Monday, December 31, 2007

Beta Day - FET

And now... we wait.

Went to the clinic this morning for my beta-hCG test. I should find out the results sometime this afternoon. Bad as it sounds, I'm not feeling very hopeful about success this time around. Maybe it's fear because of the miscarriage last time. Maybe it's because the embryos were so small this time (4 and 6 cells). Maybe it's just because I'm feeling pretty beaten about the whole process. Maybe I've been wrong all along in the most certain feeling I've ever had... maybe I'm NOT actually meant to be a mom. I shouldn't get my hopes up anyway... I should know better by now... any time I DO get my hopes up, they're surely dashed to smithereens without fail.

Either way, I just wish today was over already. 2007 has not been a good year. True, not as eventful as some years... no floods, no car crashes, no deaths of people we've known for years. But bad enough all the same... bad diagnosis, months of waiting, an IVF cycle with more needles than I ever thought I'd have to deal with in my lifetime, a BFP only to have it end in miscarriage, and FET cycle with fewer needles, but still more meds than I ever thought I'd be taking, and more needles than I care to think about. Trasvaginal ultrasounds... my girlie bits on display to more people than I ever thought would see them in such a short period of time... blood draws from painful places more often than not (they hardly ever seem to be able to find a vein in my arm... I know they're there... I can see them quite clearly... maybe next time they sould try my shoulder, 'cuz they've become even more visible there lately... whatever, just keep them away from my hands!)

I don't know where we're going to go from here if this beta comes back negative, though. More questions, maybe more testing, maybe we'll just give up.

Happy freakin' New Year.

Thursday, December 27, 2007

I'm so proud of myself!

the 2ww is over on Monday... it's Thursday now, which means I've made it through more than a week of queasiness, fatigue, dizzy spells, funky tastes in my mouth, sore boobs, middle-of-the-night pee-breaks, unexpected food aversions, etc.... and I HAVEN'T TESTED!

Yay me!

Of course, having written that, I do have every intention of doing one "oh, what the heck" test tomorrow morning (which would be 11 days after the transfer of 2 3-day embies... so arguably the equivalent of 14 DPO... or the day most people who're actively trying test ;) )... I don't expect much, though.

Truth be told, I don't expect much on Monday, either. But I guess we'll see soon enough!

Friday, December 21, 2007

Ah, the joys of a 2ww

Yup... let the madness begin. The insanity of the 2ww (two week wait for the uninitiated) is well upon me.

Every twinge, every sensation, every tiny thing could be "a sign". Yeah, right, 'cuz I'm absolutely sure that none of them could possibly be due to the fact that I had a foreign object inserted into my girlie bits mere days ago, or the fact that I'm still popping pills like a mad woman and stabbing myself in the ass every night with progesterone. Not a chance.

Oh, did I mention the mood swings? *laugh* Yup, that's the latest... add it to the list with the cramping (on and off), the exhaustion (did I mention I went to bed at 8 freakin' 30 on Wednesday night?), the mild nausea, the sore boobs, and the teensiest bit of colour to my CM today (OMG... is that implantation spotting?). I'm going to be such a joy to have around at Christmas ;)

Madness, I tells ya... madness! And the creative math has begun, too. My beta is set for New Years Eve. 14 days after the transfer. Oh, but the transfer was 3-day embies, so I could say that 14 DPO (days post ovulation) is the 28th, so I could test then. Oh, or... some people get a BFP at 10 DPO, so that would be Christmas Eve... so I could test then!

Madness!!!! Why do we do these things to ourselves?!?!?

So... maybe I'll pick up a 2-pack... test on Christmas Morning, just in case I can give D a good present ... and other than that I'll hold off 'til the blood work comes back. Yes, that's what I'll do. Definitely.

Oh who am I kidding? I'll be testing all next weekend, I'm sure. *laugh*

Thursday, December 20, 2007

Transfer complete... stick, babies... stick!

So... Monday was the transfer (and yes... it's taken me this long to blog about it... I was on bed-rest for Monday and Tuesday and catching up on work email yesterday ;) ). 2 little embies squirted into my uterus in the hopes that one or both will find a nice snuggly place to curl up and stay 'til at least August.

The day went something like this:

Got up. Showered. Had some breakfast. Got picked up by my parents who were giving us a ride to the clinic (so D wouldn't have to leave me to get the car after the procedure). I should mention at this point for anyone who might be reading this and NOT in Southern Ontario... we got buried on the weekend. Seriously... I've heard 40 cm of snow (and 30 is a foot, so that's a heck of a lot of snow to fall in a day and a half)... and our street didn't get plowed until Sunday night at about 9:30... and then, not well. Anyway, in the car, I started drinking my mandated 1 litre of water. Poor choice. We got stuck in traffic and ended up getting dropped at a subway station so we'd at least be close to on-time for our 9:45 check-in. 9:45, checked in with the clinic and got changed into the gowns (yup.... plural... one on front to back, one on back to front... at least my butt didn't get cold *laugh*) while I sent D off to buy some more of the meds I need, as the ones I have would run out 4 days before our scheduled beta. By that point I was very uncomfortable and dancing. I think I may have mis-measured the water. Or perhaps it had something to do with the fact that I haven't been quite so enthusiastic with my water consumption since the miscarriage and my bladder shrank. In any case, I couldn't hold it and made a mad dash to the washroom to 'take some pressure off'. Those of you who've tried to stop the flow when you really need to go can imagine how well that didn't work. So, convinced that I'd let too much out, I sent D down the hall to find me a cup of water. Then another. Then another.

Seems I sent him one too many times. But I'll get to that in a minute.

While we were waiting, my doc came out of the procedure room where she had been doing a retrieval. As she was about to head back over to her office, they said "you have a transfer"... she had no idea. Very reassuring. But it seems the retrievals and transfers are scheduled in two different books (which could also explain why the retrieval went in at 10:00... which was supposed to be when my transfer was scheduled... really, it would have been better the other way around, since you don't need a full bladder for a retrieval)... and she only got told about one of them. Miscommunication. Fun.

Anyway, they took me in and got me up on the bench for the initial u/s to determine the shape of catheter they'd need. The u/s tech determined that my bladder was too full, so they sent me off to pee "one cup only!" I walked out of the procedure room and the nurse on the desk said "Oh! You get to pee!" like this was the greatest thing in the world. Highly amusing.

One cup later, I was back in and back on the bench with my feet in the stirrups and the hatchway to the entirely male-populated lab open... with a wonderful view, I'm sure.

Seems there was some resistance encountered inserting the catheter, which left me feeling a wee bit bruised inside afterwards. But they got it in, and I have a picture of the squirt of fluid containing my 2 little embies (1 4-cell, 1 6-cell). The doc said she's betting on the 6-cell, but watch me have twins because, and I quote, "I'm knocked up, and it seems to be working for me"... seems every transfer she's done since she got pregnant has resulted in at least one positive beta (including my last transfer, although it didn't last... so who knows how many others didn't last, either). Immediately after the transfer, she did say "I just have to straighten out her uterus and then we're good to go". That was a little unnerving.

Anyway, catheter out, speculum out, and then she did something cute, but very odd. She rubbed her very pregnant belly (she's 32 weeks... measuring 34, apparently) and then rubbed mine. Seems she's decided pregnancy is contagious and wanted the embies to get the idea of what they're supposed to do *laugh*

2 days of bed-rest (going stir-crazy)... one day of "light duties" (still going stir-crazy)... and now I'm back to work with the warning to avoid running and jumping (as if I'd be likely to do either). Monday was crampy and gassy.... Tuesday was just back pain... yesterday was a few crampy moments, one quite sharp pain (but I'm choosing to take that as a good sign), and a lot of pain at my various injection sites.

I think there's a chance I might be mildly allergic to sesame oil. All my injection sites are swelling and itchy... and bruised. I'm going to give it a couple more days and then maybe head back to the clinic to see if I can trade in my other 2 vials for one of the other oils.

Here's hoping for good news at New Years!

Friday, December 14, 2007

Here we go again...

So on Wednesday (yes, 2 days ago and I'm only blogging now), I went to my clinic for a status check so we could figure out when to do the transfer for this FET cycle. It was interesting on a few fronts:

- for the first time in all the times I've been there, there was no-one waiting ahead of me for bloodwork. Likewise was the u/s process quick and easy (in fact, they put me in a room with an u/s tech already in there... no waiting!). I got to the clinic at 7:30 and by 7:45 I was done and waiting to see the doc (unlike usual visits, where I'm there at 7:00 and am lucky if I'm done my u/s by 7:45)

- for the first time in all the times I've been there for monitoring I was asked by the u/s tech (who's done my scans before) if I had any allergy to latex. As it happens, I'm fine with it, so long as my exposure is relatively short, so no worries there.

- for the first time in 3 rounds of purchases, I was asked what kind of oil for my progesterone injections. There's more than one kind???? Yes, I've been using sesame oil... not my fave, thicker than I'd really like, and stinky, but since I've got one vial left over from last time, I figured I should get the same for consistency's sake. But apparently they also have it in cottonseed oil and grapeseed oil (and possibly another one... I stopped listening after she got to sesame again)

- for the first time my doc actually said to me "you know... I was thinking about you last night and wondering how it was going... and here you are!"

Anyway, what it boils down to in the end is this: My lining was nice and thick "perfect... Beautiful!" says my doc. So I was told to keep taking the Estrace and that they could do the transfer any time from Saturday on. So we're set for Monday (a commitment I can't get out of for Sunday, so Monday works better).

As a result, today (Friday) I add to the mix:
- Doxycyline - 1 pill twice daily for 3 days (Friday, Saturday, Sunday... for transfer on Monday)
- Progesterone injections - 2 mL once per day in the evening in the butt (self-delivered, I might add... such fun... I get to test how far I can twist!)

They'll call me on Sunday to let me know what time the transfer will be at.... and then I get to go back for my beta on.... New Years Eve. I was told I could come in on the 30th if I'd prefer, but really... do I want to get up in the darkness of early morning to get in there for a simple blood test that may or may not yeild good/bad news several hour later? Or would it be better to stop in on my way to work... where at least I have a purpose in being up and something to distract me in the intervening hours? So I think we'll stick with New Year's Eve... and shoot for a low-key evening at home to be either very depressed (if it's negative), or very nervous (if it's positive... since the last positive didn't last).

Oh joy.

Right now it's still a little unreal. Like "this is too easy... it can't possibly work". I'm hoping that starting the injections tonight will make it more 'real'... last time I was at this point I'd already been doing injections for 2 weeks and been through a retrieval.

Thursday, December 6, 2007

3 cheers for happy side effects

Hey... when you're where we are with the rest of things, you take joy where you can find it.

TMI alert... this deals with icky girl-type-stuff. LOL as if that'll make a difference if you're reading an IVF blog.

Normal AF: 5 - 7 days of full flow, plus a couple of days of spotting on either end. Yup... lovely... up to 11 days of ick.

This AF (and I'm going to chalk it up to the Estrace): 1 moderate day, 2 heavy (very) days, 1 day of spotting and I'm done. Done! It's CD5 and I'm DONE!!! Excuse me for a moment while I get up and dance around my chair :)

See? I told you... you take the joy where you can find it. I'm not back at the clinic until CD11 (6 more days... just 6 more days...) and that just seems like ages to wait. But on the up side, if things look good next Wednesday, then we'll likely be doing the transfer of our little kidsicles on Monday or Tuesday following. On the down side, that also means that the progesterone injections self-administered in the butt will be starting again soon, which kind of sucks, but if it means I can get (and STAY... that's the trick) preggers, then it'll be worth it.

And hopefully I can make it through the month without any stupid comments about "when are you going to have kids" or "we weren't even trying" or "it was our first try" or "I'm going to be x months pregnant in x+4 months' time" or the like. At least most of our friends either already know, or just don't go there.

Monday, December 3, 2007

Here we go again!

So… yesterday AF (Aunt Flo… the red tide… pick your preferred euphamism) started right on schedule. I guess I should count myself lucky that my first cycle post-miscarriage was ‘normal’. I should especially count myself lucky on that point since my RE (reproductive endocrinologist, for the uninitiated) is going on mat-leave (yeah… ‘cuz that’s not a kick in the face every time I go to the clinic) at the end of January and I really don’t cherish any particular warm feelings for either of the docs who’d be picking up her patients for the 3 months she’ll be gone. Ergo (there’s that grade 12 dead language cropping up… I feel the need to get some value for it every so often), I wanted to get our next kick at the can out of the way before she left.

So… that brings us to today. Today was CD2… which means I dragged my butt out of bed at the crack of dawn to trek to the clinic before work. Who am I kidding… Dawn was nowhere near cracking when I crawled out of bed. But off I took myself to the commuter train at 6:14 to get to my clinic for 7:10 (they open at 7:00, but I can never make it there by public transit for 7:00 unless everything times out exactly perfectly… which we all know it never does). Signed all the requisite clipboards (my clinic has clipboards for u/s, to see the doctor (one for each doc), regular bloodwork, and betas), and waited until my name was called by each of 3 people.

Got my blood drawn. For once, they found a vein in my arm and didn’t have to dig too deep or take from my hand. It took a bit longer than usual, but the blood techs were having a pretty quiet moment when I was at that point.

Then off to u/s, where for some reason they were rushed off their feet this morning. Odd, since they generally only do u/s on the same days as blood work… but maybe there were a lot of early pregnancy gals in this morning. The clinic likes to do first trimester monitoring before referring to an OB… makes sense, and really, the success stories are gone before they start to show and cause stress for us less successful folk. Waited quite a while for the u/s and then it was done by a woman who is lovely to talk to, but a bit heavy-handed with the wand. Ouch.

Then out to the waiting room again (after putting the clothes back on, obviously) to wait for my doc. And wait. And wait. I was done with blood & u/s by 7:45 and then had to wait a full hour for my doc. But… barring any bizzarro results from my blood-work, we’re good to go on our FET cycle.

So, starting today… 12 mg Estrace per day (2 tablets per dose, 3 times daily)… plus one low-dose Aspirin daily… and back in to see how things are going next Wednesday. If all looks good, we’re probably looking at a transfer around the 17th. So now I get to try to schedule all my December things around needing time off that week. Fun.

I’m not sure how I feel about it. If the transfer takes place on the 17th, then the beta will be New Years Eve. Could make for a very special, or very horrible NYE depending on the results… and then potentially starts the nervousness, too.

Guess we’ll see, won’t we?

Tuesday, November 27, 2007

And so we begin....

Ok, ok... this isn't the beginning. Not by a long shot. But it's the beginning of my blogging here, so I'll call it the beginning.

Since this is the post with "the story so far"... be warned... it's going to be long. Very long. Very Very long. Sorry ;)

We decided in May of 2005 that we wanted to try to expand our little clan (currently just the hubby and myself). A trip to the doc for a "pre-conception check-up", however, revealed that my thyroid's a wee bit lazy. Since an unregulated thyroid problem can cause problems with conception and carrying to term, we figured we'd better get that sorted out before we started to try. In August of the same year, we "pulled the goalie". I had been charting my temperature and cervical mucous (such a lovely-sounding term, isn't it?) since I came off the pill in late '03 (which actually helped get the doc to test my thyroid function), so I was pretty sure I knew when our best chances were. Nothing.

In spring of '06 I had a chat with my doc again. He agreed that since I wasn't getting any younger and we'd rather have more than one child, he'd give me a referral to a fertility specialist. In theory, they faxed off the referral and I should have heard something to get an appointment within 3 months. Every time I asked them to follow up, though, they told me "it could take a while". Finally, in March of this year I summoned up the courage to DEMAND another referral. Admittedly, it was made a bit easier because my doctor had decided not to return from his 1 year sabbatical, so this was someone new ;) They faxed it off and we had our first appointment 6 weeks later. in the meantime, we had had 3 cycles where I (who am lucky enough to be basically regular as clockwork, and who knew that her LP was 12 days without fail) was late. No + HPT, and at most 3 days late, but late none-the-less, with all the raised hopes and crushing defeat that went along with it. To me, these were early losses, but since they were never confirmed, they're just losses to me.

Off we went, armed with two prior SA results for Hubby (neither particularly good, but both noting the sample was tested outside of ideal time ranges), and a full blood work up for me... as well as 2 years worth of cycle charts. Needn't have bothered. She glanced at my chart enough to ask "are your cycles regular? Do you know when you're fertile? Are you timing things right based on when you're fertile?" (yes, yes, and yes)... then off we went for a myriad of tests. For me: 15 vials of blood, pelvic and transvaginal ultrasound, and an appointment for an HSG the next day (more on that later). For him: 5 vials of blood, and an order for another SA and DNA Fragmentation testing. Although we had to pay extra for the DNA Frag, at least we got all the testing out of the way at once and saved some time in the long run. I mean, we were already nearly 2 years into trying at that point with nothing to show for it, not even recognized recurrent losses (and heartbreaking as that would have been, at least we would have seen SOMETHING).

Off I went the next day to my HSG. I had been advised to take 2 Advil about a half-hour before the test. Good call. I was told it would be "no worse than a pap". Bad call. OMG, my doc has never cranked me open that far! Ever! Then, once the catheter was inserted and they squeezed in the dye I had the joy of hobbling down the hallway with an IV bag (the dye) strapped to the inside of my thigh and hopping up on the x-ray bed. I should mention at this point that I'm 6' tall and the gown was designed for someone 5'4". I was feeling a wee bit 'exposed'. Then, of course, it was lunch time and they couldn't find an x-ray tech to take the few plates they needed... and when they finally did, it was the lone guy, of course. Anyway, I was told, unofficially, that everything looked good. Out came the catheter, on went the pad, and off I went to change and head back to work. While waiting for the elevator, I had cramps bad enough that I had to sit down... off I went to the bathroom. A few Kegels later a good portion of the dye was out of my girly bits and I was feeling a LOT better.

After a false start on our follow-up appointment (I'm sure a future entry will talk about DragonLady, and will touch on this), we had the appointment to review all our test results. I found out my blood type... positive, so we didn't need to worry about RH factor compatibility issues... I tested positive for some antibody or other which basically meant any assisted cycle would require low-dose aspirin... and other than that I was good to go. Hubby, on the other hand, didn't score so well. Motility issues, but morphology looked good. The DNA Frag results weren't so hot. Basically, although the swimmers energetic enough to get off the couch and go for a spin looked good... they weren't so bright. The results were bad enough, indeed, that we were told IUI was not going to be an option for us and if we wanted a child of our own biological matter, we'd have to go straight to IVF.

That news was delivered in July, a few days before my cycle started. Since Hubby is like most guys and not exactly prone to open communication of fuzzy qualities like emotions, we didn't take advantage of that cycle... and the next one would have put us out-of-town during an important part of the process (right around beta time), so that was out, too. So when CD2 rolled around in September, off I went to the clinic again to get poked and prodded (bloodwork and trans-vag u/s)... and wouldn't you know it? I had a monster cyst. However, having broken down sobbing in front of the doctor covering for my RE (and making her VERY uncomfortable by showing a less than purely scientific approach to the whole reproductive endeavour), I found myself on BCP for the first time in 4 years with an order to come back in 10 days for bloods and u/s and we'd see what we'd do from there.

10 days later I was told to stop taking the pills and come back on CD2. CD2 came and Hubby was actually available to come with me to the clinic... where they told me things looked good, and if my blood estrogen was at the right level, we could expect a call later in the afternoon.

Off we went on the 90 minute drive to his parents' place to let them in on what we were about to do. My parents had known the score for almost as long as we had... and we figured his should know, too... so they wouldn't ask questions or make comments that might upset us, and so they wouldn't think I'd been switched by aliens if I suddenly got very cranky from the meds. We got home to voicemail telling me we were good to go and to come back the next day to start my protocol.

My protocol was a mixture of Gonal-F and Repronex (FSH meds which would stimulate super-ovulation, hopefully), daily low-dose aspirin (for whatever antibodies they were that I had), and frequent monitoring. Also added was Cetrotide from about CD11, since I normally surge and ovulate on my own (Cetrotide is a LH inhibitor which suppresses spontaneous ovulation). At their notice, I stopped the Gonal & Repro and took my trigger shot of hCG and started taking a short course of Doxycyline (anti-biotics are common when doing IVF)... Hubby also had to take the Doxy. 2 days later, I was in for my retrieval.

Ah yes... the retrieval. In spite of me telling them that the blood tech had frequently had to use my hand because my veins were small and hard to find, they tried to insert an IV of regular size. Needless to say, it didn't work. Probably a good thing, since they had me signing papers after the IV was finally in, and the first attempt had been to insert it into my writing hand, and punctured both sides of the vein, leading to one hell of a bruise that I couldn't explain to folks not in the know. Second attempt was a baby needle in the other wrist... I feel sorry for the other gals who were in for retrievals that day... the screaming must have been disconcerting. Oops. Anyway, first they hydrated me, and then once I was in the OR for the retrieval, they started the "twilight sedation"... or as I like to call it "loopy juice". A narcotic cocktail allowing for conscious surgery, basically. It numbs the awareness of pain and for some has an amnesia-inducing effect. Well, they had 15 eggies to retrieve, and were only at 13 when the 3rd dose started to wear off... so they kept going for the last two and I was quite aware of the pain of my vaginal wall being pierced and the eggies beeing sucked from my ovaries. Luckily, it was only 2 of them, so I managed to deal. This was followed by 30 minutes sitting while the loopy juice cleared my system and they hydrated me again (and fed me... all of this was done on a 14-hour fast... so the crackers, peanut butter cups, granola bar and juice were VERY welcome!)... and then sent me off to the bathroom to "try to pee". Try? That doesn't sound good! Luckily, I had no issues, but apparently, there is a possibility of damage to the urethra or bladder during retrieval. (you'd think with an u/s wand shoved up the WooHoo along with the needle they'd be able to avoid that 100%, but apparently there's something like a 3% chance of problems).

Once I had a successful bio-break, they unhooked the IV and sent me home. No driving for 24 hours. Best to sleep it off for the rest of the day. I also started taking Estrace (and estradiol/estrogen pill) twice a day, and daily injections of progesterone. Let me tell you, I thought injecting myself with the Gonal and Repro was bad (DH doesn't handle needles well, so it was up to me!)... jabbing my butt and injecting an oil every night was even worse. The needle was, by necessity, larger and that, combined with the on-going Aspirin therapy meant lots of bleeding and bruising.

the day after the retrieval, I got a call letting me know that of the 15 retrieved 8 were mature, and of those 8, 4 fertilized. Half of them. Half of half of them, even. With ICSI (where the sperm are injected into the egg... matchmaking, as opposed to regular IVF, where they're just sent to a "singles mixer" and hope for an introduction). 3 days after the retrieval I was back at the clinic again... this time with a very full bladder for the transfer. Lots of discomfort with that one (you try holding a full bladder for 2+ hours... then having a catheter pushed up your WooHoo... and then having to hold it for another 15 minutes before you're allowed to "go pee... slowly!")... but 2 grade 1 embryos (1 8-cell, 1 10-cell) were transferred. And the pills and injections continued.

But the injection frustration was worth it! 14 days after the transfer I went for my first beta. The call came later "It's positive, but low"... well, low doesn't sound great, but since the gals in the breeding section of a board I frequent told me that several of them had really low initial betas and went on to have healthy babies, I wasn't concerned. I WAS slightly concerned that I didn't get a BFP at home until Friday (the first beta was on Monday)... but the betas every 2 days showed the number was practically tripling every 48 hours. Unfortunately, I had spotting for two consecutive afternoons early the following week, and by Wednesday had received the news that my hCG was dropping and I was miscarrying.

Rest in Peace Babies (because I believe I lost twins)... 5 1/2 weeks, Halloween 2007.

I recognize I was one of the "lucky" ones. My miscarriage was fully natural. My hCG levels declined to zero on their own, and 3 days later I started to bleed. It lasted about as long as a regular period, and was about the same... with the exception of the first day when the cramping was very bad, the bleeding was quite heavy, and I passed several clumps of grey matter (I think the gestational sac). I didn't make it to 6.5 weeks to see a heartbeat. I didn't get far into the happy planning. But it didn't hurt any less, emotionally.

So now what? Well, we took the next cycle off (RE wanted to move ahead right away, but I needed a mental break and time to recover emotionally)... and when my next CD2 rolls around I'm going back in to start a FET cycle with the two kidsicles we've got on ice. Thankfully, this cycle will be a lot less medications... just the estrogen pills untill they tell me to start the progesterone 3 days before transfer. Since it looks like Mother Nature might co-operate with a 'normal' cycle post miscarriage, the roller-coaster should be pulling out of the station again in the next week or so. Hang on to your hats... it's going to be a bumpy ride!