Tuesday, May 23, 2017

Our Infertility Journey: Round Three, Part Two

Click here for Part One

Wednesday, April 12
I received my IVF calendar/schedule and meds list in the mail yesterday. It's slowly starting to feel more real! I also have two appointments scheduled already over the next few weeks. Next week, Tim and I both have to go in for blood work and I'm also getting an ultrasound. Then about a month from now, I have my baseline scan and blood work scheduled.
According to the schedule, it looks like transfer and retrieval are going to be around the end of the school year and into Memorial Day weekend. I might have to miss the last day or two of school, but I'm okay with that. I just need to find a sub who'll cover for me on the days I'll have scans.
I'm still currently waiting to get my second period, but it should be here any day now.

Wednesday, April 19
Finally, my second period started a few days ago on Sunday and I began taking my birth control on Monday. Tim and I had to get initial blood work done today (they had to stick me three times & dig around, ugh!) and they did a saline ultrasound on me to make sure everything looked okay down there after the miscarriage. Thankfully, everything looked great and we are on track to being IVF on May 12! On that day, I'll have my baseline scan and labs to begin the IVF process. Between now and then, I'll make sure that I get all of my meds through the mail-order fertility pharmacy and continue the birth control until May 9.

Friday, April 21
I'm getting a bit nervous about being pregnant again. I'm so worried that every little thing I feel is going to make me think something is wrong. I keep telling Tim that if I get pregnant this summer, I'm just going to lay around all summer and not strain myself at all. I'm worried that my cervix won't hold up and that being checked every two weeks won't be often enough. Just under two weeks went by between the last time I was checked and when the boys were unexpectedly born. I'm worried about going back to work if/when I get pregnant, especially in the heat - thank goodness I have that room air conditioner!
Even with all of these worries, I am SO excited to get pregnant again. I can't wait to have more kids! I'm really, really hopeful that it's going to work on the first try. I hope that my body responds appropriately to all of the hormones and medications (wow, that med list is LONG!), that I don't get too over-stimulated, and that we have several embryos that survive. If we do have more than one, we plan on freezing the extras to implant at a later date to have more children through a frozen transfer cycle.
Oh, one of my other worries, of course, is getting pregnant with twins. Now I'm pretty sure everyone on the staff knows that we are planning on only transferring and implanting ONE embryo, but I still have that fear that it'll split into identical twins - there's no way to control that. I don't know what I'd do if I found out it was twins again - I'd be terrified! Of course, we'd deal with it, and I really wouldn't want to move my entire pregnancy, but I could never go the route of 'selective reduction'. So right now, I'm really hoping that it works on the first try and we get pregnant with ONE little bean this time around. :)

Monday, May 1
We're officially in IVF month. In February, when we first met with the clinic, May seemed so far away, but here we are less than two weeks away from my baseline scan. Over the last week or so, I've been back and forth with the fertility pharmacy and the fertility clinic making sure that the correct meds are ordered and covered by insurance. IVF has a lot more medications than my IUIs, so making phone calls without my list is impossible. Unfortunately, one of my meds, Lupron, isn't covered by my insurance. I called the fertility clinic this afternoon to see if there's a replacement drug available, because I'm not paying $649 out of pocket for it! In the meantime, the fertility pharmacy is going to mail me all of the meds that have been approved by insurance this week. Hopefully this will help narrow down what's left. Thank goodness they ship quickly in case we need something last minute - I feel like next Friday is going to be here before we know it.

Right now the plan is to continue birth control until May 9th, then I should start my period. On May 12th I'll go in for my baseline scan (ultrasound to check that I don't have any cysts or anything that'll prevent us from moving forward) and labs (to make sure my hormone levels are in check). Then, they'll tell me exactly which medications I'll be taking, how much, and when to begin, to stimulate follicle growth. The nice part about going through the IVF process is that we can harvest eggs from both ovaries this time (unlike IUI where eggs on my right side were useless because I don't have a fallopian tube there), so hopefully we'll get a lot!

Thursday, May 4
I'm getting stressed out already, and I don't like it! I've been playing phone tag with my fertility clinic over the last four days trying to figure out if I have the right medications. They've been returning my afternoon calls the following morning....while I'm working.

I got a shipment of meds yesterday in the mail, and two of them were not on my original list of meds that I'd be getting. It's worrying me that I just paid $80 for these two (plus $105 for others) and they aren't even what I need. I'm sure there's no return policy!

Monday, May 8
Thankfully I was able to get in contact with someone at my clinic on Friday and discovered that the two meds that weren't listed were basically just generic brands for medications I needed, so we're good! Now the issue is that one of my hormone levels on my blood work from April was a bit high. This means I'm at a higher risk for hyper-stimulating. If this happened, then I'd have to trigger with a specific shot, one that's not covered by insurance and is $649. It also means that if I did hyper-stimulate, they may follow through with the retrieval of eggs, but may need to freeze any embryos to implant them the next cycle, to allow my body to recover from the over stimulation.

All of these unknown factors are making me a bit nervous, but I'm definitely not as stressed about everything as I felt on Thursday of last week. Tomorrow is my last day of birth control, then I'm expecting to get my period on Wednesday/Thursday and I'll be going in to get my baseline scan and labs done on Friday. This is also when I'll be learning all about what medications I'll begin taking and injecting. It's getting close....

Friday, May 12
I'm so happy to not be feeling stressed out right now!! I had my baseline scan and labs this morning and everything looked great on my scan. They even were able to get my vein in one poke (with some maneuvering), so I'd call it a success. One of the nurses was able to answer all of my questions in the office, and then they told me they'd call me this afternoon to tell me my instructions based on my lab results.
Well, just got my call from the clinic and I'll only be doing two shots per day - how easy is that?! I'll also be taking an oral antibiotic (Tim, too) for ten days while preparing for retrieval. So, starting tonight, I'll be doing Gonal-F and Menopur injections each evening, and I'll be going back on Wednesday (today's Friday) to see how I'm progressing. Thanks to one of my favorite techs, she's going to scan me at 7:15am so that I can get my blood work and get back to work as soon as possible.
The tricky part about all of this is that I'll have to be seen a lot by my fertility clinic so they can monitor my follicles and ovaries very carefully to watch for hyper-stimulation, so that means lots of trips to Springfield which is 45 minutes one-way, and also some time from work. Thankfully I have amazing and very understanding co-workers who are willing to step in and help watch my class while I have to be out so much.

Wednesday, May 17
Up bright and early (as usual) to get to Springfield and back this morning without missing too much work. Of course I had a dream last night that I ended up taking a school bus there instead of driving, and we got lost out in the middle of no where. By the time we got to Springfield, I learned that their clinic had moved to Decatur, actually in the office of my school building (convenient, huh?!). Can you tell I'm stressed about being late to work?! I feel bad, but appreciate SO much, that people are giving up their plan times to watch my kids so that I don't have to get a random sub for an hour.

Anyway, I'll be leaving in less than an hour to head to Springfield. I'm hoping to be the first one there so I can get in and out quickly. They'll be doing an internal ultrasound to look at my ovaries and count & measure the follicles that are growing inside. I'm so excited to be able to consider BOTH sides this time around, something we've never been able to do before. Then I'll be getting blood work done - they usually struggle to find a vein - to check/monitor my hormone levels. I'm guessing, just like on Friday, that they'll meet with the doctor after lunch and call me this afternoon to update me on my information and any changes I'll have to make.

Good news, everything seems to progressing as it should! :) I was indeed the first one there and had my scan quickly. I had 18 follicles, 8 on one side and 10 on the other. They were pleased to see that I didn't have any giant ones, so I'm guessing that means I'm not hyper-stimulating...yet. For some reason they always struggle to take my blood. It took three people and three pokes to finally get a vein. They better get it together because I'm going to be back a lot over the next few weeks!
One of the nurses called this afternoon and told me to continue both of my shots (Gonal-F & Menopur), keeping the dosage the same, and to return on Friday morning. That will be one week into the shots, and I'm curious to see how much will change in two days. I'm already going on day six tonight. This retrieval is going to be here before too long!

Friday, May 19
I had another scan with labs this morning. Thankfully they are so flexible and didn't even care that I showed up a half hour before my scheduled time so I could get back to work. AND, they even got my vein on the first poke!
I had three measurable follicles on each side today. This surprised me, especially since I thought I had 18 just two days ago. But I tried not to stress too much about it - we only need ONE.
After speaking with one of the nurses this afternoon, things seem to be progressing well. I'm now adding another injection to my nightly routine - Cetrotide. It's supposed to help the eggs mature, but keep me from ovulating too soon. I'll be going back to the fertility clinic on Sunday morning for my next check.
Retrieval is coming up quick. Tonight was my 8th night of injections. Let's hope that the six eggs that are growing continue to grow and mature like they're supposed to, and maybe a couple more will sprout up by Sunday. The more eggs they retrieve, the greater chance we have of a good quality egg fertilizing and developing before they transfer it back into my uterus.

Sunday, May 21
More labs and another ultrasound this morning. It was packed!! I didn't think it would be so busy on a Sunday, but I think every woman going through IVF was there this morning. Thankfully I didn't have to rush in and out to get back to work because they were a bit slow-moving because they were so busy.
Today I had 10 measurable follicles. :) Two of them are pretty big already and the rest vary in size. They want me to continue my three injections tonight and come back tomorrow morning for another scan and labs. Right now, it looks like I'll be having my retrieval on Wednesday (last day of school). And, good news, it looks like I won't have to pay $649 for a Lupron trigger shot!!! So far my hormone levels have been normal and I'm not hyper-stimulating, so I can trigger with Ovidrel which I already have in my fridge!
I'm getting excited for my retrieval because I'm anxious to see how many follicles they can harvest. I hope we have good quality embryos, but I just have to keep reminding myself that we just only need one....and hope that it takes when they put it back in.

Tuesday, May 23
I'm am completely over driving back and forth to Springfield and getting poked a million times, but we're having good results, so I really shouldn't/can't complain. Yesterday, my follicles were similar in size to Sunday, so they wanted me to do my three shots again last night and come back today to see if they got any bigger - they sure did! The nurse who did my ultrasound, Holly (my favorite!), told me that I looked great and was definitely ready for retrieval after today's scan. They were able to get my blood after one poke today (took FOUR yesterday), so I took today's appointment as a definite win...especially because they told me that I have about 15 follicles!! Of course not all of them are mature enough, so they're guessing they'll be able to retrieve about 12 good ones. I can't wait! I really hope things go well. :)
So, I'm all set for retrieval on Thursday. I have to do two trigger shots tonight (the ones I already have, NOT the $649 one - woo hoo!) and then go in tomorrow morning to make sure my hormones are reacting appropriately to the trigger shot. Then Tim and I will go in on Thursday morning for the retrieval. After they take out my eggs, Tim will do his part and then they'll try to fertilize all of the mature eggs. From there, we wait 3-5 days to see which one(s) develop properly into embryos and they'll put one back in when it's ready. If we do have any left over good quality embryos, Tim and I plan to freeze them to transfer (one at a time) at a later date.
I am getting really excited to see how this all pans out over the next few weeks! This whole process has definitely been more involved than an IUI, but it really hasn't been as tough as I expected it to be...so far. The injections have been manageable (I've done 26 so far, plus the two triggers tonight); I'm so thankful that I haven't over-stimulated; and I'm also so thankful that I have been responding to the injections appropriately.
And a HUGE shout-out to my work family for helping cover my kiddos over the last two weeks when I've had to come a little late on some days. I really, really appreciate you understanding that I need to go through this to help grow our little family.


From here I'll begin recording "part three" and will hopefully share it if/when we get some good news. :)

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