Saturday, September 1, 2007

Psyched Out

Last night, I prepared both shots and decided to start out with the Menopur to get it over with. I even did it while Michael was awake and sat at the table. After I started the injection, I started seeing stars and getting really hot. Michael had to bring me water. I stuck with it (no pun intended) - I think I just freaked myself out. I don't know. I started thinking it was the meds. I was planning to ask a nurse about it today when I went in for bloodwork and ultrasound, but that's a whole other story. The good news is that I was totally fine with the shots tonight. (Even with Michael yelling during the Auburn game.) I think I need to do the Follistim first to get "warmed up".

Okay - so this morning I go in for bloodwork and ultrasound. They leave me sitting pantsless in the exam room for no less than 20 minutes. Different people would come in - be surprised that I was in there, and say something like - I'll let them know you're here. So finally, this ultrasound technician comes in, acts surprised and then just gets started. I've always had a doctor or nurse in addition to the tech, but I just figured they'd come in. They didn't. And the tech didn't tell me anything. The only thing I managed to get out of her was that I had 2 follicles on each side somewhere around 11 mm. So, I was going to ask the nurse who called with my bloodwork results - but she called when we ran to the grocery store (of course). Her message said my estrogen level was good and to continue my dosage and come back in on Monday AM.

That probably all sounds fine to you, but I'm feeling very frustrated right now. 4 follicles is not enough for an IVF cycle. If I don't produce some more good ones, they'll either cancel this cycle or convert it to another IUI. I doubt they'll do the IUI because with 4 good follicles, that means there's a chance (albeit slim) that I'll get pregnant with quads. And I think I'm frustrated that I couldn't talk to anyone about all this today.

So, please root for more follies! I hope Monday shows some more good ones. Fingers crossed!

Friday, August 31, 2007

Drama Queen

Some of you remember that when I was little, I used to pass out whenever Ashley would hurt herself (my poor mother is all I have to say about that). Then, a few years back, I was fainting again for no reason and had a complete workup and docs concluded that I was "prone to vagal episodes". (The equivalent of "unexplained").

I learned last night that it's bad to have a "vagal episode" when you have a needle in your stomach.

Michael had already gone up to bed and I was just going about my injection business. I had already done the Follistim and was giving myself the Menopur injection. You have to push the really slowly on the syringe because the medicine burns like a you-know-what. Well, I got about halfway through and started feeling the familiar signs of fainting. I leaned on the counter, bent my knees more, and started deep breathing. Thank goodness I was able to finish the shot and remove the needle before I passed out. I had to sit down and put my head between my knees for several minutes before it passed.

Lessons learned - (1) SIT DOWN while giving the injections, and (2) do it while Michael is still awake!

Thursday, August 30, 2007

I've Changed My Mind

Not about anything to do with IVF or having a baby, but about the blog. When I first started this in the spring, I think I only shared it with our siblings and parents. Then I started letting a few friends know who asked about how we were doing with all this. Then I started mentioning it to other family & friends. I asked that you all share it selectively, if at all.

Well, I've changed my mind. I say if people want to read about injections and follicles, have at it. I'm not sure why I was nervous about people reading this in the first place. Maybe because reproduction is such a personal thing. Maybe because I didn't really think anyone would WANT to read it. Or because it's kind of like reading my diary. Maybe it's because I was ashamed of our infertility - our apparent inability to do what every species on the planet can do seemingly without effort. I didn't want people to judge us or pity us.

I now realize that there's no use in being ashamed. Our troubles conceiving have nothing to do with us as people or with anything that either of us have done. It's not God telling us we'd be bad parents. It just is what it is - something for us to deal with. So - feel free to share the blog. Maybe it can even help someone else. At the least, it can help others to understand infertility a little more. (I know I was clueless before all this.) I've shared it with an on-line group of women struggling with their own fertility situations - incredibly strong, kind, wonderful women that I am so grateful to have found. It's good to be able to talk to people who know me in real life about this - but to be able to "talk" to people who have been there - or are there right now is so helpful and in a way, therapeutic.

So - with that out of the way - on to the injection report! The Follistim was easy - same thing I did for the IUI's, just more of it. The Menopur threw me for a loop though. I had 2 different syringes, 2 vials of powder, 1 vial of sterile water, and a Q-cap (which is kind of like a little internal needle that fits on a vial). Somehow - the stuff from those 3 vials had to get into me. Even with the instructions, I was stymied! Michael had to come help me. I was surprised that he knew what to do and he said - yeah, it's not like I went to a class for this or anything. ;-) So, he helped me figure it out and the needle was really very small, but the medication did burn a bit going in. Luckily, I didn't have any sort of skin reaction to it like the Lupron. And - I haven't freaked out and started randomly crying today with these hormones, so that is good too! Don't worry - I'll be sure to let you all know any insane things I do. I'm sure we'll get at least one good freak out through all this.

Wednesday, August 29, 2007

Done with Lupron!

Check one drug off my list. No more Lupron shots! I went in this morning for bloodwork and an ultrasound to make sure my ovaries are nice and quiet. Looks like the Lupron did its job and everything is good and calm in there. Tonight I will start 2 new injections - Follistim (which I have done before with the IUI's) and Menopur. The Menopur involves mixing some sort of powder into sterile water vials, drawing it into a syringe, and injecting myself. Yes, I have officially turned our kitchen into some sort of freaky drug lab.

They'll call me with the results of the bloodwork this afternoon to give me the official go ahead for the shots tonight. I'm not anticipating anything stopping that - they are just doing a precautionary pregnancy test and checking my estrogen levels. That should all be fine.

I'll do these shots for 3 days and then go back in for more bloodwork and another ultrasound on Saturday morning to check progress. I'll likely continue those shots for another several days to a week. I'll post the follicle update Saturday - keep your fingers crossed for many nicely growing follies!

Thursday, August 23, 2007

1 Down, 599 to Go

Did the first shot like a CHAMP! Now I'm not so sure what I was so worked up about. Well, yes I am - it was the unknown. I'd never had to draw medicine out of a vial and inject it into myself. All the other injections I've done have been pre-filled syringes. For those, I just had to get used to the idea of sticking myself with a needle. (Still working on getting used to that by the way...) For this one, there seemed to be several places where I could screw up. The next shot I have to do involves mixing some sort of powder into a solution. Sounds like a science project. I won't have to do that one for another week.

So, our schedule is that I'll stop the birth control pills on Saturday (8/25) and wait for my period to start. Once that happens, I'll go in for some baseline testing (bloodwork and ultrasound) and further instructions (like when to start the next shots...), and we'll be off and running.

I'm kind of kidding with the 600 shots, but seriously, it's a lot.

Wednesday, August 22, 2007

Last Day of Normalcy

Tomorrow is the first of my many injections. I realized that this is the last day for a long time that I am free of any additional hormones coursing through my body.

Looking at that from a positive viewpoint - after tomorrow, I'll be able to randomly freak out on people and have a legitimate excuse. Heh-heh.

More seriously, I'm excited to get started - but I'm also scared. I just had my bloodwork done this morning for my thyroid because the main danger with the Hashimoto's is risk of miscarriage. I can only imagine going through all this, having it work, and then losing the baby because of my stupid thyroid. But - I can only worry about one thing at a time (and right now it's doing the new injection in the morning). ;-)

I think that's all for now. I'll let you know how tomorrow morning goes!

Tuesday, August 14, 2007

Mocked Up

I had the Mock Embryo Transfer this morning. I wasn't worried about it at all. That is, until I got to the doctor's office and had to sign some consent thing about all the risks. Oh - and the form said something about it being similar to the HSG (which is the test I had back in March to make sure my tubes weren't blocked - and was seriously painful).

Luckily, this experience was nothing like the HSG. Phew! Before the doctor started, I expressed some concern about the catheter and he assured me that it was nothing like the one used for the HSG. He told me to let him know if anything hurt and he'd stop right away. He also gave me the blow-by-blow of everything that he was doing which was also nice. It was mildy uncomfortable, but no big deal. (Oh, and it only took about 15 minutes.)

He inserted a catheter into my uterus and squirted some water in there so that it would show up on the ultrasound. Then, we looked at the catheter and the little bit of water in the uterus so that we could see where the embryos would be placed during the actual transfer. Everything looked good! He also checked out my ovaries while he was in there and they look nice and quiet as they should. No cysts or anything at all to be concerned about.

I did ask him again about my FSH level (follicle stimulating hormone). Mine was 10.8 when they did my initial tests and anything over 10 is considered "diminished ovarian reserve" - meaning - not too many eggs left in the basket. He said he would be concerned if my other levels (estrogen, leutinizing hormone (LH) etc.) were out of whack and if I hadn't been responding well to the stimulation medication used for the prior IUI's. Since those all look fine and I'm "still young", he's not worried. He said he will likely be a little more aggressive in the dosage of the stimulation medication for me for the IVF because of my FSH level, but that it's no cause for concern. So - that made me feel better. Some of the very scientific Internet research I did mentioned early menopause. Sometimes the Internet is not your friend.

So, based on the practice run, all should go well for the Embryo Transfer. Only a week and a day until I start the first injections. Fun, fun!

Thursday, August 9, 2007

I Could Be an Intravenous Drug User

Seriously. With the amount of meds and syringes I now have - and the level of comfort I now have around needles, I'm a little worried about the slippery slope to the hey-ron. Okay, not really. (I still don't have to find a vein).

We had our IVF class this morning. On the way there, we were going over all the consent forms for the procedures and for cryopreservation (freezing any extra embryos). We had to not only decide what we want to do with any embryos they don't put back in me this time, but we also had to decide what would happen to the frozen ones if we get divorced, if one of us dies, or if both of us die. Happy conversation. If both of us die, we can give ownership of the embryos to someone else. So - Ashley got a really weird call this morning! She's now officially the godmother of our future frozen embryos. How's that for weird?

The class took way longer than I thought. Luckily, Michael took advantage of the downtime at his office and had taken the whole day off. The nurse spent the first 1/2 hour going over the IVF process & what to expect, the 2nd 1/2 hour explaining all the meds, and the 3rd 1/2 hour having us practice with the injections in this nasty piece of rubber-flesh.

Let me just say that I am SO glad we had done shots before with the IUI stuff. There was another couple in there who had never done injections and I swear the woman looked like she was going to pass out. We had to go over how to give ourselves 4 different shots and how our husbands had to give us 1 shot in the "upper hip". (Umm, yeah - that's the butt.) Luckily, I've already given myself 2 of those shots so it wasn't quite so overwhelming. The needle for the big shot in the butt is HUGE. I am scared about that one, but I'm trying not to think about it. The nurse actually had to tell us not to try to do that one on our own. Who does that?

After the class, we went to pick up the prescriptions - and left with not one, but TWO shopping bags full of meds and needles. If I can figure out how to post a photo of them all, I will. Anyway, here are the estimated dates for stuff - hope it makes sense. Now, don't break out your calendar right now to put all those dates in - because they'll most likely change. ;-) Don't worry, I'll keep you posted here on our progress.

8/14 - Mock Embryo Transfer (trial run for the real thing)
8/23 - Start Lupron Injections (to quiet the ovaries before stimulation) & Baby Aspirin (to thicken uterine lining so the embryo will have something to latch onto once they put it in)
8/25 - Stop Birth Control Pills
8/28 - Expect start of period
8/30 (or day 2 or 3 of period) - Bloodwork and Ultrasound (to ensure ovaries and hormones are ready for stimulation). Wait for instructions to start daily Follistim & Menopur injections (to make those eggs grow, grow, grow!) After I start these injections, I'll be going in for bloodwork & ultrasound every other day - then every day as we get close to retrieval.
9/10 - Estimated Egg Retrieval Date
9/13 - Estimated Embryo Transfer Date & start of Progesterone Injections (the dreaded butt shots)

After the embryo transfer, I'll have 24 hours of bedrest. Glad we've got lots on TiVo! I better make sure it's stuff I actually want to watch.

Okay, so I'll end with the funny part in all this - right before Michael has to give me the butt shots, they will draw targets on both cheeks with a Sharpie! Maybe we'll take pictures of THAT! Ha!

Wednesday, August 8, 2007

I Told My Boss

I hadn't been NOT telling her on purpose. It had just never come up. When we talk, we usually talk about work. And I know she is a very private person, so it isn't like we share personal stuff anyway. However, one of my close friends at work (Lura) gave me the heads up that - while I was on vacation our boss asked her if I was trying to have kids. So, I figured I should probably tell her - especially with me needing to take a lot of leave with the IVF stuff coming up.

She was AMAZING. I swear - it's like she had the handbook of all the wonderful, supportive things a boss should say. She didn't tell me to relax, tell me that my time would come, or try to offer up advice. She simply said she couldn't imagine what I must have been going through during this whole process. When I told her about needing some time off after the IVF (I think I'll be on bedrest for 48 hours), she offered to come over to entertain me if I get bored.

I am so thankful to work in such a great environment, for such an understanding woman. It's a relief that she knows, even though it wasn't something I was consciously hiding from her. It's nice to have a good story to tell every now and then with all this infertility stuff. So - I thought I'd share it with you all. ;-)

We have our IVF injection class tomorrow and I'll pick up my prescriptions (which I understand will take up an entire crisper drawer in the fridge) tomorrow, so I'll probably post more then.

Monday, August 6, 2007

The Train Has Left the Station...

We are off and running with IVF! Right on cue, I started my period on Sunday (Day 24). I just followed the instructions on the birth control pills and went ahead and took the first pill on "the Sunday following your period, or the Sunday it starts". Apparently, that was incorrect. Oops! I was supposed to call the clinic on Day 1 and they would instruct me for what to do next. I somehow missed that. The nurse said she would have had me wait until Tuesday to start the Pill, but that it was really no big deal. Phew. I was worried I had already screwed up my IVF cycle before it even started. Leave it to me.

So, here's what I know so far. We have our injections class this Thursday 8/9. Michael gets to learn how to give me shots in the booty this time. Woo hoo! I don't know which of us is more excited. The majority of my shots are subcutaneous which means they can just be in any old fatty part of me. (I choose to pinch some skin on my tummy for those.) The progesterone shots that I will need to sustain any potential early pregnancy after they do the IVF (put the embryos back in me) need to be intramuscular - which means they need to be in the upper outer quadrant of my rear. That's where lucky ol' Michael comes in. Normally, progesterone is produced by the ovaries after ovulation, but since my ovaries will be suppressed (if I ovulate, they can't get the eggs!), and hyperstimulated (to produce lots and lots of good eggs), the normal hormonal process is all screwed up - so I'll need extra progesterone.

After our class, I am scheduled for a "mock embryo transfer" on 8/14. That is where they put a catheter into my uterus and take a look at the lay of the land. They want to make sure they know all the bumps that could occur during the actual embryo transfer, so they literally make a map of my uterus so they know the best place to put the little guys.

After that, I will start the Lupron injections on 8/23. Lupron will supress ovulation so the eggs stay squarely in my ovaries until they are ready to remove them surgically.

Those are all the dates I know right now. The actual procedure dates will be based on how I respond to the stimulation medication. I'm not sure when I will start that - but it will likely be late August / early September.

Here's a pretty nice (but technical) summary of IVF for anyone who is interested...
http://www.shadygrovefertility.com/treatmentsearch/treatment_listing_detail.cfm?ListID=1259 I'll add it to the links on the side for future reference. I've read it several times and still don't totally understand it, but it will at least give you an idea of what goes on.