Thursday, December 26, 2013

8 Weeks

 


How Far Along:  8 weeks.
Webbed fingers and toes are poking out from our baby's hands and feet, their eyelids practically cover their eyes, breathing tubes extend from their throat to the branches of their developing lungs, and their "tail" is just about gone. In their brain, nerve cells are branching out to connect with one another, forming primitive neural pathways.
 

Total Weight Gain: 134 today.
 
Maternity Clothes:  Not yet, but I did get a BellaBand and gift card to Motherhood Maternity for Christmas! 
 
Sleep:  Definitely still tired all the time.  No more cramps though!  I find myself waking up frequently in the middle of the night. 
 
Best Moment This Week:  Christmas was definitely the best moment.  Christmas Eve was spent by ourselves as this would be our last Christmas with just us two.  We spent Christmas Day with Jared's family.  I was super excited to get maternity and nursery items from both parents.  It's all becoming so real to us!  Today was also very heartwarming - a coworker wrote me the most touching note and included an ornament that read:  "Believe in Miracles".  It definitely made me tear up thinking about the journey that got us here and the road we have ahead of us. 

 Movement:  None
 
Food Cravings:  Same cravings as last week - Sweets!  And they are so bad for me!  My trainer would kick my butt if he knew what I was eating!
 
Things Making Me Queasy or Sick:  Nothing
 
Looking Forward To:  Monday is when we go back to Columbia to see our baby's arms and legs.  I'm really sad and scared to be released from Dr. Wilshire.  I hope my new OB will be as wonderful as he as has been!

Wednesday, December 18, 2013

7 Weeks


How Far Along:  7 weeks. 
Hands and feet are emerging from developing arms and legs. Technically, our babies are still considered embryos and have a small tail, which is an extension of their tailbone. Our babies have doubled in size and are now about the size of a blueberry.
 
Total Weight Gain: Back to 134 today.
 
Maternity Clothes:  Not yet, although some work slacks are getting tight.
 
Sleep:  Definitely tired all the time.  Not waking up nearly as much as I was before, but the cramps still come and go.  
 
Best Moment This Week:  The best moment was definitely today!  I had a scare this week though -- had spotting about every day for the past 5 days.  I was freaking out!!  When I called the nurse, she said there was nothing to worry about as this is very common with twins.  That made me feel somewhat better, but I wasn't completely comfortable until I saw two little heartbeats from our babies!  The doctor also told me that I'm done with my Progesterone tablets!!  Thank God!! 
 
 
Movement:  None
 
Food Cravings:  I guess I had my first cravings this week.  It was bakery treats -- cupcakes, cake, brownies, cookies.  So random!!
 
Things Making Me Queasy or Sick:  Nothing
 
Looking Forward To:  In two weeks, we go back to Columbia to see the arms and legs.  This will be the last appointment with Dr. Wilshire and going forward, we will be seeing our new doctor (once we get one) here in St. Louis.  It will be a bittersweet day for sure!
 
 

Monday, December 9, 2013

6 Weeks

 

How Far Along:  6 weeks. Per the bump.com and babycenter.com, this week's major development:  The nose, mouth, and ears are beginning to take shape.  Our babies' eyes and nostrils are starting to form.  Their emerging ears are marked by small depressions on the sides of the head, and their arms and legs by protruding buds. Their heart is beating about 100 to 160 times a minute and blood is beginning to course through their body. Their intestines are developing, and the bud of tissue that will give rise to their lungs has appeared. Their pituitary gland is forming, as are the rest of their brain, muscles, and bones. Our babies are the size of a sweet pea at about .25 inches.

Total Weight Gain: 132 today (-2 lbs). Probably because I haven't had dinner yet.
 
Maternity Clothes:  Not yet
 
Sleep:  I'm still waking up during nightly with cramps. Guess they are trying to make room for each other.  
 
Best Moment This Week:  I called Missouri Baptist (www.MOBapbaby.com) to sign up for a tour of the labor and delivery rooms, the nursery, NICU and mother-baby rooms.  This will be done in early January. I also signed us up for a 5-week class on multiples, which will be from March-April.  Finally, I have a consultation in a few weeks with an OBGYN from MOBap that has gone through IVF herself. 
 
Movement:  None
 
Food Cravings:  None specifically.  Eating a little more this week though.  My cousin told me that I needed about 300-600 extra calories a day to get these twins up to their proper weight! 
 
Things Making Me Queasy or Sick:  Nothing
 
Looking Forward To:  I can't stop thinking about appointment next Wednesday when we'll see both of their heartbeats!    
 
 


Tuesday, December 3, 2013

5 Weeks - Ultrasound Results

I hope everyone had a wonderful Thanksgiving!  We certainly did as we have so much to be thankful for.  All weekend long I was anticipating today's doctor's appointment.  Well, as we thought from the hCG numbers, we are expecting TWINS!
 
 
 
From the ultrasound photo, you can see two sacs, along with a yolk in each.  We couldn't be happier!  Granted, just as the doctor reminded us, things can change drastically over the course of the pregnancy, but we only want to think positive thoughts.  The doctor said my uterus and ovaries looked great and that I can cut down my Progesterone suppositories from 3x/day to 2x/day.  Thank God!!  I hate having to do that at work!!  Our next appointment is on the 18th, when we will hopefully see two heartbeats. 
 
I'm going to start blogging weekly now with a baby bump photo, along with answers to the below questions.  Since there is no bump now, I have no picture.
 
How Far Along:  5 weeks.  Our babies are the size of an appleseed.  The embryos don't look like much more than a tadpole right now, but they are already starting to form major organs (heart, stomach, liver, kidney) and systems (digestive, circulatory, nervous).

Total Weight Gain: At the appointment today, I was 134 -- which was the same weight I was when we started the IVF cycle.
 
Maternity Clothes:  Not yet
 
Sleep:  I wake up during the night for about 15 minutes due to cramps.
 
Best Moment This Week:  Seeing my two babies in my uterus for the first time.
 
Movement:  None
 
Food Cravings:  None.  In fact, I haven't had much of an appetite lately.
 
Things Making Me Queasy or Sick:  Nothing

Wednesday, November 27, 2013

2nd Beta Test

Today I had my second lab test at 7:30am and then headed off to work.  I was definitely more nervous today then on Monday.  I was so scared that my hCG level wouldn't double, or worse, would decrease.  Just had to keep thinking positive thoughts!  Around 1:30pm, the nurse called and told me that my Beta hCG test came back at 1800 (mIU/ml)!  Holy Cow!  She said that I needed to come in for an ultrasound, so we scheduled that for next Tuesday.  Hopefully, she'll be able to see how many embryos we have!  She wants me to continue with the baby aspirin and the progesterone.  I only have a few days worth of progesterone remaining, so she had to order some more for me. 

Wow!  What a wonderful Thanksgiving this be!  We have so much to be thankful for!  I hope you all have a Happy Thanksgiving!  Travel safe and I'll update you on Tuesday with the results of the ultrasound!  

Monday, November 25, 2013

1st Beta Test

What a day it has been!  I had my lab test at 7:30am and then headed off to work.  It was the longest morning ever as I waited for that one important phone call from the nurse.  Around 11:30am, the phone rang and it became one of the most unforgettable moments on this journey.  My first Beta hCG test came back at 700 (mIU/ml)!  Usually, for single baby pregnancies, normal hCG levels are 5 to 430 at 4 weeks.  Since my level is so high, it is highly likely that we will have twins!!


Weeks of pregnancy
after last menstrual period
Days after conception
Approximate hCG levels
for single baby pregnancy (mIU/ml)
Week 3
7
0 to 5
Week 4
14 (next period due)
5 to 430
Week 5
21
180 to 7400
Week 6
28
1,100 to 56,500
Weeks 7 to 8
35 to 42
7,600 to 230,000
Weeks 9 to 12
49 to 70
25,300 to 290,000
Weeks 13 to 16
77 to 100
14,000 to 243,000
Weeks 17 to 24
4,000 to 165,000
Weeks 25 to birth of baby
3,200 to 90,000
4 to 6 weeks after birth
Less than 5

The nurse told me that she wanted to retest in 48 hours (Wednesday morning), as my level should roughly double.  I got off the phone with her and just started crying tears of joy!  I was so overwhelmed and happy to hear this news.  Immediately, I called Jared to share the results with him.  He was excited as well, although I think he was also in shock.  After talking to him, I called my parents, then other family members and friends.  I don't even know how many times I broke down in tears today!  It was such an emotional day that I ended up leaving work early so I could relax and let everything sink in. 

If we do end up with twins, the expected due date is July 12, 2014.  Otherwise, it would be August 3, 2014.  I just can't thank everyone enough for their thoughts and prayers!  It's been quite the journey to get here and I'm blessed to be able to share it with you.  We are so excited to enter this next chapter on the road to parenthood. 

Sunday, November 24, 2013

9DP5DT - 9 Days Past a 5 Day Transfer


Friday night I had terrible cramps and woke up feeling very depressed.  I just knew that this cycle didn't work.  Jared told me to stay positive but I was preparing for the worst.  Even though I swore I wouldn't test early, I decided to go to Walgreens and pick up a HPT - First Response.  I immediately went home to test and was floored when I saw this:
 

After almost two years of trying, I finally was able to see what  a positive result looked like!  I couldn't believe my eyes!  And I just knew it couldn't be a false positive, since the HCG from the trigger shot was already out of my system.  I immediately called Jared to share the news and he was just as excited -- although he told me to not get overly excited and wait until we get the official word from the lab on Monday.  That was easier said than done!  I couldn't stop smiling!

I then woke up this morning to test again to make sure I didn't have a faulty test, and again it was positive!  OMG!  I'm completely overjoyed!  Granted, I still need the blood test to confirm tomorrow, and then again on Wednesday.  And yes, we still have a long road ahead of us, since IVF pregnancies can be higher risk for miscarriage, but just having a positive test shows how far we have come!  I'm not sure when they will be able to tell if both embryos implanted but I'll be happy regardless!

I appreciate the love and support we have gotten from all of our family and friends.  Just to listen to me when I needed someone to talk to meant so much.  The simple call, text, or email meant more than you know and kept our spirits and hope alive.  I really never thought we'd see this day and here we are. 

Wednesday, November 20, 2013

5DP5DT - 5 Days Past a 5 Day Transfer

Well, I'm officially at the half way point between my transfer and my blood test to confirm if this worked.  Talk about a stressful few days.  I've had days where I 'feel' like I'm pregnant (sore boobs, tired) and other days, I feel just fine.  If I'm pregnant, the implantation is complete and tomorrow I should be able to get a positive result on a HPT (Home Pregnancy Test).  Since the start of this process, I swore I wouldn't use a HPT because I didn't want a false positive due to the trigger shot, but I'm so anxious right now that I just want to know.     

5-Day Transfer
Days Past
Transfer (DPT)
Embryo Development
One
The blastocyst begins to hatch out of its shell
Two
The blastocyst continues to hatch out of its shell and begins to attach itself to the uterus
Three
The blastocyst attaches deeper into the uterine lining, beginning implantation
Four
Implantation continues
Five
Implantation is complete, cells that will eventually become the placenta and fetus have begun to develop
Six
Human chorionic gonadotropin (hCG) starts to enter the blood stream
Seven
Fetal development continues and hCG continues to be secreted
Eight
Fetal development continues and hCG continues to be secreted
Nine
Levels of hCG are now high enough to detect a pregnancy
 

Saturday, November 16, 2013

Embryo Transfer

Yesterday was not only my birthday, but more importantly, it was the day of the embryo transfer.  I drank lots of water as we drove up to Columbia to ensure I had a full bladder as instructed.  Upon arrival, we stopped by the pharmacy to pick up my prescription for Valium and took one of the pills.   The nurse then took us back to get ready for the embryo transfer and gave us the most recent stats on our embryos.

1 was an Expanded Blastocyst Grade 1
2 were Blastocysts Grade 1
2 were early Blastocysts Grade 1
1 was a Morula Grade 1
1 was a 10-cell embryo Grade 1
2 fell apart and arrested to develop

The embryologist and the doctor recommend we transfer two embryos - the Expanded Blastocyst and one of the other Blastocysts.  They were going to freeze the other Blastocyst, the early Blastocysts and the Morula.  They decided to discard the 10-cell embryo since it was so far behind at this point.  The nurse gave us a photo of the two embryos that they were going to transfer -- our first future baby pictures!
Once we signed a form stating we agreed on the number to be transfered and frozen, they wheeled me into another room.  It was actually the same room where the retrieval took place.  Jared sat by my side as the doctor got everything set up.   The doctor reminded us that he only has 20 seconds to get the embryos from the lab to the uterus.  When he was ready, he called for the embryologist.  The embryologist came in, confirmed our names, and gave the doctor our embryos.  The doctor then quickly inserted them into the catheteter and into my uterus.  Jared was able to see a little speck on the ultrasound.  It was really exciting and overwhelming!  We were thrilled to be at this point. 
 
I was then wheeled back into the original room where I rested for 30 minutes.  This really surprised me -- reading other blogs, it seemed like most patients were kept at the doctor's office for up to two hours!  I was scared to get up this soon.  Not to mention, we had an 1.5 hour drive back to St. Louis.  She said I would be fine, just needed to be on bedrest for the next 48 hours.  I had to trust that she knew what she was doing.  She also wanted me to empty my bladder as well.  I was super paranoid -- I didn't want to lose these embryos!!  She laughed and said I had nothing to worry about. 
 
I laid down in the front seat of the car during the ride back and then spent the remainder of the day sleeping in bed.  That Valium really knocked me out.  Today, I plan on resting on the couch.  Being on bedrest is definitely not fun -- Jared has been a big help though!  Can't wait till I can start moving around again.  The nurse gave me an order to get a pregnancy blood test done on 11/25.  If it comes back positive, she'll want a retest on 11/27.  So now we have a 9 day wait....better than a two week wait though!  Gosh, we really hope this works...so much anxiety and stress right now.  We will be devasted if neither embryo takes.   
   
 
 

Wednesday, November 13, 2013

Day 3 After Retrieval

Today was another FANTASTIC day!  Remember back on Sunday, when Dr. Wilshire said they were able to retrieve 11 total eggs?  And then on Monday, they informed me that only 9 fertilized?  Well, today we got news that we have 9 perfect embryos!!  I was shocked and confused that we went went from six to nine!?  The nurse said they kept the eggs that didn't fertilize to see what would happen and then ended up getting fertilized!  She also said that she misspoke when she told me that three had arrested to develop yesterday -- they were just completely undeveloped at that point. So it sounds like of the 11 eggs retrieved, only two have arrested to develop.

So at 72 hours, the embryos should have 8 cells.  Here are today's results:

4 embryos have 8 cells and are Grade 1
1 embryo has 10 cells and is Grade 1
2 embryo have 6 cells and are Grade 1
1 embryo has 4 cells and is Grade 1
1 embryo has 2 cells and is Grade 1

I couldn't be happier!  What a great looking team!  Yes, we got some slower ones, but they are developing beautifully!  The embryos will be left alone the rest of today and tomorrow. 

My transfer is scheduled for noon on Friday.  I have to arrive at 11:30 with a full bladder and they will give me valium at this time as well.  Additionally, they will give me the final stats of the remaining embryos and they will choose the top two to be transfered back into my uterus.  The others will be frozen for a future transfer.  I will stay laying down at the office for two hours before they release me.  I plan on bringing a book and some cards to entertain ourselves.  Too bad, we don't have a tablet....hmm, I should put that on my Christmas list!  Then I get to spend the rest of my birthday and the following 48 hours on bedrest.  Not sure what that all entails at this point -- can I shower, can I lay on the couch?  I am just simply thrilled right now at how well things are going.  And the support!!  It has been tremendous!  Just being able to share these little details with you really keep my spirits up.  Hopefully soon we'll all get to meet Baby Williams!      

Tuesday, November 12, 2013

Day 2 After Egg Retrieval

After stressing out all day, waiting for the phone to ring, I got the call I was waiting for!  Dr. Wilshire's office does a 3 point scale from1 to 3, with 1 being the best.  As I stated yesterday, at 48 hours, the embryos should have about 4 cells.  Here are our results:
 
3 embryos have 4 cells and are Grade 1
1 embryo has 5 cells and is Grade 1
1 embryo has 6 cells and is Grade 1
1 embryo has 3 cells and is Grade 1
 
So 6 perfect embryos!!!  YAY!  I'm SOO excited!  Unfortunately, the other three embryos arrested to develop. Because so many embryos were considered perfect today, my embryo transfer will definitely be on Friday.  The nurse will call me to tomorrow to let me know how they are doing.  Now we just have to hope that they continue to grow and develop normally and that we don't lose any more along the way. 
 

Monday, November 11, 2013

Day After Retrieval

Today I got the anticipated call from our nurse. She said that out of the 11 eggs, 10 were usable  and 9 successfully fertilized!!  This was so exciting to hear and really brightened my day!  Tomorrow, she'll call me and give me the grade of each embryo and will let me know when the embryo transfer will be. 
 
Basically, each embryo is graded as A, B, C, or D ("A" being the best and "D" being the worst).  What determines the grade is the cell number, regularity, and fragmentation.  Embryos should be at 2 to 4 cells at 48 hours after egg retrieval and preferably about 6 to 10 cells by 72 hours.  It is generally best if the size of the individual cells are similar in size.  A Grade A embryo is one which has equal sized cells in it (Blastomeres). Fragmentation, is a process where portions of the embryo's cells have broken off and are now separate from the nucleated portion of the cell.  A Grade A embryo is the one which has no fragmentation or less than 10% fragmentation. A Grade C embryo, however, does not mean that the baby will be abnormal. It just means that the chances of implantation are reduced, as compared with a Grade A embryo. Below are some examples of the different Grades. 

GRADE A :


10-Cell Grade A embryo
  1. Regular Blastomeres.
  2. No Fragmentation.

GRADE B :


10-Cell Grade B embryo

  1. Regular Blastomeres.
  2. > 10 % Fragmentation.

GRADE C :


8-Cell Grade C embryo

  1. Irregular Blastomeres.
  2. > 10 % Fragmentation.

GRADE D :


8-Cell Grade D embryo

  1. Irregular Blastomeres.
  2. > 20 % Fragmentation.

The number of good embryos will determine if we do a Day 3 (Wednesday) or Day 5 (Friday) transfer. Below is a table that compares the transfers.

Sunday, November 10, 2013

Egg Retrieval Day!

Before I get into the events of this morning, let me catch up from Friday night...

So Friday night, Jared and I went to play poker at a friend's house.  We had to bring a bag with the trigger shot since we wouldn't be home at 10pm to take it.  We both set an alarm on our phones to not be late!  Jared's alarm was set earlier than mine so that he could get everything all set up in the bathroom and then I joined him a few minutes later.  This medicine was a little more difficult to mix than the others, but the added stress of meeting a deadline probably didn't help either.  We were ready to go at 10:01pm.  The 1.5in needle surprisingly wasn't too bad, probably because I had so much adrenaline and excitement for the retrieval.  However, the injection site has been sore since!   But, I'll gladly take the soreness since this was the last injection!  I just kept hoping and praying that we did the injection in the right spot and everything would be okay for the retrieval.

We woke up today at 5:15am to get ready to make the trip to Columbia.  We arrived right at 7:30 and the nurse took us back so I could get ready for surgery.  The anesthesiologist came in and asked a few questions as well.  I then said goodbye to Jared and they took me to another room, where they started the IV.  Twenty minutes later, the surgery was over and  I was waking up with Jared at my side.  The only pain I was experiencing was moderate to severe cramping, which was expected, so the nurse gave me some Tylenol.  Dr. Wilshire then came in to give us our egg count...only 11 eggs were retrieved.  9 were matured and 2 were expected to be mature within 24 hours.  I was devastated and began to cry.  All these shots and all the pain and tears for 11 eggs?!   He was pleased with this number though, as he aims for 10-15 eggs, but I wanted more.  Luck is never on our side and I know that not all 11 will fertilize - in fact, roughly 70% will fertilize, and even fewer will be considered normal by day 5.   I was so disappointed....

The nurse  then went over all of the post-op directions with us.  I start the Progesterone suppositories tonight.  Tomorrow they will call me to give the exact number of eggs that fertilized and on Tuesday, they will let me know how the embryos are doing -- if only a few look normal, they will want to do the transfer on Wednesday.  However, if several look normal, they will let them continue to grow and we'll do the transfer on Friday.   I'm hoping for a Friday transfer! 

Friday, November 8, 2013

Injections: Days 10 and 11

Day 10:

Today we had to do the shot of Follistem.  And just like last time, it was pretty easy and painless.

Day 11:

This morning, we had to do Ganirelix again so I had to deal with a sore thigh for a few hours.  I then drove out to Columbia for blood work and an ultrasound.  About 3-4 of my follicles were at 19mm and the others (about 11-12) were at 17mm.  My Estrogen came back at 1800!    And then I received the news I have been waiting for: 
TONIGHT I CAN DO THE TRIGGER SHOT!!
Never have I been so excited for one of the worse injections!!  After enduring almost two weeks of shots, I couldn't be happier to hear this.   So at precisely 10pm, Jared has to give me the HCG (Pregnyl) shot in the butt (sounds glamorous, I know!).  This is the most critical part of the IVF process.  This shot has to be right at this time...any earlier or later, and my egg retrieval will not be a success. 

 
Tomorrow morning, I start another antibiotic to be taken twice daily and tomorrow night, I have to douche (again, sounds so attractive!).  Sunday morning at 8am is my scheduled egg retrieval!!  I cannot wait!  I hope Jared has good numbers as well, otherwise we have the frozen samples as backup.  Let's hope all the eggs get fertilized.
 

Wednesday, November 6, 2013

Injections: Day 9

Today I had another appointment in Columbia for an ultrasound and blood work.  I was hoping the nurse would tell me that I was done with the meds and that I could take the HCG trigger shot tonight for preparation for the egg retrieval on Friday.  

Well, that didn't go as planned.  The ultrasound showed 14 eggs and all were about 16mm in size.  She wants them to get to be about 18 mm.  My Estrogen level came back over 1000, which she said was fantastic .  She wants me to the Ganirelix tonight as well as Follistem, which is another FSH drug.  Tomorrow, she said to just take the Follistem and then on Friday, to take Ganirelix in the morning and then come back for a final ultrasound.  As of now, it looks like Sunday will be my egg retrieval.

Ugh!  I totally wasn't expecting to do anymore shots!  Jared had to keep reminding me about the end goal so I wouldn't lose focus.  So after some complaining on my part, we did the two injections.  Follistem wasn't bad at all.  We did that one in the belly and Ganirelix in my thigh.

Two more days of shots!  I can do this!!  I'm just so tired of these meds and I'm tired of being tired!  And on top of feeling super drowsy lately, I have a constant feeling of being 'full' due to the swollen ovaries, resulting in me having little to no appetite. 

Sunday can't come soon enough...

Tuesday, November 5, 2013

Injections: Day 8

This morning I took the Ganirelix injection in my thigh.  Just like last time, the shot itself didn't hurt, but about 30 minutes later, my leg was throbbing in pain.  It was sore during most of the morning at work as well.  All day I was super tired.  These shots are wearing me out and making me so sleepy.  Not only that, I'm getting so much more emotional and sensitive due to the high level of estrogen.

I wasn't looking forward to coming home tonight since I knew that awful Menopur shot would be waiting for me.  I just kept thinking to myself that if the retrieval is Friday, that this may be the last injection before the trigger shot.  We decided to try my thigh to see if that would be less painful.  While it was slightly less painful, this shot still burned like hell!  Menopur is by far the worst injection I've had to take in regards to level of pain.  I just want to be done with these shots already!! 

Monday, November 4, 2013

Injections: Day 7

I went up to Columbia today with Jared for an ultrasound and blood work.  Jared had to provide another sample to combine with the first sample that he gave last week.  His motility went from 8% - 12%, and his count increased to two million motile. 

During my ultrasound, the nurse saw 10 follicles in my right ovary and 4 in my left. All are about 12-15mm in size, which is right where they should be.  My estradiol level was 343, which is in range as well.  So tonight, she wanted me to take 300 IU of Menopur, which is similar to Bravelle in that they both contain FSH, but Menopur also contains LH (Luteinizing Hormone).  That shot STUNG!!  I'm sick of these shots already and all the pain and tears that go along with them.  Just gotta remember that I'm almost done!!

Tomorrow morning, I am supposed to take the Ganirelix again to prevent ovulation.  This one shouldn't be too bad.  And then tomorrow night, I'm to take 300 IU of Menopur again....definitely dreading this one!

I go back to Columbia on Wednesday to check my follicles (size and number) as well as my Estradiol level.  The nurse said I should be prepared to have my egg retrieval done on Friday or Saturday!  Yippee! 

Sunday, November 3, 2013

Injections: Days 5 and 6


Day 5:
   
Last night we did left arm again.  My arm was sore due to the amount of injections in the same area, but the shot itself, didn't brother me.  We are officially at the halfway mark for injections!!  Whoo-hoo!  

Day 6: 


Tonight was the first night of two injections:  the Bravelle shot and the Ganirelix shot.  We did the left arm for the Bravelle shot and the left thigh for the Ganirelix.  The thigh wasn't bad at all -- just felt the prick of the needle and that was it!   But about 30 minutes after the Ganirelix shot, my thigh became very sore - almost like a stinging sensation.  Not sure if it is due to the location or the injection.  

My only other symptoms are still my sore ovaries and bloated belly.  I've been tired lately and have had a few headaches, but I'm not sure if either are due to the meds or stress.

Tomorrow, it's back to Columbia for another ultrasound and blood work.  Let's pray for more eggs!  Hopefully by the end of this week I will be done with these crazy injections and will have my egg retrieval!

Friday, November 1, 2013

Injections: Days 3 and 4

Day 3:
   
Last night we decided to try the right arm since the left arm was pretty painless.  Well, Jared must have hit a muscle or something, because that injection stung!!  Thank God it only last for a couple minutes.  

Day 4: 
    
Today I drove out to Columbia for my second ultrasound and blood work.  The nurse saw about 10 follicles in my right ovary and about 5 in my left.  She said that was good and that more will develop as we continue this process.  I wanted to see like 20 follicles, but she told me not to worry.  Right now, she just wanted to make sure that all the follicles were growing and were all roughly the same size. They were all about 1-2 mm in size, which is great!  I told her that my belly was slightly tender to the touch.  She laughed, said it was normal, and told me that by Monday, I won't even want to tough it...LOL.   

My Estradiol level was 127 today, which was in the normal range, so she said to continue the 300 IU of Bravelle for tonight, tomorrow, and Sunday.  But on Sunday,  she also wants me to take the Ganirelix Acetate 250 mcg prefilled syringe so that I don't ovulate prematurely.  This injection, like Bravelle, is a SubQ injection, so hopefully it's not too bad.

Tonight's injection was a breeze!!  Jared did such a good job! We went back to the left arm, around the same area that we did it last time.  I applied ice for about 2 minutes prior and felt nothing!!  It was the first time that I was actually smiling after the shot, rather than wiping away tears!!

Wednesday, October 30, 2013

Injections: Day 2


Today was the first day doing the injection on our own.  This time we decided to try the back of my left arm since my belly was still sore.  While Jared was getting my medicine set up, I iced my arm as I was told that would help with the pain. 

























Wow!  What an improvement!  It still stung a little while the medicine was being dispensed, but it wasn't nearly as bad.  And it wasn't sore after the fact either!  I'm glad we found an injection site that worked.  Tomorrow, we'll probably try my right arm so that my left arm doesn't bruise.  Other than that, I'm not having any side effects from the medication.

Tuesday, October 29, 2013

Injections: Day 1

Well we just got back from our first of many doctor's appointments in Columbia.   The nurse did a Day 3 ultrasound to make sure my uterine lining was thin - which it was!  She also checked to make sure there were several small follicles in both ovaries - which there were!  I asked for a count to give me some sort of idea of what we were working with, but she said she would do that on my next appointment.  Jared gave a semen sample to be frozen and combined with the fresh sample at the time of egg retrieval.  Unfortunately, his count was super low -- a little over one million.  So she asked him to come back next Monday to provide a second sample to be frozen and then combined with this one to make sure we have enough.  
 
Then came the dreaded injection.  She is starting me off with 300 IU of Bravelle (FSH)  per injection.   She showed Jared how to mix the liquid and powder from the vials to the syringe.  The injection can go in my belly, thigh, hip, or the back of my arm.  We decided to try my belly.  The actual prick didn't hurt, but when the medicine starting going in...WOW, that stung!  And it continued to hurt for about five minutes afterwards.  Postings from other blogs and forums said that these first injections didn't hurt.  Maybe I just have to get used to it.  Or maybe I simply have no tolerance for pain.  There is no way that I would be able to administer these shots myself -- I would have immediately withdrawn the needle!   
 
Jared is supposed to give me the injection at the same time tomorrow and Thursday.  We are going to try other injection sites to see if those don't hurt as much.  Friday, I have an appointment to do another ultrasound, as well as blood work.  Based on these results, the nurse may adjust my medicine, dosage, or number of injections.  Below is a picture of all the wonderful meds that I'll be taking over the course of the IVF cycle.
 
 

 
 
 


Monday, October 28, 2013

Getting Excited!

I'm so excited for tomorrow!  Up until this point, I was nervous and filled with anxiety, but right now, I couldn't be happier.  I just can't believe we are here already!  Since Jared's counts are so low, Dr. Wilshire is going to take a semen sample from him tomorrow to freeze and then combine it with a fresh sample on the day of the egg retrieval.  How cool is that?!  I'm really anxious to get my baseline numbers as well.  And then I'll get my first round of injections...I don't want to keep speculating on how painful the injections will be, because I know I'll get through it and all the negative thoughts just bring me down.  I hope it's not too confusing when it comes to mixing the medicines though.  Thank God Jared's a chemist -- this will be right up his alley! 

Just think, in four weeks, I could find out I'm pregnant!  I don't want to get too ahead of myself, but I've been looking at really cute maternity shirts online.  This one is a must have! 
  

Friday, October 25, 2013

And so it begins...

Well today is the day that Jared and I both start our antibiotic - Clindamycin.  It is taken twice daily - once with breakfast and once with dinner.  It is also the day that I take my last birth control pill.  Yippee! 

We have officially begun the process and I'm so excited. Below is a list of all the medicines that were prescribed, along with the calendar of daily medications to take and upcoming appointments.  I'll let you know how the injections go on Tuesday!



Wednesday, October 23, 2013

A little bit of history...


I was torn whether or not to create a blog to document our journey that I have called ‘Operation: Baby Williams’.  Something so personal, like infertility, provokes so many emotions that it’s hard to fully understand and gasp what we are going through.  But that’s why I thought it would be therapeutic to get my thoughts and feelings written down, rather then keeping them inside.  My husband, Jared and I, have been trying to conceive for the past 18 months and as devastating as that is, we know we will appreciate parenthood that much more.  I’ve spent numerous hours reading blogs and forums online about infertility;  the stories can be both heartbreaking and inspirational.   They have helped me get through this process  and maybe I can help others who are in a similar situation. 
Now let me catch everyone up to date:
‘Operation: Baby Williams’ began back in March 2012 – yes, it was three months before we were married but we figured if I were pregnant during the wedding, it would be too early to show.  We knew we wanted to start a family and therefore, figured we wouldn’t prevent it from happening, because if it was meant to be, it would happen.  After five months of trying to conceive naturally with no luck, we decided to start using Ovulation Predictor Kits (OPK).  With each month that passed, we felt so disappointed. Why isn't this happening?  Soon it was November 2012 and still, no baby.  Yet all around us, people were getting pregnant so easily.  What were we doing wrong? 
When I went to my OB for my annual appointment, I asked her for answers.  Her response with the standard:  “It takes a normal, healthy couple about a year to conceive”.  She wanted me to wait until March 2013 to do any testing.  I couldn’t wait that long – it seemed like eons away.  Two more months passed with no luck and I couldn’t take the wait any longer.  In January 2013, I went back to my OB.  She decided to send me to the lab for some tests:  TSH, Prolactin, T4, and FSH.  Everything came back normal, expect for my thyroid.  I found out I have low thyroid, which can contribute to infertility.  I was so upset when I found this out because this is something she could have tested for back in November.  She put me on Levothyroxine to get my levels in normal range and told me to come back in three months if I still wasn’t pregnant.
I was so frustrated.  I just felt that we kept hitting barriers and we would never be able to start a family.  Like everyone just kept turning us away and didn’t want to help.  But we stayed strong and tried for the next three months.  In March, I was back in her office.  This time she prescribed Clomid, which can cause multiple eggs to be released during ovulation.  After 2 months on Clomid with no success, she suggested that Jared submit a semen analysis.  Again, something that could have been done months ago!!  Well, his results came back with significantly low sperm count and motility.  This news was so hard to hear on both of us.   We did tons of research and nothing seemed scientifically proven to increase counts.  Would we ever be able to have a family? 
My OB referred us to Wash U Reproductive Center.  We met with our RE (Reproductive Endocrinologist), Dr. Keller, and she recommended that we do a Hysterosalpingogram (HSG) test, which is an X-Ray test that examines the inside of the uterus and fallopian tubes.  We took her advice and scheduled the procedure for the end of April.   This was the most excruciating and painful thing I have ever experienced!  I cried the entire time.  Never in my life have I felt so much pain.  But all I could think about is the end goal.  The results showed that the iodine solution passed through my left tube, but not my right.  They couldn’t confirm if this was because it was blocked or if it was because I was so tense.  Again, when we heard this news, we were devastated.  We felt that we just kept getting knocked down and our vision of a family would never be a reality.  Based on these results, Dr. Keller recommended a laparoscopy to further check my tubes and uterus to confirm or deny the blockage.  She would be able to unblock the tube if need be, and then we could proceed with 3-6 months of Intrauterine Insemination (IUI).  IUIs increase the chance of pregnancy by about 10%.  Her other recommendation, was In-Vitro Fertilization (IVF) – which has about a 45% success rate nationally.  IVF, at that time, was out of the question due to the cost.  We also didn’t want to spend the money on the surgery since we just spent money on the HSG test.  So we decided to skip the laparoscopy and go straight to the more affordable option of IUI and see what happens. 
So Dr. Keller increased my Clomid dosage to increase the amount of eggs that would be released.  She also did some more blood work, including a Progesterone test and an AMH test to check my ovarian reserve.  My AMH was high – way above normal!!  This was the first good news we’ve heard in a while.  We tried to stay optimistic and were excited to do the IUI.  The first IUI was early May 2013. Jared’s motile sperm count was about seven million.   The recommended sperm count for IUIs is at least 10 million motile sperm.  The nurse asked us if we wanted to proceed.  We felt we could still beat the odds and get pregnant.  Well, two weeks later, I got my period.  We did the IUI again in late May, and again his count was low.  This was so frustrating!!  My blood tests in between fertility treatments were coming back normal and still nothing was working!  We were doing everything we were told -- cut out alcohol and caffeine, no boxer-briefs, take multivitamins, drink lots of water.  Why couldn’t we get pregnant??  
I started to become comfortable with the idea that maybe a family wasn’t in our future.  That maybe it just wasn’t meant to be.  Never did I think we would be dealing with this -- especially a year after getting married.  However, Jared would not let me give up and with his strength and encouragement, we kept moving forward.  We decided the end of June would be our last IUI and then we’d consider other options.  This time Jared’s count was a little over one million.  Again, the nurse told me the chance of pregnancy was slim, but I wanted to go ahead with it anyway.  After all, it only takes one good swimmer.  Another month down, another month without a baby. 
At first I was embarrassed and felt inadequate, but I knew I couldn’t keep these feelings inside.  I started reaching out to family, friends and coworkers for support.   Surprisingly, many people I talked to either had similar struggles, or knew someone that did.  This was so comforting to hear.  I wasn’t alone and I had people who understood what we were going through.  And even those who were unfamiliar with infertility were willing to learn and listen to our story.  We were so grateful and appreciative of the support we received.  But there were others, unaware of our struggles, asking us “When will you have kids?”.   It was hard to smile and say ‘Maybe one day’ or ‘Hopefully soon’.  And then to hear comments ranging from “You’re young, you have time” to “It will happen when you least expect it” or  “I know people that have been trying for a lot longer.”   It was even harder to hear those around us so excitedly announce their pregnancy.  The whirlwind of emotions was overwhelming.  In my online searches, I came across an excellent essay of one woman’s struggles that I could really relate to.  Here is a link to it:
Being faced with the cards we were dealt, we knew IVF was our only solution.  We attended a few seminars and listened to other people’s struggle with infertility.  We’ve learned so much over the past several months that we are probably darn near close to being experts.  We started comparing fertility centers in the area to get the best doctor, with the best success rate, for the most affordable cost.  We already had information from Wash U, so we met with Dr. Dayal at SIRM in St. Louis, Dr. Ahlering at MCRM in Columbia, and Dr. Wilshire at MMRMS in Columbia.  It was information overload and each RE had a slightly different plan in place for us.  But it was at Dr. Wilshire’s office where I felt the most comfortable.  His office was not only affordable, but has one of the highest success rates in the country (63%).
It was during his office visit, where I had my first ultrasound – no one else ever bought that up in all the months we were trying.  It was during this ultrasound that he found a fibroid about the size of my uterus.  He said we can’t move forward until it’s removed – which required a laparoscopy and hysteroscopy.  Another expense and another delay in our plans to grow a family. He told us that after the surgery, we would need to wait three months before moving forward with IVF – so that would put us at November 2013.  WOW…another delay.  We went ahead with the surgery on August 5, 2013, and it was a success.  In fact, it confirmed that I did have a blocked right tube, which the Dr. was able to clear. 
During my post-op appointment with Dr. Wilshire we discussed IVF in more detail.  I never knew how involved it was.  Many people, in fact,  don't understand how big of an emotional, physical, and financial investment IVF is. The average cost of IVF in the United States is anywhere from $12,000-$20,000 a cycle (month) depending on your location. This is not always covered by insurance, and this cost does not include other necessities like medications for injections, which run anywhere between $3,000-$6,000. IVF is a very intrusive daily process, where on average you are giving yourself between 1-3 shots a day-mostly in your stomach. This eventually leads to an egg retrieval, which you are sedated for about an hour. Three to five days later, you undergo your embryo transfer, which typically consists of one to two embryos being placed back into your uterus in hopes that they will attach. After this transfer takes place, the shots continue for a two week period minimum. Within less than two weeks, a blood test is given and it is determined whether or not you are pregnant.  With the clinic in Columbia, this also meant many trips back and forth for doctor’s appointments. Dr. Wilshire also recommended that we do Intra-cytoplasmic sperm injection (ICSI) – which is basically a procedure where the embryologist injects each egg with a sperm to increase chances of fertilization.  This was all so overwhelming.  There was a lot to consider and definitely not a decision we made over night. We would be going through the biggest infertility treatment of them all, with only a 63% of success.  It’s a lot of money and emotional strain for something that’s not guaranteed!  All of our savings which we were putting towards a new home would now have to be used to start a family.  Will I be able to handle the daily injections?  What about the hormonal roller coaster ride that these medicines will take me on?  And the timing of everything has to be so precise.  The anxiety and stress was quite alarming. We ultimately decided that you can’t put a price on a child, and this is what we had to do.  October 29th would be the start of our injections. WOW – this was becoming a reality for us. 
The first thing Dr. Wilshire did was put me on birth control pills to relax my ovaries.   He then scheduled a Mock Embryo Transfer.  This is a painless procedure, similar to an IUI.  It is the of the most critical parts of a successful IVF though.  The RE only has 20 seconds to get the embryos/blastocysts into the back cavity of the uterus.  Through this mock transfer, the RE will know what type of catheter to use and exactly where to place the embryos.  This was done September 27, 2013.   

So there you have it:  ‘Operation: Baby Williams’.  Next important date is Friday, October 25th.  Jared and I will both be put on an antibiotic so neither of us get sick during this process.  I also take my last Birth Control pill.  On Tuesday, October 29th, it’s off to Columbia for blood work, an ultrasound, and my first round of injections!   Less then a week away!  I’ll keep you posted on our progress.