Bravery, Chemistry Sets and Things

This week I told a good friend of mine that L. & I are going through IVF. I don't know why I've kept it from her for this long, but I did. When I told her, some of the first words out of her mouth were, "Wow, I am so impressed with how strong you are. You are so brave."

I hadn't thought of it like that, and I tried to remember that today when I went to get my shiny, new chemistry set (aka IVF meds) from the local Fed Ex. I can't believe how many needles they can stuff into one carton. Trust me, they used every inch of that box - it's overflowing with liquids and potions (I half expected a little smoke to billow out when I finally got it open).

So, I'm focusing on my bravery as my good friend expressed to me this week. I am so grateful for her and her wonderful, warm understanding.

Meanwhile, I'm resisting the temptation to write a post on how I feel like the guest star in a science fiction flick about hormonal potions, vitrifcation, and embryos.

On with the journey...(I'm also going to resist the Wizard of Oz references today).

Off to acupuncture!

The Ultimate Reframe

Today I am psyching myself up for the big box of medications that will arrive on Thursday. You see, I've been dreading the arrival of this box for many months - every time I pondered the prospect of IVF I thought about that damned box and everything it represents to me: over $1000 of medicines and needles to remedy what my body is apparently not doing for some reason.

My two-timer IVF "friend" showed me her box of IVF meds once. I made myself look at it while cooing positive affirmations because I knew it was so difficult for her. Of course, all the while I was thinking, "Surely that won't happen to us...we'll never come to that point."

And, now here we are. We have officially arrived at that unthinkable stop on the yellow brick IF road.

So, today I'm trying to think of that box as the ultimate Christmas gift - the present we are giving ourselves that could dramatically change everything in our lives forever.

Let's hope so anyway.

IVF Questions Answered: Our First Joint Post!

Nity (you can find her at I Believe in Miracles) & I decided to do a "joint post" (see her blog) to answer all the questions we asked last week in our IVF teachings. We both attended IVF classes last week, and thought this might be helpful in answering many of the questions we all have about IVF. My answers are in red, and Nity's are in blue. Hopefully, this will help someone out there - it was certainly educational to compare notes, and I'm learning a lot about this crazy process. It's interesting to note the differences between treatment protocols.

Thanks for your help with this, Nity!

1. ICSI vs. natural fertilization. When is this decision made? Do we have to make it ahead of time or can we wait to see how things are going naturally before opting for ICSI?
   L: Our nurse said that it is most advisable to make your decision about this before egg retrieval day. If you give the green light, the embryologist will do whatever she has to do to ensure fertilization (i.e. ICSI or assisted hatching). Apparently, it is advisable to make this decision before hand so that you're not trying to do this after a very important window of time has passed (i.e. no eggs are fertilizing naturally – what should we do now?).
   N: Since we're approved for ICSI, we're definately going to have the option of doing it on the table. However, they said the # to try and not try would be based on how the eggs/sperm were mixing. They do not want to do it unless necessary because it is a lengthy, extensive process. They mentioned the decision is usually whether or not you can have the option to do it and like L, it will be made the day of egg retrieval. With assisted hatching, they said this might occur if the woman is over 38, but I shouldn't have to worry abou it at this point. I didn't even have a consent form to sign.


2. Recommended time off after egg retrieval and transfer.
   L: Our clinic is pretty liberal with this. It is most advised to do whatever makes you feel comfortable. They do not recommend anything other than "having a relaxing day" after transfer – if this means laying in bed, fine. If it means shopping, also fine – just no strenuous exercise. But, after paying 15K for a procedure that gives us a chance to get pregnant, you will find me in bed or on the couch for at least 2 days post transfer (and maybe 3 if I'm having a really good time).
   N: They recommended is to take the day after (at least) for the egg retreival; and one or two after the transfer. Essentially "no working or flying." They did not say 'strict bed rest' but did imply that taking it easy, so resting, lying low, not doing much. I plan on taking time off, and hanging out on the couch.
   
3. 3 vs. 5 day transfer - is the lab able to recommend/handle a 5 day transfer (I've heard that some aren't equipped to do this).
   L: This is determined based on how the embryos are developing. The lab will call to give us progress on a daily basis. The five day transfer is sometimes recommended in instances of numerous embryos as the doctor wants to wait and see which embryos are strongest for transfer. Pregnancies obviously result from both.
   N: They no longer do 5 day transfers at my clinic.


4. Do meds have to remain refrigerated throughout the cycle -can you travel with them?
   L: Meds have to be refrigerated prior to opening them.. They need to be at room temperature of course (not baking in your car trunk), but the refrigeration is what keeps them viable for lengthy periods of time. Not all that sure about this one – I plan to research this a little more when I actually have the meds in my possession.
   N: I have a wedding to go to after I start the lupron, so I asked about traveling with the meds. They said it was fine; we could get a small cooler and the nurse would write me a note to take on the plane. Different medications have different max temps. I think a lot of whether or not to refrigerate depends a lot on how warm/cool your house is and what you feel comfortable with.
   
5. Traveling home after transfer.
   L: Again, it's whatever we feel comfortable with. There is no research that says that traveling in a car will lead to negative results, but you want to look back on this process and know that you gave it everything you had to make it work. We plan to stay put for 24 hours post-transfer.
   N: This doesn't apply to me too much since our clinic is about 30 minutes away. They did talk about your partner or friend needing to pick you up afterwards (i.e. they would not put you home in a cab) because you'd still be under the influence of anesthesia.


6. How is the pain of the egg retrieval handled - I've never been under an anesthetic so I'm curious how this works.
   L: According to my husband (who is in the medical profession) and the nurse, the med they're going to give for this will make me pretty much out of it during the ER. After it, however, I will probably feel discomfort (and from what I've read in the blogging world, I pretty much expect that this isn't going to be a pleasant moment in the process)..
   N: They discussed not haivng anything to eat or drink 8 hours prior to the procedure (not even water), otherwise you would need a spinal, which did not sound like fun because it would require 4-6 hours of recovery time on a bed floor! They demonstrated how they go in under u/s and get all the follicles. Even though some might not fully be developed yet... As you recover there are different amounts of nice drugs to help with the pain (hence the not go to work afterwards or next day) and it would be uncomfortable. I'm assuming this could be as bad as bad cramps or but not as bad as labor. Just need to put it in perspective.


7. What kind of stim will be used -Gonal F is what we used during IUI - I'm hoping they'll stick with that since I responded well and since I'm familiar with the pen.
   L: My clinic usually uses Follistim, but since I've responded well to Gonal-F historically, that's what we're going with.
   N: Each of us have individual plans. I think on a whole our clinic uses Gonal-F. I will have both Gonal-F and Repronex. Apparently they want to give me an extra boost.


8. General timeline questions: how will things progress in terms of the timeline?
   L: I start Lupron Oct. 1 with plans for ER and Transfer Halloween week. Hmmm…a little frightening and somehow very appropriate.
   N: So L we are on almost the EXACT same timeline. I start Lupron Oct 2... with everything finished probably before the end of October. This is great. I can go to the weddings without a problem. :o)


9. What sort of monitoring will be done throughout the timeline? (this sort of falls under travel, but my clinic mentioned once I start, I need to be fully committed and be there).
   N: I have to go in for baseline U/S Oct 11 and blood test on cd 2-3; then start Gonal-F, Repronex and lower Lupron. cd7-15 will be close monitoring (i.e. be around daily) and then ET and transfer. Start antibiotics with ET and progesterone.. Go in for a scheduled beta 15 days after the transfer, because pregnancy tests can be deceiving. If pregnant, keep doing progesterone for 10-12 weeks of pregnancy, vaginally.


10. Number of eggs they are aiming to retrieve? I've seen a lot about quality vs. quantity.
    N: They never gave me an exact #. They said they would go in and get all the follicles, but nothing on the # they like to see or not go above. That's part of the daily monitoring.


11. How many eggs planned for the transfer? Statistic, probability, expectations - when will I hear about what your prognosis is during our timeline?
    N: Embryos for transfer will be discussed the day of transfer in the pre-op. A lot of this relates to the quality of embryos, age, etc. Our hospital is really worried about multiples and they are trying lower their numbers of twins. Max they put in 5, min 1. Although the doctor will go off of what you say... they will give you their medical input. Regarding the timeline, you will hear the # that are retrieved and then the # fertilized. The specifics will be given the morning of the transfer.
    
12. Heard about possible bed rest for 2 days after transfer... is that suggested?
    N: Suggested to "take time off", but not specific on # of days.


13. Have you had a mock transfer?
    N: Yes.


14. Acupuncture after egg retreival/transfer?
    N: Was told: Acupuncture is fabulous. It could only improve the situation. It has definately helped older couples.


15. What is the protocol/process regarding embryo freezing? Is that covered under insurance?
    N: Generally you can freeze; but it is a decision that you need to make with your partner. Some people do not want to fertilize anymore than they want to transfer, other people do. Our clinic does not do embryo adoption, so our options are to freeze, discard, or give to science (i.e. for practice of ICSI in lab). I still need to look into what is and isn't covered by insurance.


16. Can we order our meds from Europe? Does insurance cover them?
    N: Insurance covers our meds, not need to worry about this. Mine should be ready to pick up on Monday...

A Question for the IVF Experts Out There

Well, the IVF meds are officially ordered and should arrive Thursday. Stay tuned for the obligatory photo of my great big box of meds which will be posted for your viewing pleasure sometime next weekend.

I have a call in to the RNs at my clinic, but I wanted some input from some of you who've been through this. I am wondering about the difference between the painful PIO shots versus progesterone suppositories. Was one better than the other for you? Recommendations?

It's going to be an exciting week - pre-IVF acupuncture begins tomorrow evening! Hopefully that will get me ready to begin playing with needles as well as my very own, personal sharps container!

A Tiny Bit of Sunshine

Some days on the IF road are actually hopeful, filled with a sunshiny sense of optimism and the belief that all of this might come to a grand conclusion. Today was one of those days.

Our IVF teaching couldn't have gone better. Our IVF RN answered every question we had and was more than willing to explore any fear that we have about the process. She explained every detail of what is to come, and she was reassuring throughout our meeting.

She said that, although it's often frustrating as hell, our unexplained diagnosis is actually a positive in terms of ultimately getting pregnant. She was very encouraging about the results of my Clomid Challenge test, so I guess my ovaries really are doing their job down there.

So, today I feel a tiny bit excited about what we're getting ready to do. In some small way, I actually feel blessed to be going through this. How many people can actually say they've gone to this extent to have a child?

No matter what happens, watching all of this unfold will be one of the most memorable, amazing experiences of our lives.

I suppose it's days like today that make the IF road worth traveling.

Nity - let us know how your IVF class goes. Maybe we could get together and do a post later this week re: the answers to all of our questions! I got most of them answered today! Hope your class goes very well tomorrow! :)

The Great Big Spotted Elephant & The Plague

Today I'm struggling with the sickening irony that I'm preparing to throw a baby shower for my friend three days after I start shooting myself up with Lupron. And if that's not ironic enough, consider the fact that we'll be in the 2ww when she gives birth.

This is my friend who absolutely doesn't get it. For those girls out there who procreate like rabbits - I don't expect much understanding (and am pleasantly surprised when I get it). However, perhaps I expect a little more of her given that she's been through IVF twice.

To the contrary, her understanding of what I'm going through reminds me of a spoiled girl who expects you to be her primary wedding planner while you're amidst the nastiest divorce.

Many months ago, in an effort to salvage the relationship, I encouraged her to process this whole situation with me. This wasn't easy as she prefers to ignore the growing, fat, spotted elephant in the living room. Ultimately, however, she expressed that she wished it had been me who got pregnant first because she would have handled it "so much better" than I did.

If you can't tell, I'm still having a hard time with that one. I guess I wasn't aware that there is a "right" or a "wrong" way of handling this situation. I certainly don't remember expressing anything like that to her while she was going through it. How soon she has forgotten that now that IF is in her backyard instead of her front!!

Frankly, I feel the need to protect myself through this process from her and people like her who always have a healthy dose of negativity to heap on me. I guess the old adage applies here - if you don't have anything nice to say, just don't say anything at all.

And if you insist on continuing to talk, I'm not just going to sit back and listen.

I'm going to avoid you like the plague - after I help with your baby shower, of course.

That's what "supportive" friends do for each other, isn't it?

She's Here!!!

So, this is how I feel today:

Less than 45 minutes after my post last night, AF made her official appearance. I guess she finally accepted that I wasn't going to be toyed with this month.

Please, God, let the Good Witch's magic wand make us pregnant very, very soon.

IVF Teaching (which was rescheduled from its original date) is next week.

AF is the Ultimate Witch from Hell

Well, the ultimate "Hail Mary" cycle* is about to conclude, but not without a little tease from my dear friend Aunt Flo. AF & I have become very tight over the last 23 months - I know her every trick, twinge, and cramp. Of course, this month in my heart I can't help but think how wonderful it would be to have a story that begins with this:

"L & I were on the verge of doing IVF, and right before we signed on the dotted line to purchase our fresh and frozen cycles, there they were - two pink lines!!!!"

This is not our story, of course, and AF is determined to play a few Jedi Mind Tricks before we submerge ourselves into a sea of needles and hormones. She begins with the smallest amount of spotting and then adds a few minor cramps. When I refuse to acknowledge her attempts to drive me mad (as well as everyone else around me), she decides to play with my mind for at least 3 to 4 days.

She is satisfied only when she manages to coerce me into a full blown, obsessive google search for "implantation bleeding" and "implantation cramps". Trust me, you can always find a woman out there somewhere in cyberspace who has experienced the exact same "premenstural" symptoms as you before realizing she was knocked up. I've read it over and over: "It felt just like my period was getting ready to start..."

So, enough, already AF! I get it, damn it, and I know exactly what you're doing! Let's just get this thing going so we can officially start the IVF countdown/kickoff!!

Hell, haven't you tortured us enough over the last 23 months???!!!

*Note: I want to attribute the term "Hail Mary Cycle" to my blogger friend Nancy. I picked up this expression on your blog, and I absolutely love it!

Standing (Stationary) in the Emergency Lane

So, today was a little downhill for me.

I attended my work's "Family Fun Day", an event for all the Agency staff, families, kids, etc. Calling it a "Fun" day is a bit of a stretch, because it didn't feel too damned fun to me.

First of all, why is it that everywhere I go, someone is compelled to share their pregnancy story, their daughter's pregnancy story or, hell, even their cat's pregnancy story? It's as if I have something written on my forehead that says, "Tell me about how easy it was for you (and/or anyone you know) to procreate."

Secondly, I feel so left out. I'm either surrounded by early 20-somethings who haven't even begun thinking about pregnancy (and the daunting prospect of IF isn't even a blip on their radar screens - how I miss those days!) or 30-somethings who have children who look old enough to enter high school. I swear, I look at some of these kids and feel so behind. I find myself wondering if I missed something somewhere...how the hell did I get here again?

I guess that "family" can mean many different things, and right now, my family is L. I do feel fortunate for that, as well as the many other blessings in my life. But you know, sometimes it just feels like the whole world is forging ahead, and I'm standing on the side of the road looking at everyone whizzing past.

Another lovely day in IF world. Here's to a better day tomorrow...I'll let you know about that.

An Epiphany

Today, as I forced myself to do my 30 minute power walk, I was overcome with love and adoration for my husband. Typically, during these walks I am wrestling with "poor me" thoughts and the nagging question: "Why us?" However, today, the answers flowed into my consciousness in a way that let me know for certain that God was with me. Suddenly, I was overcome with epiphany afer epiphany about this whole infertility experience. The resounding thought in my brain was that this whole thing has given me the opportunity to demonstrate love for my husband in a way that most people never really get. I mean, really, how much commitment does it really take to hop into bed a couple of times, have great sex and end up with two pink lines?

Because of this IF challenge, I have to face a tremendous fear and demonstrate an insane amount of dedication. Sometimes I have to remind myself why I'm doing this:

The reason I'm preparing to shoot myself up with a hormone cocktail is because I love this man and want to have a baby with him more than anything in the world. And going through what we're going through truly is a demonstration that it is something we both want more than anything in the world. Damn, I'm blessed to even experience this much love for another human being without being a mom myself.

I hope this doesn't sound too corny - sometimes I'm overwhelmed with emotion these days as I never quite envisioned that my life path would be winding through Lupron and Gonal-F injections. But, sometimes, just for a fleeting moment, all of this craziness really does make sense.

Okay, I'm signing off for now. Somebody remind me of this post next month when my belly and butt are bruised from injections. :)