SECRET MISSION

The infertility department isn't "open" on the weekends at Mayo, but they are for those doing IUI's or IVF since you still need to come in for blood tests and ultrasounds according to your cycle! So, it's like “mission impossible” when you go in on Saturday or Sundays because the lights are all off and there's only a nurse and doctor there. It's like it's a secret meeting or something. You feel as if you’re trespassing!

Nick would have to meet a guard in another building to be escorted to the special place for sperm samples, because it wasn’t open. Then we’d go to the Infertility Dept. and wait around in the dark. It was just crazy! You feel like you’re in a ghost town, but rather a ghost clinic!

For both of our IUI’s at Mayo, my cycle landed them on weekends. (Which worked out nice for Nick’s work schedule.) And during our IVF cycle, we had some ultrasounds on the weekend as well. So, we did a few of these “secret missions.” And they were sort of fun!

LESSONS LEARNED FROM INFERTILITY: (MY CONTINUALLY GROWING LIST)

I’ve learned that unintentional hurts come from loving but uninformed acquaintances.

I’ve learned that nothing is really as scary as I imagine it to be.

I’ve learned not to take everything so seriously or personally.

I’ve learned to stop planning so much for the future and enjoy the present by living in the moment.

I’ve learned that sometimes just putting your feet on the ground and one in front of the other, is enough.

I’ve learned that a lot of goodness can come from the unknown.

I’ve learned that people who are there for you the most, oftentimes are the people you’d least expect.

I’ve learned that the people you’d expect to be there for you the most, oftentimes are there the least.

I’ve learned that life offers far more good than the bad.

I’ve learned that the friends you thought would be there for you may let go of you, which makes you feel unworthy and unloved.

I’ve learned that even though you want no one to have to go through this – it helps to know someone who is. Because then you don’t feel so alone. Anything to help you not feel so lonely.

I’ve learned that even though I might not want to attend a baby shower – I still want to be invited. Because it hurts much worse to find out about it later.

I’ve learned that you can keep going long after you think you can’t.

I’ve learned how to react and respond to people who say insensitive things.

I’ve learned that I have more patience, strength, and resilience that I ever imagined.

I learned I’m glad I didn’t track of the number of hours total that I’ve waited for doctor appointments, the number of miles driven in the car to appointments, or the number of hours on hold on the telephone.

I’ve learned that two people can look at the exact same thing and see something totally different.

I’ve learned that I have a lot to be proud of.

I’ve learned and gained a deeper love, devotion, and appreciation for my husband due to the trials we’ve faced together.

I’ve learned to stop looking at the piles and piles of hospital/clinic statements, bills, and prescription sheets.

I’ve learned that no matter how bad your heart is broke, the world doesn’t stop for your grief.

THE IVF PLUNGE!

I found this online and wow…what a wonderful writing by Laura Mitchell. It is so true!! Hilarious! :)

"The IVF Plunge" Copyright © 1997 Laura W. Mitchell

The latest.... The greatest.... Come ride the spectacular new roller coaster, now open at an IVF clinic near you! Take...THE IVF PLUNGE!
Thrills! Chills! Stabs! Jabs! Laughs! Screams! What makes THE IVF PLUNGE so unique is that it is actually several rides in one! But not all riders will experience all the rides - automatic track switchers randomly select cars to go on any particular sequence. In addition, selection of a clinic also results in different protocols, behavior, treatment, cost and support. So THE IVF PLUNGE is never the same ride twice!

For more details, read on....
Some riders will experience thrills on the INSURANCE ride! Swinging you around, upside down and inside out, a brass ring of coverage will be tantalizingly close, only to be snatched away at the last minute! For those riders who manage to snatch the brass ring, a FREE RIDE on THE IVF PLUNGE is available! (Provided they meet certain restrictions.) Riders who don't grab the brass ring get a consolation prize - a ride on the CASH attraction! Whether maxing out the credit cards, taking a second loan on the house, or sponging off of future grandparents, this is a ride that you will remember for the rest of your life as you struggle to pay off the debt!!
A new attraction for PCO (Polycystic Ovarian Syndrome) sufferers has recently been added - called DAY ONE. This ride starts with the well-known classic DAY ONE - a big draw in the INFERTILITY group of attractions - and ratchets the anticipation UP!!! Will YOU meet the cut-off date??? Then of course there is the Day 3 FSH - do YOUR ovaries have what it takes?

The first part of the main ride is familiar to those who've been to the INFERTILITY attractions before – OPKs (Ovulation Predictor Kits)! But the intensity is GREATER - the highs are higher and the lows are lower and the kits are even HARDER to read!! But it all pays off as you move into....
MEDICATIONS! This is the most intense part of THE IVF PLUNGE, described by visitors as the ride from hell!! Whether your shots are sub-cutaneous or intramuscular, you won't want to miss the artificial menopause brought on by lupron, and don't forget THE HORRORMONES! You think you've done injectibles before? You think you're a pro? THINK AGAIN!! With HIGHER levels of injectibles, and DAILY monitoring, this is where the nightmare becomes reality! Then who can forget the terror of HYPERSTIMULATION, one of those random side trips! Another random side trip, POOR RESPONSE, has a chance of ending your ride early!!! Just another sense of anticipation! Can YOU make it through this part of the ride?

If so, it's on to RETRIEVAL AND TRANSFER. This ride is unique in that NO TWO PEOPLE EXPERIENCE THE SAME THING!! Some will sail through with arms raised, careening into the next sequence. Others will be shunted off due to poor egg or sperm quality, incomplete fertilization, or fragmented embryos! Your heart will be in your mouth as you await the phone call telling you how many embryos made it! And will you be sick with anticipation, or is that a reaction to the anesthesia???

Then the TWO WEEKS FROM HELL. Words cannot describe this phenomenon! With daily intramuscular shots of progesterone in oil, this is probably the most painful part of the ride! The highs and lows are even more intense, as you are surrounded by well-meaning but offensive friends and relatives saying "Well?" and otherwise telling you what you SHOULD have done. NOTHING you have experienced in the two week wait of prior cycles will prepare you for this!! You will laugh, cry, scream - all at the same time!

You will feel suspended in time as you wait for.....THE TEST. The most anticipated part of the ride!!! Some random number (depending on clinic stats) will PASS!! Those lucky riders will go on to the PREGNANCY ride, a swirling maelstrom of emotions, changes, and risks! Those who receive a negative beta-HCG are not left out though. They will descend a huge drop of what will seem like ten miles in about 10 seconds!! The misery and tears will be just the beginning, as pregnant women and women with babies and adorable toddlers will be EVERYWHERE! But never fear, because for only thousands of dollars you can once again -Take THE IVF PLUNGE!!!

"The IVF Plunge" Copyright © 1997 Laura W. Mitchell

INFERTILITY: THE ULTIMATE WAITING GAME

I wait in the waiting room for countless appointments. I wait for test results. I wait for treatments. I wait for my cyst to go away so we can continue on to the next treatment. I wait for Nick to be back in town, so he’s around for my next treatment according to my cycle. I wait for my insurance to go through because my bill was charged wrong again. I wait on hold on the telephone with the doctor. I wait on hold on the telephone with my insurance company. I wait on hold on the phone while ordering my fertility drugs from a specialty pharmacy out of town. I wait for my fertility drugs to arrive. I wait to find out if my follicles are big enough. I wait in the pre-op room for surgery. I wait to find out if our embryos are fertilizing. I wait for pregnancy. I wait for my period not to come. I wait…

MY MIRACLE NURSE - MY SISTER

She loves to inflict pain upon others. (Just kidding!)


My miracle nurse is my sister, Jesse. She's been my best friend for my whole life. (Along with my other sisters!) Who would have thought through all our trials and tribulations that we'd grow up to experience this together. I say "together" because I know she felt many emotions along with me through the entire process. And I say "together" because she was there with me every step of the way. But honestly we've pretty much done everything together our whole lives, so why stop now?

I know I couldn't have gone through IVF without her. What a blessing to have a Mayo nurse for my big sis. And to live just a few blocks away from her to help me with all my shot medications. We went over everything over and over to make sure we understood it all. Wait, who am I kidding, it was more like she went over and over it to make sure she understood it all as I stood there scared out of my mind. With each injection, she double and sometimes tripled checked the amounts.

Jesse, thank you for helping me, for supporting me, and for always loving me. Thank you for listening, giving me advice, and telling me when to chill. Thank you for letting me love your children as if they were my own. Thank you for drying my tears and holding me until they stopped. I can't thank you enough for helping to get me pregnant. I love you! Thank you for being my big sis, my friend, my heart...

I wish I could truly express how much you mean to me. This poem makes me tear up every time I read it. It's how I think of you, Erin, & Corrie!

My Sister by Lisa Lorden

My sister is my heart.
She opens doors to rooms
I never knew were there,
Breaks through walls
I don't recall building.
She lights my darkest corners
With the sparkle in her eyes.

My sister is my soul.
She inspires my wearied spirit
To fly on wings of angels
But while I hold her hand
My feet never leave the ground.
She stills my deepest fears
With the wisdom of her song.

My sister is my past.
She writes my history
In her eyes I recognize myself,
Memories only we can share.
She remembers, she forgives
She accepts me as I am
With tender understanding.

My sister is my future.
She lives within my dreams
She sees my undiscovered secrets,
Believes in me as I stumble
She walks in step beside me,
Her love lighting my way.

My sister is my strength
She hears the whispered prayers
That I cannot speak
She helps me find my smile,
Freely giving hers away
She catches my tears
In her gentle hands.

My sister is like no one else
She's my most treasured friend
Filling up the empty spaces
Healing broken places
She is my rock, my inspiration.
Though impossible to define,
In a word, she is...my sister.

Only your sister would give you a shot in your buttcheeks. Now that's true love!

FINANCES: The Infertility Gamble

The financial burdens from infertility are indescribable. The results are not guaranteed, it’s a gamble. And many couples have zero coverage for reproductive technology. While others I’ve heard of having $25,000 lifetime coverage. As you can tell, it greatly varies across the entire country.

I’m currently on COBRA health insurance, from my last job. We were blessed enough while going through our first initial attempts at our IUI’s to have some insurance coverage, which helped out tremendously. But was still very expensive. After my 5th failed IUI, we found out my insurance had switched to cover an $8000 lifetime max toward any ART (Assisted Reproductive Technology), with a $3500 medication lifetime max toward ART. We were overjoyed! This meant we could go ahead with IVF, as before none was covered. Of course we’re already past those lifetime maximums, but we’re not complaining. It’s better than nothing!

After 18 months of COBRA coverage, you are kicked off and need to find an individual plan. We were under the impression that when my COBRA was done in May, I would have to find that individual plan. Which then means that you can’t have a baby for 18 months, in order to have full delivery coverage. (It’s sort of considered a “pre-existing condition” otherwise. Fortunately, we received great news that there’s a portability clause, which allows me to stay on the same plan with similar benefits, and it’s cheaper. We can still have my delivery covered when the baby comes in October. What a blessing we’ve spent so much time worrying about!

Obviously the expenses would be so much easier if the results were guaranteed. But they’re not. Most clinics have a 50% success rate with IVF. It’s a gamble. It’s throwing your money out there and taking a chance. But honestly we made the decision that we’d spend anything to have a chance to at our baby.

WAITING TO BE EXPECTING

Can you find the "baby" in this photo? I love this picture!

We’ve been “waiting to be expecting” for longer than we’d like. And these next particular 12 days of “waiting to be expecting” are by far, the longest and hardest we’ve ever experienced.

I think nearly all would agree that the most agonizing time of any IVF cycle is the two-week-wait after your Embryo Transfer. After your IVF transfer, you have to wait 12 days before you go back in for a blood test to reveal if you are pregnant or not. The constant poking and prodding is replaced by a big void you have to fill while under instructions to rest and relax. Talk about cruelty. It’s about the worst thing you can do to a wannabe parent! It’s like someone telling you, “Just wait 288 hours and you’ll know.” What? 288 hours. That’s like forever! And relax…yeah right. The thing that would relax me the most right now is to drink a few glasses of wine, but that’s obviously not an option. So what now? I just pray and pray and pray and find myself hoping these little babies really will make a nice cozy home in my uterus.

You try to completely trust in your body and God. That together they’ll make these babies survive implantation. I prayed and prayed, but I found this difficult because this time I was desperately praying for what I was wanting so badly, not for what God wanted for me. If we could be assured that once, just once we’d become pregnant, this waiting game would be a little less stressful. But of course there are no guarantees and no magic ball showing the outcome. So we just keep playing the waiting game until our day comes.
After IVF, you are advised to stay away from doing any activities involving twisting or not to lift anything over 25 pounds. Every sudden move I made, I thought maybe I shook those babies right out of place. I thought maybe I should just lay around in bed all day in order for maximum results! I’m not even kidding when I say I didn’t want to pee too hard, laugh too hard, or sneeze too hard! One day, my niece, Cora, jumped on my lower stomach while I was laying on the floor. I imagined the embryos shooting right out from my uterus, through my vagina. Ahh, scary! I sure hope those babies held on tight!

Now that I think of it, someone should really invent a way to be frozen in time, just sleeping or something, and then be woken up right when it was time for the results. How sweet would that be!? But since that can’t be done, I guess we just continue our 288 hours of “waiting to be expecting.”

EMBRYO TRANSFER

Nick in his special scrubs! Ready for the Embryo Transfer!



After our Embryo Transfer! Come on babies...make a nice home!


We had our Embryo Transfer this morning at Mayo. And amazingly not much nerves...mostly excitement!!!!!

We left early because we had to drive in the freezing rain! (Seems there always bad weather when we need to drive there!) We checked into the hospital at 8:30am, I took a Valium, and relaxed in the room. (The Valium actually didn't do anything to me. They said some people get loopy and some don't, but I didn't feel any different. Guess I can handle my drugs! HA!) We watched a movie, "The Proposal” to pass the time. At 10am, they wheeled me down into pre-op and Nick got to come along in his sexy scrubs, booties, cap, and mask! I was so glad he was able to see the rooms I was in on Tuesday and experience this with me. The Embryologist said our embryos were right on schedule and growing great.

They were all the same group of nurses and doctors that were with me on Tuesday. I have a "grandpa" crush on my favorite doctor there...meaning I wish he was my grandpa. He is such an amazing doctor and it doesn't hurt that he has a wonderful accent! The nurses had told me how wonderful he was and that once you're his patient, he treats you like family! They weren't kidding - he held my hand, was very supporting, and gave me kind words of encouragement. The procedure went great. It was painful, as the “clamp” had to be in for a while and they sort of scraped the area out. I was taking deep breaths pretending I wasn’t there. Anything to keep from moving my body. I didn’t want to harm the embryos! Another not so fun part was my full bladder. By that time I hadn't urinated in over 4 hours and had to go bad! But you need a full bladder for the procedure to go smoother.

They injected 2 embryos (no chance of a future octomom here!), which is the highest that Mayo will put in for someone of my age. It was pretty incredible to watch the ultrasound on the screen and watch the catheter go in and once it reached it's destination - out popped the 2 little round embryos. Incredible! Not many people get to see their babies at that stage. I couldn’t believe this was happening. These are our babies! I already feel so "attached" to these little embryos. I pray they burrow into my uterine lining to stick around and grow strong.

So, back up to the room at 10:50am and I was on bed rest for 1 hour. I was determined to make it without having to pee. But about 35 minutes into it, I was about ready to explode, so I had to use a bedpan. The pressure was just too much, I couldn’t take it anymore. I was stabbing myself with my nails trying to get pain elsewhere so I wouldn’t wet myself! I called Jesse quick to ask her how it worked because I was scared! (What a wimp!) I really didn't want to but I had no other choice. But now I can say I've done that. Everyone needs to say they've used a bedpan at least once before right? Isn't it on everyone's lifelong to-do-list? HA!

This time they made me leave the hospital in a wheelchair. I enjoyed being pampered by Nick and waited for him to get the car to pick me up. The men at the door were funny. When Nick pulled up, they said, "Your Camry has arrived." Then they wheeled me out. I could get used to that service. HA!

There are some interesting rules I need to follow during all of this. Such as: no hard working out or twisting of the waist (no golf, tennis, bike riding, etc.) We gotta protect those embryos! No lifting more than 25 pounds, no using any lotions/perfumes, no alcohol, no being around chemicals/toxic fumes such as paint, glue, etc., No sex until after the pregnancy test! And if positive, then no sex until after the ultrasound 3 weeks later. (Gee, this is a nice break. HA!)

I'm feeling pretty good...just super tired...a little cramping and my butt hurts from the progesterone shots. I've been relaxing the rest of the day while Nick worked from 3-7pm. I napped twice! My body is so worn out...but I'm not complaining. Naps have now become a part of my daily routine. I am excited to hopefully get some energy back and feel a little more normal. For the next few weeks, there's no exercising or twisting (this includes vacuuming...woo hoo!) and no lifting over 25 pounds.

Today is one of my dearest friends, Keri's birthday. She joked it would be good luck for us! I sure hope so! Now the waiting game begins. Come on babies...love your new home!!

Being wheeled to the car after the embryo transfer.

OUR FERTILIZATION RESULTS

More great news! I called the "Mayo Lab Talk Hotline" and received a wonderful message from the Embryologist. Out of the 14 eggs they retrieved yesterday, they inseminated 12 with Nick's sperm (I sure hope it was Nick's anyway! HA!) 10 out of the 12 fertilized normally...which is awesome! So, they froze 8 embryos yesterday on day 1, which will be stored at Mayo for 3 months and then transferred a cryostorage company in Minneapolis. And the remaining 2 embryos are waiting to be transferred back into me tomorrow morning!! We go in at 8:30am for our Embryo Transfer. Just a Valium and bedrest for 1 hour, then we can go! :) Then the wait begins!!!!!!!!

I can't believe we have 2 "babies" waiting for us tomorrow! And 8 "frozen babies". I sure hope they behave well in their embryo daycare! It's weird you have to pay for daycare for embryos!!

So, 2 embryos could mean 2 babies...twins! (With IVF, it's around a 20% chance for twins.) And if those split naturally - then that's 4! Yikes, let's just hope for 1 or 2. We're so excited with anticipation, faith, and hope! We know God has great plans for our family and we pray and hope that this is it!

EGG RETRIEVAL

Nick and I "all smiles" on the Egg Retrieval Day!


Looking sexy before surgery!


Looking a little groggy after surgery!


Today was the Egg Retrieval day! We have great EGGSpectations for today! Ha Ha! We drove through the bad bad fog to Rochester and checked into the hospital at 7:30am. We waited together in the room for about an hour, then I was wheeled down to wait in pre-op for another 40 minutes by myself watching all the "sick" people getting wheeled into their surgeries. It made me actually thankful for the reason I was there. I looked absolutely stunning in my hospital gown, sockies, and cap. Ha Ha! The head of the "Reproductive Endocrinology and Infertility Department" came and spoke with me. I was relieved to know he was doing the egg retrieval! He is such an amazing man. The moment he looks at you and starts speaking, you just feel the love. He makes you feel cared for and peaceful. Everyone who helped me today was so friendly and nice, which helped me stay calm!

It was interesting being wheeled into the operating room with all the people with their masks on. I felt like I was on a TV show or something. The worst part was when they put the IV in for general anesthesia and that wasn't even too bad. Just a few second of pain! I didn't necessarily like being strapped onto the table like a crazy person, but then they put a nice heated blankie on me and I didn't care anymore. They put an oxygen mask on me and said, "You don't look very sleepy, so we'll give you a little more." I started to count the people in the room. I think I got to 8 and then I don't remember anything else until they told me it was all over and everything went fine.

The "surgery" probably took around 25 minutes. I was wheeled back up and got to see Nick! Yippee! All I had was slight cramping, but honestly I have worse cramps that that every month with my normal period. I had to stay and rest for about 1.5 hours after. They need to make sure you can eat, pee, and walk fine. All was well and we were outta there a little after 12pm. I've just been taking it easy today. Besides some slight pressure down there, I'm feeling just fine!

Amazingly I wasn't scared today. I was nervous last week, but today I was excited and anxious to get this part over with! I was shocked I felt this way and was so brave! We feel really at peace and are hopeful and excited for the Embryo Transfer on Thursday. I just have a good feeling about all of this!!!

In case you forgot what the Egg Retrieval involves, here is a quick summary:
The surgery is performed to move the eggs from the ovaries. A needle is passed through the top of the vagina through ultrasound guidance to get to the ovary. The fluid in the follicles is aspirated through the needle and the eggs detach from the follicle wall and are sort of sucked out of the ovary! The fluid with the eggs is passed on to the embryology laboratory where the eggs are identified, cleaned, and placed in dishes. Those are kept in IVF incubators under a controlled environment. Then, since we are doing the ICSI IVF, today the sperm were directly injected into the eggs.

Also, this morning Nick got to give another semen collection to be injected in to the eggs today. Although they already have a backup frozen sample, “Semen Cryopreservation” in case if something happened to be “wrong” with this sample.
We are actually doing a different form of IVF. “Regular” IVF is where they put the sperm and egg next to each other and let them do their thing. But, we’re doing the ICSI IVF which is where they will directly inject the sperm into the egg. (And this one is more expensive….of course!) ICSI is “Intracytoplasmic Sperm Injection” and it can dramatically improve the likelihood of fertilization when there’s a male factor of low sperm counts, low sperm motility, or abnormally shaped sperm. So, just hours after the retrieval, Nick’s sperm will be individually injected into my eggs. How romantic!

I also start on my last set of antibiotics today. Twice a day for the next 5 days.

The doctors took out 14 follicles and right now, they are "hatching." So, tomorrow we call in to find out how they are growing and how many fertilized embryos we have! Just think, all our future babies could be growing in dishes RIGHT NOW!! Absolutely amazing!!

Come on strong spermies, good fertilized embryos, and a warm, hospitable uterus!

PROGESTERONE OIL SHOTS

Tonight begins the progesterone shots in my butt. (Nice visual, huh!?) These are the long needles that are intramuscular. Two days of a half dose of 25mg and then after 50 mg for the rest of the injections. This progesterone is a thick oil, so you can feel it going in! I guess it'll be sore and feel like the pain of a bruise. So, we'll see how they go! Jesse will have to teach Nick to give the shots because we'll be outta town next week.

The rationale behind the supplemental progesterone is that following egg collection, ovarian hormone production may be impaired because many of the hormone-producing cells are removed at the time of follicle aspiration. In addition, the use of medications, such as Lupron that I took, may diminish ovarian steroid production following egg collection. So, basically - you take progesterone to keep the uterine lining healthy for good implantation. It keeps your uterus healthy and hospitable! If we're pregnant, we’ll end up taking this for a total of 10 weeks.

Your body naturally produces progesterone. Getting a steady stream of progesterone during pregnancy is vital for these reasons:
1. Makes the uterine lining develop and secrete fluids after being primed by estrogen.
2. Maintains the functions of the placenta and fights off unwanted cells near the womb that could cause damage to the placenta or fetus.
3. Keeps the uterine lining in a thickened condition.
4. Stops the uterus making spontaneous movements.
5. Stimulates the growth of breast tissue.
6. Prevents lactation until after the birth (with estrogen).
7. Strengthens the mucus plug covering the cervix to prevent infection.
8. Strengthens the pelvic walls in preparation for labor.
9. Stops the uterus from contracting thus keeping the baby where it is.

THESE FOLLICLES ARE BREAKING MY BACK!

On Monday afternoon I started having intense pain in my mid-back. Any way I laid didn't seem to help with the pain and I couldn't get comfortable at all. I’ve never felt anything like it. Even just laying flat on the floor didn’t help at all. I took some Tylenol and that helped for bit. I woke up with the back pain still the next morning.

Nick and I thought it must have something to do with the fertility meditations. But after talking with a nurse at the Egg Retrieval, she said it's probably because of the increased number of follicles taking up all that extra space and pushing, causing the pain. Remember that with all the medications, I have many more eggs than normal. I had around 18 follicles and in a normal cycle without medications, you only have 1. So, my ovaries were working overtime!

Turns out she must have been right because after the Egg Retrieval, the pain was immediately gone! :) Awesome! I’ve never experienced anything like that! It seemed like a miracle!

Here's an example of an ultrasound photo of someone going through IVF. That's a lot of follicles!!

TIME FOR OVULATION!

Yet another trip to Mayo today for a blood test and ultrasound today to check on the follicles and see if they are mature enough. We were hoping to hear that the follicles were big enough and that we could trigger ovulation tonight with the hCG injection. The hCG (Human Chorionic Gonadotropin) is a hormone that supports the normal development of an egg in a woman’s ovary. It basically stimulates and kicks in ovulation which releases the eggs.

We really wanted the hCG shot to be tonight, due to the fact that that would work best with Nick’s work schedule this coming week. And because we were almost out of some of the medications and would have had to get it last minute from the specialty pharmacy in the cities. Or maybe at Mayo, but we would have had to pay full price, because my insurance didn’t cover the medications from there.

The blood test needs to be done before 9am and our ultrasound was at 10am. So between those times, we went to our newly found favorite quaint bakery, and ate there for Sunday brunch. We also sported our Minnesota Vikings gear, ready for the big game later that afternoon.

We met a new doctor today who did the ultrasound, and she was wonderful. She gave us great news and said my follicles are lookin’ great. I have about 18 or so, with 9 or 10 that are big enough, so we’ll see how many they “use” for embryos. (Normally you have 1 follicle in a normal cycle with no drugs - so with 18 - my ovaries are working overtime! No wonder I have such pressure and bloating!)

There is one follicle that has blood in it, but I guess that can be common and so they don't use that one. My uterine lining is "beautiful,” in the words of the nurse! The doctor also checked the computer system quick around 10:30am to see if our blood test results were miraculously in, as she said they sometimes aren’t there until 1pm. She didn’t expect them to be in, but they were there! The results were great. So, she told us right then and there that we’d be triggering with the shot tonight. It was exactly what we wanted to hear and we didn’t even have to wait long for the results. Wonderful!

So - we'll take the HCG shot tonight, which will trigger ovulation! As they say, "timing is crucial" so we take the shot at 9pm tonight. And retrieval is approximately 34-38 hours after.

The hCG shot is given intramuscularly, which means “super long needle that goes right into your muscle above your butt” and involves all that crazy mixing of vials. I can’t shoot myself in the buttocks, so that means someone else has to give me the shot. And that will be my Miracle Nurse, my sister, Jesse. I don’t think anyone has seen my butt as much as she has! HA!

BUMPS IN THE ROAD

Throughout our infertility, there have been many bumps in the road - above and beyond the typical ups and downs from the monthly disappointment of negative pregnancy tests.

We spent countless hours on the phone with my insurance company for appointments and services charged wrong. With referrals over to Mayo, oftentimes it would get mixed up and I’d get charged “out of network.” And then trying to figure out medications. Many of the infertility drugs are “specialty drugs” and aren’t available in many areas, so they have to be ordered from specific pharmacies that were covered under my insurance. That equaled a lot of time on the phone with pharmacies, clinics, and the insurance company!

Along with figuring out where to get the medications shipped from, more than once they arrived frozen to our house as our IVF was in the dead of winter in Minnesota. This proved to be difficult as oftentimes you’d receive the medication just as you needed it very last minute, since you didn’t know if you would need it and it was too expensive to just have on hand “in case.” Then we’d have to hustle to try to get another delivered on time, without being frozen and unusable!

Then there were painful procedures that weren’t supposed to be, such as my first IUI that went horribly wrong. Not to mention the crazy acupuncture experience I had! There were also times that I had cysts in my ovaries from the strong medications, therefore our treatments would get pushed back in order to allow time for the cysts to disappear.

One time I was even told to take the wrong dose of medication. But it didn’t seem right to me, so I called the clinic to check and I was correct. It’s important to be on top of what you’re putting into your body and understanding what it is and what dosage it should be. Trust the doctors and nurses, but trust yourself too!!

Another stressful experience was finding out the cost of IVF was going up in 2010, right as we were doing our IVF. We were fearful that we’d have to pay the large 20-some-percent increase (thousands of dollars) since ours would be done in January, just a few weeks after the new year. After weeks of calling, emailing, etc – we finally find out that we’d still be charged the 2009 rate. Wow! I could have done without that stress!!

All of these bumps in the road were things we weren’t expecting, but as if we had ever expected to experience infertility in the first place. So, you just deal with it, move on, and keeping looking ahead. Nothing is perfect…I know! But I try to think that all of these experiences just strengthened us and made us even more appreciate for our future children!

ESTRADIOL BLOOD TESTS

On Wednesday, January 13th, we went to Mayo for an estradiol blood test. This checks the ovaries response to the stimulation. They also want to make sure that the ovaries aren’t being over stimulated, which can cause OHSS (ovarian hyper-stimulation syndrome), and is very dangerous.

I called lab talk to receive my results in the afternoon. My level was great and I was given instructions to lower my dosage of both GONAL F to 75 units and continue on MENOPUR at 75 units. I also am to continue the LUPRON at 10 units.

Today, I went for another estradiol blood test and ultrasound. There are 10 follicles on the right and 9 on the left. Everything looked good, but the follicles still need time to grow.

So, back to Mayo on Sunday for yet another blood test and ultrasound. We’re hoping the follicles are mature enough so we can take the hCG shot on Sunday night!

THE ARRIVAL OF FROZEN MEDS

Here are two photos of how my drugs would arrive in a cooler!




Ahh, the joys of doing IVF in the frigid Minnesota winter…

There are a lot of medications that have to be taken at the same time, so I have learned it’s a good idea to set alarm reminders on my cell phone. For someone who doesn’t even like taking ibuprofen when I have a headache – these past 3 years of infertility drugs has been a big change for me. I’ve also been taking pre-natal vitamins daily…”just in case.”

I order most of my drugs from a specialty clinic in the cities as they’re not available in the town where I live. They come via UPS. It’s interesting because some need to be refrigerated, so most arrive in a cooler. I don’t know why, but I feel like it’s an illegal drug deal or something! During IVF, the shipments were bigger and my largest one had 12 prescriptions delivered at once! Woah!

Ordering these medications is stressful. Just thinking about the cost is enough to make anyone sick to their stomach. As I wait for the drugs to arrive, I pray that they don’t get lost along the way, because we can’t afford any mistakes. Fortunately the pharmacy I’ve ordered them through has been a Godsend. They are so nice, helpful, and knowledgeable. They actually return your phone calls and follow through! Wonderful! I’d recommend them to anyone and everyone!

During my first IVF cycle, while I was taking LUPRON, I knew I was going to run out of the drug, just barely, according to the dosages. I called the pharmacy and it was scheduled to arrive. For the scheduled days that the drugs arrive via UPS, I have to stay at home and make sure I’m there when they arrive. They tell you they can arrive any time between 9am and 5pm. Wow…what a specific time slot! Ha! This makes it extra difficult in the frigid winter months here in Minnesota. As all mediations have restrictions, these have specific requirements of between what temperatures they can be stored. Many also list, “DO NOT FREEZE” in capital letters! So, as I wait all day, I begin to think about how long they have been in transit and outside in this very cold, 8 degree day.

I was getting anxious and when they finally arrived a little after 5pm, I was relieved. But as I opened the box, my relief quickly turned to anxiety. It was exactly what I had feared - the liquid medication was frozen! I was freaking out knowing that even if they told me it was still okay to use – there’s no way I would! I was paying and going through way too much for this whole process and I wasn’t going to mess it up with a bad drug.

I called the clinic and they were great. The pharmacist tried to contact the drug company to check to see if I should still use the LUPRON or not. Of course it was too late in the afternoon and they were closed because I hadn’t received my drugs until 5pm. So the pharmacist said he’d call me back tomorrow after he found out. And he did! The drug rep said not to use it as there were no studies as to if it still worked after being frozen. They told me they’d try it again and mail another in a cooler with an unfrozen ice pack. This way, if it were to get too cold, it should freeze the ice pack, instead of the medication.

I prayed this would arrive unfrozen as I don’t know what I would have done otherwise as this drug isn’t available where I live. Where would I be ale to get it last minute? Where would I have to drive? I received that package the next day, and it arrived just fine…with no trace of being frozen…just in time for me use it in my next shot because I had just run out. Praise the Lord!

SUPER SCARY SHOTS

I’m not afraid of needles. I donate blood as often as I can. It doesn’t really bother me. But that’s when a trained professional is doing it. Give me a needle and tell me to poke myself and I may panic. Especially when it’s something this important that I don’t want to take any chances of messing up!

Even though I’ve gone through the shot class at Mayo and watched the video at home, it still just scares the crap out of me. I’m constantly scared that I’ll put the needle on wrong, mix it up incorrectly, or inject the wrong amount.

This is a whole different thing. These fertility drugs are extremely expensive and the vials come in very specific amounts, so there’s no room for error. Otherwise you might not have enough medication for the next day. And unfortunately, these are specialty drugs that aren’t available in the town where I live. So you just can’t get them last minute.

These 2 new shots are quite scarier than the LUPRON. I can handle the LUPRON because you simply draw the air into the syringe, insert the needle, push the air in, draw the units back into the syringe, remove the need, and inject. Easy. Something I can handle.

But the GONAL F is a “pen”. The dosing adjusts with the turn of a dial, which, as it says, makes it easy to inject your precise medication dose for every injection prescribed. But it still doesn’t seem so easy to me. I’m still paranoid I’ll do it wrong. What if I set the dose wrong? What if when I load the new dose in, it doesn’t really all go in? I don’t trust it when you can’t see how much you put in like you can when it’s a vial. And besides the fact that you have to put a new needle on each time. Wait, I guess now that I’m writing it down, that putting the new needle on each time part doesn’t seem so scary. I need to stop being so scared of doing it wrong.

And for the MENOPUR medication, it involves two vials, one of which is sodium chloride and the other the MENOPUR tablet. It involves mixing these together with the use of more than one needle. This medication also comes with a Q-Cap. It is the only available vial adapter for needle-free reconstitution. It’s really quite interesting. The Q-Cap helps to eliminate stress, anxiety, and accidental needle sticks. This involves way too many steps for me still which therefore, still scares the crap out of me.

So, with all these shots, I am so very thankful to live just 2 short blocks away from my sister, Jesse, who happens to be a nurse at Mayo. And she gets everything together and injects the shots for me. Luckily for her, this stint of 3 shots per day only last for the next 10 days. So, I should be able to relieve her of her duties after these 10 days are up. We bundle up every night in this cold Minnesota winter weather a little before 9pm to head over to get shots from who I call, my Miracle Nurse…Jesse!

The shots go just fine. 150 units of GONAL F and 75 units of MENOPUR. All are given into my stomach. My only complaint is the MENOPUR shot, which is painful. It feels like someone is pinching your skin as hard as they possibly can. I can feel the medication going into my body and spreading out in different directions.

So, I guess I'd say I'm afraid of the medication...not the needles!

INITIATION OF STIMULATION

Today starts the stimulation phase of the protocol! Awesome! So far so good and right on schedule. What a relief! This now means I’m adding two nightly shots to my still morning shot. So, now we’re up to 3 shots a day!

Since my ovaries have “shut down,” as they are supposed to, my dose of LUPRON now goes down to 10 units daily. I start two more shots at night, GONAL F and MENOPUR. GONAL F (Follitropin Alfa – pronounced “foll-ih-troh-pin) is a follicle stimulating hormone (FSH) that makes the follicular cells in the ovary grow, which then stimulates egg development and the female hormone estrogen. This basically means it helps the ovaries to make more eggs. (The follicles are what contain the eggs.)

MENOPUR (Menotropins – pronounced “men oh troe pins”) is a human menopausal gonadotropin which is an ovulation drug. It’s an equal mixture of the follicle stimulating hormone (FSH) and luteninizing hormone (LH). These are both important for the development of the follicles (eggs) produced by the ovaries. MENOPUR is used to stimulate the development of multiple eggs to be collected for IVF.

I take these 2 shots daily at night (with the LUPRON in the morning for a total of 3) until the week of January 18th.

DOWN REGULATION CHECK

I stopped the birth control pills on January 1st and got my period on January 5th. Today is the “down regulation check,” which is an ultrasound and a blood test to check ovarian suppression. (“Ultrasound” sounds like fun, but of course these are vaginal ultrasounds, so it’s a not as enjoyable if you know what I mean!)

So, I braved the snow, wind, and icy roads by myself to get to Mayo this morning for an ultrasound and blood test. My ultrasound showed a few cysts, which is weird since that's one of the reasons they put you on birth control (it's supposed to help so you don't get any.) The ultrasound nurse asked me, "Do you have a history of endometriosis?" I thought to myself, "Oh no, this doesn't sound good." I said no and asked why. And then she said I had a cyst. I know if you have a cyst it could rupture and of course that's not good. (I've had cysts multiple times in the past and when that occurs you have to stop the medications and wait until it clears the next month or 2.) I met with a nurse quick and she told me the doctors would meet up at noon to discuss the ultrasound with my blood test results. If the cysts were too big, we'd have to wait it out and try again next month. I had to wait until 3pm to call the "lab talk" line, where they leave you messages. And yes - great news - they said it is still a go. The blood results were good, cysts were small and they're not worried at all. So, tomorrow starts the next phase – stimulation! More drugs = more side effects! Oh joy!

THE LOVE OF MY LIFE

My husband is absolutely amazing. Besides his obsession with golf and his small touch of OCD – he’s absolutely perfect. Perfect for me! And anything else that sort of annoys me about him really isn’t his fault – it’s a result of something I’m ultimately just annoyed with about myself. Nick is so supportive, loving, giving, and understanding. He’ll do anything to make me feel better. Like running out late at night to pick me up some ice cream while I was in one of my “moods” and craving ice cream RIGHT NOW!

He loves me when I’m happy. He loves me when I’m sad. He even loves me even when I’m hormonally imbalanced because of all the medications. He holds me when I’m crying and squeezes my head when I have a headache. He gives me shots in the butt even though it scares the crap out of him. He gives me a backrub without even having to be begged…sometimes! I’m convinced any other man would have left me by now, and I take comfort in the fact that I know he never will. We’re in this together…for better or for worse.

I’m thankful for a husband who is full of faith and prays for God’s will. I’m thankful that God has used this in our lives to make us stronger as a couple and more faithful in our relationship with Him. I’m thankful for my husband who will never leave my side…my husband who loves me for me and who lets me feel how I need to feel. I love you, Nick!

MENOPAUSE UPDATE

Menopause is still going okay! The side effects have been “okay” - nothing a strong woman like me can't handle...ha! The "hot flashes" have moved to my ears! A few times a day my ears just start burning like crazy. It's the weirdest thing! I can feel the follicles in my ovaries, lots of pressure and bloating. I even stopped going to workout at Curves because I'm afraid they're gonna blow. And I've still been very tired. (I'm happy to report Nick has given me a couple back rubs because my lower back has been quite sore!) There's other symptoms that I won't discuss, most of which involve interesting mucus (too much information!) since you probably don't want to hear about them anyway. But yes, I’m happy to report that I’m surviving menopause….so far…

PATIENTLY OR NOT-SO-PATIENTLY WAITING

Can you imagine having to pretend for 2 weeks of every month for 39 months in a row that you’re pregnant? 39 months…that’s 1220 days. That means for a total of approximately 20 months of my life, I’ve had to pretend to be pregnant without ever being pregnant. With that many months of being pregnant, I could have popped out 2.22 babies by now!

Oftentimes, at this point of the month, I’m afraid to hope because I don’t want to be more disappointed. You put up a guard because without one, the crushing disappointment is often too heard to bear. I often wonder if I have the emotional resilience to survive another failure and start over again the next month.

But then I get my period, which as contradictive as it sounds - is almost a relief. I’m so anxious, but then have a sense of peace because at least it’s a definite answer. And I can try to look forward to the next month. Nevertheless, I seem to find enough renewed strength and hope to at least try. Even though “trying” can mean very different things in every different month!

After the two-week-waiting game, (I’m so sick of playing this game!) starts what I call the “almost-two-week-at-least-you-know” phase. A little under 2 weeks that you definitely know you’re not pregnant. It’s about two weeks of being able to do what you want. Get in that hottub, drink that wine, and indulge in some extra caffeine.

I’ll patiently wait, I’ll not so patiently wait…no matter what, I’m waiting…