Week 3 - Egg Retrival

As week 3 started I was already a little disappointed because I thought this week would be all about egg retrieval and in my mind an end to the shot/vitamin regiment. I felt like I was sailing through my update appointments in Week 2 and my eggs where growing at a good rate.The  disappointment came on the Sunday at the end of Week 2 check up appointment, when i found out my eggs where not big enough yet for egg retrieval. Which meant more check up appointments and no definite date of when the egg retrieval will actually happen.

My 1st update appointment of week 3 was on Tuesday 2/21/17

• Blood work - 1 vial, My favorite nurse was back. Yippee
• Ultrasound-9 follicles previously I refereed to theses as eggs, but I learned that the follicle are like sacks that hold the eggs and normally there is one egg in each follicle. The size  of the follicles ranged from 4.5 to 13.5 millimeters. I was very disappointed at the end of this ultrasound because the largest follicle had only grown 0.5 mm since my appointment on Sunday.  I later learned  this could be due to having a different person preform the ultrasound or it could be  the machine itself measuring smaller than others ones in the office. On this particular morning, on the ride to and from the doctors office in Virginia, I was very emotional. I think it was the hormone shots starting to really affect me, I did shed some tears before and after.
• Clinical Staff Meeting- Added another check up appointment in 2 days, but no changes to my medication doses. The great thing that happen today was that the clinic had sample medicines they where able to  give me to get me through to my next appointment, which meant I did not have purchase additional medicine. That was a savings of over $1000. Even though I was very concerned about the lack of growth of my follicles from my previous visit, the staff said Dr. Robin was not. I was still worried and worse case scenarios where rolling through my head till my next appointment 2 days later.

When the doctors office adds an update appointment I get a call from their office later in the day once they have seen all the current IVF cycle patients and have had time create the schedule for those who are still needing to continue update appointments.  By week 3, I was obviously one of the last patients in the group that where still in the egg growing process and continuing the update appointments, because my appointments times kept getting earlier and earlier. Previous appointments where at 9 or 10 am, but my next scheduled appointment on Thursday was for 7am. I have to admit that I had a small heart attack when the lady on the phone told me 7am and later called back to make sure I had heard her correctly. I am not a morning person and the clinic is about 1 1/2 hours away from my home. That meant getting up at 4:30 am to leave home by 5:15 to be there on time. I tried to stay positive about the early appointment thinking that at least I would be able to get to work and not have to use my sick time, but that did not happen even with the early appointments I was still using 2 hours of sick time vs 4 hours for later appointment times.


Thursday 2/23/17 Update Appointment 7am

• Ultrasound - Due to the appointment being before 8 am and the ultrasound tech needing to go to the surgical side for others who where doing egg retrieval they switched the order of the appointment. 
• I lost track of the actual number of follicles it was either 9 or 10 but they ranged in size between 8-15 millimeters. This made me happy as I could see them getting close to the 16 mm size needed for egg retrieval.
• Blood work - Labcorp who runs the blood work lab does not arrive till 8am, so the clinical staff  draws blood for patients who have appointments before 8. I think I mention in last week blog how I don't have the greatest veins. The Labcorp nurse Patricia says my veins are deep and are not morning veins. Unfortunately, Patricia had not arrived yet when it was time to draw my blood and the clinical nurse stuck me twice before giving up and went to find another clinical nurse to draw blood. As soon as the next clinical nurse came in to begin looking for a good vein Patricia walked in and took over, but even Patricia struggled this morning and had to stick me 2 more times. I am bruising from the blood being drawn so much. My husband was joking around with me saying people are going to think I am a crack addict and that I needed to wear long sleeves. lol The things I have done in this IVF process.I just can't seem to bring myself to post a picture of the terrible bruising going on in my stomach area where I have been administering the shots every days.

• Clinical Staff Meeting-Added another update appointment to my schedule for Friday and had me to continues on the same medicine schedule of 20 vitamins/pills a day and 5 shots a day. Again the doctors office was nice enough to provide me with a few samples so I did not have to reorder medicine. 

Friday 2/24/17 Update Appointment 6:40 am

• Ultrasound - This was the first time I had follicles in range. I knew I was close to Egg Retrieval now.
•  3 follicles where 16 - 18 mm (egg retrieval size) and 5 follicles where 4-13 mm
• Blood work - Again my appointment was before 8 am so the labcorp nurse was not in yet, but Erica who is a Clinical Nurse did a great job only having to stick me one time for the blood work part of the visit. I was able to tell her exactly what Patricia with Labcorp does and Erica was so patient and took her time to make sure she was able to get it right the first time.
• Clinical Staff Meeting- They announced I was scheduled for Egg Retrieval on Sunday 2/26/17 at 6:30 am and provided me with a HCG and Oocyte Retrieval instructions sheet spelling out what I needed to do to prepare for Egg Retrieval on Sunday. They went over how mix and administer the trigger shot and what I could and could not consume for the liquid diet.

HCG & Oocyte (Egg) Retrieval Process - To prepare for Egg  Retrieval the process took 2 days. 

• Friday - 
• Took my last 2 doses of Micro Luperon Shots- These are the shots that had to be taken at 7:05 am and 7:05 pm. I was so happy to finish this up, because I felt like my life revolved around theses times.
• Took my last Follistim shot. I was only required to take the am shot and was taken off the PM Menopur Shot
• Since I had spent weeks taking Micro Lupreon to stop ovulation, I now needed to take a shot to trigger ovulation. This shot was called Pregnyl  and had to be taken exactly at 8:45 pm in upper right side of my butt. The clinical nurse actually drew a circle on my butt while in the office earlier in the day, so I made sure to inject it in the right location. All other shots I was injecting into my stomach with this being a new location that was harder to access I asked my husband to pull the trigger and inject the shot. I think he enjoyed that fact that he got to give me a shot, for me the anticipation of someone else doing it was worse than if I just did it myself. 

 

• Saturday -
• Well here the weird part of Saturday is, I had to take a pregnancy test and call into the doctors office by 12pm to verify that I got a positive pregnancy test. That pretty weird to see your pregnant on a test when you know your not. 

• Took all morning and any time (16 pills) vitamins/pills but not evening pills (4 pills). 
•  At 1pm I began a bowel prep series of medicine taking 2 pills every 15 minutes for 2 hours and then had to continue with a liquid diet till midnight. I slept very little Saturday night waiting for the bowel prep medicine to begin. I was so concerned when I showed up to the doctors office on Sunday with out having a single bowel movement, however they where not concerned and said that it does not always work with patients. The reason patients are put on a liquid diet and bowel cleanse is because your bowels can wrap around your ovaries and hide your follicles. If you are cleaned out they will be able to see all the possible follicle and not miss any eggs that could be hiding. 

 

• Last step was to stop all liquids even water at midnight. 

Egg Retrieval Day 2/26/17

• My husband and I arrived at the New Hope Center at 6:15 am.
•  A little after 6:30 I was called back to the pre/post op room. I was given a hospital gown and asked to remove all my clothes and put on the gown. I was placed in a room with 6 big reclining chairs, where the nurse Virginia prepared me for the egg retrieval procedure. She inserted an IV in my hand and gave me some medicines for the procedure. The nurse was very nice and being we where the only 2 in the big room we spend lots of time just chatting about HGTV which I was watching and life. The anesthesiologist came in and went over the process of putting me to sleep and then the embryologist came in to verify what the plan was for my eggs. The plan is to do a procedure called ICSI and testing called PGS. I will go into alot more detail in next week's blog as it will take some explaining and this weeks blog is getting very long. 
• Virginia then took me to the procedure room via a wheel chair where there was the clinical staff, anesthesiologist, and ultrasound tech. They had me lay down on a table and strapped my legs into these stir ups very similar to a women going to her annual exam but the stir ups literally where strapped up to my calves. EKG monitors where applied and the staff was working feverishly setting everything up. That the last thing I remember before waking up and the procedure being over. Virginia was still there with me unhooking the monitors while everyone else was leaving moving on to the next patient. My first question was how many eggs did she get. They said they where able to retrieve 5 eggs. Don my husband said Dr. Robin came out and spoke with him after the procedure and acted like she was happy with being able to retrieve 5 eggs and also removed a poly op from the Hysteroscopy part of the procedure.
• I was then taking back to post op room via a wheel chair. Where my blood pressure and pulse was monitored for about an hour. I  was put back in the those big reclining chairs where I enjoyed a nice warm blanket, watched some HGTV and may of took a little nap.  I saw Dr. Robin walk through the pre/post op room twice and each time she said we got 5 eggs and  one time stop for a second to hug me.I had to ask after I saw her, does she ever slow down. They said no. Every time I see Dr. Robin walking around the clinic she is walking at a speedy pace. Even when you talk with her you can tell she works fact pace all the time. In talking with Skeeter the ultra sound tech earlier she said the earliest she ever come in for egg retrieval is 3 am and she mention that every month she works 3 weeks straight during the IVF cycle. I am always amazed at the hours the New Hope staff puts in. It is truly amazing that the amount of time they make themselves available (7 days a week 6am to 6pm). Now that I had finished my post procedure monitoring I was asked to verify that I could urinate and then was allowed to get dress and was walked back to my husband to be able to leave. The whole process from arrival to leaving took about 3 hours. 
• Sometime during the time I was taken back for the egg retrieval my husband was taken to another part of the clinic to produce a specimen for the embryologist department to be able to mix with the eggs they retrieved from me.

Week 3 turned out to be the busiest week yet. Next week is all about our embryos and how they fertilize. If everything goes right and we have viable embryos then they would be implanted at the end of March. We still have along way to go, but we have finished a big part of the IVF process.

Week 2 - More of the Same

Week 2 is in the books!!

Week 2 followed the same vitamin (20 pills a day) and shot regiment (5 shots a day) as week 1, except  with more doctor visits than the previous week. This week continued the egg growing process. The goal is to get as many eggs to grow and get to the mature size of 16 millimeter (the size of a walnut). 

My first doctor visit of the week was on Valentine's Day 2/14/17. 

• It started with blood work. Only 1 vial this trip, thank goodness. 
• Next up was an ultrasound to determine how many eggs there where and the size of them. I had 5 eggs all together and they ranged in size from 4 to 6 millimeters. This is the worst part of  each visit. The ultrasound is similar to getting a pap smear and that is never fun. 
• Next was a meeting with Dr. Robin who will do the egg retrieval and  Hysteroscopy the following week. A  Hysteroscopy is a procedure that allows the doctor to see the inside of the uterus (womb). She will be looking to see if there is any issues that may exist that would cause the embryos to not implant on transfer day. During our meeting she had me sign consignment forms and went over pre and post surgery instructions. The actual date of theses 2 procedures will not be determined till early next week.
•  The last meeting of the visit was with the clinical staff. The clinical staff meeting communicates any changes in medication dosages which I did not have any changes.Both the clinical staff and Dr. Robin said my eggs and size where normal and what to be expected at this stage of the process.

The nice part about having a doctors appointment in Virginia on Valentines Day was getting to spend the entire day with my husband. We where able to go see a movie after the doctors visit, walk around Lyhaven Mall, enjoyed lunch out and then finished the night off with dinner at the restaurant where we were married. The funniest part of the night was giving myself my 7:05pm Micro Lupreon shot in the bathroom at the restaurant. lol

The 2nd Doctor Visit of the week was on Friday 2/17/17.

• Bloodwork - 2 vials this trip. 1 to test liver functions and I am not sure what the other vial was to test. 
• Ultrasound- 8 eggs total, Size ranging from 4-12 millimeters. 
• Clinical Staff Meeting - No changes to medication doses. 

Another funny shot story-I went to a fundraiser event Saturday night. I was all dressed up in my nice dress and 7:05 pm rolls around. I went to the bathroom to give my self a shot in the bathroom stall. While in the stall there was no where to sit my purse or shot. I was trying to sit down in the bathroom stall while trying to pull up my dress and my panty hose down when the shot fell on the floor and rolled under the bathroom stall door. Of course the bathroom had about 2-3 women in it at the time. I can only imagine what was running through their mind when they saw a syringe roll under the door. lol


The 3rd Doctor Visit of the week was on Sunday 2/19/17. I was very surprised to have an appointment on a Sunday and at 9am in the morning on top of that.

• Bloodwork -  1 vial this time, but it was a new nurse and she struggled finding a good vein to draw blood from. She tried inside bend of my right elbow with no luck. Looked at the left inside elbow and decided the top of hand was the best spot. My veins are not the greatest, so I am not surprised when someone struggles. It was nice with the previous nurse as she had learned how to get the blood she needed as painless as possible. I hope she back on  Tuesday.
• Ultrasound - I am up to 9 eggs but they have not grown as large as I had hoped. The range is between 4-13 millimeters. I have to go back next Tuesday for another update appointment. I had hope that my next visit would be the egg retrieval procedure, but I guess I am trying to rush the process quicker than my body says it should go.
• Clinical Staff Meeting - No changes to medication doses, but I am starting to worry as the medicine is beginning to run out. I have already had to order 1 extra dose of Menopur on Friday and will have to order another dose on Monday. The follistim will run out in the next 3 days and that is very expensive medicines. I have my fingers crossed and will say a couple extra prayers that my eggs get to the 16 millimeters size by next appointment in 2 days.

Week 1 - Complete

We have  officially completed our first week of IVF!! 

I feel like I need to rewind real quick to finish getting everyone update before I really dive into week 1. In my last blog post I talked about how we came to the point of finding out that IVF would be the option we needed to use to bring a baby into this world. Since that 1st appointment in December with the IVF clinic, the wheels have been turning trying to get everything in line to start the process.

I went for an appointment in January to see whether or not I could get into the January IVF cycle, but I was too far along in my menstrual cycle and had to be moved back to the February Cycle. That gave the IVF clinic time to create the right protocol for my specific situation. On January 24, my proctol was emailed to me and I began the vitamin regiment of IVF. Minus the 2 bottles on the right of this picture below.  I have been taking theses pills everyday since January 25. The pills are taken at certain times a day. I don't know how they help in the process, but as long as the clinic tells me to take them, I will continue to take them. I should tell yall, I am not good at taking pills.  I rather do the shot portion of this process than take theses pill, but I do take them one by one. I am up to 20 pills a day.

  

Daily  I take:

• Prental is 1 vitamin a day 
• CO-Q 10  is 3 vitamins a day (chewable)
• Royal Jelly is 4 vitamins 2 in the morning and 2 in the evening
• Maca Root is 5 vitamins a day 
• DHEA is 3 vitamins a day, 1 in the morning and 2 in the evening
• Baby Asprin  is 1 pill (chewable)
• I was on Birth Control for a little over 2 weeks, but that one has ended now and 2 more prescriptions where added on 2/10/17
• Letrazole is 2 pills a day 
• Dexamethasone is 1 pill at bedtime.

  On 2/6/17 I started a 4 day series of wearing a patch called Androderm. I applied the patch to my thigh for 24 hours and then stopped the patches on 2/10/17. This has been the  easiest part of the process so far. I wish more of the process was this easy.

Our Baseline Appointment was on 2/7/16. I call this the official start of the IVF process. The appointment took about 4 hours.

• It started with an ultrasound to determine how many eggs I currently have and the size of them. This information will be used as a baseline to determine, if the eggs are growing based on the medicine prescribed. 
• Next was blood work. I am not exaggerating when I type they took 10-15 vials of blood from me and only 2 from my husband. The blood work was called IVF LABS which checked to see if my husband and/or I are carriers of the cystic fibrosis gene. I know many other things where checked as well but I can't remember all the things the nurse said they where checking for. We both did the IVF labs, but I had to do a metformin labs as well. This is the reason I had so many more vials of blood compared to my husband. I have been trying to research the blood test on line to be able to provide you with more details but I am not having any luck.
•  After blood work, we met with the clinical team who went over the new protocol prescribed and how to administer the shot medication, etc. 
• Next was a meeting with the embryologist who went over lots of paperwork that we had to sign. Making sure we fully understood the process and the risk associated with this process. We even had to make decisions on what to do with eggs/embroyos that  can't be used. We choose to donate them to research. 
• The last meeting was with the finance department to pay for the process. I am choosing not to share the actual cost we are paying for IVF, because honestly it is way more than we had planned to spend. I should of said no we are not paying that much but truthfully I am so emotionally invested in the idea of having a child that I can't seem to walk away. With all that written we will just say the price is an INSANE amount. My husband is very supportive and has graciously allowed me to spend this crazy amount of money on this option.

The shot portion of the IVF process began on 2/8/17 with a medicine called Micro Lupron. This medicine suppress ovulation.  I have to take 2 shots a day every 12 hours on the dot. I take one at 7:05 am and 7:05pm every day. The training video from my clinic talks about how you have to be exact with the time. Being more than 3 minutes late could cause you to ovulate to early and the IVF cycle could be cancelled. For that reason I have 3 alarms set on my phone every 12 hours - a notice at 7:00 am & 7:00pm to inform me that I have 5 minutes till its time to give a shot. Then I have a one minute warning set at 7:04 am and 7:04 pm, then lastly is the 7:05 am and 7:05 pm alarm to let me know its time to administer the shot. I give the shots in to my belly and it does not hurt. Below is a picture of my shots already pre-filled,so that it will be easier to take them on time.

On 2/10/17 I added 2 additional prescriptions that are administered through shots. Both prescriptions are used to help produce multiple follicles (eggs) and to help them mature to a walnut size (16 millimeters).

• The first prescription is Follistim AQ (follitropin beta injection) which contains follicle stimulating hormone (FSH), a naturally occurring hormone and is used to stimulate a follicle (egg) to develop and mature. I take 450 IU's in the morning and 150 IU's in the evening. Below is a picture of Micro Luperon and Follistim that I take each morning.

• The second prescription is Menopur. Menopur (menotropins) injection is an equal mixture of the naturally occurring follicle-stimulating hormone (FSH) and luteinizing hormone (LH) used to stimulate the development of multiple eggs. This prescription has to be mixed before it can be injected. It starts with extracting sodium chloride with the big syringe using the Q cap and then injecting the sodium chloride into the Menopur (white powder substance) slowly swirling the mixture. Since my prescription calls for 2 vials of Menopur each evening. I have to inject the mixture into an additional bottle to mix the 1st bottle solution with the 2nd bottle solution then attach the smaller needle to do the injection. Below is a picture of the shots and everything needed for the shots that I give myself each evening.

This is what the first week of IVF has looked like for us. Next week will be filled with continuing the medication prescribed and more doctor visits. Check back for Week 2 coming soon.

How does a couple get to the point of needing to do IVF?

Well for my husband and I it started back after we got in engaged in June of 2015.  We talked about whether or not he would be up to the idea of having another child. I assumed the answer would be no, because he has a son that he raised mostly on his own, that is now in his early 20's. To my surprise, he said yes. So the journey started.

We decided that after we where married we would cease taking the steps to prevent a pregnancy and just let nature take it course. We where married in January 2016 and by June 2016 nothing had happened and I started noticing some changes in my monthly cycles like the time between cycles (28 days some months other months 45 days) and then the consistency (light some months heavy other months). I decided in August  it was time to reach out to a doctor to see if there was a problem that was preventing us from conceiving. Plus in the world of reproductive medicine my age of 36 is consider pretty old.

 After I met with a local OB-GYN doctor, he decided to run a series of test.The first test was blood work that test hormone levels which all came back normal. I found the following information on www.babymed.com to help explain what hormones where tested.

The hormonal testing is referred to as "cycle day 3 (CD3) blood work."
 
Generally, the following hormones are measured:

• Follicle Stimulating Hormone (FSH) - is produced by the pituitary gland and is responsible for the egg maturation process. High day 3 FSH levels are associated with diminished ovarian reserve.
• Estradiol (E2) - is produced by the ovary and levels should be low in the early part of the menstrual cycle. High day 3 levels may indicate a cyst in the ovary or diminished ovarian reserve.
• Luteinizing Hormone (LH) - is produced by the pituitary gland and levels are increased before ovulation. A LH/FSH ratio of greater than 2:1 or 3:1 may be diagnostic of Polycystic Ovarian Syndrome (PCOS).
• Prolactin - Both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are necessary for ovulation. If, for example, hyperlactinemia is caused by a prolactionoma, a tumor in the pituitary gland, then this could interfere with the secretion of LH and FSH. Any change in LH and FSH can cause ovulation and menstrual abnormalities. The normal range for hormone levels will vary between laboratories. 

 My husband completed a semen analysis in October to see, if he had any fertility issues, which he did not. The testing for me continued with a 2nd test called Hystrosalpingoram (HSG) commonly referred to as a dye study test. The test was performed in October but was unable to be completed due the doctor diagnosing me with a narrow cervix which caused the thin tube to not be able to be inserted to perform the test. The following information explains what  HSG testing is and was found on www.webmd.com

• A hysterosalpingogram (HSG) is an X-ray test. It looks at the inside of the uterus and fallopian tubes and the area around them. During the test, a dye (contrast material) is put through a thin tube. That tube is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes. The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes. They can also show a blockage that would prevent an egg moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. The test also may find problems on the inside of the uterus that prevent a fertilized egg from attaching (implanting) to the uterine wall.

 For the 3rd test I had two options to choose from: I could retry the HSG test with medication that would force me into labor and dilate my cervix, but this option may or may not work. The other option was to have the HSG test done as Laparoscopy surgery. Laparoscopy surgery was the option I choose, because it was guaranteed to work. The surgery allowed the doctor to make and incision in my belly button and above my pelvic area. The lower incision allowed the HSG test to be performed while the belly button incision allowed a camera to be sent into my uterus to see if there where any issues with my ovaries, tubes, etc. By the end of the test the doctor had determined that I had one Fallopian tube completed blocked and another almost completed closed. The doctor was also able to correct the narrow cervix issue by removing scar tissue while I was under anesthesia. I found a  pictures online to give you an idea of what the surgery looks like. 

Now that we knew the problem was with me, we where referred to a specialist in Virginia. In December we went for our first consultation and the news which was no surprise by now, was that if we wanted a child in our future the best option was to conceive with the IVF process. I imagine you are problem thinking . . What is the IVF process? In simple terms its where eggs are retrieved from my ovaries and them mixed with my husband sperm in a laboratory to at a later date be placed back in my uterus in hopes that the new formed embryos will stick to the uterus walls and grow into a baby. At my age, we have a 50-60% chance of success.

We chose to move forward with the IVF option and the process begins in February. Stay tuned to learn exactly what it likes to go through IVF.

The Big Secret

How  do you start a post that puts your dirty little secret out for everyone to know and why would someone want do it? Well my name is Lauren and I am about to share with you my darkest secret but once it out there for the world to read, there will be lots of people who will say they too have been through something similar. It seems silly that when 1 in 8 suffer from this that we all tend to keep these type of things a secret and make it so taboo to talk about it. I don't know why we don't talk about it, but I am going to break away from the norm and share my journey with you all.

AND THE SECRET IS ???? (DEEP BREATHE)

I CAN'T HAVE A CHILD THE NATURAL WAY BECAUSE MY FALLOPIAN TUBES ARE BLOCKED. TO CONCEIVE A CHILD DON AND I MUST DO 
IVF.

 
 Why I am I sharing this with the world in the form of a blog.There a couple reasons why:

•  First I thought this might be a great way to continue to update those who already knew this. Those family members and close friends could become a follower of this blog and be automatically sent updates. I also  would not have to remember who I told what too and who I had not updated. 
• Second, As I have been reading posts on IVF from facebook support groups, I realized all these women who are going through the same thing are not being supported by the people who care about them the most, because they are afraid to tell them. If I had a friend going through this and they choose to keep it quiet. I would wish I had know so I could of been a support system while they where going through this. 
•  Lastly, As I think of the future and if the IVF is successful and that moment when we would be able to announce that we are having a baby. I think about how people would not know what we went through to get to that moment and I feel the need for people to know that we did not just pop up  pregnant one day.  I feel the need for people to know that it was hard work, that its was painful, that it was very emotional  and that it affected every aspect of our lives.

So with all that written, I hope you get an understanding of why I am choosing to invite you into our journey and maybe this helps someone else going through this.  If you would like to support us, we love to have you follow us through the good, the bad and the ugly that goes in to the IVF Process. I plan to share exactly what we are going through and to be as real as possible with those reading this. I personally feel like with a great support team and not having to hide this from the world will only make this process easier in the long run.

If you believe in prayer, we be honored if you would pray for us, if not we be just as honored if you sent good vibes/well wishes our way.

Thank you for taking the time to read our first blog post.