And the verdict is....

We had our ultrasound today. This is the one where we get a good look at the body parts including the genitalia! Our little BOY looks awesome! He is a very "proud" boy per the ultrasound tech as you can see from the picture. I am trying to fix these pics a little so I can post them individually instead of in groups but you can click on the images to blow them up!

He is growing and moving and his heart, kidneys, brain, stomach, diaphragm, upper lip and legs, hands and feet look awesome!

Funny stories

As I sit and knit and catch up on BSG (Battle Star Galactica) and watch the snow blowing around in the arctic winter outside, I thought I would share a few stories!

Yesterday, Tom decided we needed to go shopping. For the baby.....Yes for the baby. He didn't think we needed clothes or furniture or diapers or anything that we might get from someone else. He thought it should be top priority to make sure that our NEWBORN had books! I know my kiddo is in good hands with a daddy who thinks the top priority is books! So we went to Powells and I told him how new babies like to look at pictures of other babies. We got a few board books with other baby faces on it. We then stopped at Saturday market and looked at baby slings. I have long been a fan of the ergonomic devices to substitute for other baby carriers, car seats, etc. There is a really nice lady who makes them there and I have been to her website many times. She has a drawstring on either side so you can really adjust to the size of the baby and rather than tying or wrapping around yourself, she uses a backpack clamp which can more easily be undone to remove the baby if it falls asleep and leave the baby in the crib/carseat - YAY! She showed us a demo and Tom proclaimed it something he would have to come back and get for me before Christmas time! I told him to pick colors he wouldn't mind wearing ;-)

My belly is getting bigger
I still await definitive movement
I sometimes think that I might be feeling something but then convince myself it is just lunch digesting. Who knows.....

Last week I had to go bra shopping. I was excited as a barely B cup to be shopping for a C cup! I had to text my sis about it and let her know. Now, having an iphone, the texts come up as the contact is listed in the contact section so for my sis it says Sis and Hubby Last Name MObile. I cannot tell without looking at the number which is my sis and which is her hubby. But, I know that she texted me earlier in the week a bout a book for the kids so I used that. Text read, " I am so excited, went bra shopping today and bought a C cup" The response " Tom much be happy about that! By the way, this is Hubby phone, if you were looking for your sis you might want to text her" UGH ! Fortunately I have a good brother in law. So I texted back "Just thought you might all want to know" They both got a good laugh at that one and my sis was soon texting me "So why are you texting my Hubby your bra size? ;-)"

I am sure that will come back to haunt me come Christmas Time. At least now everyone knows what bra size to buy.....

A few weeks ago I had a strange dream. We were going in for a routine visit. But instead of going to the office, went to the hospital. Apparently I was also working in the labor and delivery that day. Tom went to hide somewhere while I attended a few deliveries. Then they asked if I wanted to see my baby. Thinking they meant an ultrasound I said sure bring in the Ultrasound machine. No no no, they have a new method where they can remove the baby and look at it and then put it back in. Of course! Bring it on! (I did mention this was a dream...okay) SO they took out the baby and showed it to me. At this point I was maybe 13-14 weeks pregnant but the baby came out looking full term, bald head, and no genitalia - think Barbie doll. I asked if they could tell if it was a boy or a girl and they said it was too early. So they put it back in and pulled the drawstrings tight and I was good to go. The only thing was TOm didn't get to see. They told us it was too dangerous to pull the baby all the way out again but they could pull out the head and the shoulders. Tom got to hold the baby's hand and look at it for a second before they cinched me back up. Now here is where it really gets weird (as if it wasn't already) When they cinched me up again, I noticed that there were pencils coming out from.....down there. Lots of sharpened yellow No 2 pencils! I pulled out maybe 1-2 dozen. I asked why there were all of these pencils in there and they told me that's how they kept everything suspended and in place. Then thankfully I woke up!

Several people that I have since told this story to have tried to analyze parts of it - the appearance of the baby is my baby's psychic way of telling me even though I can't feel it , it is okay.....I have a telepathic baby!
The pencils are because the baby needs something to do - that would be my baby then, Tom's baby would be quite content to sit in the dark and chill for the next 5 months......I have an either bored or artistic (not to be confused with autistic) baby!
And the genderless genitalia is obvious since I don't know yet, I am not assigning it a gender yet!

So in short I have a bald, genderless, artistic or bored, psychic baby! I am going to call TLC right away and see if I can get my own show. Although I think you have to have litters of children or little people children for them to really get excited! Oh well, back to knitting and BSG.....

Getting bigger

Our last visit was on Wednesday. Just a quick check and normally we wouldn't get to see squiggly at all but my friend brought in the ultrasound for a quick look even though she was running behind on her schedule. We got to see hands and feet and arms and legs and head and lots more bones are calcified. She tried to get a shot of the crotch and actually squiggly tried to comply but it was too grainy to see if there are boy parts or girl parts. Our next visit will be Christmas Eve and our big ultrasound where they look at all of the organs (and maybe an extra organ) will be the day after Christmas.

My closet has been completely decimated. I cleared out most of the clothes because they aren't fitting anyway and then got a couple of bella bands from my friend so I could salvage at least a couple pairs of pants. Most helpful was going shopping with my sis over Thanksgiving. Where do you find Maternity Clothes in Grants Pass? Ross Dress for Less! They had several pairs of jeans and a pair of dress pants and a few shirts. I got three pants and two shirts and a new bra and all for less than I likely would have paid for one outfit at a maternity store! Now I am set. I still haven't gained much weight (maybe 2-3 pounds) but things have moved and my lower abdomen is no longer slender enough for low rise pants.

I am starting to tell some of my patients. WE are getting to the point that the ones who are coming in for 5-6 month follow-ups would find that I am not here. Bizarre. Only that little amount of time until we will be able to see squiggly. I still can't wait to feel movement and that hasn't happened yet. I think my uterus is tilted backwards so as to avoid me being able to feel it well in the belly. But, I am reassured by the growth and the recent brief peek.

I am also NESTING! WE just had carpet in the living room and tile in the extra bedroom placed this week! The storage unit is getting some use from stuff I needed out of the way to make some room for squiggly. I don't think I am going to start with the nursery until I am closer to 24 weeks (minimum viability time), but I have some plans!

We are having a Christmas party for my office at my house so we will see if all of those people can fit in my house!

WE didn't get any pics this time so I no more ultrasound pics to show yet but next time should. I will likely hold off on sending out Christmas cards until then as well so we can send them updated with the most current info!

I found out that one of my patient's who follows this blog and is having her own fertility issues is on hold as her financing was denied for doing in vitro - her only option at all - it would be really impossible to get pregnant otherwise. I can't imagine. She is a little younger than I am so I hope that will give her and her husband some time to get the money together to afford the difference between what the insurance will pay and what they can afford. It doesn't seem fair and my thoughts are with her!

More to come in a few weeks with hopefully news of boy or girl! Merry Christmas! Happy Hanukkah! Happy New Year!

Good Genes Bad Jeans

So we finally got the results back on the hormone testing....
It was a "negative screen". We have less than 1:360 chance of having a Down's Syndrome Baby and less than 1:1200 of other chromosomal abnormalities. This is great news and allows me to relax a little bit and enjoy the beginning of the second trimester as we head into it next week.

The fatigue is starting to let up.
Have only gained a pound or two so far

BUT.....none of my jeans fit me. I still have some work pants that fit higher on my waist so they are okay but that didn't help this AM when I needed to get ready to go see Twilight with some friends. I tried the rubber band trick - not really helpful.
So I purchased my first piece of pregnancy clothing while wearing sweats in the store- a pair of corduroy pants with adjustable side elastic to make the back/side panel tighter. It is really a great thing to feel comfortable in pants again.

Bring on the second trimester. I am ready! Now if squiggly could just start moving rather than just growing at a seemingly snail's pace :-) I will be happy - still another 6 weeks or so for that.......so just keep growing little one, I have plenty of room on these pants to expand with you!

The best ultrasound pics yet!

We had a more high resolution ultrasound this Wednesday to look for any markers that would indicate chromosomal abnormalities. The ultrasound was good and squiggly wasn't as wiggly so we had to poke and move a little to get the good views. Then once the movement started he/she was swimming around trying to be acoomodating. There is blood work (hormone levels and a special protein marker) to go with the ultrasound and based on those two things, my age, etc, they come up with a statistical risk of having a baby with chromosomal abnormalities. We will hear this coming Wednesday.

Our hope is to get a call from my friend Laura (my OB) saying all is well rather than the call from the counselor saying there is concern and we need to do more testing. This is the last hurdle. As little squiggly is hanging on into the end of the first trimester nicely and as the fatigue is fading, this will be the thing that will allow me to start planning the nursery and getting the house rearranged.

We will find out if it is a boy or girl about 4-6 weeks from now. Hopefully in time for Christmas if all goes as planned!

Here are the pics. One looks like an alien with the shot from above. Three have squiggly with hand next to face. Two are very very close up to get the measurement of the fluid at the back of the neck that they needed for the genetic risk analysis.

Baby is about 12 weeks and 1 day old in this pic and due date is May 25th or 26th deepending on your math.

Latest Baby Pics

We had our last ultrasound and appointment with the fertility clinic today. They are letting us go until June (after our due date)! We have our first visit with my OB/friend next week. Baby has grown a lot. Now it has s huge head and arms that are very wiggly. Baby was moving a lot and heartrate was a lot higher. Big brains with two hemishperes were immediately apparent and labeled on the ultrasound pic if you look closely. We are more excited and ready to start thinking more positively about this going full term!

I am doing well. Other than the fatigue and some food aversion, it is not so bad. I am lucky! I get to take a nap at work on one of the exam tables if I am lucky each day!

More updates to come as there is more to say!!

Thank to you all for your support and well wishes and prayers and everything! It has made this all very much better than it could have been! I love you all!!

Here it is.....

So a picture speaks a thousand words....
As soon as the ultrasound probe was used, I could hear the heart beat and allowed myself to breathe!
Heartbeat is 127 per minute - perfect
Size of baby is right on for age - awesome
ONE BABY ONLY - YAY!
Due date Memorial Day 2009 - almost all babies in our family have been born this time of year - group birthdays here we come
Recheck of ultrasound in 3 weeks
I think I might go take a nap ;-)

Two more days until the ultrasound

So, here I am waiting the two more days for the ultrasound.
I am tired.
It really feels like I may be able to sleep all day and still be tired.
These hormones are my Kryptonite.

Also, I am having stress dreams again and I am sure that having my brain active all night solving the problems in my dreams is not helping my fatigue.

Fortunately, my husband is fussing over me. Making me eat and go to bed early. Making me take naps on Sundays when I feel tired and not expecting me to do everything like I have in the past.

Only two more days and maybe the knowing will make the stress dreams go away. I hope that they are not just a side effect of the hormones.

I am trying to cut back a little at work. I may even close my practice to new patients right now. I will see.

More to come on Wednesday PM.

Doubling the Hormones!

So last Thursday (sorry for the late post) we had our second hormone level and then I went ahead and did a third one yesterday. The hormone levels should double every 48 hours so...
Tuesday 16th- 93
Thursday 18th - 180 (48 hours last)
Monday 22nd - 780 (96 hours after last)

So, good news....not huge numbers which likely means that there is one or two not five or six!

Ultrasound will be October 8th - seems like a long time.

No nausea
Some minimal food aversion - some things make me feel nauseated.

I am feeling a little bit more of a yay but still cautious until the ultrasound!

This is a little surreal - which is normal so that is all good!

More to come soon - I hope

Positive Testing

Thanks to all of you for your positive thoughts and wishes. I had my pregnancy test today and it was also positive! This of course means retesting again in two days to make sure that hormones are going up at the right rate. It also means very little until we see something on the Ultrasound in another two weeks or so. But, it is a start. A quiet "yay" for now with a bigger YAY to come if all looks good on the ultrasound. My "scruffy" little embryos are trying! Now if everyone can focus their energy on thinking about there being just one or at most two babies, please! I will have another update on Thursday!

Knitting Project fininshed while on bed rest

Just thought I would post my completed project for the week. It was a fun knitting project and I hope to use it someday. I got the pattern book for this project on Bainbridge Island at a cute little Yarn Shop call Churchmouse Yarns and Teas. The yarn was on sale and I thought I would just have enough to do the cardigan but apparently, I also had enough to make a hat (barely) and I hybridized the pattern to make the hat in the book (which was just a generic hat) match the cardigan pattern. It kept me busy until late last night and I finished it this AM.

Oh and for those of you not on Facebook where this pic is posted, I have also attached a copy of my new digital piano which will get much use in the coming months I hope!

Guarded Optimism

Okay ladies and gents get out your rosaries, prayer shawls and lucky pennies.

We got the call this AM that the embryos (numbering 8) were looking pretty bad. Last time wasn't a fluke, just how our embryos act when they are in a petrie dish. There were a few that may work. They thought that getting them "in vivo" (in the uterus) may help and they have "seen successful pregnancies from this quality of embryos in the past."

On a grading scale of 1 to 4, 1 is good and 4 is useless, our embryos were 2.5 at best and 4 at the worst. They like to only implant 1's or 2's.
The goal is for there to be 8 cells and only 3 embryos had at least 8 cells.

I wanted to talk to the doctor before I got naked and wasted my time on 2 days of bed rest. He said that the first test tube baby was an embryo that they almost threw away because the quality was so poor. He figured we might as well be aggressive and see what happens.

So, we went and had the embryos put where they belong.

Now I am on bed rest for 48 hours. The transfer of the embryos was MUCH easier than the extraction!

So I am catching up on Battlestar Galatica with my buddy Jason and tomorrow my friend Cathy will stop by to knit for a while. Yay for friends!

Tom is getting mad if I am up for more than 2 minutes. I am only allowed to get up to go to the bathroom, otherwise sitting (but not quite straight up) and lying only. I will be unshowered and sleeping on the couch until Sunday.

We won't know if this worked until the 16th or 17th of September when we have our pregnancy test.

If it doesn't work, the fertility challenge is off and adoption shall begin.

There is still always a chance we can get pregnant on our own. I still have one good tube. Tom's sperms are the best swimmers up that the doctor has seen. We are just caught in a catch 22. The chances of having another tubal pregnancy is pretty high and the method to avoid that complication is not working so well.

So start the good vibes and we will hope that something works out one way or the other....

Yay fertilized eggs!

So just a quick update as I am running on reserve battery power and am too lazy to get up and plug in the computer right now.

The clinic called this AM.

We had 15 follices
13 of those were mature eggs
8 of those fertilized!!

This is one more than last time.

They will see how the embryos look on day 3 AM for the PM transfer. If they have awesome embryos, likely they will just transfer 2, but if they are a little "if"ey (or sensitive as I like to think), they will transfer 3. I am hoping the cells are nice and relaxed. I felt like telling them to take better care of my potential children this time, but refrained. I think asking them to read them bedtime stories and play them Mozart may be a little too much.

I spent the day updating my Ravelry site (knitting site meets way to catalog all of your yarn, patterns, books and fininshed projects) oh how the OCD me loves this site!!!

My keyboard gets here tomorrow. Guess I better vacuum that spot of cat fur that is right where I want to put it!

More on Friday AM/PM for transfer day.

Retrieval

So we had the egg extraction today. This whole cycle has been so much better than the last one. I think it is the knowledge of what is to come. This time I have had no scary or weird dreams. I slept well like my acupuncturist said I would.

We arrived a little late but the office was much busier than the last time (likely because the last time was Memorial Day). They took me back to the room - a different holding area than before - thankfully! The female anesthesiologist came in and reviewed my history. The very able nurse came in and painlessly placed my IV. They wheeled me back to the room before giving the Versed so I remember the room. I helped them get me up in the stirrups and then the oxygen cannula went on and that is all I remember.

I awakened and immediately asked Tom how many follicles they retrieved. He said 15 and that this was the third time I had asked :-) As I slowly awakened from the anesthesia, they came to check on me and give me instructions for the rest of today and Friday - the day of hopeful transfer.

I stopped slurring my words (per Tom all I did initially was talk all slurry) and drank some water and Sprite and they sent me on my way.

I think there is a lot less pain this time than last. I only briefly used the heating pad and I think I could have gone without. I did take some Tylenol but that was more for a headache than anything else.

I have worn my glasses all day which always makes me feel tired (I only ever wear them to walk to bed and my body is well trained to think sleepy thoughts when my glasses are on). I have rested all day. Tom made dinner, vacuumed, cleaned the garage, folded the laundry and will do the dishes tonight after he enforces some sort of bed time.

I plan to relax and not do much for the next couple of days as I have the days off.

More to come on Friday and I hope that things go better and that there are at least embryos to transfer. It will be another couple weeks after that before they let us take a pregnancy test.

Keeping a positive attitude

We are almost ready to take the next step. I had three ultrasounds last week. Tuesday, Thursday and Saturday. The growth of the follicles and the hormone levels were a slight bit more gradual than last time. The best guess on Tuesday was that I would have retrieval on Tuesday of this coming week and that is the date that looks like it will be indeed!

We were able to go to the Duck game on Saturday but I had to come back late last night after the game so that I could have an ultrasound early this AM. The follicles are rapidly growing now and the hormones are rising almost exponentially. My doctor says it just shows that the ovaries do what they want to do.

I am tired today though, a combination of elevated estrogen levels, large follicles and oh yeah, I only slept about 5 and a half hours last night.

Since I will have the week off, I have lots of knitting, movies and small projects set up to do. We will see if I can keep myself from going stir crazy!

I will have one more session of acupuncture tomorrow (he works too much).

I have been finding more and more company on this path of IVF. Some have had success and some have found more sadness than they deserve. It is not easy to explain why some couples are able to have babies without even trying and others try an try and spend lots of money and still have no success. It certainly isn't based on merit, or hard work, or ability to care for a child. I will have great appreciation for a baby when we finally have one!

There is a section from Randy Pausch's THE LAST LECTURE where he speaks of walls that you hit as an opportunity to demonstrate how badly you want something. So, I guess I will continue to find ways around the wall. I am thinking happy thoughts tonight as Tom steadies his hand for the big trigger shot to allow the eggs to be released.

I will let you know more in two days. There were about 20 follicles between the two ovaries and we will see how many are available for retrieval.

Have a great week.

Back in the saddle

It has been a couple of months since my last blog. And FINALLY we are back in the cycle and ready to go. We spent the month of July waiting for the cycle off. The date for the next cycle fell right on the weekend we were supposed to go to Seattle, so they worked with us to delay the start a little bit. It actually worked out well as my period was late in July.

I started birth control pills at the end of July and started doing Lupron shots (the turn off meds) about 2 weeks ago. Last Saturday (5 days ago) I started on the stimulation drugs. Yesterday was my first ultrasound and things are looking good. The goal this time is to have the eggs mature a little more slowly in the hopes of having some more mature eggs to work with. Last time we had 14 follicles, 10 eggs and 7 fertilized eggs before the arrested development debacle.

This time we are hoping for more follicles, more mature eggs, more fertilized eggs and embryos that want to grow into babies. We will be transferring the embryos at three days of development instead of the 5 days last time. This will hopefully allow the embryos to grow in a more accurate environment rather than a petrie dish.

Next week, I already had MOnday (Labor day) and Wednesday (my new normal day off) off, and had Thursday off as well just incase. BUT of course it looks like the extraction will likely be on Tuesday with transfer back on Friday. SOOOOOOO, no work for me next week.

I am collecting knitting projects to work on. I was able to go to the yarn store on Bainbridge Island while we were there this last weekend. I got a cute new book and yarn. I also ordered a digital piano - Yamaha with built in peddles and full keyboard. I have been wanting to play again and this will fit in my room without major cost or moving expense. Plus I can use the headphones to play without sharing all of my music with our new neighbors! I am sure they will appreciate this.

I am also looking forward to getting caught up on all of my errands.

We are also working on selling Tom's truck since we aren't really using it and trying to use mass transit and become a one care family.

Lots of activity.
Lots of action.

I will try to keep the posting coming more regularly again.
We are all hoping that things go better this time.


Oh, and I am doing acupuncture !! I really like the acupuncturist and although difficult to know if it is helping, at least it is a set aside time to relax and just clear my head.

He is worried about the possibility of his needles bruising me. I don't think he knows how much the one stimulation drug bruises and welts. His needles are nothing!!! He has encouraged me to be happy and relaxed to grow many mature and happy eggs. So I have been listening to more Disney music. Trying to do things that are relaxing and happy making. MOre time off and massages. We will see if this all works out and makes more happy embryos that want to grow. The acupuncturist thinks twins (one boy and one girl) would be nice and then we can be done....I wonder what meridian he needs to needle for that ;-)

More waiting

It has been a busy last couple of weeks.
I went to Branson, MO for a conference. Tom and I have been busy running around town. We have been to Las Vegas, San Francisco and I also have the above mentioned Branson. I feel like I am firmly coming out of my baby making focused funk.
Before I left for Branson on the 19th, I had an appointment with my fertility doc.
Summary of the visit is basically, they are not sure what happened. No other couples had any issues in the time around us. No other embryos stopped growing. That being said, they have NEVER had this happen when the couple is young and healthy so they are taking some of the fault on themselves and allowing us to have a free cycle this next time. They tried sending the embryos for genetic testing but they didn't get accurate information due to the "age" of the embryos by the time they were sent.

So now we wait some more. I have to have a whole cycle off and then we start with the suppression again. This places our expected transfer on the only weekend for the rest of the year that we have out of town plans. We are planning to go to Seattle for a long weekend for the A's Mariners. We have non-refundable hotel in downtown.

We discussed this with the nurse at the fertility clinic. She said we can always have me take two extra weeks of birth control pills which would put the extraction and transfer closer to Labor Day. And move the due date closer to our birthdays at the end of May, first of June.

This time around, instead of waiting until day 5 for transfer, they will likely try day 3 since that is when the embryos had their issues (we may just have sensitive embryos). In that case, the chances of each embryo making it is much lower. They may decide to transfer 3 embryos in that case. This will be a tough decision. But for now, we will enjoy the summer sun and heat and wait for cooler days to think about hormone therapy again. May not be too many updates to come from now until then.

Tom did get me a book on IVF for my birthday which I read on the flight to San Francisco. If anyone wants to read a different view of IVF, it is called Pregnancy Wishes and IVF Dreams. The only thing that was frustrating about reading this book is that the couple in it had a clear diagnosed male factor problem and was able to get pregnant the first time with twins. This is not always the experience that people have. I actually have a patient who has been through IVF 5 times without success and was only able to get pregnant the last time with IVF. I can't imagine. This is it for us for a while. I think if this time around doesn't work, will look into adoption a little bit more and wait to do another round of IVF for a year or two.

Have a good summer all, stay cool. More to come in August is my guess.

The Big Day

So today was the big day. After suffering through bloating and thrush on my tongue from all of the steroids and antibiotics, today was the day that we might actually get pregnant. I had my couch all arranged for the two days of bed rest. Knitting...check. Books..check...Comfy blanky...check. Change of clothes, brush, meds, computer...check, check and check.

I did some laundry last night and this AM so my work clothes wouldn't accidentally get placed in the dryer.

We arrived on time. Bladder full. Happy thoughts and song in the head.

We were in the same room as they put us in for the extraction. Gown, booties, head covering all the same as before. They kept checking the bladder fullness and I was reading while drinking water and humming. Thirty minutes to go.

The Dr. entered the room and sat on the edge of the bed about 15 minutes later.

And then the other foot dropped.

After introductions, he started, "I am sorry, I have some bad news, tragic news actually."

He went on to explain that all of the embryos had arrested development on day 3. I don't think he ever told us how many there were on Thursday when they last checked them, but looking at the chart he was holding in his hand it looked like at least 6. They were looking really good that day. Everything was pointing to there not only being embryos for transfer but also some to freeze. He anticipated this would have been a really awesome chance for pregnancy.

Maybe it was the construction and duct work they were doing in the building, although they have been doing that for some time and they haven't had any other issues. The room is a "clean room" and extra filtered. They had no other transfers today so they don't know if anyone else has been affected.

And then he told us the next cycle would be on them. They would make good on this since it was likely something in their system. He said in his twenty years of doing this he has never seen anything like this. It is never good to be an anomaly in the medical system.

He suggested that maybe we get away for the weekend.

So we did, we went to Vegas where I now type this blog. We sat next to the pool this afternoon. We enjoyed the cool water and the sunshine and heat.

We will have to start over again. Suppression, stimulation, extraction and hopefully this time we will make it to the next step.

That will take at least another two months.

I am not sure why we are not supposed to have kids right now. But apparently we aren't.

As Tom pointed out, we have been very lucky in all other aspects of our life, just not this one. I am doing actually really okay. It was almost like I have become so used to this not working, I wasn't really ready to let myself think that it would work. I just was more prepared to have another negative pregnancy test than to not have any embryos after they looked so good.

And I really wish I could end this one with the then I woke up phrase......

Diminishing returns

We arrived at the Oregon Reproductive Medicine Clinic late. They showed us to the auditorium where we waiting with what seemed like 100 other people for our turn. The clock was ticking and I knew that if the eggs weren't extracted by a certain time, I could ovulate on my own. Tom was asked to "make his donation" and came back with what looked like a urine sample. I could not believe my luck to make it to this point and not have any workable sperm to go with my eggs! We pressed on thinking this could still work. They finally called my row in the auditorium and we marched onto the stage. Others there were coming out of the back of the stage proclaiming failure. No eggs retrieved despite having good hormone levels and lots of follicles on ultrasound. It was then that I realized that although we had been herded into the auditorium, we were supposed to be in the clinic. We ran over to the clinic an hour after arriving we where we were supposed to be. Apologies for being in the wrong place. They showed us back to a conference room where there were refreshments set up. I was so hungry that I started eating a chicken nugget. Realizing that I was supposed to be NPO (Nothing per oral - no food or drinks), I quickly spit them out in the trash can. We waited a brief time while a group of very pregnant women set up for their prenatal yoga class. Finally they were getting ready to show me back to the procedure room when, I woke up!!!

And this is how my day started. I call them stress dreams, I used to get them before the start of the school year. Encapsulated within each one are all of the possible worst case scenarios.

Fortunately maybe because my brain is so prepared to handle them, these situations never arise.

We arrived exactly on time to the clinic. Tom's "donation" went well. They led us immediately back to the procedure room recovery and pre-op area where I changed into a gown. The only difficulty was the IV placement (I hadn't made it that far in the dream I guess). Since I couldn't drink any water and I already have bad veins, the anesthesiologist was the one to place it and he did a great job. A little versed. Dreaming in 1 minute.

Recovery area I felt like I had to pee very badly. The nurse mentioned that they were giving me antibiotics because the needle may have nicked my bladder because it was pretty full.

They had retrieved 14 eggs. I waited for another hour while they took vitals and let the saline run into me.

Then home to the couch where for the rest of the day I was not allowed to even do so much as get up to get a drink of water lest Tom shoo me right back to sit and get it himself.

There was some discomfort - constant fullness like having a really full bladder and gas at the same time. Heating pad helped immensely and no pain meds were required.

Last night another round of stress dreams. The embryologist would be calling with the number of fertilized eggs today. So there were all sorts of dreamy calls from 0 to over 50 - somehow the eggs had defied science in one of the dreams and they said what looked to be 14 eggs were actually 14 clumps of eggs all 2-3 each!

This morning the real embryologist called to given the update on the status of the eggs.

14 eggs retrieved
10 eggs were mature
7 eggs had been fertilized.

This is only as far as we will know until Saturday when they will transfer the embryos at the blastocyst stage into the uterus (only two will be transferred if there are two to transfer).

They estimate that about 1/2 of the currently fertilized eggs will make it that far.
After the transfer on Saturday, I will be on strict bed rest for two days. I also have Monday off work just in case as we weren't sure if this extraction would happen today or yesterday and needed to think ahead.

I will be able to take a blood pregnancy test on the 9th and if it is positive again on the 11th to make sure the numbers are doubling as they should.

First ultrasound won't be until the 23rd of June!

This will be a very long pregnancy at this rate....

Today I am feeling well. No fullness. I may even go to the DMV to get my license renewed.
Hopefully there will be no updates until Saturday. I hope those magic seven stay strong!

We are a go for launch!

Had our fourth ultrasound this week. All the follicles are huge and growing even without my evening dose of stimulator medications for the last three days. My estrogen levels are sky high. We will be doing the "trigger shot" tonight and on Monday AM they will pull out all of the fluid around the ovaries and see if they can make some embryos! I am instructed to take it easy. Eat lots of protein and not so much potassium - which is harder than you think as a lot of the sources of protein have also lots of potassium. They are still concerned about too much stimulation so I will be giving myself 1/2 the normal tirgger shot dose.

Monday AM I will arrive and undergo some minimal sedation to extract the eggs from their current nesting spot. The trigger shot helps the eggs become mature before they are extracted. I even get a day off work on Tuesday! I am trying to relax and rest and not stress my body too much today even though it is a beautiful day. I have some knitting and a book to finish!

Overachiever

Today I had my second ultrasound to check the progress of the stimulation. After Tuesday I had high hopes for the progress of my ovaries.

And my ovaries stepped up to the challenge. Not happy to accept any blame for this infertility issue, they have developed huge follicles. I am on the verge of being too good. They have cut my evening dose of stimulation medication (the expensive one will go mostly unused I am afraid).

And on to another ultrasound tomorrow. They cannot give the "trigger shot" to make the ovaries release the follicles until at least day 8 of stimulation (Saturday), but it looks like that will be the most likely day to do the shot. Which means retrieval will be Memorial Day! What is even nicer than having retrieval on a holiday is that the embryo transfer would then be on Saturday so my 36 hours of bed rest will be on a weekend! Oh well, so much for my days off from work but at least the clinic schedule won't be too disrupted.

Tomorrow repeat ultrasound and blood work - oh yeah, did I mention my estrogen levels more than doubled since Tuesday?

All is well, except my ovaries feel swollen. It is a strange feeling, not really like gas but almost like something egg shaped may be swollen to three times it's normal size and suspended in my abdomen by a small ligament. Yup pretty much like that. No jumping they said but even walking and sitting feels a little bit weird!

The next step is coming soon. Exciting to think about having a possible positive pregnancy test within a couple of weeks!

"Follicles of a Donor"

This statement is the equivalent to body of a 20 year old! Ultrasound went very well today. My doctor reports that my follicles are more like what they see in their 20 year old egg donor patients!

I am on a fairly low dose of the medications and rather than having 6 mm follicles all of mine are about 8-12 mm! There are about 6-7 good sized ones on each side and several smaller ones that may or may not actually do anything. All of the good sized follicles are about the same size which is very good.

So, I am way ahead of the curve and may move up our extraction date a little bit. We may now be looking at extraction more like Memorial Day or the day after instead of Wednesday or Thursday!

Our next step is ultrasound on Thursday and Saturday to make more possible adjustments to the dose of meds and then they tell me when to give myself the trigger shot.

The trigger shot is the shot that tells the ovaries to release the many eggs in a usable form. Then they go in 30 hours after the shot and suck out all of the fluid which includes several eggs on each side before they are release to the Fallopian Tubes. This is done under anesthesia with a large needle directly into the ovaries via the back wall of the vagina. Sounds like fun? You wanna sign up too?

Five days later 2 embryos are carefully selected to be placed back in. We won't know if they are boy embryos or girl embryos and due to our low risk of genetic malformations, we will not be doing the very expensive pre-implantation genetics testing. They then do a blood test about two weeks later to see if the embryos behaved and stayed where they were supposed to and started growing.

So, the scary thing is we could end up with one to up to four embryos! They don't like the 4 babies so much so they try to chose so that only 1-2 will take off. Twins wouldn't be so bad. If this is how we have to get pregnant, the fewer times the better.

More to come on Thursday.

Sore Belly!

So as of Saturday, I am now giving myself three shots a day! One shot in the AM to stimulate. One in the PM to stimulate and actually a lower dose of the suppressor I imagine to keep things from going to haywire. With all of these needles, my belly is getting a little sore. Tomorrow I go in for an ultrasound to see how the follicles are coming along. Do we need to increase or decrease the medications? When might we be looking to extract the eggs?

Right now I am loading up on sushi and raw oysters! It will be a long 9 months without these things.

Soon also, I will be unable to hop, skip or jump. Yes indeed, my ovaries will be like unto a water balloon on the end of a rubber band and jumping may encourage twisting and cutting off of blood supply. I guess we should try to sit for the MIA concert on Friday.

Tomorrow we will have more info.

Oh and congrats to my buddy Shannon who had a beautiful little boy today! Hopefully I'm not too far behind ya babe and welcome to the world little one!

SUPPRESSION

Today I felt like an astronaut clearing the final physical exam before take off. Early this AM, I arrived at the testing facility apprehensive and afraid that there would be something found to scrub the mission.

Today was the day that I find out if there is enough medication in my system to suppress the ovarian function. That has to happen before the stimulation session. I worried about every time that I gave myself the shot an hour or two after the 24 hour period before. Traffic was bad. I was on time though. They had tried to reschedule my appointment yesterday to two hours later not realizing that means I have patients that I would have to reschedule.

"How are you feeling today?" Dr. Bankowski asks as he enters the room.
A little exposed, I think with my small paper gown covering my huge butt on the table and the AC in the office on for the expected 90 degree day.

"Fine" I say
"Usually people feel about the worst at this point because of the Lupron. Any side effects?"
"Nope, I actually feel pretty good. My mom thinks my husband will have an easy time of it if this is menopause for me!"
"Okay, first we are going to look at the ultrasound and see what the ovaries look like"

As a physician, I am a least familiar with the ultrasound procedure and can tell mostly what the gray and black things are on the screen. They were looking at the ovaries today - huge on the screen with multiple darker areas. "It looks good on the left! No cysts. Ten follicles all suppressed, largest is 4.5 (mm)" and "Right side also looks good. No cysts. Twelve follicles. Largest 6.5 mm" You look good to go as long as the Estrogen levels are low enough.

They drew my blood - vein tried to hide and they had to dig around for it - I hate that!

"We'll call you with your estrogen level later today"

They reviewed the calendar again. I tried to pin them down on specific dates for retrieval and implantation but the crystal ball was at the shop.

I paid my "Cycle Deposit" the amount of money they want you to pay up front for the whole procedure. OUCH!

About two hours later they called with the blood test results. "Looks good! You will proceed with your stimulation medications on Saturday as planned!"

Next step is the ultrasound on Tuesday. They will see if the follicles are responding to the stimulation at the right amount. They may adjust the medications at that point and will have a better idea when the extraction may occur.

But for now it feels like lift off! Or at least nothing has been scrubbed yet. There are still about 10 more phases of checklists and of course the weather has to be right. But, we may just make it to the moon afterall ;-)

The next step

Had a great visit home for mother's day. Saw all the big boys - nephews...

I am now on day 8 of the suppression shots. It has been going fairly well. No major side effects! Supposedly this could have been like menopause but I haven't felt any side effects at all. Tom is probably happy about that!

This week on Thursday I will have an ultrasound to ensure that the ovaries are nice and turned off. If all goes well, Friday I will start the super hyper ovulation meds. No other big news at this point in time. There is mostly just daily medication routine.

First Shot

Today I took my first big dose of medications for suppression:

List of medications ingested this AM and why I take them:
Aspirin 81mg (aka Baby aspirin) Bet ya didn't know it was the correct dose for making babies (corny joke sorry!) - reduced inflammation and improved blood low to uterus
Birth Control pill - to suppress ovarian function
Folic Acid - so that I can get my stores up and don't have a baby with spina bifida
Prenatal vitamin - this has folic acid as well but only 400 mcg and I think I should have at least 800 mcg a day
Doxycycline 100 mg - to eliminate any germs that magically would have been transmitted into my body

Tonight I gave myself my first Lupron shot in the belly! This is with a TINY insulin needle so it doesn't hurt at all.

I barely even felt it and it went well. Small little spot of blood came out and quickly dried up.

I also have to take a Dexamethasone tablet tonight and another dose of Doxycycline tonight

Tom will take Doxycycline twice today too.

They actually have a checklist which is helpful for we OCD people!

I feel like I need to get one of those pill dispenser plastic things that old people use for their numerous medications!

The cats dutifully watched in awe!

Step One: Suppression

The first step in creating many eggs is actually to turn the ovaries completely off. This means birth control pills and shots of a medicine called Lupron. The shots will hopefully not be that bad as they are in the belly (not too many pain receptors there compared to other places). Sometimes these shots put you into a sort of "menopause". Hopefully not too many bad effects. The shots only last about 10 days and then the ovaries are checked to ensure that all is shut off.

It is kind of strange to think about having to turn everything off to get things started. There are two reasons why turning things off is important from what I can tell:

1) It is sort of like a computer that is frozen. The first step is to turn off the computer. So if the system isn't working well, the first step is to shut off the ovaries.

2) There is a syndrome that sometimes occurs when hyper stimulation medications are given (Step Two). This is when the ovaries basically go crazy and get swollen and painful and can be made worse by pregnancy. I think that to some degree the turning off helps the ovary to not do this when stimulated by the step two meds.

The shots start on Monday.

Should be exciting new adventure.

Let's start at the Very Beginning

The impetus behind this blog is to help my friends and family understand our journey towards growing our family. I know some are afraid to ask questions, some do not know what we have been doing and some have been in the loop asking and keeping abreast the whole time.

It all began at the end of residency. I am a family medicine doctor and we had put off trying to have kids until residency was over. As a chief resident, my schedule was busy and my learning had to come first. June 2006, the same month I finished residency, we went off birth control, with three nephews on my side and two nephews on Tom's side, we were ready to start having kids of our own. November comes and still no pregnancy.

I discussed with my Gyn friend and she suggested some testing. All normal. Clomid she says (a pro-ovulatory med) may help. I wanted to give my body a chance. I wanted to be like my siblings and most of my family and do things naturally. I DID NOT want to be Jon and Kate plus 8.

By March 2007 I was ready. We got the prescription, we counted the days that it should take and no period came the next month. A week later a pregnancy test turned positive. YAY!

Having helped my friends and patients through miscarriages, I decided only our siblings and parents needed to know. Until the ultrasound, until we knew that there was a heartbeat (that usually means a <5% chance of pregnancy loss). We waited and tried not to get too excited. I used the pregnancy as a good reason to leave a position that I knew wasn't a good fit for me at an Urgent Care that I was working at part-time.

The ultrasound was done it secret, after hours by my Gyn friend while she was on call to avoid the rumor mill of the hospital to start. But, no pregnancy could be seen, no heartbeat, no pregnancy sac, nothing. NADA.

So, we started down a road of medical investigation and medications. The end result was this pregnancy (which felt like a phantom) was an ectopic (outside the uterus). It landed in the left tube we later learned. My health was never in jeopardy (although it is not uncommon for that to happen with ectopics). The left tube was scarred and there would likely be zero chances of it every acting like a normal tube.

"50% chance of pregnancy each month" I was told......

Clomid 6 more times, increasing doses over the next 8 months. Nothing. No pregnancy. No missed periods. Nothing except the increased hormonal emotional roller coaster a few days a month from the Clomid.

Repeats of tests, tests of Tom's sperm, ultrasounds, all normal. There was the slightest hint of tube disease, maybe this was the culprit.....

We went to Hawaii in Jan of this year. We were hopeful. Maybe this vacation would help the stress go away. It was actually timed perfectly for conception. It was our last round of Clomid before we would be strongly encouraged (read forced by my Gyn friend and our own sanity) to see a fertility specialist.

Failed again.......Fertility specialist great guy. Lots of advise. We could try doing Artificial Insemination (where the best sperms are placed squarely in the uterus). This would give us a chance but our risk of another ectopic was also higher. Tubal bypass was the best option. That means IVF (in vitro fertilization - test tube baby).

An expensive adventure which we are now embarking upon. I will be posting to keep you in the loop. These people are good. They have good success rates. I wish I could be more optimistic but it is coming up on two years since we started to try and my optimism is running short. We will try and hopefully succeed. I will keep you posted!