter?  Because for persons in my circumstances especially (meaning not fertility issues, but genetics,) it really is a "numbers game."  Meaning that for many women who have fertility issues like recurrent miscarriages, etc., they often have no problem creating embryos, just getting them to "stick." But for me, my greatest challenge is getting something to transfer!  If I can get that far, my chances of a solid pregnancy are higher than a woman who has other fertility issues.  Here is how the numbers work:

1) You take meds to stimulate as many follicles as possible....ones 14mm or bigger have a good chance of containing an egg.
2) Of all the eggs collected, only some will be mature.
3) Of all the mature eggs, only some will fertilize.
4) Of all the fertilized eggs, only some will fertilize normally.
5) Of all the normally fertilized eggs, only some will grow to a solid 7 or 8 cells by day 3. (This is when many IVF patients choose the best-looking embryos to transfer and freeze any others.)  But for us PGDers, it continues:
6) The embryos then are subjected to the embryo biopsy procedure.  They use either a teensy drop of acid or a tiny laser to create a hole in the zona pellucida (the "shell" that hardens around a human egg once it has been fertilized) and use a very tiny needle to remove one of the cells.  (The other seven cells then go on to compensate for the loss and a normal baby develops.  That's why embryonic stem cells are such a hot debate right now -- in theory each one of those cells could be turned into a new heart, lungs, liver, whatever.) The embryologist does this as carefully as possible, but it can cause the embryo to stagnate, or stop growing.
7) The embryos that survive biopsy must then grow and develop for two more days.  This may not sound like a big deal, but keep in mind that this whole process is NOT supposed to happen outside the human body.  So when you are doing it in a petri dish, (or whatever medium they use) instead, not all embryos are strong enough to make it.
8) During those last two days our biopsied embryonic cells are overnighted to RGI so their DNA can be extracted and analyzed using our personal test.  So we go to RCC five days after egg retrieval and sit down with the doctor to review the report from RGI.  Our biggest fear is that by the time we get there, the only surviving embryos will have CF.  If that were to occur, we would have nothing to transfer and this process would be over for us.  Or, as what happened last time, we had four embryos alive by day 5, and two of them were only carriers for CF, so we transferred both and I became pregnant with our daughter. :)  We literally will not know until the very last moment whether or not we have an embryo to transfer.

So can you see why there is not a ton of confidence in starting with only five eggs?  (I have a friend who just went through IVF, and she got 20 eggs from only one ovary!  What would I give for those starting numbers?!) Again, though, last time I had a few things in my favor.  My fertilization rates tend to be higher than average (I can't kick out quantity, but I seem to produce quality....) and they all survived the biopsy.  And all I need is ONE strong embryo without CF at day 5.  So I am back to what I said before:  IF I am supposed to have another baby than my Heavenly Father will see to it that it works.  And IF I am not, then it won't and I can close this door.  And mercifully this process takes a matter of weeks, not months to find out.

I Feel Icky...Isn't that Great?!

Today (and yesterday, really) I just feel icky.  Take bad menstrual cramps (and increase the intensity) and add pregnancy nausea (due to the HCG that is part of my drug cocktail) and that is a start of how I feel today.  I don't have to stop and think about whether or not my ovaries hurt; they do -- all day, with more intense aching with any physical movement. And then the constancy of the aching seems to radiate to my lower back.  And the crazy part is -- this is a very, very good thing!  The worse I feel, the better I am responding to the meds.  So I feel really lousy, and I am grateful!  (I told you this was a surreal world!)

That said, today is where I hit "the wall" where this whole process stops being "fun" and I am ready for it to be over. I am grateful that I only have a few days more of taking stimulation medication and then it will be time for the "trigger shot."  (This is a high-dose of the HCG which signals to the body that it is time to release the eggs.  So something like 36 hours after you "trigger" you MUST go in for egg retrieval or you lose all your eggs and the whole thing was for nothing. So that day is quickly approaching.)  I am not trying to complain, merely trying to explain how I am feeling right now.  I am also starting to get antsy about everything.  Will this be successful?  Will it not?  How will I feel about actually being pregnant?  How will I feel if I am not?  Even though I am very content to stay "neutral" about everything, with the constant reminder of aching ovaries I can't help but think about it all somewhat.  And I guess tonight I don't really care what the outcome is, I am just ready to get to that point.  It's a good thing this whole process is relatively short, because dragging it out would only make the "antsyness" worse.

So tomorrow I go back in for another ultrasound.  It will be very interesting to see if all this feeling icky translates to more or bigger follicles....I hope so!  And Sunday one of my best friends is bringing her boyfriend and coming to dinner and then Monday my hubby is coming!!  So lots of things to look forward to, which will help get me through the last of my stimming days...    

When You Wish Upon a Star...

So last night my mom and I were driving back to her home after having dinner at my sister's house.  (I haven't made this very clear in previous posts, but my entire extended family lives in Utah so this IVF experience has also been a fantastic excuse to come and spend time with my family. I am staying with my parents and spending time with my siblings and their children.  Definitely helps with all the waiting and waiting that this process involves!)  Anyway, we were driving home and we saw a shooting star!  I have only seen a handful of these in my life, and I found myself thinking, "Oh!  I should make a wish....I wish that I will become pregnant!"  And then I caught myself and thought, "hmm...do I really mean that?"  But then again, earlier yesterday evening in the store with my mom and sister I saw a darling baby boy and I actually wanted to pick him up and snuggle him.  So honestly, as a surprise to me I think my willingness to have another baby right now is actually becoming wanting.  (Good thing, too, huh?  Since I am in the middle of an IVF cycle!!)

And on that note, I found out today that my first blood draw before starting stim meds my estradiol level was less than 25.  And then I took my meds for a few days and had a blood draw on Monday.  They told me they liked to see a number of 150 - 200.  Well, mine came back at 65.  So not anywhere near what they "like," but going up just the same.  So today, my estradiol came back at 174.  So still not as "good" as what they aim for, but steady improvement.  The crazy thing is those numbers are with me doing SIX VIALS of Bravelle a day!!!  That is a HUGE (and expensive!) dose.  I am just a "low responder." And the doctor wants to keep me on that high dose, so tomorrow I get to call and order another 10 vials of Bravelle, so a price tag around $500...crazy.  That's one thing about this process -- after awhile the money just becomes a figure that has to be dealt with.  Normally I would NEVER just call someone and order something for $500 without really thinking about it and really talking it over with my hubby.  But yesterday I had to call and prepay $2,500 for the PGD portion of our process that is coming up and now the additional meds.  That means that by tomorrow I will have racked up another $3,000 on our credit card.  But what else do we do?  Everyone in this business has to be paid upfront.

But back to today's ultrasound results.  (Sorry - this post is kind of all over the place, because that is how my mind is feeling tonight.  Everything is happening so fast and I am trying to process it all, but tonight I am tired and my mind is wandering...)  I didn't catch what my uterine lining measured at, but hopefully it is doing what it is supposed to.  (It has to get to a certain thickness to make implantation of an embryo possible...)  But as far as follicles go, he found two on my left ovary measuring 10.84 and 9.56.  Then on my right side he found a 13.38, 11.93, 7.64, 12.3, 10.56, 6.51 and 6.23.  The little 6 and 7 ones are very small, and may not end up with a mature egg inside.  (Though they have a few more days to grow....come on little ones, you can do it!)  So right now I am showing a potential of six mature eggs, hopefully maybe seven or eight if I am lucky.  What do I think about that?  Well, I don't know.  I don't know because the last two times I think I started off even worse, and then was a "late bloomer," meaning I had lots of small follicles decide to develop in the last two days and ended up with mature eggs from them.  But my med protocol was also different.  So I am really, really hoping that my system does that again and I can get a few more eggs.  Six is just SUCH a low number to start with.  But the truth is, it only takes one.  So I am not worried.  I am hopeful that more will develop, but at peace with what is happening so far.  Especially because I really think I have more big ones at this stage of the game than I did last time.  So I am not going to "worry" until my next ultrasound.

One last thing for today's post.  Around 5:00 I got a surprise knock at the door.  It was a person delivering three vases of flowers!  A big one for me and two little ones for my girls.  They were of course from my sweet hubby.  The cards just said, "I miss you!" "Love, Daddy" and "I can't wait to see you!"  And I have to say, I have been given flowers a handful of times in my life, but these are so beautiful!  My arrangement features 15 small yellow roses, two yellow tulips, two fuschia pink gerbera daisies and a large bunch of delphiniums.  And that meant a lot to me, because delphiniums were the main flower I used for my wedding...I love them!  They are a cobalt blue wildflower, and I just love them.  The flower guy told me that my hubby wanted something "bright and springy for my girls."  It really made my day.  And my little girls were so thrilled to receive flowers of their very own.  So for tonight I will end with a picture of the gorgeous flowers....thanks hon!

Not much to report today.  Went in for another blood draw to monitor my estradiol level but I haven't heard back from them yet.  But I really think my ovaries have been hurting a little bit today.  (Which will be interesting if something is indeed happening already, since last time I went days with very little changing.  But this new protocol is supposed to work better, so...)  Wednesday I go in for a blood draw and another ultrasound.  That's when I will find out how many follicles look like they are starting to grow.  Will be interesting!

My New Drug Habit...

So yesterday I officially started my stimulation meds.  This means that twice a day (8 am and 8 pm) I get out a collection of little glass vials, syringes, alcohol wipes and needles and mix my drug cocktail.  Honestly - I think this part is kind of fun.  It is a bit tricky to do it correctly, so I take about 15 minutes to do it to make sure I don't miss a single drop of my special concoction.  Then when I am done I take the syringe and inject it in my leg or stomach and it's like plunge - there goes $300.  That part of is very crazy.  It makes me feel like a heroin addict -- sinking 100s of dollars a day in one little syringe!  And I had forgotten how much it stings as it goes in!  And my skin goes bright red around the injection site.  But both effects only last for about five minutes, so it really is quite tolerable.   So if all goes well, in a few days I should start feeling my ovaries swell as multiple eggs start growing....good times. :)

Supplies used to mix my stimulation cocktail (and no, I don't inject with the big needle...that is for mixing only.)

A Good Start

Today was my first "monitoring" appointment at RCC.  So that meant going in for a blood draw followed by an ultrasound.  I made sure to have the heater blasting in the car on the way down, (plus it was cold outside anyway!) so the blood draw went smoothly.  Then it was time for the ultrasound.  Today I had eight antral follicles on my right ovary, and three on my left.  So it looks like I have eleven total potential follicles.  (Which translates to a potential total of eleven eggs for this cycle.)  Wish it were a few more, but eleven is at least something to work with.  And the even better news:  my "uterine congestion" is all cleared up!!  He said my lining looked nice and thin, like  it was supposed to today.  So I still don't know what caused that congestion last time, but hooray that it is gone!!

So I start my stimulation meds tomorrow.  But Dr. Heiner told me that they have been working with a consultant to increase their pregnancy rates, so they are doing things a little bit differently this time around.  For one thing, they have added a steroid pill to the mix, which is supposed to help "beef up" the eggs or something.  Then last time, they started me off on a lower dose of Bravelle, and then as time went on (and I wasn't responding super well,) they kept upping the dose.  At the end, I was using five possibly six vials at a time.  But this time I am starting with the highest dose, and they will supposedly decrease it as I progress.  Also they are splitting the meds into two doses -- one in the morning and one at night.  So tomorrow I will make my drug cocktails using three vials of Bravelle in the morning and three vials at night.  This also doubles the amount of HCG as well.  It will just be interesting to see how my system reacts to the changes.  Before I was dubbed a "late bloomer," it will be very interesting to see if this new protocol changes things.  So stay tuned!

And one more thing...As we were heading down to Utah the girls finally asked me why we were going.  So I explained to both of them that a doctor was going to help Mommy and Daddy get another baby in Mommy's tummy.  Then I asked them if they wanted a baby brother or sister.  And both of them got really excited and said, "Oh! That would be so cute!!"  So today, they knew I was going to the doctor because they stayed home with Grandma.  So when I got home, Sophie came up to me and softly patted my tummy and said, "Is there a baby in there?"  It just melted me.  I told her that it would take some time but that I was trying.  Regardless of what I want, I really hope this works so that I can have the pleasure of telling my precious girls that yes, there IS a baby in Mommy's tummy!

Cold + Dehydrated = Ouch!

Today I went to RCC to do a blood draw to measure my FSH level.  I found out today this means "follicle stimulating hormone" level.  In other words, it helps the doctor get a starting point for what my stimulating meds need to be.  Now I don't mind needles (good thing, too, because this process is FULL of them!!) and normally I don't really mind having my blood drawn.  But normally I also have a really good vein in my right arm that is really easy to access.  But today when I pulled up my sleeve -- I couldn't see any veins!  And even when they put the elastic thing on my arm, still not much to work with.  And then the nurse asked me if a) I had been drinking enough water, and b) if I was cold.  Apparently both being dehydrated and being cold make your veins constrict and difficult to find.  So she did the best she could, but she ended up having to dig a little...ouch!  Hopefully if I can remember to drink lots of water between now and Friday (and blast the heater in the car on the way to RCC) Friday's blood draw will be easier.

The First of the Waiting

After spending a few days washing (and ironing!) what felt like every article of clothing in my home, I finally packed up all our stuff and headed to Utah.  Saying goodbye to Daddy wasn't fun, but the girls were excited to get to Grandma and Grandpa's house.  Plus - my sister and her kids were visiting as well.  So after a very pleasant five-and-a-half-hour drive (the girls were so good!) we arrived.  It was chaos as expected with all the kids running around together, but a happy chaos just the same.  And Grandma whipped up a batch of homemade doughnuts, too, so that was fun and tasty as well!

Then this morning the kids played until it was time for my sister to go home.  That left me and my girls at my parents home by ourselves. (My parents had somewhere to be.) Not that this is a bad situation--my girls have happily been playing on the swingset in the backyard together, etc.,--just sort of strange.  Meaning I just feel kind of out of my element today.  I am here in Utah, but I am just waiting to get started.  Really this whole process involves a LOT of waiting, so I better get used to it.

And So It Really Begins...

A few days ago I actually had to write RCC a very large check. (So large, in fact, I  had to actually stop and think about how to write that amount...)  Plus I had to pay a large bill to Rox-San Pharmacy for all my meds.  Up until this point, everything had just been a "plan."  But now we have actually "put our money where our mouths are" and it suddenly became very real.  I am not freaking out though, it will be okay.  Eventually loans will get repaid, right?

We also had the chance to buy a new dresser for a bedroom at a fabulous price (normally $1,200, got it for $200...gotta love RC Willey's "Wild Web Wednesday" sales!) So yesterday I moved my old dresser upstairs to what would be the nursery/playroom, and moved the new one into my room.  And as I did that, I found myself thinking how cute that dresser would look next to the crib, and how it would have plenty of room to hold all the baby's things.  And then I kind of laughed at myself.  I am not saying that I am jumping for joy at the prospect of become pregnant soon, just that the idea is growing on me.  I am saying that I am indeed slowly warming up to the concept of actually having another baby.  Then today, I ran into a friend at the store and saw her new baby for the first time, and I actually felt the smallest glimmer of excitement inside.  I am grateful that I have not been feeling anxious or uneasy about moving forward with this plan, but here's the problem:  I don't want to be really excited or expectant -- that only sets me up to be crushed if things don't go well.  So honestly I am trying to just not think about it much, and just go through the motions.  That way I can just take it one day at a time and deal with things as they happen. Though there IS excitement about actually starting for real -- kind of like embarking on a spontaneous trip, not knowing for sure where you'll end up.

With that said, tonight I started my Lupron injections!  I had to call my sister-in-law for a few pointers (thanks Rosie!) because I sort of forgot how to do them.  But she walked me through it and all went smoothly.  And in a little over a week, I head down to Utah to start the big stuff....crazy how fast it is all happening.

Crinone - My New Best Friend...

So my big cardboard box of drugs arrived today. The first time I experienced this, I opened the box and was so overwhelmed by the array of needles, syringes and little glass vials that I just wanted to cry.  This time it was just a matter of going through the checklist to make sure that it was all there.  It really is amazing how much less scary that big box was since I have dealt with it all before.  And in fact, I actually think mixing my own "drug cocktail" is kind of fun, even though it is a little tricky to do correctly.  But the really, really big news about this box of drugs is that it contained CRINONE, instead of injectable progesterone-in-oil (or the spawn of the devil, you choose...)  And Crinone is going to be my new best friend!  Let me explain why:  when a woman releases an egg  from her ovary naturally, the lining of the follicle where the egg was (called the corpus luteum) begins to produce progesterone.  That progesterone acts as a chemical signal to the body saying, "Hey! Possible chance for a pregnancy here...don't have a period!" And as long as enough progesterone is being produced, the sloughing off of the uterine lining (or a period) will not take place.  And if an embryo manages to implant, the placenta takes over producing the progesterone.   So this progesterone is very, very important!  But in IVF cases, the process of egg retrieval also removes the corpus luteum, so no progesterone is being produced.  As a result, it MUST be   manually introduced into the picture.  And in the past, the only reliable source for doing this was daily intramuscular progesterone-in-oil (PIO) shots.  But let me just tell you, those injections may be reliable, but they are just plain awful!!!  The oil is very thick, and actually difficult to inject. (Although I learned at the very end that warming the vial up in hot water in the sink first to make the oil "thinner" really helped!)  Then because the long needles are going into muscle, and a shot must be given everyday, my whole body got so achy and sore.  It felt like how I feel after the first day of a new snowboarding season -- where it hurts to move at all and I just want to  lie in a warm bath all day -- only it never goes away. So for THREE SOLID MONTHS I am pretty darn miserable.  But now enter CRINONE!!!  Crinone is a vaginal gel that delivers the progesterone right where it is needed.  And in tests it has been proven to be every bit as effective as the PIO shots.  So my doctor has officially switched to Crinone!  (Apparently a lot of whitish discharge must be dealt with, but I will gladly stock up on pantyliners rather than deal with the PIO shots...)  When I found this out I was so happy I almost cried.  The news that the absolute worst part of the whole entire process was just gone did wonders to improve my attitude about the whole thing. :)  (And for any of you doing an IVF cycle, ask your doctor if you can use Crinone instead.  And if not, the PIO shots are awful, but hang in there....the end result is so worth it!)

My box of Meds and Supplies

This is the main "stimulation" drug.  Each little vial costs $49.75!  And on some days I will inject five or six vials at once... 

Congratulations.....for what?

So ever since we have made public that we are attempting IVF/PGD again, I have had a bunch of people tell me "Congratulations!" Now I know they mean well, and their kindness is very appreciated, but I must admit I kind of chuckle inside every time I hear that. Telling me "Congratulations" at this point in the process feels very much like telling someone who is entering a talent competition "Congratulations!" before they have even competed!  I suppose you could be congratulating them on their courage to even enter the competition, but still, it isn't quite what one would expect to be wished at the very beginning. 

So the next time you find out someone is going on an IVF journey, try saying, "Good Luck," "Bonne Chance," "Buena Suerte," or "Best Wishes."  Then hopefully at the end of the process there will plenty of reason to offer your warmest "Congratulations." :) 

And So It Begins...(Sort Of)

Today was sort of a strange day for me.  It is one thing to talk to Dr. Heiner on the phone about starting this process all over again, but quite another to actually do something about it.  On one hand it was fun being a patient again in a place that has given me such profound joy.  But on the other, I am just not sure how I feel about all of this.  I am mostly just "going through the motions" because we agreed we would.  (Read: I am doing this because my hubby really wants me to.  It's not that I don't, it's just that right now I can't say I do, either...) 

So since we were already coming down to Utah for family stuff, we went to Reproductive Care Center to do pre-IVF tests.  First we both got our blood drawn for an infectious disease screen.  No biggie, I don't mind having my blood drawn.  (Good thing, too, because in March I get jabbed every other day for weeks!)  Then the nurse handed us cups for a urine sample.  Oops!  The first thing I did when I got to RCC was run to the bathroom, because I really needed to pee.  I sort of laughed and told her I'd try.  I did, and I handed her the cup with the tiniest sample in it.  I was feeling sort of sheepish until Rich came back with an empty cup!  He couldn't pee!  He had to drink a Sprite and wait awhile before trying again.  It was just funny.

The next thing we did was a saline sonogram.  That is where they insert a catheter into my uterus, use a balloon-thing to open it up a little bit, then fill it with a saline solution so they can examine the uterine cavity via ultrasound.  It makes you cramp a little bit when they do the balloon part, but really it wasn't as bad as I was expecting.  (I remember it hurting worse last time....maybe I was just more nervous the first time around.)  I was totally expecting everything to be normal, but Dr. Heiner found some fluid in my uterus.  At first he thought it was a polyp (which would not be good--that would delay our cycle and require surgery), but once he really got looking he decided it was just fluid.  He said that it just happens sometimes....just some type of uterine congestion.  Still -- "uterine congestion" doesn't sound very good, does it?!  He said we had plenty of time for it to clear up on its own -- it only would be a problem if by egg retrieval day it hadn't gone away.  So I am not going to worry about that right now, and hope that it just clears itself up.  He also found 10 antral-follicles on my right ovary and 4 or 5 on my left.  Those are the "pre-follicles" which give an indication of how many eggs are possible.  It's not an accurate predictor as that number can change all the time, but with my previous two cycles that number proved to be right on. 

The last test we needed to do was Rich's Kruger test.  This basically measures the count, motility and morphology of a sperm sample from him.  Initially I went with him to The Room, but we quickly decided it would just be easier without me.  (Don't ask...when you take 100% of the intimacy out of certain actions, they just become very, very awkward.  That's all I am going to say about this. ;) )  So while I was waiting for him, I noticed a man in his office that looked familiar to me.  I stuck my head in and said, "Aren't you the anesthesiaologist?"  "No, I am the laboratory director, but you look familiar as well -- have you been here before?"  After we established that he had been the one to handle our eggs & embryos, etc., the last time, I was able to ask him something I have been wondering about.  "So tell me something, how do you guys select which sperm to use for ICSI? Because that person is basically determining the gender of my potential children."  He got a big smile on his face, pulled out a pad of paper preceeded to draw me pictures and explain stuff to me.  Then he turned to his computer and pulled up a PowerPoint presention that went though the entire IVF/ICSI process, complete with actual ultrasound video footage of the egg retrieval, ICSI and transfer processes.  It was fascinating!!  (For those who have no idea what ICSI is, it is where they select a single sperm and inject it into a single egg.  Some couples require this procedure if the male has low sperm count, bad morphology, etc.  For us, it is because if more than one sperm touches the egg, we will have cross-contamination of the DNA samples for the PGD testing...)  And just in case anyone besides me is curious, they really do put all the sperm in one end of a media strip and select the best-looking ones that reach the middle line first.  So it literally is the "fastest swimmers" that get selected!  I don't know why, but for some reason knowing that just makes me chuckle...  Dr. Reggio spent a good 20 minutes showing/explaining stuff to us. (My hubby had joined me after a few minutes.)  And when we finally thanked him and said goodbye, I was left with two main impressions: 1) gratitude that a person who is so very key in our cycle being successful is so very passionate about what he is doing!  I mean, he could have just waved me out of his office or given me a very brief, undetailed answer to my question.  But instead, he got very excited and took the time to really show us everything!  2) just that satisfied "ah-hah" feeling I get when I truly understand something in-depth that I previously only sort-of understood before.  

And then we were done, and we left.  Now I am just waiting for my next period to start, when I will start taking birth-control pills again.  Then sometime in early March I will start Lupron injections.  So today's visit was a "beginning--sort of."  :)