Ten Tips for IVF

They're a bit random, but here are some things I did during my IVF that helped things go smoother, as well as some things I wish I would have known beforehand. 

1. Get an electric heating pad. You will never want to take it off! It's great to help with the cramping after egg retrieval and also nice after the embryo transfer.

2. Try to relax and keep your retrieval and transfer week free. I still went to work, but I sit all day at a desk. Just take it easy, take deep breaths, and try to relax.

3. Before doing your injections, push and pull the syringe several times to make it less stiff. It will help the injection go in more smoothly.

4. Document everything. Whether it's a journal, blog, or keeping all your medical documents in a folder. You can use what you saved to help others, or to use again for reference.

5. Stay away from the infertility forums. Maybe this tip isn't for you, but I learned my lesson back in November with my first IUI. I was constantly checking an infertility board on Baby Center and it stressed me out more than it helped. If you need someone to talk to, this leads me to my next tip...

6. Confide in a friend. Whether everyone knows or nobody knows, find a friend you can confide in and discuss all the details with. It's a huge relief to just talk things over with someone you can trust. You can talk to me too! 

7. Download an app to remind you to take your medications. I used the app, MediSafe, and it gives me reminders to take my vitamins/meds/injections at the appropriate time of day.

8. If doing injections make you nervous, play a happy song! I frequently listened to "Happy" from Despicable Me 2. It helped make the situation more light and -can you believe it- fun.

9. Think happy thoughts! Just thinking positively or repeating affirmations can positively affect your attitude. By just saying phrases like "My body is healthy," and "I can carry a baby," you will start to believe yourself and your body will too. 

10. Try to schedule your transfer early in the morning. You need to go in with a full bladder to straighten your uterus and make the ultrasound visibly better. I woke up in the morning and went straight to my appointment without using the bathroom. Yes, it was uncomfortable, but I didn't have to worry about drinking a ton of water, and my bladder was so nice and full it gave my doctor a straight shot for transferring those precious embryos. 

Bonus: If you have any remaining embryos that you plan to freeze, make sure you are fully aware of when they plan on freezing them and what the odds are of them surviving until the freeze so you get no surprises. I was unaware they were doing an extended culture to six days. I was shocked to get a call saying 2 of our embryos didn't last and just 1 was viable for freezing. 

I hope these help! Let me know if you have any great tips by commenting below.

Embryo Transfer!

Saturday was the BIG day! I am blown away at how far we've come.

We arrived at the clinic at 8:30am Saturday morning with my bladder very full. They ask you to come with a full bladder because it helps straighten the uterus and visually helps through abdominal ultrasound because water helps with ultrasound waves. TMI, but I never peed when I got up that morning, so I really had to go! 

First we met with a nurse and signed some papers. From the sounds of it everything has been going by the textbook. Usually by day 5, half of the embryos are too poor quality to keep for freezing. With transferring the 2 that day, we would only have 3 leftover for cryopreservation. Good thing is that those three were all good quality and should be great for future frozen transfers.

The nurse offered me Valium and I almost said yes, but for the wrong reasons (I'm hilarious on it). I'd heard that transfers are similar to an IUI so I knew I could handle the pain. Plus I wanted to be coherent during the procedure. This time Chris got to join me in the OR. I got to put on my sexy grown, hat, and booties, and Chris got a ravishing yellow cover, complete with booties, hat, and mask. What's with the mean face Chris?

When we went into the OR we had to wait for awhile, so we got to chat with one of the Medical Assistants and get to know her better. I was cozy with warm blankets and my husband's hand holding mine. It was also very cool because they had a TV screen showing the view through our embryologist's microscope in the next room over. It was amazing to see him prepping our little embryos. He introduced himself as our "babysitter" and that they've been doing great! He also kept calling them our little babies. I thought that was funny because I figured the embryologist would be more technical in his terms. I loved it though.

Eventually our doctor came in and got everything ready which included the dreaded speculum. That thing was just hanging out in my you know what for a good 20 minutes. I've lost count how many times I've had to encounter that evil device. But I didn't even care this time, I was too excited. They have to handle things very carefully and have a set of keywords to know when the doctor and embryologist are ready and are transferring the catheter with our two precious little embryos, or what I like to call our little "embies". I actually didn't even realize when he inserted the catheter and released the embryos, I was that relaxed! Sometimes you can see a little speck pushed through the catheter into the uterus on the ultrasound, but I missed it. The embryologist then checked the catheter to ensure both got out. Everything looked good, so they had me rest for a little while and then sent us on our way.

We went home and took it easy the rest of the day per doctor's orders. I felt bad because it was my brother's birthday and we had to miss his family dinner. The next morning I had exerted myself a little too much, so now I'm really paying attention to my body and making sure I'm relaxed as possible. I'm still on several medications and have added in progesterone and Cabergoline. The Metformin still makes me sick, but I just taking it all in stride.

And the best part of all this? We got a picture! It might sound weird to love a bunch of cells, but I do. I love them for their potential. Their potential to make us parents and give us not just one, but maybe even two very desired children, and to fulfill our dream of starting a family.

Babies first picture?

We are just so excited and truly hope it works this time. Knowing I have two precious embryos inside me is just so surreal. I can't tell you how overjoyed I will be if I become pregnant! It's strange to think that if all this works out, technically I will be three weeks pregnant tomorrow. What?! It's weird because I'm not pregnant, but by the way it is measured I would be three weeks pregnant at this point. 

Implantation should happen within the next few days. Praying and having faith is all we can do at this point, and boy are we praying!

See the sucker in his mouth? That's his favorite part of going to the doctor with me!

 

IVF - This is happening!

On Monday I had a phone appointment with my Reproductive Endocrinologist. We went over my past treatments and made a plan for IVF. Since I've been on birth control the past 3 weeks it shortened the treatment plan by three weeks and I get to start medications today. I had a 2 hour appointment yesterday for another ultrasound, blood work (6 vials this time, yuck), urine sample, and to sign a ton of paperwork which also included paper work for freezing the embryos. Unfortunately insurance doesn't cover freezing so I had to write a huge check in advance. I will be going to the doctor numerous times this coming week. I already have more blood work for Friday and Chris is having blood work and a Kruger test to have a closer look at his sperm morphology on Saturday. The test looks at the shape of his sperm to see if they're developing properly. If a man has a decreased number of normally shaped sperm on the Kruger analysis, he is at risk of fertilization failure or lower rates of fertilization. Then I have more blood work and an ultrasound on Sunday. That appointment will determine next weeks appointments and how many more ultrasounds I will have. It sounds like they will be every other day since it's extremely important to monitor the growth of the follicles. 

If a man has a decreased number of normally shaped sperm on the Krueger strict morphology analysis, he is at risk of fertilization failure or at least low rates of fertilization. - See more at: http://www.babymed.com/male-infertility/sperm-morphology-kruger-sperm-function-test#sthash.ovotEWTi.dpuf

If a man has a decreased number of normally shaped sperm on the Krueger strict morphology analysis, he is at risk of fertilization failure or at least low rates of fertilization. - See more at: http://www.babymed.com/male-infertility/sperm-morphology-kruger-sperm-function-test#sthash.ovotEWTi.dpuf

I'm actually not nervous at all. Even though I will be starting multiple medications, injections, and going to numerous appointments, I am SO excited. I really feel like we are being guided right now and that Heavenly Father is watching out for us. I've been feeling his calming love so much. I literally feel like I am being carried. My heart is full.

Progesterone: The Grinch Who Stole My Christmas

When I got my IUI I asked my doctor about progesterone supplements. I had done some research and noticed many women that had an IUI were prescribed progesterone supplements after. My doctor said she wanted me to do some blood work first do see if it was really necessary, so a blood draw was scheduled for a week later. 

Progesterone comes from the corpus luteum. Basically what happens is after you ovulate, the ruptured follicle turns into the corpus luteum which is responsible for the production of progesterone. Progesterone is an extremely important sex hormone in early pregnancy because it builds a strong uterine lining and helps maintain the lining of the uterus to help nurture a fertilized egg until the placenta takes over around the second trimester. An inadequate amount of progesterone often results in miscarriage or if there isn't a fertilized egg, your period begins. 

Hormones involved in the initiation of pregnancy and the development egg cell (ovum) from follicle to embryo.

Progesterone levels rise after ovulation, and the rise can usually be detected about a week after ovulation. According to BabyMed, progesterone levels about a week after ovulation in a nonpregnant patient are generally at least 8-10 ng/ml. Much lower levels usually mean you did not ovulate. Doctors like to see progesterone levels around 16-18 ng/ml or more in pregnant women.

Want to guess what my progesterone result came back as? 8? 6? 5? Let's try 0.46 ng/ml. This tells me two things: 
1. I didn't even ovulate, which my doctor said makes no sense because of the trigger shot I took which forces you to ovulate and my ultrasound right before my IUI appeared as if the egg had already been released.
2. I have a severe progesterone deficiency or what's also known as luteal phase defect. Super.

Looks like I have the latter and I fit right in with the symptoms, which include:
Irregular periods
Not ovulating
Fibrocystic Breasts 
Low Thyroid (Hypothyroidism -ding ding ding! Why didn't they make this connection before?)
Ovarian Cysts
Reduced oxygen levels in all cells (Perhaps this is why I feel like I'm dying when I run?) 
Anxiety
Indigestion
Headaches and more. 

Everything is interconnected. Also because I have progesterone deficiency, I have a 1000% greater chance of dying from cancer.  According to the American Journal of Epidemiology, "researchers found that infertile women who demonstrated a progesterone deficiency had a premenopausal breast cancer risk that was 540% greater than that of women whose infertility was due to non-hormonal causes. Furthermore, the women with a progesterone deficiency had a 1,000% greater chance of death from all types of cancer." Happy New Year to me. Chris hugged me all night when I told him that. I'm not worried though. I know God has a plan for me.

To finish my story, I found out about all of this the Monday before Christmas. That is why progesterone is the Grinch who stole my Christmas. My family still has no idea I'm going through all this. We were all staying at my mom's house and I locked myself in the bathroom and cried and cried and cried. The Doctor called in some progesterone supplements to the nearest pharmacy just in case of the extremely rare chance I did get pregnant. I know it wasn't going to happen though. It was all I could do to bring myself to taking a pregnancy test the following Friday since I already knew it was going to be negative. And it was. 

What kills me the most is knowing that there very well could have been a fertilized egg, but it didn't have the enough progesterone to nurture it to implantation. Every month my heart shatters into more pieces than the previous. This is hard, really hard.

I hope everyone had a wonderful Christmas and got to feel the spirit of Christ in their hearts.

Progesterone levels after ovulation (midluteal, middle of the second half of the cycle) in a nonpregnant patient are generally at least 8-10 ng/ml. Much lower levels usually mean you did not ovulate. - See more at: http://www.babymed.com/fertility-tests/progesterone-levels#sthash.ikBCoH97.dpuf

Progesterone levels rise after ovulation, and the rise can usually be detected about a week after ovulation. - See more at: http://www.babymed.com/fertility-tests/progesterone-levels#sthash.ikBCoH97.dpuf

Progesterone levels rise after ovulation, and the rise can usually be detected about a week after ovulation. - See more at: http://www.babymed.com/fertility-tests/progesterone-levels#sthash.ikBCoH97.dpuf

Progesterone levels rise after ovulation, and the rise can usually be detected about a week after ovulation. - See more at: http://www.babymed.com/fertility-tests/progesterone-levels#sthash.ikBCoH97.dpuf

My First IUI

Well it's about time I post my IUI experience. It's a good thing I waited a couple days because I have been on a roller coaster of emotions, but know I can look back on the experience with fresh eyes. 

The hCG shot definitely got to me. My raging hormones have resulted in countless unnecessary tears. Some women test out their trigger to know when it's out of their system, but I'm just trying to play it cool so I don't become obsessed with it and think I should still have the side effects because it's still in my system.

So here's IUI story #1 (wouldn't it be nice if it stayed #1?!) 

For those of you who don't know, an IUI stands for intrauterine insemination also known as artificial insemination. Basically my husband's sperm is inserted directly into my uterus, creating a more direct route with less obstacles. 

We arrived at 7:30am for Chris's SA (semen analysis) to get a collection for the IUI. They wash the collection so only the best sperm remain. It's crazy to think there are millions and millions of candidates, but it only takes one.

The whole morning my emotions were running high. Nothing felt like it was going right that morning and I already lost hope before I even went in for the IUI. At 9am I got prepped and waited and waited and waited. Finally my sweet nurse came in and talked me through the procedure. They simply insert a speculum (ouch) and then guide a catheter until they find the top of the uterus and then the sperm is injected. It's simple enough that my nurse did the whole procedure while we talked about Thanksgiving to try and distract me from all the pokes and prodding going on. It only took about 3 minutes. After everything was removed, they had me rest for about 20 minutes and then they sent me on my way with good luck wishes.

All throughout that day I had no hope. I kept saying, "We'll have to try this medication next time" and "Next time I rather do this". I was already setting myself up for a negative. But that's how I protect myself. I don't get my hopes up so I'm not crushed when what I hoped for doesn't happen. Needless to say, I cried and cried and cried all day. 

Hormones. Gotta love them.
I had moderate cramping for two days and just took it easy. I am now in what's know as the two week wait. Two weeks until I take a pregnancy test to see if all the pills, injections, ultrasound, and IUI were worth it. My goodness I hope so! All the appointments, medications, and sticking needles in myself is emotionally exhausting!!!

But this is why I'm glad I'm writing this two days later. I found my hope. It's small, but I'm hopeful. There are so many little things that have to go exactly right to become pregnant. It really is a miracle. And that is where I found my hope. I've stopped thinking about the medications and how big my follicles were and if the trigger shot worked. Now I just think of the miracle it all is. It's completely in God's hands. If it's God's will, I will become pregnant. There is nothing more I want to be in life than a mother. I want to have children and raise a family with my husband. The thought consumes every spare moment. It is always in the back of my mind. It is everything to me. 

Ultrasound and hCG Trigger Shot

On Saturday I had my follicular ultrasound. My follicles were still a bit too small, so my doctor had me do a forth FSH injection. He said the follicles grow about 2mm a day, so he set my IUI for Wednesday morning. I'm excited and nervous! Although I've learned by now that I should stop being nervous because every time I am it turns out to not be a big deal at all. 

Oh boy, now I'm bringing in the big guns!

Last night I took the hCG trigger shot. hCG (human chorionic gonadotropin) is a hormone that is used to aid in the follicle maturation process and stimulate egg release. Typically women ovulate around 36 hours after the injection. That puts me at exactly 9am Wednesday morning, the exact time I'm getting the IUI. Timing is very important since eggs only typically live for 24 hours.

On another note, we are doing well. I have slowly been putting up Christmas decorations (yeah, yeah, yeah, you probably think it's too soon...) and we have been addicted to the new show Reign. Life is good and we are enjoying our time together! 

Timeline Update

A lot has happened since first meeting our doctor. I've been trying to play catch up since we started treatment over a month ago, but this blog is only a week old! Here's a timeline update: 

September 19th: First appointment with our fertility doctor. 

September 20th: My blood work came back and I was diagnosed with hypothyroidism. I started taking Prometrium to induce a period.

September 25th: Had further blood tests, thyroid exam (found nothing wrong) and was prescribed 50mcg of Synthroid a day. I will probably be taking it for the rest of my life. 

September 26th: Met with my gynecologist and got her up to date. Free Prenatal vitamins, yay!

October 3rd: After taking the Prometrium for 10 days my period started just three days later. 

October 5th: Went to the doctor for blood work and a follicular ultrasound. Everything looked great! Except my bladder was so full in preparation for the blood work that he couldn't see anything until I emptied it. I came back and my bladder was in the shape of a heart so he gave me an ultrasound picture for kicks and giggles. I got blood work done for an OAR, Anti-Mullerian Hormone, and TSH for my thyroid. My thyroid went down quite a bit which is great! Also my Ovarian Assessment Report came back and it was like I got straight A's! We're in the clear there. I also started taking 5mg of Femara today.

October 9th: Finished taking Femara. I didn't experience any side effects thankfully.

October 11th: The dreaded HSG! My next post will have all the details.

That's a wrap! Just keeping it positive :)  

 

My First Video Blog

Vlog, aka video blog.

 

Totally out of my comfort zone, but that is why I'm doing it. I get really quirky in these... 

But hey, if you don't like reading about us (ehh, mostly me) now you can watch! 

   

 

Fertility Specialist

September 19th, 2013

Today was a wonderful day! We got up at the crack of dawn to get to our 7am appointment to meet our fertility specialist. Our doctor went over an extensive medical history for both of us and our families. He didn't have much concern for Chris, so he recommended some things for me. First off, he wants me to increase my BMI since I'm considered underweight and that is not healthy for pregnancy. He also prescribed me some fancy $85 prenatals (thank goodness for insurance!). Then he told us we could approach this three different ways, which are in short:

1. Gain weight, see if my period comes back, try naturally.

2. Do some blood tests and pop some pills, try naturally.

3. The whole show, tests, pills, HSG, IUI, IVF, etc. 

We chose in between 2 and 3. 

Our plan is as follows:

1. Induce period with Progesterone pills

2. Schedule for OAR and follicle ultrasound on day 3 of cycle

3. Take Femara days 3-7 of cycle

4. Get an HSG during days 5-10 of cycle

5. Take ovulation tests until we get a positive and come in for an IUI (intrauterine insemination)

If I don't ovulate I will do a progesterone blood draw and try all over again the next month. Try, try, try. Sometimes that word is very vexing.

I was prescribed a ton of stuff, which was a little overwhelming at first. However, it all seems simple now. After meeting with our fertility doctor, I got my blood drawn for TSH (thyroid stimulating hormone), CBC (complete blood count), and Prolactin. Fun little side story I will share about my blood getting drawn in my upcoming vlog!

All in all, we are so happy and thankful we could meet with this doctor. We have a plan in place and have already learned so much. We are slowly taking baby steps. Literally.Baby.Steps. 

Our Infertility Journey

I always knew deep down that I would have a hard time getting pregnant.

 I was hoping it wouldn't be a reality, but it is. My body has always been a little wacky when it comes to "lady" things. I didn't start my period until I was nearly 17. I was fairly regular for the first few months and then it went downhill from there. After I started college, I experienced the freshman 15...in weight loss, not weight gain. For already being very slender, that certainly didn't help. I was only getting two periods year. After I got married I knew I needed to get this under control. I was eating healthier, taking vitamins, exercising, trying to gain body fat, but my efforts had no luck and my period was distant as ever. 

I've neven really been on birth control. My husband and I weren't trying, but we weren't preventing either. I was ready, but my husband wasn't totally warmed up to the idea of a little one yet. But soon enough we were doing everything we could. After much discouragement and feeling broken, we made an appointment with a fertility doctor. Meeting with our doctor was like a breath of fresh air and a force of hope! I'm starting this blog as a way to document and share our story. Someday we will have an Itty Bitty Ivie come into the world. Welcome to our journey!