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......
Saturday, May 31, 2008
Tuesday, May 27, 2008
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!
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!
Saturday, May 24, 2008
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!
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!
Thursday, May 22, 2008
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!
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!
Tuesday, May 20, 2008
"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.
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.
Monday, May 19, 2008
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!
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!
Thursday, May 15, 2008
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 ;-)
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 ;-)
Monday, May 12, 2008
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.
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.
Monday, May 5, 2008
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!
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